HealthCare ADR Update

The news arrived in June that Virginia did not receive federal dollars to establish its pilot program for disclosure, communications and compensation discussions following an adverse medical event. (This Virginia program is discussed in the Health and ADR entry herein of June 1 which you can read further below).  AHRQ, the federal agency to which Virginia had applied for these funds, made a slew of grants to other program applicants. Congratulations to all the recipients.  (You can see who won the grants at at
Those who have interest in this field will want to learn from outcomes of the programs that have been funded. But the Virginia model and the collaborative framework on which it is based are too good a start  to wait indefinitely or be lost altogether. It is thought that consideration may now be given to whether there are other options to get something started in Virginia and sooner.

ADR and Healthcare Reform – Overwhelmed?

It is understandable that stakeholders are somewhat insecure about where the gains and where the losses will ultimately fall from healthcare reform. There will be improvements and there will be losses. I do not address the matter as a political issue but rather its realities. Core capability to manage the changes, the uncertainties and their effects, on the morale, tenacity and focus of those whose job it is to deliver health services is vitally important.
For example, the rapidity of changes announced in just the last several weeks (June into early July) concerning healthcare has been breathtaking for anyone paying attention. Medicare MD compensation has been put on hold, slashed, restored, and then a new slash proposed - all within the last 6 weeks alone! Small businesses providing health benefits for employees believe that tax credits will be available to assist their providing such benefits. Announcement by the US Taxpayers’ Advocate this week suggest that there may be hidden and other costs that will actually impose additional financial burden on small businesses trying to offer health benefits to their employees. Certain insurance mandates will kick in this September 2010 that should help persons with pre existing conditions changing health plans - if you are 19 or under. If you are older, take a look at the federal website to see if you can purchase a plan through the government options. (
HHS has just released new rules under HIPAA privacy and security that require additional learning and compliance actions by healthcare providers . At the same time providers are expected  to learn to manage electronic health records without making errors. Such learning is estimated to take upwards of several hours/day  which eats into time  available for patient care. Meanwhile more patients (consumers) will need access to care.   Understanding and coping with the changes and the speed of them  will be vital to doing as good a job as possible of implementing the changes , or quickly deciding which changes should wisely be “let go” to avert unintended costs.   The importance of conflict management and ADR processes in healthcare settings, as mentioned in other entries, only seems more evident. Let’s hope that persons in positions to encourage use of such processes to facilitate wise and effective reform will do so and not fall prey to “penny wise pound foolish.”

Jeanne Franklin