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Kimberly Mueller is a Healthcare Analyst with HealthInsight. Her health care experience includes data collection, validation, analysis, and feedback to support data-driven quality improvement projects; designing and conducting formative and summative project evaluation activities; providing research and analytical support for state and national health care scorecards and collaborating on case studies of high performing health care organizations; and coordinating quality improvement efforts in federally qualified health centers. She is also a Licensed Clinical Social Worker in the State of Utah with over 10 years of clinical practice in both inpatient and outpatient health care settings. Ms. Mueller earned a bachelor’s degree in psychology from Texas Christian University, a master’s degree in social administration from Case Western Reserve University, and master’s degree in public health from the University of Utah.

Behavior Change and Duct Tape – the Stickier, the Better!

Couple walking

Adopting a new behavior, even one that is good for us, can be difficult. I belong to a gym, and I've come to observe each January with interest. That's when the resolutionists, as I affectionately call them, flood the gym for the first several weeks of the new year after making some sort of fitness resolution. The parking lot becomes crowded and exercise machines are busier than ever. (They really like the treadmills for some reason). While I hope a few new faces will stick with it and become familiar over the coming months, most of the crowd has dispersed by the early part of February and continues to taper over the following months until we're largely back to our usual routine. As I looked around the gym recently, I wondered – what would it take to retain a greater percentage of the resolutionists?

We know that individual behaviors are substantial contributors to our health outcomes, representing about 30-50 percent according to a Health Affairs Policy Brief. But how can we effectively take charge of our own health by implementing and retaining more healthy behaviors?

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What’s Next for Transparency in Health Care?

Stethescope

Regardless of whether you celebrated or grieved the results of our recent presidential election, the reality is a new administration will soon be upon us. And as with any change, there is fear, there are rumors and there is uncertainty.

On a website that details the President-Elect's views on health policy reform, Transparency—an issue near and dear to our HealthInsight hearts—appears to be a priority:

"Require price transparency from all health care providers, especially doctors and health care organizations like clinics and hospitals. Individuals should be able to shop to find the best prices for procedures, exams or any other medical-related procedure."

This policy principle is consistent with a business-like approach to health care, an industry that has historically lacked some of the fundamental elements of successful, competitive business markets, such as a consumer orientation and access to comparative performance information.

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Between the Upstream and the Downstream – The Proximal Impact of Social Determinants

Group of Young Adults

Back in March, Margy Wienbar wrote a blog on the Upstream Parable, describing the association between high school graduation rates and health status. In short, improved high school graduation rates are associated with improved health outcomes.

While improving high school graduation rates is a worthy cause for a variety of reasons, there have been a number of studies that demonstrate we can act to improve health and social conditions without having to go so far upstream, as it were. While conversations about the intersection of genetics, health care, and social, behavioral, and environmental influences are heating up, the changing payment environment provides an opportunity for us to 'put our money where our mouths are'.

Social determinants of health (SDH) are "the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life." These conditions include socioeconomic status, education, the physical environment, and social support networks. In a recent article, U.S. states with a higher proportion of social spending relative to health spending demonstrated significantly better outcomes for several population health-type measures. But while SDH can have a substantial impact on health outcomes (estimates as high as 90 percent for some conditions), they are not funded in the same way as other health-related services. There are a number of reasons why these efforts are not aligned, but some recommended policy principles provide opportunities for us to bridge this gap without going very far upstream:

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Flight of the Bumblebee – A Soundtrack for Innovation

Flower

Consider the bumblebee – industrious worker, agricultural catalyst, cooperative colonist. When winter's chill is chased away by spring's warm breezes, bumblebees will help ensure we have beautiful flowers and healthy fruit to enjoy this summer. Effecting a valued outcome through deliberate activity, the bumblebee is an apt metaphor for an activity which is highly valued in innovation circles - cross pollination.

For many years, the concept of cross pollination has been considered a mechanism for stimulating creative solutions to challenging problems by working across functional silos to reframe successful approaches in inventive ways. In theory, combining individuals from different disciplines will create fertile ground for innovation and promote visionary thinking. But is this true?

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