Our value proposition
This page describes the value proposition that we provide to
certain health care providers using the AWF is the adaptive web framework. .
Our value proposition is:
- For differentiated health care providers
Who are interested in improving the fairness and validity
that centralized planning can't
achieve; increasing strategic leverage, and
operational alignment; so as to help all aspects of the
enterprise understand, learn and improve-on what they
- Striving to deliver a world class customer
- Responding to hospital over-building and the ACA is the Patient Protection and Affordable Care Act amended by the Health Care and Education Reconciliation Act of 2010 (Obama care). In part it is designed to make the health care system costs grow slower. It aims to do this by: increasing competition between insurers and providers, offering free preventative services to limit the development of serious illnesses, constraining patients' use of expensive services, constraining the growth of payments to Medicare providers and piloting new ways for PCPs to manage patient care to keep patients away from costly E.D.s. It funds these changes with increased taxes on the wealthy. It did not include a Medicare buy in (May 2016). The law includes:
in payer power, narrowing
of provider networks - When all health insurance plans are comparable on line people are expected to choose narrower less costly plans. This has the effect of encouraging providers and PCP to compete to be part of the narrow plan by reducing their charges and driving down the prices of the plans. By limiting the number of providers/doctors offered in the plans the few that are included should get more business. Across the US in 2015 39% of health plans offered in public exchanges are narrow (30 - 70% of areas providers) or ultra-narrow (30% or less of providers). In large cities narrow networks are even more common. Typically if consumers go outside of the choices offered in their narrow network they will be responsible for the high bills. There are problems induced by narrow network constraints:
- Alterations, in title I, to how health care is paid for and who is covered. This has been altered to ensure
- Americans with preexisting conditions get health insurance cover - buttressed by mandating community rating and
- That they are constrained by the individual mandate to have insurance but the requirement was supported by subsidies for the poor (those with incomes between 100 & 400% of the federal poverty line).
- Children, allowed to, stay on their parents insurance until 26 years of age.
- Medicare solvency improvements.
- Medicaid expansion, in title II: to poor with incomes below 138% of the federal poverty line; an expansion which was subsequently constrained by the Supreme Court's SCOTUS decision.
- Hospital Readmissions Reduction Program (HRRP) which was enforced by CMS mandated rules finalized in 2011 and effected starting Oct 2012.
- Medical home models.
- Community transformation grants support the transformation of low income stressed neighborhoods to improve their lifestyles and health.
- Qualifications for ACOs. Organizations must:
- Establish a formal legal structure with shared governance which allows the ACO to distribute shared savings payments to participating providers and suppliers.
- Participate in the MSSP for three or more years.
- Have a management structure.
- Have clinical and administrative systems.
- Include enough PCPs to care for Medicare FFS patient population (> 5000) assigned to the ACO.
- Be accountable for the quality and cost of care provided to the Medicare FFS patient population.
- Have defined processes to promote: Evidence-based medicine, Patient-centeredness, Quality reporting, Cost management, Coordination of care;
- Demonstrate it meets HHS patent-centeredness criteria including use of patient and caregiver assessments and individualized care plans.
- CMMI Medicare payment experimentation.
- Requirements that pharmaceutical companies must report payments made to physicians.
- A requirement that chain restaurants must report calorie counts on their menus.
and reduced funding from Medicaid is the state-federal program for the poor. Originally part of Lyndon Johnson's 1965 Bill, eligibility and services vary by state. Less than 10 percent of Medicaid recipients, those in long-term care, use one-third of all medicaid spending which is a problem. The ACA's medicaid expansion program made state optional by the supreme court (SCOTUS) was initially taken up by fifty percent of states. As of 2016 it covers 70 million Americans at a federal cost of $350 billion a year. In 2017 it pays for 40% of new US births.
- Queuing issues - while a surgeon and a hospital may be in-network other agents in an operation, such as anesthesiologists or anesthetists, may not have the same set of insurance contracts. Even if a subset do, once these are allocated to a task the hospital must then manage a complex set of resource constraints to keep its ORs running. If it does this by ignoring the 'out of network' status of these necessary resources the patient will be impacted by a high bill.
- Success is more likely when the plan maintains a broad list of PCPs but a narrow list of specialists and hospitals (Oct 2016).
- Hoping to leverage the increased visibility of the value
of their offers.
We offer innovative collaborative infrastructure that:
The AWF is the adaptive web framework.
- Simplifies, the complex iterative process of, capturing
the problems of the front lines and executives and then
- Helps in developing effective strategically aligned goal
chains that fix the problems.
- Replaces dependency on infrastructure, poorly matched to
planning, such as Email
- Tools - bundled within the configuration
editor is the graphical user interface that allows its users to generate dark web pages, check the links of dark webs, and change the filters and frame configuration files that control the generation process.
(AWFCE). AWFCE allows you to build adaptive supports the agents writing and using the dark webs by:
dark webs is a web site that is not open to the Internet. It is a set of deployed HTML files in a directory which refer to each other via file based references relative to the directory. .
- Leveraging unstructured HTML documents to allow clusters of related information to be juxtaposed.
- Allowing source data to be private to a particular agent or shared and jointly edited within a team.
- Allowing the writers to define streams of information (signals) within the source HTML.
- Supporting the linkage of the signals to other streams of information deployed into specific dark webs.
- Genetic operations can be applied to the source data. Key items are labelled. They are prioritized. But they should never be deleted from the source documents.
- Transforming the streams of information as they are gathered for deployment into target dark webs. Aspects like checklist and glossary references can be augmented with details. Changes in one area of the dark web can be signalled in other pages.
- Constraining which dark webs the information streams will deploy too.
what your operations are doing to achieve your
goals while reducing communications. Match the
network structure to the operational organization in
use. As strategic goals are: agreed, delegated,
worked on and validated; the network and priorities of
goals can be adjusted to match.
on key results. Operations can generate
signals in the dark webs is a web site that is not open to the Internet. It is a set of deployed HTML files in a directory which refer to each other via file based references relative to the directory. ,
appropriate to their recipient, indicating important
changes of status of actions to achieve key
organizational goals. As the report of an
important event flows across the network the constituent
signals will transform becoming appropriate to each
- Improve the effectiveness of your organizations
communications by viewing
the glossary definitions captures HTML descriptions of glossary item definitions so they can be deployed as hidden content within a HTML reference to the glossary target item. During a mouse over the content is revealed allowing the reader to reflect on the details of the glossary definition if desired. The filter file commands addgltag, addgltext and glfile tell the generator how to identify the source references to be augmented, the glossary definitions in the source document and what the glossary page reference is in the dark web.
of key business terms in
the dark webs and then making them more
- Manage operational risk. Checklist are signals which remind the reader of highly significant aspects of a process. They are designed to be consulted at a point in the process where forgetting about the aspect will have a significantly detrimental effect. Often the processes are being used to respond to failures in the regular operation. Atul Gawande argues that effective use of checklists is vital to coping with situations that are complex.
deployment captures HTML descriptions of checklists so they can be deployed as hidden content within a HTML reference to the checklist target item. During a mouse over the content is revealed allowing the reader to reflect on the details of the checklist if desired. The filter file commands addcltag, addcltext and clfile tell the generator how to identify the source references to be augmented, the checklist definitions in the source document and what the checklist page reference is in the dark web.
processing to allow your operational plans to include
synchronization points where users leverage the
checklists you have developed.
- Develop strategic alignment. SWOT
and other processes support the
alignment of the adaptive plan's strategies and
- The classification of events from the environment into strengths, weaknesses, opportunities and threats (SWOT).
- The clustering process for grouping the classified events into goals.
- How the clusters can support planning and execution.
- Templates - Get started fast.
The AWF source
document set is discussed. Sources of a health care
provider adaptive plan are provided along with control
files to support the generation of a business and
operational planning dark web.
- Dark web is a web site that is not open to the Internet. It is a set of deployed HTML files in a directory which refer to each other via file based references relative to the directory.
In this page we first introduce the problem of complexity
increasingly affecting business. We discuss how adaptive
planning can help cope with complexity. The adaptive
planning process that is supported by the AWF is outlined.
providing 'how to' examples and tips on:
Each plan is an aggregate of data and analysis
focused by the mission of the particular
business within the portfolio. AWF's set of template
documents, tools and processes is introduced.
- Organizing your business and operational planning
source documents and
- How to setup and use the tool.
- An example pair of health care provider dark webs