Kent Thiry explains DaVita in less than 82 minutes

[Bill Peckham]

http://www.youtube.com/watch?v=oRsMIOdR2dc

I haven't watched the whole thing but I wish the camera would pan back to consistently show the slides
Favorite scene so far ... at the 8:15 minute mark: the DaVita chant song
"It is exceedingly uncomfortable for lots of people"

Wow the musical interlude at the 26 minute mark

[okarol]

  Gag me.
There's more musical entertainment at 1:17:20 

[Bill Peckham]

So if Thiry is the mayor of the village and the teammates are his constituency, his voters ... the people he has his town hall meetings with ... then who are the patients in this metaphor? A natural resource that the village earns its living mining? Or maybe cultivating.

[bioya]

Bill
I am not sure what this is. Its not a national meeting. He talks like these people don't know what dialysis is so I have to wonder if this is an academy or what??? KT is a POS. He is a self centered, arrogant, egotistical jerk. I miss my job as FA, I miss my clinic, I miss my patients. But when Gambro was bought by DaVita it was no longer about the patients, it was (and is) about money.

His "culture", his "village" is all good feeling talk to cover how bad DaVita is.

After watching more of this video, I can't figure out who he is talking to. Its not an academy??? What is it? I have not watched the whole thing.

[bioya]

Bill
I am not sure what this is. Its not a national meeting. He talks like these people don't know what dialysis is so I have to wonder if this is an academy or what??? KT is a POS. He is a self centered, arrogant, egotistical jerk. I miss my job as FA, I miss my clinic, I miss my patients. But when Gambro was bought by DaVita it was no longer about the patients, it was (and is) about money.

His "culture", his "village" is all good feeling talk to cover how bad DaVita is.

After watching more of this video, I can't figure out who he is talking to.

It looks like maybe a guest speaker at a business school or something.. I got sick when the hail duh-vita song came on. I just can't tell you how sick you feel when your sitting with your ROD and RVP and these things are forced down our throat. If you don't participate, your blackballed... trust me.. it happens. 







EDITED:Fixed quote tag error=kitkatz,Moderator

[dialysisbiller]

stanford school of business, says so right on the podium in the front of the class when he walks by in the beginning of the video and walks over there several times.

DaVita is a business as most health providers have become over the years... they have to be run as such or they will not be able to stay afloat. He's a businessman first. The reason he's tossed up there is because DaVita when it started was about to fold up as Total Renal Care. The people that I work with who worked there when it was TRC said they didn't know if they were going to be paid each week because the company was just about run into the ground, then Kent showed up and brought a company on the brink of closing to where it is today.

The whole Village idea is a good thing, but the bigger it gets the harder it becomes to manage. Yeah the songs are corny but the point is to lighten up the atmosphere.  He even says that some people think it's rediculous but the intent is to get people's attention. (which it does)

You had a bad taste and always will, as some patients have as well, that's unfortunate. I have had good ones and cannot really bad mouth them, but then again, I am on the business end of it and don't have experience at the facility level. I rec've mostly good comments from people that I've talked to who have had treatments or know someone who have had them at a DaVita center near me.

The video isn't that bad, it's explaining DaVita's business and management 'style' and/or intent

[okarol]

Stay afloat?

Kent J Thiry's Compensation 2008 - from Forbes.com

Salary     $0.89 mil   
Bonus    $1.80 mil 
Other    $2.35 mil     
Stock Gains    $29.64 mil     

Total Compensation    $34.68 mil  (Yes, that's Million)   

[Sluff]

What a farce.

[Bill Peckham]

The whole Village idea is a good thing, but the bigger it gets the harder it becomes to manage. Yeah the songs are corny but the point is to lighten up the atmosphere.  He even says that some people think it's rediculous but the intent is to get people's attention. (which it does)

I'm wondering how the village metaphor applies to patients - how does the internal messaging refer to patients? If the staff are the "voters" and he's the "mayor" what are the patients?

[Bill Peckham]

Bill
I am not sure what this is. Its not a national meeting. He talks like these people don't know what dialysis is so I have to wonder if this is an academy or what??? KT is a POS. He is a self centered, arrogant, egotistical jerk. I miss my job as FA, I miss my clinic, I miss my patients. But when Gambro was bought by DaVita it was no longer about the patients, it was (and is) about money.

His "culture", his "village" is all good feeling talk to cover how bad DaVita is.

After watching more of this video, I can't figure out who he is talking to.

It looks like maybe a guest speaker at a business school or something.. I got sick when the hail duh-vita song came on. I just can't tell you how sick you feel when your sitting with your ROD and RVP and these things are forced down our throat. If you don't participate, your blackballed... trust me.. it happens. 

I would have a very hard time being a song singer (assuming I hadn't been drinking) I feel your pain. His initial comments suggests that these are the remaining attendees from a larger group that gave into a sunny day. I've spoken as the last speaker at multiday conferences so in that way Thiry has my sympathies.

The approach he describes is a business approach - take care of the employees, focus on the employees. His approach and leadership have been very good for the business - my issue is with the role of business in the provision of healthcare. My issue is when business ethics are entrenched in place of medical ethics. I think that trade is a bad deal.

[Kitsune]

The whole Village idea is a good thing, but the bigger it gets the harder it becomes to manage. Yeah the songs are corny but the point is to lighten up the atmosphere.  He even says that some people think it's rediculous but the intent is to get people's attention. (which it does)

I'm wondering how the village metaphor applies to patients - how does the internal messaging refer to patients? If the staff are the "voters" and he's the "mayor" what are the patients?

Bill,

The village metaphor applies to patients in a very important way and don't you forget it. The patients are the natural resource that "The Villagers" mine so that the "The Mayor" can have his "meager" salary, and they should be glad to help. Don't you know you should be  ing  and  ing Kent Thiry's  for the charity service he provides? With 30+thousand dollars a month per patient coming in, he can barely afford to feed himself!    Shame on you for slamming this poor, warm, caring man! Especially you "HIPPERs", why you're his favorite people! Must be your personalities he likes because he and his "Villagers" go out of their way for you (Read: They can charge what they want for your dialysis), and you do this to them? You all sicken me!

 Well, this reminds me, I have to call my center to ask if I can move in there so that I can "help the cause" by making more money for them by doing 24/7 dialysis (I'll get poked 3 times a day so that the lines don't clot, but it's well worth it to keep Fresenius afloat. Hey, they do this out of the kindness of their hearts, don't you know?

All sarcasm aside though, Kent Thiry is a greedy bucket of manure who thinks that once your kidneys don't work right and you have to go to dialysis, you now belong to the center and they can do whatever they want to you. Not that Fresenius is too much better, but at least I've never heard of them injecting anyone with bleach or letting someone freshly out of nursing school be a charge nurse. But all those for-profit companies are way too damn greedy for their own good.

[dialysisbiller]

the dialysis treatment itself isn't bringing the big money in the door, it's the drugs.

and if you think that each patient brings in $30K a month, you are definitely uninformed. On average, it's from $4K-$6K per month per patient. There are Hippers scattered throughout  that bring in the extra money, but well over 85% are Medicare, Medicaid and government plans (Veterans affairs etc) that pay on average $150 per treatment NOT including drug charges.

I'm not a KT 'follower' or 'worshipper'.... he's a businessman, plain and simple and knows how to run a good business. The idea of treating your employees well means they'll do better work and be better with patients etc etc.... core values and such.

[Kitsune]

the dialysis treatment itself isn't bringing the big money in the door, it's the drugs.

and if you think that each patient brings in $30K a month, you are definitely uninformed. On average, it's from $4K-$6K per month per patient. There are Hippers scattered throughout  that bring in the extra money, but well over 85% are Medicare, Medicaid and government plans (Veterans affairs etc) that pay on average $150 per treatment NOT including drug charges.

I'm not a KT 'follower' or 'worshipper'.... he's a businessman, plain and simple and knows how to run a good business. The idea of treating your employees well means they'll do better work and be better with patients etc etc.... core values and such.

Oh, and what about treating the patients well? Does anyone think of us? It's because of us these companies exist. No one is doing us a favor, as much as you dialysis staff like to think you are. Oh, and I saw my statement from Medicare, and it's not $4k-$6K. More like 36,000. So I'll thank you not to tell me I don't know what I'm talking about.

[Bill Peckham]

the dialysis treatment itself isn't bringing the big money in the door, it's the drugs.

and if you think that each patient brings in $30K a month, you are definitely uninformed. On average, it's from $4K-$6K per month per patient. There are Hippers scattered throughout  that bring in the extra money, but well over 85% are Medicare, Medicaid and government plans (Veterans affairs etc) that pay on average $150 per treatment NOT including drug charges.

I'm not a KT 'follower' or 'worshipper'.... he's a businessman, plain and simple and knows how to run a good business. The idea of treating your employees well means they'll do better work and be better with patients etc etc.... core values and such.

Your numbers do not fit what is reported in the United States Renal Data System's Annual Dialysis Report.

Dialysis Biller reports:
Treatment revenue  = $150 x 13 = $1950
Drug revenue = $4,000($6,000) - $1,950 = $2,050($4,050)

USRDS reports
Total Expenditures on Outpatient HD $3,658,947,000
Total Expenditure on separately billable drugs $2,629,298,000

About 60/40 treatment/drugs

You'd expect about $1,300/month in drug revenue based on your $150 per treatment.

[Bill Peckham]

the dialysis treatment itself isn't bringing the big money in the door, it's the drugs.

and if you think that each patient brings in $30K a month, you are definitely uninformed. On average, it's from $4K-$6K per month per patient. There are Hippers scattered throughout  that bring in the extra money, but well over 85% are Medicare, Medicaid and government plans (Veterans affairs etc) that pay on average $150 per treatment NOT including drug charges.

I'm not a KT 'follower' or 'worshipper'.... he's a businessman, plain and simple and knows how to run a good business. The idea of treating your employees well means they'll do better work and be better with patients etc etc.... core values and such.

Oh, and what about treating the patients well? Does anyone think of us? It's because of us these companies exist. No one is doing us a favor, as much as you dialysis staff like to think you are. Oh, and I saw my statement from Medicare, and it's not $4k-$6K. More like 36,000. So I'll thank you not to tell me I don't know what I'm talking about.

The way I would say it is that by agreeing to take Medicare patients the units get a license to vastly overcharge private insurers. For Small and Midsize Dialysis Providers (everyone except Davita and FMC, the LDOs) all of their net income comes from treating the privately insured patients. For the LDOs a lot of net income comes from treating the privately insured and some comes from treating those on Medicare - see the Avalere cost report released by the NRAA at the end of their letter to CMS (pdf link)

[Rerun]

Bill, we would be "the village idiots"....  The sacrificial lambs that come in 3 x a week to get our blood cleaned.  Baaaaaaaa

It makes me so mad that these CEO's are making huge amounts of money off of sick people.  Striping Medicare of its original use of helping people in there old age. 

The single needle dialysis is dead in the water because they would have to spend additional money to get the single needle component and double pump.  Yet, Canada has them. 

Bring on socialized medicine baby!   

You better bet when Medicare is taken away they will close these dialysis clinics the next day and step right over our dead bodies at the door walking to their next business deal.

Is there an even trade:  Our lives for millions of dollars?  Makes me wonder.

[nursewratchet]

This is from the Sanford Business School, as it says.  He is talking about "DWOM",  the "Davita Way of Management."  Kent holds a Harvard MBA.  He was asked by Harvard to build a course, based on his management style, which he did.  It is now being taught at Harvard, as well as other business schools.  ALL Davita FA's must attend this course, and it continues to be taught at Harvard.  I went, and despite what you think one way or the other about Davita, or Kent Thiry, it was an amazing course.  I use many parts of the course in my everyday management, and am thankful that I got to go.  I'm not sure that the rest of "the village" uses any of this information.   

[RealityCheck]

Kent admired WalMart's model and adopted some of its basic practices, like regular conference calls to loop in all managers and hold them accountable.  He developed the concept of HIPPERS, which are patients with insurances that have high reimbursement.  He hired a vast fleet of financial specialists to hold biweekly calls with facility administrators and social workers to review the current status of all the hippers in a unit, their satisfaction with service, any changes in their household or empployment, who was the decision maker for the patient, if the patient had talked about switching to another unit.  They called this the SAMS call, which is named after Sam Walton of Walmart who developed it.  When public opinion began to change during the healthcare reform debate, they no longer called patients Hippers, but COmm1, or commercial one, Medicare+private were comm2 and Medicaid were Comm3.  They always said there was no difference in the care given to the different tiers of patients, but there were no biweekly calls asking if the Medicaid patients were happy with their care.  I don't think he mentions this in the Stanford lecture.

[nursewratchet]

All true points, REality Check.  i will tell you though, that none of the teammates that actually do the patient care, know who the HIPPERS are, or who has Medicare, or Medicaid.  At least not at my clinics.  The staff could care less, so, yes, patient care is the same.  ALL of management knows the HIPPERS, though, I promise you.  And, FYI, ANY problem, in ANY clinic has a SAMS call about it. 

[rsudock]

the dialysis treatment itself isn't bringing the big money in the door, it's the drugs.

and if you think that each patient brings in $30K a month, you are definitely uninformed. On average, it's from $4K-$6K per month per patient. There are Hippers scattered throughout  that bring in the extra money, but well over 85% are Medicare, Medicaid and government plans (Veterans affairs etc) that pay on average $150 per treatment NOT including drug charges.

I'm not a KT 'follower' or 'worshipper'.... he's a businessman, plain and simple and knows how to run a good business. The idea of treating your employees well means they'll do better work and be better with patients etc etc.... core values and such.

Oh, and what about treating the patients well? Does anyone think of us? It's because of us these companies exist. No one is doing us a favor, as much as you dialysis staff like to think you are. Oh, and I saw my statement from Medicare, and it's not $4k-$6K. More like 36,000. So I'll thank you not to tell me I don't know what I'm talking about.

I actually got a bill one month (when my insurance was messed up) that was for $36,000 as well...weird you had the same number too?

[RealityCheck]

The nurse managers know, the secretaries know, very often the dietitians and floor staff know, and without question the doctors know.  Whether it changes the performance of any of them toward the patient has a lot to with the person.  I have known doctors who were very interested in keeping Hippers happy, and VERY concerned when one wanted to move to a clinic closer to home.  There are often situations in urban areas where more than one patient wants a spot at a clinic at the same time.   The inconvenience to a poor medicaid patient with no car might be MUCH greater than to a Hipper with easy transportation. There is no law, or rule, against admitting a HIpper ahead of the Medicaid patient, and even if there were, it is done without transparency, and it is done routinely.  Do you think 9 months of traveling by bus to a center 20 miles instead of 2 blocks away will impact your health? 

If you have been on dialysis more than 30 months AND you have Medicare, you are not a Hipper.  It is only people for whom commercial coverage is primary. 

[NDXUFan]

All true points, REality Check.  i will tell you though, that none of the teammates that actually do the patient care, know who the HIPPERS are, or who has Medicare, or Medicaid.  At least not at my clinics.  The staff could care less, so, yes, patient care is the same.  ALL of management knows the HIPPERS, though, I promise you.  And, FYI, ANY problem, in ANY clinic has a SAMS call about it.

I had private coverage for 30 months and they were just as goofy in the beginning as they were in the end.  They did not care about Medicaid patients, how shocking.  That is why Obamacare and socialism is a very bad deal, Thiry is not forced to care, as if he would be, if he had competition. 

[cattlekid]

I was a HIPPER the entire time that I was on dialysis, both in-center and home hemo.  I will be bluntly honest - I used it to my advantage wherever and whenever I could.  I didn't go around proclaiming my HIPPER status and I never threatened anyone but I always casually let them know that they weren't the only game in town and that I had choices.  That seemed to get everyone to snap to, especially when the FA got wind of it because it was their  on the line if I chose to leave.

Of course, this only works in a large urban area where choices of providers abound.

[NDXUFan]

I was a HIPPER the entire time that I was on dialysis, both in-center and home hemo.  I will be bluntly honest - I used it to my advantage wherever and whenever I could.  I didn't go around proclaiming my HIPPER status and I never threatened anyone but I always casually let them know that they weren't the only game in town and that I had choices.  That seemed to get everyone to snap to, especially when the FA got wind of it because it was their  on the line if I chose to leave.

Of course, this only works in a large urban area where choices of providers abound.

ND:

Yes, I had choices also, and that is why my good friends at Davita were fired out the door.  I love IU.