In the article, Kevin Haeberle, senior vice president and senior adviser at INTEGRATED Healthcare Strategies, a healthcare consulting company in Kansas City, Mo., said merit raises or bonuses should be at least 2 percent of an employee’s salary to alter their behavior. Even with this, a better approach may include offering a variety of incentives of the same value—continuing education, vacation time, or even cash.

Haeberle said that expectations of employees should be concise and include how the employee is expected to achieve a goal. In addition, focusing on the employee’s four or five most important duties would allow them focus their efforts and maintain their motivation.

For physicians who do not know what will motivate their employees, a good tactic to find out is to send  anonymous surveys for an honest response. However, consultants say that the “golden rule” holds in most cases—employees will value recognition ahead of money.

The North Texas Accountable Care Partnership (NTAHP) morphed from a pilot project in early May. Two major systems—Children’s Medical Center of Dallas and Methodist Health System—participated in the launch. Both were among nine hospitals and 1,000 physicians that launched the test last year in 13 North Texas counties—including Dallas-Fort Worth.

The HIE attempts to link the electronic health records (EHRs) of North Texas providers to provide seamless, coordinated care for North Texas patients.

Katherine Lusk, Children’s senior director of information management and exchange said, “The HIE affords providers and physicians much quicker access to critical health information, which means that Children’s patients and families will not only continue to receive the highest quality of care, but they will also receive that care much more quickly.”

Pamela Stoyanoff, Methodist Health System’s chief operating officer, said “The health of our entire community will benefit from enhanced coordination and continuity of care.”

Joe Lastinger, NTAHP chief executive officer, said there were three big project pieces. The first was a successful pilot project. The second way to establish privacy and security policies to govern how information would be shared, which was no easy task given that hundreds of organizations would be involved. Third, it took about five months to create a uniform participation agreement, which included input from dozens of lawyers.

Lastinger is optimistic there will be robust participation in the HIE.

“We have a number of other hospitals and physician groups that are very close (to joining). We are engaged right now with every large hospital and physician group (in DFW). We will have a steady flow of organizations joining us throughout the remainder of the year. Having large hospitals (in the HIE) is the shortest path to delivering maximum value,” he said.

Lastinger said the next technological hurdles are creating a model for small provider organizations, such as solo physicians, and connecting with post-acute care providers such as nursing homes and home-health agencies.

Lastinger said NTAHP would be one of the first HIEs to connect to the state infrastructure. The Texas Health Services Authority and Texas Health and Human Services Commission coordinate the development of 10 regional HIE networks throughout Texas. Ideally, a statewide HIE would connect hospitals, physicians, payers, pharmacies, and labs and follow the patient to wherever healthcare is provided.

NTAHP earlier this year successfully connected with the Greater Houston Healthconnect, which is Houston’s HIE. The state’s two largest HIEs are expected to account for more than half of the state’s patients.

Texas received funding from the 2009 federal economic-stimulus legislation to help develop the HIE. However, that funding ends this year. Texas is taking a market-based approach, relying on health plans, hospitals, and physicians to finance HIE after the funding expires—which may be a true test of its value to stakeholders. Many other states have relied on government entities to create and coordinate HIEs.

Lastinger said at this point, NTAHP has only spent about one-third of its initial grant. He said the HIE could survive at least two more years without operating revenue. However, the business plan anticipates that NTAHP will generate 30 percent of its operating budget from stakeholders this year, and that is expected to rise to 60 percent in 2014. He said the annual cost of running the HIE is $1-$1.5 million.

Steve Jacob is editor of D Healthcare Daily and author of the book Health Care in 2020: Where Uncertain Reform, Bad Habits, Too Few Doctors and Skyrocketing Costs Are Taking Us. He can be reached at steve.jacob@dmagazine.com.

The pharmacy, called RightSource, is Humana’s pharmacy management company that provides mail-order delivery to members. RightSource – with similar operations in Arizona and Ohio – serves 1.5 million customers and filled nearly 20 million prescriptions in 2012, making it one of the nation’s largest mail order pharmacies.

Humana plans to renovate all three floors of a building at 2001 W. John Carpenter Freeway to accommodate operations. The location of LifeSynch, a Humana behavioral health subsidiary in an adjoining office at 2101 W. John Carpenter Freeway, was a factor in the location decision, according to William Fleming, president of Humana Pharmacy Solutions.

Quest Diagnostics also has entered into a long-term agreement with Concentra to be its primary provider of workplace drug toxicology and clinical laboratory testing.

“With this transaction, Concentra’s patients, physicians and employer clients will gain access to Quest’s industry-leading menu of innovative workplace drug and clinical lab diagnostic information services,” Steve Rusckowski, Quest Diagnostics president and chief executive officer, said in a statement.

Concentra’s advanced toxicology network laboratory business is based in Memphis, Tenn. Under the service agreement, Quest will provide workplace drug toxicology testing services primarily to Concentra and its employer clients, and clinical laboratory testing services to patients and physicians in Concentra’s network of primary care and urgent care facilities.

Decisions should be easy, right? If you take Yogi’s advice, you just need to pick one and get on with it. Unfortunately, most healthcare design and construction-related decisions do not take you to the same place, and various routes have vastly different impact.

At our oldest child’s graduation last weekend, I learned “Dare to Plan” is the motto for the University of Illinois’ 100 year anniversary of their College of Urban Planning (the oldest in the country). The “dare” part of setting a plan is you have to live with decisions made ahead of time.  Further, the more money involved and the more people affected, makes critical decisions even more difficult.

Most healthcare projects require plans involving high-dollar decisions that affect large numbers of people and go through sometimes laborious administrative approvals. Many times a delayed decision results in unwanted cost impact. Although it is easy to cast blame on the decision-maker, more often there is insufficient backup preparation to allow a timely decision to be made, and sometimes “analysis-paralysis” results.

One of the challenges we face in working toward leaner, more efficient design and construction of healthcare facilities is that decisions need to be made early enough to allow follow-on activities such as design, coordination, prefabrication, site logistics, installation, and start-up to happen in proper sequence.

Today, we have more accurate tools (such as one page “A3’s”), better technologies (such as computer-modeling or BIM), more collaborative processes (such as “IPD”) and loads of ‘great practice’ examples at our disposal. It takes a team approach to not only design and build the building, but increasingly, to provide the proper metrics to allow informed, timely decisions to be made along the way. In best application of these, a few example questions may be asked about the information used in making the decision:

• How current is reference information? Has it been updated in the past 2 quarters? [Market Data]
• How similar is the reference project to the subject project? How many applicable similarities (or differences) are you able to draw conclusions from? [Relevant]
• Which choices make a difference and which don’t? [Sensitive Variables]
• What was the outcome of prior projects or decisions? What would they do again (or not)? [Reference/Outcomes]
• What were/are the long term impacts? [Life Cycle]
• How widely have the proposed solutions been reviewed by the right people? [Buy-In]
• What are the Pro’s and Con’s? [Choosing By Advantages]

If the majority of these items are covered, there is a very good chance that solid, timely, and informed decisions can be made. If not—it might be good to get the team to take another look at the back-up.

Many design and construction teams today have approaches to aiding decision-makers, with early project planning. At Turner, we have a database tool (T-Cost Model) which is able to analyze hundreds of sensitive variables, based on preliminary quantitative information, utilizing data on hundreds of healthcare projects from our experience, to give solid support for long-term planning decisions.  The goal is to help confidently drive facility costs down, increasing savings below reimbursement, while maximizing patient satisfaction and outcomes.

“Waiting is waste of time” may seem a Yogi-ish banality, but we find ourselves waiting more often than we realize.  Bringing together a proactive team, experienced in using the latest tools, processes and technologies, while addressing questions like those above, gives the best opportunity to make critical decisions, execute the plan timely and produce successful results.

I would be happy to hear your thoughts (or favorite quote)—

— Steve Whitcraft, CHC, CPC, EDAC, is director of healthcare for Turner Construction Company, and he can be reached at swhitcraft@tcco.com

Nearly all U.S. employers who offer employer-sponsored insurance are likely to continue to provide those benefits to workers in 2014.

The Modern Healthcare/ECRI Institute Tech Price Index from this month shows a decrease price in almost every category of top supply items since last year.

The prices of common stock items, such as implantable pacemakers, heart valves, and shoulder implants, have all decreased by more than 4 percent since last year. The price of pacemakers dropped by almost $300, from $4,312 to $4,049, a 6.1 percent decrease.

The prices of doctors’ most expensive items fluctuated across the board, some rising, while others fell. Cardiac Cath Lab and PET/CT technology both increased by almost 20 percent. The most drastic of these was radiosurgery technology, which increased by more than $1 million in one year, from $3,202,657 to $4,557,381.

See the full list here.

Many feared firms would drop insurance coverage in 2014 because of Affordable Care Act mandates and the introduction of health insurance exchanges. The percentage increased nearly 98 percent, compared with about 95 percent in its 201

About 4 out of 10 say they will increase emphasis on high-deductible health plans with a health savings account and increase participants’ share of premium costs and increase their focus on wellness initiatives. About 1 out of 3 plan to increase in-network deductibles for plan members.

UT Arlington College of Nursing professors Maxine Adegbola and Phyllis Adams have been named recipients of Association of Black Nursing Faculty Lifetime Achievement in Education and Research Awards. Adegbola has been an assistant professor at UT Arlington since 2008. Her research areas include sickle cell disease, chronic pain, genomics and health disparities. Adams is a clinical associate professor who joined UT Arlington in 1995 and is currently director of the UT Arlington Family Nurse Practitioner program. Her research interests include sickle cell, HIV, and stress management.

Thomas Heffernan, M.D., of Medical City Dallas performed the first scarless robotic hysterectomy of North Texas. The surgery, using the da Vinci robot, removed the patient’s uterus, cervix and ovaries through a tiny incision in the belly button. Heffernan is one of only a few surgeons in the nation, and the second in Texas, who is trained to perform the single-site robotic surgery. Benefits of the surgery include minimal pain, low blood loss, and a typical hospital stay of 24 hours.

Sue Sebazco, R.N., MBA, CIC, infection prevention director at Texas Health Arlington Memorial Hospital, has been recognized with the Distinguished Service Award from the Association for Professionals in Infection Control and Epidemiology. The award recognizes individuals for their outstanding professional contributions in a volunteer capacity at the national level. Sebazco has been with the hospital since 1983 and has served as APIC president in 2005. Her volunteer efforts with APIC include serving as Governmental Affairs Committee chair, as Public Policy Committee chair, and as Program Committee Chair.

David J. Ballard, M.D., Ph.D., Baylor Health Care System chief quality officer and executive director of the Institute for Health Care Research and Improvement, has received the 2012 John M. Eisenberg Article-of-the-Year in Health Services Research Award from Health Services Research journal. Ballard was recognized for his article “The Effectiveness of Implementing an Electronic Health Record on Diabetes Care and Outcomes” published in the August 2012 issue of the journal. Ballard led the investigation of the study.

COMPANIES

Rowlett’s Lake Pointe Medical Center has received the American Heart Association/ American Stroke Association’s Get With The Guidelines®-Stroke Gold Plus Quality Achievement Award. The award recognizes LPMC for its achievement of 85 percent or higher to all Get With The Guidelines-Stroke Quality Achievement indicators for two or more consecutive 12-month intervals and for an achievement of 75 percent or higher compliance with six of 10 Get With The Guidelines-Stroke Quality Measures. The initiatives demonstrate the hospital’s commitment to providing quick, quality care under the urgent needs of stroke treatment.

The Texas Health Dallas Institute for Exercise and Environmental Medicine has been accredited with distinction from the Undersea and Hyperbaric Medical Society. The accreditation recognizes the chamber for its high performance measures in patient safety and care. Only 13 percent of the nation’s hospital-based hyperbaric units are nationally accredited. The IEEM chamber, one of the largest in Texas, is designed to treat multiple patients simultaneously for chronic non-healing wounds, diabetic foot wounds, and bone infections, as well as to train military and civilian pilots.

Methodist Charlton Medical Center earned Quality Respiratory Care Recognition under a national program started by the American Association for Respiratory Care. Methodist Charlton is one of only about 700 hospitals nationwide to receive the designation. This is the fourth consecutive year that Methodist Charlton has received this recognition.

As we watch news reports describing the destruction of Granbury, Cleburne, Moore and so many other towns and cities, we immediately feel compassion. Such a significant loss of life leaves us feeling empty and helpless. We can only imagine the pain and suffering of survivors. My wife Rebecca and I were blessed with a beautiful granddaughter last September. Emotions ran high as we watched a grandfather on television wandering around the remains of Moore’s elementary school. His granddaughter was missing. He wanted to find her. He could not.

As in all tragedies, we must help our neighbors during this healing process. Today, let’s put health care reform, the Affordable Care Act and Medicaid expansion on the “back burner.” Political debate should be silent. Our primary focus should be to assist our friends in Texas and Oklahoma. Let’s help them during the rebuilding process, underscoring the compassion and dependability of our health care system.

Like our heroic first responders, emergency teams and volunteers, we too can be heroes by rendering compassion to our citizens in need.

— Steve Love is president and CEO of the Dallas-Fort Worth Hospital Council.