Guest blog 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 healthcare 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 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.

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.

At the Santiago Airport, three delegates on the Nashville Chamber of Commerce/Nashville Health Care Council International Health Care Trade Mission sat at a table at Dunkin Donuts, drinking coffee while waiting for the flight to the mission’s next stop – Buenos Aires.   They talked about the three days they just spent in this cosmopolitan Chilean city.

John Scannapieco, Jeff Jones and John Lowry have a common bond, other than being members of the Chamber or Health Care Council.  Each is a graduate of Southern Methodist University Dedman School of Law in Dallas – in different years.  And each has followed a different career path which led them to be on this International Trade Mission as leaders of organizations seeking health care industry opportunities in South America.

Scannapieco graduated in 1990 and joined Bradley Arant Boult Cummings in Nashville where he is now a partner and leader of the international practice team which includes many health care clients. 

Jones graduated in 2001 and after three years working on mergers and acquisitions at Vinson & Elkins, he left the practice of law for the investment banking business.  Today, he is director of health care investment banking for Deutsche Bank Securities in New York.

Lowry graduated in 2004, joined the health care practice at Strasburger & Price and is now the assistant dean for executive education at Lipscomb University College of Business in Nashville. 

So what did they think of their Santiago visit?  Scannapieco said the personal connections he made both with the participants in the programs and the embassy officials are valuable in many ways.  “It’s not only an opportunity to meet face-to-face with some potential clients, but it allowed me to develop relationships with resources our clients can access in financial, legal and governmental realms for them to do business in this country.”

Jones is responsible for health care and Latin America for the bank.  “I came on this trip to strengthen our relationships in Chile and Argentina.  We work with a variety of health care companies based here so meeting with the scope and level of professionals helps build those relationships.”    

Lowry has several goals on this trip.  He’s leading Lipscomb’s effort to build out a portfolio of programs in the health care industry university wide and its role as education partner for the new Nashville Medical Trade Center. Lipscomb is also starting an international program that will be held in Santiago in January.

“Lipscomb wants to be a leading global education provider leveraging the Nashville health care industry in anticipation of its work in the Nashville Medical Trade Center, which is targeting an international market.  I was able to speak with hospital administrators about training for nurses and administrators,” Lowry said.

As the trio gathered their bags to head for their gate, they summed up their thoughts about the trade mission.  “I was surprised at how stable and prosperous the country is. They weathered the worldwide financial crisis by having the wherewithal to have a sovereign wealth fund to serve as a rainy day fund, and a balanced budget,” Scannapieco said.

Jones explained that the country takes its copper reserves and puts it in the fund that was used to support its economy during crisis – so their stimulus package was actual “cash in the bank”. 

As they walked to the gate, Scannapieco added, “Chile’s stability, low barriers into the market, ease of access and its existing free trade agreements with Europe, Asia and North America make it an excellent entry point into South America for businesses. That, coupled with its experience with a public and private health system make it clear we have a lot we can learn from each other.”

The 30-member trade mission delegation now goes to Buenos Aires to learn about Argentina’s health care system.

Here is the first of the updates 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.

What better way to start an international trade mission to South America than to hear a perspective from Kathy Barclay, Principal, Asesorías KCB Ltda.   An American who has lived in Chile for 25 years and a former global executive with J.P. Morgan Chase, she is an international strategic advisor focused on cross-border opportunities between Chile and the Americas, including the U.S.

She painted a picture of a Chilean economy that is flourishing after 30 years of sustained growth.  The GDP has grown 216% since 1987 with the poverty level reduced to 15%.  Why?  According to Barclay, there is political and institutional stability. With the restoration of a democratic government in 1990, she described their effective executive, legislative and judicial branches as “stronger than the U.S.”  And, its low corruption rate comes close to mirroring that of the U.S. 

A strong, independent central bank, respected legal tradition, a transparent regulatory environment and “clear rules of the game” round out her reasons for U.S.-Chilean business partnerships.  “Chile has a deserved reputation for treating foreign investors fairly.  That’s because they treat foreign investors the same as they do locals.”

What is so special about Chile?  She said they have strong domestic financial markets, broad access to international markets, advanced telecommunications and IT infrastructure and a strong physical infrastructure.  We experienced that first hand coming in from the airport through a modern, four mile, multi-lane tunnel under the river. 

With a strong work force, high quality professionals, strong national literacy rates, high ethical standards it sounds almost like a business Utopia.  But, Barclay did point out some challenges.  While there is general prosperity, there is a disparity between the very wealthy and the very poor.  It is small and distant.  And it is vulnerable to commodity price fluctuations. 

So, what about health care opportunities?  That is, after all, why we are here.  Among them, she said rebuilding hospitals destroyed or damaged by the recent earthquake. 

When I talked to Delegate James Bearden, CEO of Gresham Smith & Partners, he said that the competitive landscape she described may make it harder for U.S. companies seeking to compete for business here because they will be looking globally for partners. “It’s a great opportunity for a group of U.S. companies to put together and demonstrate how to compete globally.”

James said he was pleased to hear what an open business environment they have here. “I thought it would be harder.  Between the number of U.S. companies already doing business here, the number of trade agreements between our two countries, the government’s desire to have more public-private partnerships, and the number of health care projects coming up that are tailored for American participation, it is very encouraging.” 

Barkley summed up the business environment here by saying U.S. Chile trade makes sense because the “solid bilateral relationships with shared values makes Chile an excellent place to do business.” 

We will explore other reasons and viewpoints as the week goes on.

DAY TWO — 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.

 As we listened to speaker after speaker talk about the outpouring of support the residents of Chile provided each other following the February earthquake, it was easy to think of the similarity to Nashville after the flood. The earthquake and its aftershocks hit the central part of the country in one of its most populous areas and killed hundreds of people.

The swell of national pride and patriotic support the people of Chile exhibited to the world at that time only increased during the recent mine accident, which trapped 33 miners underground for more than two months, and subsequent successful rescue.

But Janet Miller, chief ECD and marketing officer for the Nashville Area Chamber of Commerce, which is hosting this international health care trade mission along with the Nashville Health Care Council, recognized the economic opportunity these tragedies provided Chile and its international trade partners. 

“Just like the flood that devastated Nashville, the earthquake brings with it the need to rebuild, which also brings opportunity,” Janet said after this morning’s sessions.

In addition to the 20,000 homes that were damaged or destroyed, we learned that 130 of the country’s 150 hospitals were damaged. As many as a dozen must be completely rebuilt. And many others need varying levels of repair. That’s a lot of design and rebuilding in a country that has a commitment to doing business globally and implementing public private partnerships. 

But in addition to this rebuilding need, we have also been struck by the similarity in the health care challenges facing the United States and Chile. Chile is looking at reforms to its public and private insurance systems. It is experiencing a shortage of physicians and has an even greater need for nurses. It is looking at initiatives to provide more preventive services and disease management. It is looking at ways to promote smoking cessation. And, despite the ready availability of fresh vegetables and seafood, it has an extremely high obesity rate. 

It is clear that no one has easy answers to resolving these challenges, but the dialogue between health care industry experts from the United States and the countries we are visiting this week will undoubtedly help all learn best practices from each other.

By Shannon Haslam

The Wall Street Journal health blog had an interesting post yesterday about food manufacturers’ attempts to make fruits and vegetables more kid-friendly. Their approach? Package carrots like Doritos. While I whole-heartedly agree that character endorsements sell products, I don’t agree that characters influence anyone to eat foods they dislike. Let’s get honest: Shrek-shaped radishes are still radishes.

What they do influence are parents’ purchasing habits. But just because parents are buying “Scarrots” over the normal non-branded bag of carrots, doesn’t mean the carrots are actually scaring anything but the bottom of the school cafeteria trash can.

What we have here is a brilliant sales and marketing campaign. Massive kudos to CP+B and their client.

Now, check your marketing hat at the door. It’s not CP+B or their client’s responsibility to get children to eat veggies; it’s the parents’ responsibility. And from what the CDC reports, adults aren’t doing a very good job of being veggie-eating role models, which is exactly what it’s going to take.

Sure, we have Popeye, but it’s going to take real-life adult influence to move the needle in this battle.