Another update was posted today. a) Here is the direct link to the updated RFA (warning – PDF) .. b) Here are the addenda (#1,2,3) – just 4 pages – so you don’t have to download the whole RFA again. Now let’s parse the recent changes: Section II The Applicant must be a 501(c)(3) or 501(c)(4) non-profit organization. The type of 501(c)(3) or 501(c)(4) non-profit must be one of the following entity types: Community- Based organizations (CBO), Independent Practice Associations (IPAs), Health Homes, Behavioral Health Collaboratives, Federally Qualified Health Centers (FQHCs), or former/curren ..read more

Applying to be an SCN?   Wondering how to respond to this paragraph? I’ll help you for free.  No kidding.  No strings attached.   ..read more

The initial RFA for New York was posted weeks ago and got rather thorough coverage so I didn’t need to discuss it here – though (predictably) I have many thoughts on the matter. Hot off the press today is an addendum. It’s a pdf but I’ve chopped it off so the link over there is just the 1st two pages of the addended document – all of which is here ICYMI.  I’ll review the addendum (changes in red) below with some commentary: Addendum My Comments Note that this constrains the participants. Removing “including” means that others need not apply – clearly this precludes hospitals, he ..read more

Printers share attributes with fiberglass boats in that they do last a long time – especially if well cared for.  We’ve had an HP Laserjet 1320 in the house for decades and it’s been quite reliable.  Our challenge is that it’s a USB (or parallel port) printer and we’ve struggled with the network contraptions I’ve built to connect it to our home network – so when I found a printer that uses the same toner cartridges, low page count, embedded scanner and networking capability on eBay – I jumped and spent $80 to upgrade us to another (very) old printer. So long as the hardware wor ..read more

Dan used to say to me that we needed to motivate our teams to pull the rope.   At first – I wasn’t sure what he was talking about.   Why would they pull? What rope? But then .. What’s the opposite of pulling a rope?  Pushing it.  Think about how successful you will be when you do that.  Yeh – pile of rope on the floor.   When / how / if people pull the rope is a product of two things: a) Their motivation b) Our inspiration It’s impossible to inspire people who have no interest.  It’s also impossible to inspire people without a compelling mission ..read more

  Months after the concept paper was published, I’ve finally edited my initial response in anticipation of a revised proposal and public comment period that will soon occur. I’ll likely author formal comments and will submit them to NY and/or CMS. I expect that my comments will mirror those below – at least in structure. Perhaps others will find this framework helpful in the development of their own comments – hence my posting of them today. — New York’s DSRIP program succeeded in many ways and failed in many ways.  I experienced both of these, as the CEO of one of the 25 Performin ..read more

BLUF – in October, Circulo acquired my little company, Huddle Health. We are now fully integrated into Circulo – and it’s time to describe the rationale for our convergence and some of what comes next. If you haven’t read my short essay on Primary Health, please go read that first.  We’ll wait. — Ok … back?  Great.  Now, let’s resume the story.   Years ago, I was on the faculty at Albany Medical College. We had a course called Health, Care & Society wherein students were challenged to learn and think about ethical issues, health policy principles and engaged in con ..read more

  Progress is impossible without change; and those who cannot change their minds cannot change anything.” ~George Bernard Shaw I was asked by a member of my new team (more on that to follow) to share some resources that might be helpful as we migrate toward perfection.  Rather than plopping this into a Slack message – I’ll share here so he’s not the only one to benefit.   Since humans are imperfect, any convergence of humans will also be imperfect – as will the products of our shared work.  Nonetheless – our goal will always be to make our work product(s) as close to ..read more

I suspect that you have seen the drawing and blog post describing the difference between equity and equality. It’s a compelling image. Obviously, the shortest child, given equal access to view the baseball game will benefit rather little from such equality. Yesterday, along with several dozen others, I volunteered at a local county Covid-19 vaccination site. The experience was both uplifting and concerning. Uplifting: despite an allocation of vaccine that was (much) less than expected, the team – a hodgepodge of retired and semi-retired doctors, nurses, county employees, lawyers and other non ..read more

Well, it’s finally happened.  Mr. HisTalk and I violently disagree.  His note today includes: Re: journalistic style. Is it ‘health care’ or ‘healthcare?’” I use the rules of the “AP Stylebook” for journalists with few exceptions, but one of those is that I write “healthcare” as a single word. I don’t have a strong feeling either way , but the one-word variant saves space without sacrificing (although I acknowledge that (“medicalcare” or “hospitalcare” don’t work).  For reference – see the HHS web Style Guide: Health Care Not healthcare, except on an agency or organizati ..read more