John Adlesich or the ascent of a healthcare manager professional on healthcare industry trends: Expand the market while improving community health. New entrants can be a force multiplier and increase the overall market for health services. Look for opportunities where your services could have a significant impact on community health and partner intentionally. For example, about half of women age 40 and older do not get screening mammograms. If mammography services provided by a large retailer were successful in motivating this population, the majority of women receiving in-store mammograms would not need follow-up care. However, many would require referrals for follow-up diagnostic exams and, possibly, treatment. Establishing a two-way relationship with that new entrant — sharing data and providing easy access to hospitals or health systems — could open the door to a potentially significant flow of new referrals.
John Adlesich about behavior therapy in 2021: PRT is derived from Applied Behavioral Analysis and uses many of the same principals. However, the therapy strategies are more child-directed than observation-directed. The treatment focuses on pivotal behaviors like communication, social skills, academic skills, and the self-monitoring of behaviors. AutismSpeaks.org indicates that PRT techniques are: Effective for eliminating or redirecting challenging behaviors and promoting socially significant behaviors Can be implemented by trained psychologists, speech therapists, special education teachers, and parents Certifiable through The Koegel Autism Center, although certification is not required Offered in both structured and unstructured formats in six short segments that target language, play, and skill acquisition Implemented for about 25 hours each week A lifestyle as much as a therapy and are designed to complement family routines.
John Adlesich on healthcare industry trends: The new administration will also likely push to expand healthcare program funding, including ACA programs and value-based care, and expansion of coverage. The Senate may use the budget reconciliation process to push through a COVID-19 relief package and some healthcare-related policies. Budget reconciliation requires only a majority vote, as contrasted to a supermajority vote for regular legislation. However, budget reconciliation can only happen a couple of times per year, generally speaking, when the budget is up for approval, and is limited to budget-related items. Budget reconciliation pushed through some provisions of the ACA in 2010. While some of the ACA expansions, increased subsidies, and tax credits could occur through budget reconciliation, this process would not be available for bigger picture health policy issues that are unrelated to the federal budget. These bigger picture items include issues such as a public option, Medicare for all, and lowering the Medicare eligibility age to 60. John Adlesich currently works as administrator at Marquis Companies. His latest healthcare industry experience includes positions as executive director at Powerback Rehabilitation Lafayette (Genesis Healthcare) between Aug 2020 – Jan 2021, administrator at Mesa Vista of Boulder between Mar 2019 – Aug 2020, chief executive officer at Sedgwick County Memorial Hospital between Jul 2018 – Feb 2019, interim chief operating officer at Toiyabe Indian Health Project between Mar 2018 – Jun 2018.
John Adlesich believes that 2021 is a crossroads year for the health industry. There will be particular momentum for programs that have bipartisan support, including payment policies that move away from fee-for-service reimbursement and toward models that drive lower-cost and higher-quality outcomes. The overall movement to value will get a shot in the arm from two principal forces in 2021: 1) the Biden Administration’s commitment to build on the ACA’s legacy by doubling down on alternative payment models and mandatory payment changes and 2) the pandemic. When it comes to policy, the new Administration will not need convincing that value-based care improves quality and reduces costs. Ample research shows that since the move to value began, overall health spending as a percent of GDP has slowed, cutting more than $600 billion out of the budget trajectory that was predicted in 2010. Because these programs are net savers, expanding their reach will be an important and immediate objective that could be used to offset some of the COVID-19 relief spending. To that end, we are likely to see Biden’s HHS make fee-for-service less attractive and push at least some mandatory alternative payment models. In addition, the Administration is also likely to move beyond endless testing of models, making proven programs permanent, creating added incentives to enable scale, and leading the way for private payers to follow suit with value-based programs of their own.