The rise of a healthcare manager professional : John Adlesich on healthcare industry trends in 2021: Cooperative competition, or coopetition, is a key trend in health care. While some providers view big-box stores, nationwide pharmaceutical chains and other new entrants as threats, other organizations see opportunity. Their strategy is to leverage the capabilities of these power players to lower the cost of care, increase downstream market capture and focus on core specialty services while remaining highly connected to the patient. Offload financially draining services. Organizations like CVS and Walmart now offer basic primary care, simple diagnostic services and chronic disease management — services that health systems have struggled to provide and do so profitably. Identifying opportunities to partner with retail organizations to fill this gap can help simplify organizational services, increase access and provide better patient care at a lower cost.
John Adlesich about behavior therapy in 2021: What Is Behavior Therapy? The basic premise of behavioral therapy stems from the Skinnerian theory of operant conditioning, which asserts that behavior is learned, and thus, can be unlearned or modified to comply with socially accepted norms. By evaluating and analyzing behaviors and subsequently offering a reward, also called a consequence, for those behaviors that are socially significant and desirable, maladaptive and/or undesirable behaviors can be reshaped or eliminated. Applied Behavioral Analysis is a highly effective method for mediating behavior across a variety of domains.
John Adlesich about healthcare industry trends: The ACA also includes many popular, patient-focused programs, making it less likely to face repeal. These include the protection for individuals with pre-existing conditions, parental healthcare coverage for children up to age 26, and greater access to health insurance through the exchanges. Popular on the healthcare-industry side are value-based care (VBC) and the Medicare Shared Savings Program. These programs and are likely to continue, regardless of the ACA’s future, because they enjoy bipartisan support. The Biden administration may also take steps to strengthen aspects of the ACA, such as making more resources available for demonstration projects, and raising tax credits and subsidies to purchase insurance on the exchanges. These actions may be attainable within the framework of the existing law and wouldn’t require new legislation. John Adlesich currently works as administrator at Marquis Companies. His latest healthcare industry experience includes positions as executive director at Powerback Rehabilitation Lafayette (Genesis Healthcare) between Aug 2020 – Jan 2021, administrator at Mesa Vista of Boulder between Mar 2019 – Aug 2020, chief executive officer at Sedgwick County Memorial Hospital between Jul 2018 – Feb 2019, interim chief operating officer at Toiyabe Indian Health Project between Mar 2018 – Jun 2018.
John Adlesich believes that 2021 is an important year for the healthcare industry. Juxtaposed against the government’s financial need to expand these models is a stronger desire on the part of providers to participate. During the pandemic, those left in fee-for-service models suffered tremendous financial hardships once elective volumes were curtailed. Over the course of 2020, hospitals lost an average of $50 billion in procedure revenues a month, while insurers reaped record-breaking profits over the same time period from avoided claims. These realities have underscored the misaligned incentives in the current system and created real urgency for change. At this point, providers are now starting to see monthly per member, per month fees as a desirable alternative to unpredictable volumes. In fact, in a fall survey conducted by Premier, we learned that 40 percent of health system CFOs now believe that moving toward value-based care is a core strategy for future financial viability. To prepare, provider organizations can either manage their own integrated, high-value network or they can make the case for partnering with an insurance company or another providers’ network by virtue of their demonstrable results related to cost and population health outcomes. Regardless of the path, systems will need sophisticated contracting abilities, experience managing risk, care management expertise, and advanced analytics to evaluate cost and quality performance in real-time.