By: Holley West, APR

It has been a fast and furious few weeks but I did not want to let additional time go by without mentioning my recent trip. Hopefully the generous rules of etiquette that apply to deadlines for sending out thank-you cards apply to this situation as well.

As a new member of Leadership Health Care (LHC), I was fortunate to have the opportunity to attend this year’s delegation trip to Washington, D.C. as my first official LHC event.

No surprise, the majority of the trip’s activities centered on the discussion of health care reform, the then pending Supreme Court hearings and where select organizational representatives and elected officials stood on the subject.

Big surprise, the refreshingly honest perspective offered by Jonathan Bush, co-founder and CEO at athenahealth as well as the stories shared by Robert Gibbs, former White House press secretary and special advisor to President Obama.  Also enjoyable was the inside look at the U.S. Supreme Court offered by Lyle Denniston, SCOTUSblog reporter and dean emeritus of the Supreme Court Press Corps, who impressed me with both his historical knowledge of and his respect for not only the system, but for each of the Supreme Court justices. (I imagined sharing cigars and a bottle of scotch with him while listening to him tell behind-the-scenes tales of the high court’s most interesting decisions, but I knew his strict journalistic code of ethics and honor meant it would never happen.)

For an overview of the delegation, I recommend reading Nashville Post’s blog series.

By: Nan Allison, MS, RD, LDN

When I plopped down next to a colleague at a meeting the other day, she leaned over and whispered, “My employer is sending out the Fat Letter.” I gave her a puzzled look, wondering if people were getting fired, promoted or what. She acted like I should know. In fact, I should have known. You see, we both had worked on a project called “Got BMI?” in response to the public schools’ equivalent of her employer’s “Fat Letter,” telling her she was overweight. We dietitians designed the “Got BMI?” campaign, meaning: “You got your kid’s Body Mass Index (BMI) results from the school health screenings. Now what are you going to do?”

Similarly, we are concerned about and interested in what advice employers are offering along with their “Got BMI/Fat Letters” to employees to help address the problems of being overweight, having hypertension or high cholesterol. We see current practices using generalized answers and programs rather than individualized approaches at the executive and employee levels.

Often employees are told to join a gym, eat smaller portions, eat breakfast, not drink sodas, or walk more during the day. Everyone seems to be focused on weight, period – suggesting only the traditional resources typically offered up to deal with weight. These practices may be popular but they are only effective in the short term.

If employers want to get serious about reducing their costs and getting employees to eat better, they might consider encompassing the needs of the individuals and looking closely at what the company’s entire nutrition programming design should include.

In order for a “fat letter” to get employee attention and inspire action, make sure:

• It is the right action and make the most of that letter.
• It really helps your employee and doesn’t send him down the wrong path or frustrate her into taking no action.
• It leads your employee to a healthier body and a more fulfilling experience with healthy eating, so that eating well becomes easier.

Be prepared to support your employees with an environment, culture and individual support system that will help them feel good, not bad, about themselves, so they don’t feel it is a struggle to do well.

Make the most of your investment in your employee wellness program. Use the services of an expert in nutrition at the corporate food delivery level and in medical nutrition therapy to design, assess and implement your program.

We’d love to know your thoughts:

• Are you an employer who is sending or is contemplating sending letters to employees about the need to do something about their health?
• Are you an employee that has received such a letter? If not, what would you think about getting such a letter?

By Melinda Dale

• Watch the celebration on YouTube
  
• View photos from the event

In just three short months, more than 4,000 Nashville residents walked more than 100,000 miles with Nashville Mayor Karl Dean.  The feat was part of the Walk 100 Miles with the Mayor challenge, presented by BlueCross BlueShield of Tennessee, a health initiative aimed at decreasing the rising adult obesity rate the city faces while introducing Nashville residents to the beauty of outdoor exercise resources.  Twice per week residents were invited to join Mayor Dean on scenic walks along the tracks and trails of 28 of Nashville’s parks and greenways.

“In Nashville we are fortunate to have an abundance of resources, and because many Nashvillians don’t know about all the great places to exercise in our city, this walk was a perfect way to introduce people to our parks and greenways,” said Mayor Dean.

Walk 100 Miles with the Mayor culminated with an eight-mile walk, the longest of the challenge, and a big celebration event at Public Square Park in front of the Metro Courthouse on July 9, 2011.  All of Nashville was invited to recognize the accomplishments of those who participated in the challenge and enjoy fitness activities, healthy food offerings, and live entertainment from country star Jo Dee Messina, American Idol alum Melinda DoLittle, and Jeremy Lister of NBC’s “The Sing Off.”

More than 500 walkers reached and/or exceeded the 100-mile goal.  All participants enjoyed exploring Nashville’s beautiful parks while improving their health, and for some this challenge was just the wake-up call they needed.

“I feel great, I feel better than I’ve felt in years,” said walker Joe Griggs, “I saw he was doing the campaign and I felt like it was the right time for me to get on board and start doing something about my health. When I started I weighed 354 pounds and now I weigh just more than 236 and I feel great!”

Walk 100 Miles with the Mayor would not have been possible without the incredible community support of such partners as presenting sponsor BlueCross BlueShield of Tennessee and Nashvitality.

Though the campaign has officially ended, Nashville’s movement towards better health is far from over.  Coming this fall the Mayor invites residents to join him in training to walk and/or run a 5K in November.  “This is the day when we’re going to make a statement about Nashville’s commitment to getting healthier,” said the Mayor.

By: Brandon Daniell, principal, Matua Media

The other day I had to catch a 6 a.m. flight out of Chicago. I booked a cab for 4:15 a.m. I was staying in a friendly part of Chicago, but I admit I did wonder how friendly it would be on the curb at 4:15 a.m. waiting for the lights of my cab to turn down the side street.

As I quietly got my belongings together at 4 a.m., I was surprised to hear my phone receive a text message. Who would be texting me at 4 a.m.? To my amazement and relief, it was a text saying that my cab was 5 minutes away suggesting that I should get my things together. Then just as I was about to head to the door, I got another text — my cab was downstairs. When I walked out of the building, I walked straight into my cab.

During the ride to the airport, I started to think about those text messages. The taxi company used texting to deliver two very relevant messages that made my entire cab experience better.  I did not have to spend one minute waiting on the curb.

Texting is a powerful engagement and communication technology. First of all, 97% of all phones can send or receive texts. Second, more than 85% of texts are read within five minutes of being sent.  Third, the messages are relevant and timely. It is ironic when you stop to think about it that the only spam texts I seem to get are from my phone company.

Now how is it that I can get text messages reminding me that my car needs an oil change or that my flight has been delayed, but I still get messages from my doctor  on my home phone reminding me about something I need to remember or do.  What happens when I disconnect my home phone and join the 30% of American households that have no landlines.  Will the doctor’s office realize that I am able to be contacted pretty much anytime anywhere – via my mobile phone?

The potential to improve the dialogue in the health care space using texting is enormous. I mean, if an airline can tell me that my flight is running late, surely my doctor can tell me that his office is 40 minutes behind schedule.  And if a cab company in Chicago can prevent me from standing on a curb at 4:15 a.m., surely my doctor can learn to engage me in ways that are more convenient, timely, and relevant.  A little convenience in health care would benefit everyone.

By Aileen Katcher

Last night was the first night of Passover, and we had our traditional seder dinner with good friends.  Many of the guests were recovering or retired health care executives.  Somewhere between the second and third cups of wine, the conversation turned to the big health care story of the day in Nashville –the Community Health Systems’ (CHS) attempt to buy Tenet Healthcare, Tenet’s ensuing reaction, and CHS’s offer to up the ante.

I am by no means a legal or financial expert, but my assessment is that Tenet doesn’t want CHS to buy them, so they sued CHS.  But the suit isn’t related to the purchase – it alleges that CHS overbilled Medicare and that could result in more than $1 billion in liabilities.  As a result, the Department of Health and Human Services (HHS) has opened its own investigation.  So, in the words of the Passover song, Dayenu, you would think that would have been enough for CHS.

But, no.  CHS in turn revised their Tenet bid to an all cash offer of $6 per share.  So, the question raised at the seder table (besides the traditional four questions asked by the youngest) was – If Tenet wins the lawsuit and receives a whistleblower payment from the government, and CHS is successful in its take-over attempt, does CHS get to keep the lawsuit settlement and the payment?

Oy vey!

By Aileen Katcher

Last night I heard former Tennessee Governor Phil Bredesen at his best.  He, Jack Bovender, Jr., former chairman and CEO of HCA and Clayton McWhorter, chairman of Clayton Associates bantered with each other in a panel discussion moderated by former Vanderbilt Vice Chancellor for Health Affairs Harry Jacobson, MD, now chairman of MedCare Investment Funds.

These guys know health care.  The governor was more animated and relaxed than I saw him during his eight years in office. The topics included Accountable Care Organizations (ACOs), integrated delivery models, the pros and cons of the health reform law and today’s health care entrepreneurial opportunities.  And, they all managed to plug Bredesen’s book, Fresh Medicine.

My favorite quotes of the evening were:

“We all know you can’t herd cats, but you can move their food around.” Bovender regarding Health Insurance Exchanges (HIEs).

“It’s like the industry saying ‘we don’t want you to get well or die because we lose a customer’” McWhorter discussing end of life issues.

“So much in the system needs change.  This reform did the easy things not the hard things.” Bredesen re what’s missing from the reform law.

The following are some other tidbits I noted during the discussion.  Can you guess which panelist said each?

ACO:

• Is there enough of a carrot to make the investment worthwhile?
• It’s a policy wonk’s idea of how to organize health care
• Offering 10% to doctors is like offering a waiter a tip.

Integrated Physician/Hospital Model:

• You need the right leadership, including physicians, to make it work.
• Hospitals have the resources to be the centers of care – but they need protections
• It’s an inevitable part of a continued trend toward employed physicians

Most innovative current health care concepts:

• The Use of clinical nurse practitioners
• Medical care would benefit greatly from an independent quality audit system and standards.
• The Use of clinical pharmacists

Best Features of Health Reform:

• It will cover more people who need coverage.
• It is spreading cost to a greater number of people.
• It will create great opportunities for new businesses.

Worst Features of Health Reform:

• Lots of things in it will drive costs up.
• It’s complicated and hard to understand.
• Employers will drop coverage.

Thanks to Harpeth Companies for hosting this event at Belmont University and for inviting me to attend.  It was an evening well spent.

Jack Bovender, Jr., former Tennessee Governor Phil Bredesen, and Clayton McWhorter answer questions in a panel discussion hosted by Harpeth Companies.

By Aileen Katcher, APR, Fellow PRSA

The goal: raise awareness of the Nashville International Trade Mission to South America for the Nashville Health Care Council and the Nashville Area Chamber of Commerce.

The challenges: jet lag, a three-hour time difference, a packed agenda, language barriers … oh, and I was in week three of my personal push to stay off caffeine.

The opportunities: 30 delegates with different perspectives meeting health care and government leaders in Chile and Argentina and exploring the potential to work together and learn from each other.

The KVBPR solution: a plan that became the road map for best practices in intercontinental event communication, significantly raising awareness of the trip in the Nashville business community and highlighting perspectives.

An exclusive relationship with SouthComm provided advance stories, daily blog posts and post-mission trip stories. Each day of the week-long mission, the NashvillePost ran a blog or video post from their Latin American correspondents (myself and Council President Caroline Young) and included it in their daily email summary of stories.

With a three-hour time difference and a packed agenda for the mission, developing content and making deadlines was sometimes a challenge. It meant occasionally skipping lunch, leaving evening events early, or rising at the crack of dawn to write about the prior day. Sound hectic? It was, but it was also the most enjoyable writing I have done in a long time.

Although we had developed a list of potential subjects to cover, we had to be flexible and seize opportunities. For example, the “We are Chile” post practically wrote itself after we learned how the country had come together following their tragic earthquake and mining accident. Another blog developed after three delegates discovered they attended the same law school at different times yet ended up in very different health care related jobs.

While I was busily writing and recording in South America, the KVBPR team and Council and Chamber staffs in Nashville were proofing, editing video footage, formatting photos, updating social media sites and delivering completed materials to the NashvillePost each day. The Chamber posted links to the stories on its site and the Council encouraged its members to post links on their sites.

In addition, KVBPR produced The Daily Five – a daily email news digest of the top five local and national health care stories, plus any trip coverage, in a PDA-friendly format that helped delegates stay informed of news at home.

I learned a lot (including developing a love for Mate, a tea product that provides caffeine-like results without the negative side effects), met some fabulous people (including a neighbor who runs by my house everyday on his jog), saw and fell in love with two countries I had never visited, and overall had a fabulous time. And, the Nashville Health Care Council and Chamber achieved the visibility and awareness of the trip that they were seeking.

So, where are we going next?

By Greg Bailey, APR

Saturday’s inauguration of Governor-elect Bill Haslam sets the stage for a renewed conversation on controlling healthcare costs in Tennessee.  With Tennessee Republicans holding the keys to the State Capitol and both House and Senate chambers, you can bet the hallways on Capitol Hill will be filled with white-coated physicians making a new push for reforming Tennessee’s medical liability laws.

It was nearly three years ago, in 2008, when the General Assembly approved some modest changes to the liability laws in the state. But Bredesen never fully supported a full overhaul of the medical liability statutes, taking a “show-me” approach. He was unconvinced that the healthcare system, patients and physicians were truly harmed by the status quo.

But Republicans have always championed tort and liability reform, so Tennessee doctors must be tapping their toes to get on the Hill and try to push new reforms through in 2011. For many years, the American Medical Association and its state affiliate have argued that the cost of not reforming medical liability is really about the patient, not the doc.

The physician must practice defensive medicine, ordering test after test on patients to cover their trail of diagnosis, and it costs all of us. The AMA now estimates that liability pressures on physicians increases “health system costs by between $84 and $151 billion annually.” Those costs hit directly in the consumer’s pocket.

Through the years, the research has shown that physicians that face increasing liability insurance rates have dropped services; ended specialty practices such as obstetrics, and in some extreme cases, left the profession altogether. In Tennessee, where our rural areas already suffer from a lack of quality healthcare services, there is an ongoing crisis of availability of specialists outside the urban areas.

The timing is right. With Federal healthcare reform mandates coming that will balloon the cost of TennCare, there must be alternative solutions to bringing down costs. For the first time in many years, Tennessee physicians will have the ear of legislative leadership and the governor. Should the physicians be successful, this policy shift will have a positive impact on healthcare costs in Tennessee in the future.  Watch for the white coats on the Hill.

By Aileen Katcher, APR

We have all seen countless articles, blog posts and comments on new year’s resolutions, trends to watch in 2011 and predictions for 2011 this week.  It’s just that time of year.

But two blogs that caught my eye were a little different.  First, was 20 Business Buzzwords You Want to Kill. I was hooked at #1:  At the end of the day – “At the end of the day, it’s night. So what?”  It’s a personal pet peeve of mine and I’d gladly kill it.  But, as I read on, I realized I was guilty of 25% of the others.  That gave me cause to pause.

Then, I ran across 11 Hot Healthcare Buzzwords for 2011, stating in its intro: “With rapid changes in healthcare comes a new vocabulary with terms and phrases every provider should know.” Know them maybe – but do we have to use them?

There’s no doubt the health care industry has a language all its own.  The abbreviations and acronyms used most often resemble alphabet soup.  Sometimes one acronym means two very different things.

Our job as communicators is to develop messages that are understandable to all.

The dictionary definition of buzzword is “an important-sounding, technical word or phrase often of little meaning used chiefly to impress laymen.”  While there is nothing wrong with most of the buzzwords in both blog posts, if they are indeed of “little meaning” then we need to limit our use of them.

So, my resolution for 2011 is to avoid using buzzwords.  Will you join me?

Here is the latest update from the Latin American Correspondents, including KVBPR’s Aileen Katcher, APR.  She is traveling to Argentina and Chile on behalf of the Nashville Health Care Council and the Nashville Area Chamber of Commerce’s International Trade Mission to South America.

There’s always a Nashville connection …

As he welcomed the Nashville Area Chamber of Commerce and Nashville Health Care Council International Trade Mission delegates to Argentina at a reception last night, U.S. Embassy Chargé d’Affaires Jeff Brown expressed his strong connection to Nashville.  His grandfather, father and brother all went to Vanderbilt and his first cousin is currently playing football for the Commodores.  And, more importantly, he applauded the delegates’ interest in doing business in Argentina.

At the Embassy’s welcome reception for the group, the delegates were introduced to a variety of the country’s health care industry leaders and government officials, including several we heard during briefings earlier in the day.

As we found in Chile, many of the country’s health care challenges mirror those of the United States. While Argentines have historically experienced a fluctuating economy, they are currently on an upswing.  When trade mission leader Jack Bovender asked about the government’s economic policy, the Embassy’s economic counselor, John Fennerty noted that Argentina is a rich country in terms of natural resources with huge potential to grow the economic base.  He explained that there seems to be a strong interest by the government to repay international debts.

Additionally, the Argentines are entering an election year that always brings with it a pattern of heavy spending — some expect a 30 percent jump.  But, Fennerty cautioned that, although they anticipate that fueling a potential 8 percent revenue growth, it will also push up the country’s already high inflation rate.

On the health care front, our first day was focused primarily on the public sector.  Although the speakers spoke Spanish (we had simultaneous translation service) in many cases they could have been describing the United States: chronic disease, an aging population, IT needs, increasingly complex management practices and a need to reform its public insurance policies.

There is also an apparent lack of recordkeeping and systems.  Delegate George Bishop from Waller Lansden Dortch & Davis observed that it is a decentralized federal system that seems fragmented and dysfunctional.  “The provinces don’t talk to each other or coordinate care,” he commented.

However, with those challenges come great opportunities for Nashville’s health care expertise.  The average age of Argentina’s public hospitals is 70 years — more than twice what is considered a useful life in the U.S. — and much of their equipment is outdated.  In both the public and private hospital sectors, a need for experienced management professionals was identified.  As in Chile, a shortage of physicians and an even more severe need for nurses and training programs is a great concern.

In a country that identifies professional hospital management, clinical staff training, chronic disease management, new hospital buildings and equipment and health IT among its top needs, the opportunities for the Nashville health care industry could indeed be plentiful.