Monthly Hot Topic Archive

Transition

May 01, 2012

The faithful reader of this space will note a modest change from issues past. This month's column has a dual byline pointing to an upcoming change in the leadership of the Center for the Health Professions at UCSF. Learn More »

Remaking the Value Proposition Where the Work is Difficult

Author: Ed O'Neil

April 01, 2012

Last month I gave a quick sketch of what I see as the key elements of producing value in a reconfigured health system. This aim is the very best way for health care leaders to ensure that their institutions remain viable and driven toward a future state that can improve the health of those they serve and not damage the overall economy of our nation. Learn More »

Health Care's Value Proposition

Author: Ed O'Neil

March 01, 2012

After we get everyone enrolled in a health home. And the silos of the old provider world are merged into organizations that can account for care. And budgets that are global emerge, heralding the return of capitated care. Then we will finally get around to the real work of providing health care services that are valuable to those that purchase them. And then, and only then, will we do something that is really new. Learn More »

Is Primary Care Necessary?

Author: Ed O'Neil

February 01, 2012

No, it is essential. At the most macro level it has always been interesting to me that those nations that seem to take better care of their citizens for less money have the exact reverse proportions of providers--greater numbers of primary care providers than specialists; Learn More »

A Reframing of the Stream

Author: Ed O'Neil

January 01, 2012

In a recent Wall Street Journal article, David Gelernter was interviewed and in effect asked what was on his mind. Gelernter, as the IT intelligentsia will know, is the Yale Professor of Computer Science, Unabomber victim and the individual some credit with coining the term “cloud” for that amorphous aggregation of the data of our lives. Learn More »

Strategy for a Change

Author: Ed O'Neil

December 01, 2011

As the health care world changes over the next five years, leaders will need to develop and articulate strategies that move their institutions toward success. Their instinct will be to create plans that focus on maintaining what they have done in the past: providing the same services to the same clients, with the same delivery structures and being paid in the same way. Such an approach will not lead to much change and it will not make a significant contribution to the overall improvement of care Learn More »

Buy-In

Author: Ed O'Neil

November 01, 2011

It is the most common question I am asked these days in leadership development sessions: How do I get buy-in? It is not surprising given the nature of the challenge that health care leaders face. We are confronted with the need to bring almost tectonic changes to an enormous $2.6 trillion industry that for the past half century has been left to chart its own independent way. Learn More »

How Will We Get There? Part Two

Author: Ed O'Neil

October 01, 2011

I had a large number of responses to last month’s essay on how we will execute the health care reform. Not “execute” as in do away with, I had more of “bring to life form” of executing in mind. My basic premise here is that reducing access to care as a way of controlling cost or reducing the payment for specific inputs is not a sustainable pathway for reform. Learn More »

How Will We Get There?

Author: Ed O'Neil

September 01, 2011

How will we get there? The task is pretty daunting, but most of the people I speak with these days about health care are committed to changing things; they just don’t know how to take the first step. Or they see the specific thing to do, but do not have a good grasp on the framework that needs to surround the improvement or reform that is just in front of them. Learn More »

Growing with Conflict

Author: Ed O'Neil

August 01, 2011

It should go without saying that as the health system changes over the next decade, it will produce considerable conflict. At the macro level, the broad sweep of the change means doing more with less. Such a change is always a prescription for tension. And if this process involves changing the ways we organize and deliver health care to get a better, less expensive process, rather than just cutting budgets, then it will involve adapting and adjusting to a new paradigm for health care. Learn More »