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  • Predictions for 2014! Will They Be the New Reality?

    As enumerated in our first blog of 2014, posted on January 6th, most of our predictions for health care changes in 2013 became reality. Even one of the most provocative blogs entitled, “I Have a Dream: Acute Hospitals Are No Longer Necessary”, seems to have increasing credibility with numerous healthcare leaders. One such person is Dr. Robert Pearl who published a recent article in ...
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  • Are We Credible?

    As we begin the new year, the Partners at Royer-Maddox-Herron Advisors will begin a new blog series, posting a new one every two weeks. And as we did last year, we will pick current, cutting-edge, and even some provocative topics which we believe will have a significant impact on health care’s 2014 journey. Perhaps a question, one should ask is: “Are the RMH Advisor Blogs worth ...
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  • The Primary care Spectrum: Emergency Department Care VS Population Health Management

    The Primary Care Spectrum: Emergency Department Care Versus Population Health Management Most stakeholders in healthcare are in agreement that appropriate primary care resources for patients must be expanded if high quality and integrated care which is affordable and accessible is to be achieved. Unfortunately, much of this care today is being delivered in over-crowded, high cost emergency ...
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  • The Emergency Department - Round Two

    Last week my partner, Dr. Royer, wrote a blog on the “Role of the Emergency Department.” In his blog, he noted writing a paper 30 years ago titled “The Emergency Department is the Front Door of the Hospital.” I found this ironic on several different points. First, several months ago the Rand Corporation released a report, “The Evolving Role of Emergency Departments in ...
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  • What is the Role of the Emergency Department in Transforming Healthcare?

    Most healthcare leaders are in agreement that a critical transformational strategy is to increase the number of and access to primary care providers for patients and their families. However, the shortage of primary care providers has plagued the US healthcare delivery system for decades, causing Emergency Departments to often accept the role of de facto primary care provider, resulting in a rapid ...
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  • Adopting an 18 Year-Old? Why?

    For many reasons, we are continuing to see mergers being planned or occurring between various hospitals and health systems, and even including physicians practices and medical groups. Although the benefits of such acquisitions are real, often the challenges of such are not fully appreciated and the magnitude of work that is required to make them successful going forward is not totally ...
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  • Can Surgical Volumes Save the Day?

    For many healthcare delivery systems, surgical volumes have historically driven the majority of their revenues. Financial security depended upon and often paralleled growth in inpatient surgeries, and the simultaneous revenue growth from related ancillaries such as anesthesia, radiology, laboratory, and pathology. As a result, large investments have been made in the expansion of operating room ...
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  • "The Times They Are a changin'"--Bob Dylan

    The insurance exchanges opened for business this week. Politicians are using the Affordable Care Act (ACA) as the bargaining chip in the shut down of the government. Health systems are undergoing major economic challenges. The 1964 Bob Dylan classic seems like the appropriate anthem for these times. Recently, The Tennessean reported Vanderbilt University Medical Center “has a plan to cut up ...
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  • Strategies to Put Physicians on the Offensive - Part II

    In Part I of this series posted on our Blog last week, we reviewed the “present state” of many physicians, gaining a clear understanding of the reasons for much of their present negativity. We also enumerated the strategies the partners in Royer-Maddox-Herron Advisors are using when in the field with physician audiences, and which have proved successful in moving doctors from a ...
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  • Strategies to Put Physicians on the Offensive - Part I

    After reviewing our series of four blogs on physician integration that were posted last April and May, numerous readers have emailed, inquiring whether Royer-Maddox-Herron Advisors has specific strategies to recommend regarding putting physicians on the offensive in support of positive transformations changes in the healthcare delivery processes and procedures. Fortunately, our answer is yes. ...
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  • Leadership Lessons from Alaska

    I am writing this blog on the red-eye flight from Anchorage to Dallas. My wife and I are returning from our annual fishing trip to Alaska. This year’s experience merited comment in this forum. As a way of brief background, we have visited the same lodge in the Bristol Bay area of western Alaska for the past several years. The lodge provides an interesting dichotomy of experiences. On one ...
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  • Is It Worth It?

    As we work with our clients or interact with an audience after our large audience presentations, we – the three partners in Royer-Maddox-Herron Advisors –are often asked the question:…."Is it worth it being a leader in the healthcare industry today?" Fortunately based on our own nearly 120 years of collective experience, we are able to answer the question with a strong ...
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  • Could Segmented Health Care Be Part of the Solution?

    It is clear to all associated with healthcare that the redesign of the industry is high on the national strategic agenda. We all know that many parts of the health delivery system in the US are broken: overall consistent quality is mediocre; service metrics reported through HCAHPS are poor; business literacy is in jeopardy as evidenced by predictions that over 1000 hospitals will be bankrupt by ...
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  • Boards Need to Share the Seed Corn

    Take a good look at the list of governance roles and responsibilities in my previous blog. Think about boards on which you may have served. Is it possible that boards today spend an inordinate amount of time thinking only about themselves and the specific mission of their organization? Boards like to think that they shape the organization and, indeed, they do. However, what is often overlooked, ...
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  • Can Today's Healthcare Boards Become More Like a Rancher?

    Health care organizations are on the edge of major change. Recent legislation, changes in insurance and government payment policies and advances in technology ensure that change is here now. For health care organizations, especially those which have been around a long time and which are culturally ingrained with image, processes and a proud history, the major change going forward is the new ...
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  • The Toxic Side Effects of Change: A Case Study

    As we have indicated in some previous blogs, significant change in the U.S. health care system will be required to correct the quality inefficiencies and rising costs that we are experiencing today. The redesign must be part of any successful health system’s future in order to address the three major voices demanding change. They are 1. Government, 2. Business owners/employers, and now 3. ...
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  • Part III- Will the Healthcare Bubble Burst?

    Whether or not I’ve convinced you of the existence of a healthcare bubble, I’m going to use my last segment along with history and my own speculation about consequences, triggers, preparedness and responses. As I indicated earlier, the financial crisis of 2007 and the related housing bubble burst had a great impact on me. This illuminated the tremendous interconnection and complexity ...
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  • Part II: Will The Healthcare Bubble Burst?

    There are several culprits funding the healthcare bubble. Health insurance, however, is number one. Investopedia defines insurance “as the equitable transfer of the risk of a loss from one entity to another in exchange for payment.” By this definition, health insurance is not insurance. Health insurance isn’t transferring the risk of a loss; it has evolved in to the payment ...
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  • Will the Healthcare Bubble Burst?

    Today’s blog is the beginning of a three part series generated by several events over the course of the past few months. Let me disclose I’m not an economist nor did I stay at a Holiday Inn Express last night. I am, however, an avid student of history. In this first segment, I want to point out the similarities among some very large industries, the real estate industry and the ...
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  • Transformational Leadership: Changing Ahead of the Curve

    On our Web page we describe our work with clients as “assisting with developing and implementing transformational change” which will position their organizations for success in the future. Obviously, this requires Transformational Leadership within the organization. I am frequently asked for more clarification on the specific competencies related to leaders who can lead a ...
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  • The Culture of an Organization: The Trump Card

    Based on published articles and verbal communications with C-Suite teams, it appears that a significant number of hospitals and health care systems are either in or headed to a performance crisis. The leadership teams and the members of their board are often lacking a clear understanding of the roadmap to stability. Clearly, if successful turnarounds and adequate response to today's changing ...
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  • The Acute Care Hospital of the Future

    Two of our recently posted blogs – “I Have a Dream: Acute Care Hospitals May No Longer Be Necessary” and “Where Have All the Volumes Gone?” strongly suggested that the acute care hospital, as we presently know it, will look significantly different in the future. Envisioning the attributes of this “future state” will assist healthcare leaders in developing ...
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  • Where Have All the Volumes Gone?

    In June of 2011, I penned a blog entitled…. A Common Question: Where Are Inpatient Volumes Going? I began by stating that this question was being asked by a myriad of healthcare audiences – leaders in the C-Suite, physicians, pharmaceutical companies, revenue cycle experts, insurers, supply chain companies, and investors. At that time I predicted inpatient volumes would decline 2% to ...
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  • I Have A Dream

    For many years I have had a dream – wouldn’t it be wonderful if new technologies and excellent disease management would permit medical care to be delivered outside our traditional hospital walls! What a legacy we would all share if in some small way each of us could say we contributed to their closures, like our colleagues in the past did with TB Sanitariums, Polio Hospitals, and large ...
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  • What are the Key Strategies to Achieve Successful Physician Integration

    As was discussed in Blog I in this series, enhanced physician integration is essential for the future success of any hospital or health system in existence today. In addition, Blog II articulated both the historical and present reasons why this integration is so hard to achieve. Because integration is both essential and hard to achieve, we must answer the question – What are the key ...
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