| For many of us change is a difficult
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| | me provide an example using the Medicare
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| process. In organizations like healthcare
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| | program. A patient who enters the
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| it seems to advance at a snail's pace
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| | Medicare program is entitled to a paid
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| sometimes. There is a need for change in
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| | initial physical. A primary care
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| healthcare, most agree, though we would
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| | physician should take advantage of this.
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| be hard pressed to agree upon the changes
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| | Many don't. If I were the manager of such
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| needed. One incentive for change is
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| | an office, I would remind my staff who
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| pay-for-performance programs now
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| | set up appointments to be aware of this
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| beginning in several areas. I would like
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| | fact. I would remind them at regular
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| to describe a couple that affect primary
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| | staff meetings. I would post visible
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| care physicians and then give a few
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| | reminders in the office. I might even
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| suggestions as to how to adopt changes to
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| | have a message flashed on the computer
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| take advantage of these programs. Even if
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| | screen once in a while. Then I would
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| you are not in a primary care physician
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| | review the appointments of patients who
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| program, the methods suggested for change
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| | have become Medicare qualified and see
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| will be helpful, I believe.
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| | how many had their initial physical or
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| In 2006 Medicare plans to institute a
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| | were booked for it. I would adjust my
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| pay-for-performance program at the
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| | methods to remind staff of the need for
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| primary care physician level. Right now a
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| | such examinations and continue to improve
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| model is being tested and seems to be
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| | on this until the office achieves 100%
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| doing quite well. In several states Blue
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| | compliance with the goal.
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| Cross Blue Shield organizations are
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| | Booking the exam is not the only needed
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| testing pay-for- performance programs.
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| | change. Doctors who perform the physical
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| Here in West Michigan, Priority Health, a
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| | must accomplish examination details and
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| healthcare insurer, has promoted such a
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| | actions laid out by Medicare. Hence, to
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| program for over five years. How does
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| | be paid for the exam, each doctor must
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| this work, you may ask? Priority Health,
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| | adhere to the exam details. I would help
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| for example, funds the program for each
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| | the doctors accomplish this in a variety
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| of its patients a set amount. Doctors who
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| | of ways, depending on the doctor's
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| meet a requirement of the program for a
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| | learning style. For example, a checklist
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| patient are rewarded with extra money for
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| | of the exam details might be included in
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| that patient. Hence, with many patients
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| | the patient history folder when the exam
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| the income for the practice can be
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| | is performed. That way the doctor will
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| boosted considerably. The fact is that
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| | not miss any steps. As the leader of the
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| many are not rising to the opportunity.
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| | change, I would check with billing to see
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| With planned cuts in Medicare
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| | that all the steps were performed and
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| reimbursements over the next few years,
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| | adapt new approaches or reinforce
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| this source of income cannot be ignored!
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| | existing ones to see that the changes are
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| Healthcare programs need to change, no
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| | accomplished 100% of the time.
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| matter how difficult.
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| | Changes such as these should be a part of
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| The impetus for change should rest with
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| | a continuous quality improvement program
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| the leadership of an organization,
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| | at every healthcare provider
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| although the change should not be the
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| | organization. Let me quickly review the
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| sole responsibility of the leaders.
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| | most important steps. First leaders
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| Representatives from all parts of the
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| | should identify the changes needed. Then,
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| organization should be involved. Once the
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| | the leaders should convene a committee of
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| need for change in a process is agreed
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| | all affected staff to develop how to
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| upon, either because of extra revenue
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| | accomplish the change. Once the staff
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| from pay-for-performance programs or
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| | agrees upon the approach, the leaders
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| other agents or data that positively
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| | should develop ways to implement the
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| affect the bottom line, leaders should
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| | change on a daily basis adopting methods
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| convene a task force to plan the change.
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| | that incorporate learning styles of
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| With input from all, leaders should map
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| | affected individuals. Then, they should
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| the process as it currently exits and
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| | continually analyze the progress of the
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| then should make a new map of how they
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| | changes and make necessary adjustments
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| would like it to be to incorporate the
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| | until the goals are accomplished. They
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| positive changes. The new procedure
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| | should then audit the changes
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| should be standardized for all to adopt.
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| | occasionally to be sure that the
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| How do you go about adopting these
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| | organization doesn't fall back into old
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| changes on a daily basis? This is
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| | habits.
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| probably the hardest part. Because humans
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| | I believe that adopting such a change
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| learn in a variety of ways, it will take
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| | process will dramatically help at your
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| a variety of ways to implement the
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| | site. You will see savings in time,
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| changes. The implementation of the
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| | increased patient or client health and
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| changes should be based upon the learning
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| | satisfaction, as well as an improved
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| styles of the individuals involved. Let
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| | bottom line!
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