It's Not What You See in Health Care Design, It's What You Don't See that Matters

So many reports. So many end of year summaries. So many predictions.

But for most Americans, you will only see worse, especially as they get older, sicker, poorer (worse employers or illness in family)

So it is important for problem solving for most Americans to see what is not being seen.

You will not see:

• Fewer tasks for delivery team members, especially in primary care
• More ability to focus one on one with each patient across hospital and practice and nursing and primary care...
• More revenue for practices and hospitals serving the half of the nation most behind - despite and because of 40 years of CMS designs
• You will not see apologies to most Americans for the abuse over 40 year
• You will not see Value Based focus placed on their care, that values most Americans, their delivery team members, and their basic health access
• You will not see integration and coordination facilitated specific to their care by supporting more and better delivery team members
• You will only see cuts and compromises specific to most Americans most behind and their basic health access

Inequities Rule

What you will not see is

• More revenue for primary care, mental health, women's health, basic surgical, basic geriatric - instead cuts will crumble what remains
• More revenue for aging programs, cut since the 1980s
• More affordable housing in counties with concentrations of people and cost, so more will be force to leave and go to counties lowest in concentrations of workforce, access, and supports.
• Medicaid paying for 100% of the care of its patients, not just 70 - 80%. (Medicaid will pay for housing and food now, leaving even less for those who deliver the care, thanks to waivers)

Micromanagement Bandwagons Rule

You will not see cost cutting that cuts costs

You cannot see micromanagement that improves outcomes - because they are predominantly beyond clinical intervention reach or the reach of teachers or schools or practices or hospitals

You will not see cuts to those doing best, to free up funds to support the basics for most Americans treated worst

You will not see increasing support for overwhelmed teachers, nurses, and team members in primary care and mental health and social work and other front line serving human infrastructure.

Period

End of story

Can you really have value based anything when you value so many so little?

Try not to value end of year summaries or predictions or plans - if they are not specific to most Americans most behind.

CMS Prevents Seven Vital Conditions that It Recommends CMS Prevents Seven Vital Conditions that It Recommends https://www.dhirubhai.net/pulse/cms-prevents-seven-vital-conditions-recommends-robert-bowman/

Burnout Reductions Work If Designs Shape More and Better Team Members https://www.dhirubhai.net/pulse/burnout-reductions-work-designs-shape-more-better-team-robert-bowman/

How can you have person centered primary care - In conclusion these most complex patients and populations will need a transformation of our current leaders and a transformation of the financial design away from those doing best to provide for the basics of most Americans doing the worst. https://www.dhirubhai.net/pulse/how-can-you-have-person-centered-primary-care-when-most-robert-bowman/