NASH on the Road

Since Labor Day 2010 I have been traveling back and forth across our nation discussing all aspects of Health Reform---from the impact on quality and safety to the implementation of an Accountable Care Organization. I have found most persons to be very confused about this complex legislation. I have also found that Academic Medical Centers are racing to comply with ACO legislation with little understanding as to the core cultural elements.AMCs need to recognize that "accountability" is a significant challenge---it calls for a sweeping change of our culture.It means we must all self evaluate and measure the outcomes of our work together. It means that subspecialists will see their incomes slightly diminish and that primary care docs will see a modest increase.It means a willingness to practice based on protocols and the best available evidence, where it even exists. Finally, it means we must also change the training paradigm to reflect these new realities. This is a tall order indeed.From the Kansas Hospital Association, to Allina Health, to Spectrum Health, to Texas Health Resources, to Adventist Health, to Temple Medical School, my message has been consistent----it is all about changing the culture of practice!! On another note, be sure to tune in to WHYY as the hit show "Marketplace" will be coming to Philadelphia on Friday night November 19th to focus on the new empowered patient.I have been asked to be one of three panelists on this national show. More news to follow.....DAVID NASH

JSPH Annual Summer Seminar

On Thursday July 22nd, the Connelly Auditorium in the Hamilton Building on our campus was overflowing with attendees to the Annual JSPH Summer Seminar.Our topic this year focused on implementing health reform in Pennsylvania.

With faculty from the region and other schools on our campus too, we were able to present a detailed review of the challenges that we face with the ACA legislation with a particular emphasis on implementing the Primary Care Medical Home model. Leading experts described IT connectivity, changing physician behavior,the lack of sufficient primary care doctors, changing incentives, and other challenges in some detail. A panel dicsussion delved deeper into these issues.

It is clear to me that the ACA legislation in general and the Primary Care Medical Home in particular will mean a sea change in how we practice. Accountability will be the key theme and population based care will be the goal. Sure sounds good from my perspective!!!

The JSPH is perfectly situated to take appropriate advantage of these challenges and to help build the class of leaders necessary for successful management of these new enterprises. The overflow crowd demonstrated to me the demand for more unbiased information about the legislation and the need for action plans for implementation too.

The first full academic year of the JSPH has come to a close and we are vigorously planning for year two. Stay tuned for more information about our national on line presence as we close out negotiations with some regional and national provider networks in the next few weeks. DAVID NASH