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American Healthlines
December 19, 2019
A three-judge panel of the U.S. Court of Appeals for the Fifth Circuit in a 2-1 ruling issued Wednesday struck down the Affordable Care Act's individual mandate as unconstitutional, but left the rest of the law intact—at least for now. Here's what you need to know.
December 18, 2019
American Health Line's editorial team covered a wide range of health care stories this year, including the 2020 election, value-based care models, and more. We've rounded up American Health Line's top 10 most-read stories of 2019.
December 16, 2019
American Health Line's editorial team in 2019 read through scores of news stories and studies on the lifestyle choices that we face every day—from whether diet sodas increase the risk of premature death to whether exercising in the morning is better.
November 21, 2019
Pharmacy benefit managers (PBMs) have gained national attention as regulators have sought to address rising prescription drug prices. But how exactly do these companies fit into the drug supply chain? American Health Line's Jose Vasquez and Advisory Board's Gina Lohr break down everything you need to know about PBMs.
November 7, 2019
The issue of surprise bills has gripped the nation and Congress plans to take action. But there is one major roadblock: federal lawmakers cannot decide whether rate setting or arbitration is the best way to settle such bills. American Heath Line breaks down both of these proposals.
October 22, 2019
As baby boomers retire and more novice nurses join the workforce, health systems are facing a new kind of nursing shortage: an experience shortage. American Health Line's Danielle Poindexter spoke with experts to learn about the experience shortage and what nursing leaders can do to close the experience gap.
October 9, 2019
Black women were three times more likely to experience a pregnancy-related death than white women between 2007 and 2016, even among states with the lowest maternal mortality rates. Here's how providers and states are addressing the problem.
October 1, 2019
In his 2019 annual address, Cleveland Clinic President and CEO Tom Mihaljevic announced an audacious five-year goal: to become "the best place for health care anywhere." It was a sign that the system wasn't content to rest on its laurels. But how would it actually try to follow through? American Health Line's Jackie Kimmell dives deep to find out
September 20, 2019
American Health Line's Jackie Kimmell breaks down five stories you should know about the moves Big Tech disruptors have made in the past month—and how they could impact the health care industry.
September 9, 2019
Jay Crawford, a pediatric orthopedic surgeon, recently argued in STAT News that a colleague "should have been paid $4.5 billion for fixing my broken wrist, not $1,000." Here's why Crawford's argument is misguided—and what it nonetheless reveals about U.S. health care prices, according to American Health Line's Thomas Seay.
August 20, 2019
Five years ago, Mayo Clinic embraced a strategic plan to revitalize the 150-year-old system, including three strategic gambles that ran counter to prevailing wisdom. So how have Mayo's big bets worked in practice? American Health Line's Jackie Kimmell dives deep to find out.
July 26, 2019
Legislative efforts to reform the controversial 340B Drug Pricing Program appear to have lost momentum in Congress, but experts say the forthcoming 2020 Hospital Outpatient Prospective Payment System rule could include proposals to address critics' concerns. American Health Line outlines where the 340B debate stands—and what changes experts expect.
July 23, 2019
In June, CVS Health announced that it would create 1,500 new HealthHUB stores—a model that provides around 80% of the services of the average primary care practice. American Health Line's Jackie Kimmell explores why and outlines the key takeaways for providers.
July 16, 2019
Want to know what Amazon, Apple, Google, and other tech giants are up to in health care? American Health Line's Jackie Kimmell breaks down seven stories you should know about the big moves disruptors have made in the past month—and how they could affect the industry.
June 26, 2019
Millions of voters will tune in tonight and tomorrow to watch the Democratic presidential hopefuls cross swords in the first 2020 presidential debates—and health care is sure to emerge as a point of contention. Here's where the candidates stand on hot-button topics ranging from Medicare-for-All to prescription drug prices to marijuana legalization.
June 19, 2019
In recent weeks, dozens of media outlets reported that "burnout" has been promoted to a full-fledged medical condition in the ICD-11. That wasn't exactly true—but the real story reveals why it's so important to manage the hazards of workplace burnout.
June 14, 2019
This week, Facebook announced they were launching a blood donation tool on the site in several major U.S. cities. The move comes just weeks after they hired a former Google health executive to run their health efforts and made other high-profile health care moves. American Health Line's Jackie Kimmell explains what these efforts could mean for the company's future in health care.
June 6, 2019
Uber's initial public offering last month was one of the largest in tech history—starting trading at $45 a share, or a $82 million total valuation—and its efforts in health care were a major part of that sky-high figure. American Health Line's Jackie Kimmell outlines the five things you should know about their health care efforts.
March 13, 2019
Do you think you understand the full scope of Google's ambitions in health care? Think again. The tech giant's health efforts are more far-reaching and ambitious than nearly anyone understands—but they're united by these six visions for transforming health care, Jackie Kimmell reports for American Health Line.
May 20, 2019
April 24, 2019
HHS this week unveiled five new value-based payment models intended to shift primary care providers and other eligible professionals away from fee-for-service (FFS) payments. Here are four key takeaways from the announcement.
April 5, 2019
The Department of Justice now wants a federal appeals court to strike down the entire Affordable Care Act as unconstitutional. But what exactly would happen to the health care industry if the Supreme Court strikes down the law? American Health Line rounds up experts' predictions—and many say the effects would be more far-reaching than you might expect.
April 2, 2019
Lyft started trading publicly on Friday—with a robust start that could make the company one of the most valuable companies to go public in the last decade. One problem? The company has never been profitable. American Health Line's Jackie Kimmell explores why the company's betting on health care to reverse that equation—and the three health care audiences it's pursuing to get there.
Major League Baseball swings into season today, accompanied as always by controversy surrounding performance-enhancing drugs—but did you know that your own pantry or medicine cabinet might contain substances that would get you banned from baseball? American Health Line breaks down 10 substances banned from MLB that are surprisingly commonplace off the field.
March 6, 2019
FDA Commissioner Scott Gottlieb sent waves through Capitol Hill and the health care industry on Tuesday when he announced he will resign from his position within the next month. As Heather Bell writes for American Health Line, Gottlieb had largely overcome initial criticism to establish himself as the rare Trump administration official who garnered support from policymakers on both sides of the aisle.
February 22, 2019
Over the past few months, several candidates have joined and dropped out of the race for the Democratic nomination for president in 2020. American Health Line has rounded up where the remaining Democratic candidates stand on health care, and will continue to update this roundup throughout the 2020 presidential primary season.
February 14, 2019
You've endured a long, cold winter, and now, at long last, it's here: Valentine's Day, when #HealthPolicyValentines take over our Twitter feeds—and our hearts. American Health Line's gathered 10 of our favorites from this year's batch, from "It's the prices, Cupid" to "When the moon hits your eye like a big pizza pie, that's S05.91XA (unspecified injury of right eye and orbit, initial encounter)."
January 24, 2019
Perhaps because of the sheer breadth of Apple's ambitions, it can be tough to pin down the company's goals in health care. To help, American Health Line distilled all the confusing and sometimes-contradictory reporting into the five concrete ways Apple wants to transform the industry.
January 14, 2019
CMS' new price transparency rule, which mandates that hospitals post their list of standard charges online, took effect on January 1st—and the initial data paint a confusing picture for patients. American Health Line breaks down the coverage to highlight the different ways providers have been responding to the rule and hints into how it might evolve.
December 21, 2018
As 2018 comes to a close, we're taking a look back at the biggest stories in health care. From major changes to state Medicaid programs to a state-led lawsuit that might yet succeed in toppling the Affordable Care Act where Republican lawmakers failed, American Health Line's coverage in 2018 focused on topics that most affect the health care industry.
December 19, 2018
Millennials spend nearly twice as much on health care as previous generations—even though they have less money to spend overall, according to a report from the Federal Reserve. American Health Line explores what millennial patients actually want from the health care system.
December 18, 2018
American Health Line's editorial team in 2018 read through scores of news stories and studies on the lifestyle choices that we face every day—from whether to start a low-carb diet for weight loss to how long to exercise. As part of our Year in Review, we compiled this list of top stories to help you stay happy and healthy in 2019.
December 7, 2018
American Health Line's editors and writers covered some big topics this year, including Medicare's 340B drug discount program pricing controversy, a major leadership departure at Mayo Clinic, and the year-one results from MACRA's Quality Payment Program. Below, we round up American Health Line's top five must-read Analysis & Insight pieces of 2018.
November 1, 2018
As congressional candidates make their final appeals to voters, American Health Line looks at some of the most notable health care ads that graced the airways this election session.
October 11, 2018
Can you define CAR T-cell therapy? How about BCRA, melanoma, and myeloma? If you're fuzzy on the details, check out American Health Line's cancer jargon dictionary for definitions of 25 of the most commonly used (and sometimes confusing) cancer terms.
October 5, 2018
There's no question that physicians are among the country's highest-paid workers: The typical U.S. physician earned $299,000 last year. But why do some doctors get paid two or three times as much as others (or more)? American Health Line dug in to the data to find out.
September 25, 2018
Journalists and lawmakers increasingly are digging into stories about "surprise medical bills," but they often leave a root question unexamined: Where did those hospital prices come from in the first place? American Health Line analyzed Medicare's data files to see the range of average covered charges (the list price billed by the hospital) at every hospital in the United States for five common conditions.
September 12, 2018
When Republican-led states filed a lawsuit challenging the constitutionality of the individual mandate—and the Affordable Care Act itself—few were concerned, but a federal judge caused heads to turn last year when he struck down the entire law. American Health Line spoke to experts to get a clearer picture of just how chaotic things could get if this case continues to gain traction and, ultimately, reaches the Supreme Court.
September 7, 2018
Even though the GOP fell short in its efforts to repeal and replace the Affordable Care Act last year, the Trump administration remains dedicated to reforming health care through state-based waivers. American Health Line breaks down the three most significant ways the White House could change health care via waivers—and explains the limits of waiver authority.
August 30, 2018
With 2018's global merger and acquisition activity on pace to break records, it appears that the number and scale of M&A deals won't be decreasing anytime soon. Here are the four biggest health care mergers and acquisitions rumored or pending right now.
August 14, 2018
August 2, 2018
Even for those of us who work in health care, it can be hard to distinguish myth from fact when it comes to our health. Therefore, American Health Line dug into three more common health myths to learn their origin and to help you understand the scientific evidence behind them.
July 27, 2018
Thousands of scientists at the Alzheimer's Association International Conference this week in Chicago to discuss new findings about disease—which already afflicts 5.5 million U.S. residents, and could affect three times as many by 2050. American Health Line has rounded up the three most important things you should know about what they discussed.
July 19, 2018
Have you ever shared an amazing-sounding "fact" about health or the human body, only to be embarrassed later when you learn that fact either was unsupported or wrong? To help, American Health Line's dug into four of the most common inaccurate health myths and brought you the science behind them.
July 3, 2018
Packing your bags full of human forearms. Picking pieces of brain off your face. Luring strangers into your basement to inflict pain. Are these the activities of a serial killer—or a medical researcher? Twitter users are exploring the strange overlap between the two vocations under the hashtag #SerialKillerOrScientist—and American Health Line's pulled out our favorites.
May 29, 2018
If you've read health care news in recent months, you've seen plenty of headlines about how states—from Kentucky to Utah—want to reshape their Medicaid programs via "waivers." But what exactly do these waivers allow? In the first part of this two-part series, American Health Line breaks down exactly what states can (and can't) do via Medicaid waivers, how the Trump administration has pushed those bounds, and what you can expect next.
April 18, 2018
Shortly before former first lady Barbara Bush passed away on Tuesday, her family announced that she would stop curative treatment and seek "comfort care" at home—a move experts hope will spark many Americans to consider discussing their own end-of-life wishes with doctors. American Health Line's Scott Orwig explains how one health system created a program to make these difficult conversations easier.
April 13, 2018
Hospital ratings gets lots of buzz in the news, but do you know what factors actually determine a hospital's rank? American Health Line's Rachel Schulze dove into four of the most popular lists—from U.S. News & World Report, Leapfrog, and more—to find out how they work and why they're so controversial.
March 26, 2018
For 2018, the only way to qualify for MACRA's Advanced APM track—and its 5% incentive payment—is through Medicare Alternative Payment Models. Here's what you need to know about the new All-Payer Combination Option to qualify from 2019 on.
March 1, 2018
If you've followed the twists and turns in Medicare's latest changes to provider payments, you know that news coverage tends to devolve into alphabet soup: "CMS last year released a final rule for MACRA's QPP in 2018, with details on the MIPS and Advanced APM tracks." Confused yet? Don't worry—here's American Health Line's rundown of what you really need to know.
February 21, 2018
A day after announcing he will step down as Mayo Clinic's president and CEO at the end of 2018, John Noseworthy spoke with American Health Line's Josh Zeitlin about his 9-year tenure as chief executive, his approach to leading through change, and his advice for the Clinic's next leader.
February 1, 2018
February 14, 2018
Health care policy wonks are professing their love with #HealthPolicyValentines, a social media tradition that's been going strong since 2012. American Health Line's Ben Palmer gathered the 10 best Twitter has to offer—from "Will you be my qualifying life event?" to "Much like payments for certain episodes of care, you and I are best when bundled together."
January 9, 2018
The health care industry is in for another roller-coaster year in health policy, as Republicans in Congress set their sights on reforming Medicare, Medicaid, and the Affordable Care Act—all while the industry faces looming challenges from hackers and the still-raging opioid epidemic. American Health Line details what you need to watch for in 2018.
January 2, 2018
American Health Line's editorial team in 2017 read through thousands of news stories and studies on the lifestyle choices that we face every day—from whether to treat dark chocolate as a health food (don't) to the behaviors most commonly associated with cancer. Here's what we found.
December 21, 2017
Here's American Health Line's annual list of the top players who influenced health policy in 2017—ranging from leaders in the Trump administration and Congress to a certain high-profile Twitter account.
December 20, 2017
From the Congressional debate over repealing and replacing the Affordable Care Act to the ongoing implementation of the MACRA, American Health Line's coverage in 2017 focused on topics that most affect the health care industry. What were the biggest stories of the year? American Health Line's editorial team rounds up the top 10 stories of 2017.
December 4, 2017
American Health Line has put together a side-by-side chart showing how the new conference committee version of the GOP tax reform bill, which will likely pass Congress this week, compares with the House- and Senate-passed versions—including how the bills could affect health insurance, executive compensation, hospital construction projects, Medicare, academic medical centers, patients' medical expenses, and even alcohol-related deaths.
December 7, 2017
American Health Line's editors and writers covered some big topics this year, including the future of the CHIP program and the consequences rescinding the Affordable Care Act's individual mandate could have on other popular provisions of the law.
December 5, 2017
On Monday, the Associated Press reignited a debate that has divided clinicians, policymakers, and journalists alike: Should the phrase so often used to describe our industry be "healthcare"—one word—or "health care"? Here's what industry stakeholders told American Health Line.
November 30, 2017
The U.S. health insurance system is one of the most complex in the world, so we don't blame you if you need a refresher on the basics. American Health Line answers five key questions surrounding the different payers, methods of reimbursement, various forms of cost-sharing, and the most common types of plans on the market.
Consumers have more choices than ever about where to seek care, but experts say a true "retail revolution," in which patients regularly shop around for the best prices, has yet to reach the health care industry. American Health Line spoke with stakeholders to learn about the obstacles holding the industry back.
November 16, 2017
Federal funding for the Children's Health Insurance Program expired 47 days ago. This is not the first lapse in CHIP funding—but it is by far the longest, and lawmakers do not appear any closer to passing a renewal. American Health Line explores the political and policy questions at play and how they differ from those during the 2007 funding gap.
October 31, 2017
Beginning Wednesday, consumers will be able to shop and enroll in exchange coverage for 2018, but the experience will be different in the Trump era when compared with previous years. American Health Line rounds up the six biggest ways this open enrollment period is likely to stand out from the past.
October 19, 2017
Prescription drug prices continue to rise placing an increasing financial burden on patients and families—but industry experts outline three key steps providers can take to ease out-of-pocket costs for patients and reduce uncompensated care costs.
September 26, 2017
The Graham-Cassidy health reform bill would go further than previous GOP bills in changing Medicaid, which covers nearly one-third of U.S. residents at some point each year. American Health Line breaks down the six changes you need to know.
September 25, 2017
American Health Line provides a side-by-side breakdown of the Affordable Care Act (ACA) and the latest Senate GOP bill to repeal and replace the ACA from Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.).
September 21, 2017
There's a lot of talk about how the GOP has a Sept. 30 deadline to repeal the Affordable Care Act with just 50 votes. But in truth, experts tell American Health Line Republicans would still have several paths to repeal after Sept. 30—if they choose to take them.
September 15, 2017
Republicans and Democrats are deeply divided when it comes to health care, and perhaps no question more sharply divides the parties than the question of how well the Affordable Care Act's exchanges are working. So who's right? American Health Line recently sat down with industry experts to find out whether they consider the exchanges to be "stable" and discuss the key questions surrounding their sustainability.
August 18, 2017
Millions of people are expected to travel to see the total solar eclipse, and the hospitals in the path of totality and those close by it have been preparing for months, making sure they'll be fully staffed, stocked up on supplies, and ready for a potential onslaught of visitors.
August 7, 2017
President Trump has repeatedly threatened to halt payments that reimburse insurers for reducing out-of-pocket costs for low-income enrollees on the Affordable Care Act's exchanges. Here's what you need to know about the payments and what could happen if Trump halts them.
August 1, 2017
The conventional wisdom is that under Senate rules, the GOP's effort to repeal the Affordable Care Act will be officially "dead" if it doesn't pass by the end of the fiscal year on Sept. 30. But a former Senate parliamentarian tells American Health Line that things aren't so simple.
July 26, 2017
The Twittersphere was abuzz Tuesday about a STAT News article that suggested the American Psychoanalytic Association (APsaA) was breaking with a longstanding policy that bars psychiatrists from commenting on a public official's mental health. There's just one problem: the American Psychoanalytic Association had never adopted that policy in the first place.
July 21, 2017
The American Health Line team put together a chart to compare several key provisions and effects of the Affordable Care Act, the original Senate GOP health care bill, and the newly updated Senate bill.
July 12, 2017
There is some disagreement over just how much state flexibility the Senate GOP's proposed changes to Medicaid financing would create. HHS Secretary Tom Price recently said the proposed changes would make the program "much more flexible for states," but the Congressional Budget Office said most states would not "have substantial additional flexibility" under the Better Care Reconciliation Act. American Health Line's Josh Zeitlin explores who's right in the debate.
June 27, 2017
Atul Gawande, the Center for American Progress, and others have argued that the Senate's draft health care bill would lead to more deaths. But is that a fair assessment based on the available evidence? American Health Line's Josh Zeitlin asked the experts.
June 23, 2017
The Senate Thursday released its long-awaited health reform draft bill, and American Health Line developed a side-by-side chart that will help you understand exactly how it differs from the Affordable Care Act and the House-passed health reform bill.
The American Health Line team put together a chart to compare several key provisions and effects of the Affordable Care Act, House-passed American Health Care Act, and newly released Senate health care bill discussion draft.
June 20, 2017
June 13, 2017
In just the past week, several moderate GOP senators have seemed to become more bullish on the prospects for an Affordable Care Act repeal bill. American Health Line breaks down what you need to know about their comments—and what they say, and don't say, about the Senate's health care efforts.
May 30, 2017
The Affordable Care Act has created "two Americas" for health care—but the House-passed American Health Care Act would create three, each with different implications for hospitals and consumers. American Health Line explores the latest Congressional Budget Office findings and what they could mean for health care in America.
May 24, 2017
The Congressional Budget Office today is expected to release a new score of the House-approved American Health Care Act. American Health Line outlines the three key items we will be watching for when the score drops.
May 18, 2017
In the weeks since the House-passed the American Health Care Act, which would repeal and replace major provisions of the Affordable Care Act (ACA), industry stakeholders have voiced strong concerns about the bill's potential effects. American Health Line looks at a growing group of stakeholders who are raising concerns about how ACA repeal efforts could affect the future of CHIP—a health care program that covered an estimated 8.4 million U.S. children in 2015.
May 4, 2017
Following Thursday's House vote to approve the Republican plan to repeal and replace large portions of the Affordable Care Act, American Health Line breaks down what you need to know about the Congressional Budget Office—and the controversy around its House Republicans' decision to vote on the GOP bill without an updated "score."
April 28, 2017
Saturday marks President Trump's 100th day in office and in that time his administration has taken several key actions that have roiled the health care industry. American Health Line takes a look back at Trump's health care agenda thus far and identifies the five key policy issues that have the biggest implications for providers.
April 19, 2017
Automation is often cited as a threat to jobs, but some experts say it could actually create new openings in health care. American Health Line takes a closer look at these trends and how automation is being used in the industry.
April 11, 2017
American Health Line Josh Zeitlin spoke with Asaf Bitton, an internist and assistant professor at Harvard Medical School and Brigham and Women's Hospital, about misconceptions about the primary care industry, the transition to value-based payment models, and more.
April 7, 2017
Cleveland Clinic CEO Toby Cosgrove says he thinks the Affordable Care Act is largely here to stay—but that lawmakers and regulators can do more bring down health costs. American Health Line outlines the three key steps Cosgrove says policymakers could take to make the U.S. health care system more efficient and less costly.
March 31, 2017
Here's what you need to know about House v. Price, a lawsuit over Affordable Care Act subsidies that could be on track to collapse the law's exchanges—unless the Trump administration appeals the latest ruling in the case.
March 23, 2017
Is Congress really exempt from Obamacare? Has the Affordable Care Act (ACA) led the quality of U.S. care to plummet? And for that matter, are Obamacare and the ACA even the same thing? On the ACA's seventh anniversary—and as the House gears up to vote on a plan to repeal the law—American Health Line dives into the most enduring myths, misconceptions, and misinterpretations surrounding the law.
March 10, 2017
High-risk pools are back in the spotlight as a potential element of plans by Republican lawmakers and President Trump to repeal and replace the Affordable Care Act. American Health Line explores some of the lessons learned from past high-risk pools and ways in which Republicans might seek to address individuals with pre-existing conditions.
February 22, 2017
The Affordable Care Act's defenders say that keeping some of the law's most popular provisions—such as affordable coverage for people with pre-existing conditions—requires mandating that everyone have insurance. But some conservative lawmakers say the mandate is unnecessary. Who's right? American Health Line's Sam Bernstein examines the issue.
February 16, 2017
February 14, 2017
Health policy wonks are professing their love on Twitter for everything from bundled payments to antibiotic stewardship with #HealthPolicyValentines. American Health Line rounds up some of the smartest (and funniest) tweets from the annual social media tradition.
February 9, 2017
Axios contributor Steven Brill this week published a ranking of the health system CEOs paid the most "for each day a patient spends in their hospital." But while reasonable people can disagree about whether CEOs are paid appropriately, American Health Line's Josh Zeitlin argues that Brill's metric isn't very illuminating, for three big reasons.
February 1, 2017
January 24, 2017
A range of health care experts—including Uwe Reinhardt, Ashish Jha, and Thomas Miller—give their takes to American Health Line on how President Trump and the GOP-led Congress may change the industry.
January 19, 2017
January 12, 2017
Senators had a late night last night, casting their final votes at around 1:30 a.m. to approve a budget resolution that sets the stage for Republicans to repeal the Affordable Care Act. But first, they had to get through a slew of amendments. American Health Line takes a closer look at the amendments and what they say about lawmakers' health care priorities this year.
January 6, 2017
While the Zika virus is tapering off in the United States amid the cooler weather, researchers are working at full steam to create a safe and effective vaccine against the virus. American Health Line examines some of the vaccines that have shown the greatest potential in early trials.
December 22, 2016
What did stakeholders have to say about health care policy in 2016? As the year comes to a close, American Health Line's editorial team rounded up the standout quotations of 2016.
December 21, 2016
American Health Line's editors and writers covered some big topics this year, including the emergence of the Zika virus and the future of the meaningful use program under the Medicare Access and CHIP Reauthorization Act. We round up American Health Line's top five must-read Analysis & Insight pieces.
From new ways to pay physicians under Medicare to a long-discussed legislative package aimed at supporting U.S. medical innovations, 2016 brought major health care reform efforts that could shape the U.S. health system for years to come. American Health Line breaks down our picks for the top players who shook up the industry in 2016.
December 13, 2016
From the 2016 presidential election's potential effect on health reform to the ongoing implementation of the Medicare Access and CHIP Reauthorization Act, American Health Line's coverage in 2016 focused on topics that would most affect U.S. residents and providers. Our editorial team rounds up American Health Line's top 10 stories of 2016, based on reader visits.
December 9, 2016
American Health Line takes a closer look at the Affordable Care Act replacement plans likely to serve as the foundation for health care reform under President-elect Donald Trump's administration.
December 6, 2016
The GOP's plan to repeal the Affordable Care Act (ACA) likely would keep the law's coverage expansions in place for several years—but immediately institute a tax cut worth more than $550 billion over 10 years, perhaps complicating efforts to fund any ACA replacement. American Health Line discusses the potential consequences of the GOP's plan with two experts.
November 30, 2016
American Health Line explores how hospitals had prepared to comply with a federal overtime rule that was set to take effect Dec. 1, and the implementation questions raised after a federal judge temporarily halted the rule's implementation.
November 18, 2016
American Health Line takes a look at why the fate of two mega mergers in the health insurance industry could rest on whether Cigna and Humana—the two companies that would be absorbed by Anthem and Aetna, respectively—are considered "innovative."
November 15, 2016
November 2, 2016
October 26, 2016
With less than a week before the 2017 open enrollment period begins, the Obama administration is making one last marketing push to balance the Affordable Care Act's risk pool by boosting exchange enrollment among young adults. But some experts tell American Health Line that more substantial changes are needed to entice that key demographic to enroll.
October 19, 2016
October 11, 2016
Health care accounts for nearly a fifth of the U.S. economy—but so far in the presidential and vice presidential debates, the candidates running to lead the United States have discussed their health care policies only briefly. American Health Line's Josh Zeitlin asked several health experts to share the top questions they'd ask the candidates.
October 4, 2016
Lawmakers in the House have proposed tightening eligibility for a free school meals program, saying the revision ultimately helps direct resources to students who need them the most. However, experts tell American Health Line that tightening eligibility could lead to public health consequences.
September 27, 2016
Last night, Democratic presidential nominee Hillary Clinton and Republican presidential nominee Donald Trump squared off in the first presidential debate, but health care was missing from the discussion. American Health Line looks at the biggest health care issues affecting the United States and where the candidates stand.
September 20, 2016
Several states that traditionally have been rated poorly for their telehealth services are considering and passing legislation to facilitate greater access and coverage. One expert tells American Health Line that "it's a long time coming."
September 14, 2016
A recent Congressional Budget Office analysis finds most acute care hospitals will have negative profit margins in 2025 unless they improve productivity or otherwise reduce cost growth. American Health Line speaks with the experts to determine what hospitals and policymakers can do to improve hospitals' financial futures.
September 8, 2016
Sixteen of the 23 cooperative (co-op) health plans established under the Affordable Care Act have shut down, prompting some policymakers to renew calls for a public option health plan to take the co-ops' place. American Health Line asked the experts whether a public option could achieve the co-ops' goals of lowering prices and providing a check on large insurers.
August 23, 2016
In the past few months, three of the country's biggest insurers have announced they will dramatically reduce their exchange offerings for the upcoming open enrollment period. American Health Line examines what those changes could mean for exchange competition—and possible solutions to restore stability.
August 16, 2016
August 9, 2016
A recent Health Affairs study finds the Affordable Care Act's health insurance exchanges have tempered overall premium rate increases, but one expert says the findings could be too good to be true. American Health Line details the contrasting arguments.
August 3, 2016
American Health Line's Aly Seidel sat down with John Kontor, executive vice president of Advisory Board's Clinovations, and Stanson Health CMO Jeremy Orr for a Q&A on how hospitals can use clinical decision support to help providers adapt to new payment models .
July 29, 2016
Former Secretary of State Hillary Clinton on Thursday officially accepted the Democratic nomination for president. American Health Line outlines where her health care policy agenda aligns and diverges from those put in motion by President Obama.
July 26, 2016
Research shows that prescription drug monitoring programs can limit overprescribing and reduce opioid-related overdose deaths. American Health Line investigates why Congress has yet to mandate their use, despite an ongoing effort to combat prescription opioid misuse.
July 20, 2016
The delegates at the Republican National Convention on Tuesday officially nominated Donald Trump for president. American Health Line outlines where his health care policy agenda aligns and diverges from other top Republicans.
July 19, 2016
Congress has officially closed up shop for its seven-week summer recess. American Health Line takes a look at the biggest health care bills left in limbo until lawmakers reconvene in September.
July 13, 2016
Most health care providers and policy wonks are familiar with the Medicare Access and CHIP Reauthorization Act—but what will the legislation mean for patients? American Health Line attended a recent briefing where experts suggested patients could see better care coordination, improved end-of-life care, and more.
July 6, 2016
The Medicare Board of Trustees' latest annual report projects that a controversial Affordable Care Act provision—the Independent Payment Advisory Board (IPAB)—will be triggered in 2017. American Health Line checks in with experts to examine how likely that outcome truly is and what it would mean for Medicare.
June 28, 2016
United Kingdom voters' decision to exit the European Union, known as "Brexit," is causing waves in the health care industry, both inside the U.K. and abroad. American Health Line explores how the decision will affect FDA, drugmakers, medical device makers and health care researchers.
June 21, 2016
June 14, 2016
As lawmakers expressed horror and resolve following this weekend's mass shooting at a gay nightclub in Orlando, some also called attention to a little-known FDA blood donation restriction. American Health Line details the discussion and events that took place following the tragic event -- including how one hospital scrambled to respond.
June 7, 2016
Summer is here and with it comes prominent sunscreen displays in retail stores, but not all of the sunscreen on display is created equal—and some experts say regulatory hurdles are partly to blame. American Health Line dives into the debate and uncovers how consumers can protect themselves from the sun while waiting for regulators to act.
May 31, 2016
May 24, 2016
Some experts are questioning a BMJ study that made headlines earlier this month with its conclusion that medical errors are the third-leading cause of death in the United States. American Health Line highlights the arguments challenging the study and whether the researchers in fact buried their own "key argument."
May 18, 2016
May 11, 2016
Across the country, more states are taking steps to mandate price transparency among health care providers. American Health Line examines some of the latest health care price transparency laws and ways providers are preparing to comply.
May 3, 2016
American Health Line delves deeper into a new study that finds the Affordable Care Act's Medicaid expansion helped reduce individuals' collected debt and improved their financial well-being. But while some experts say the findings support a growing body of research, others say the study did not ask the right questions.
April 26, 2016
American Health Line's Sam Bernstein sat down with Rivka Friedman, a practice manager at The Advisory Board Company, to discuss Comprehensive Primary Care Plus -- CMS' new alternative payment model.
April 19, 2016
April 12, 2016
What is the best way to address rising drug costs? Some industry experts have called for more transparency or new payment models, while others propose creating mortgage-like loans to help patients bear the cost. American Health Line takes a closer look.
April 5, 2016
American Health Line takes an exclusive look at the surprising outcome of the legal battle between FBI and Apple and the implications for the security of individuals' health data on their smartphones.
March 29, 2016
As the FCC today plans to auction of large swaths of little-used wireless spectrum, American Health Line explores concerns from the American Hospital Association and other health care stakeholders about the effect opening the spectrum will have on wireless channels dedicated to health monitoring devices.
March 22, 2016
Despite recent efforts to improve health care price transparency, research suggests patients continue to face obstacles in determining the cost of care. American Health Line explores the new research and talks with experts about ways the industry can refocus those efforts.
March 15, 2016
American Health Line dives into a new report that reveals disparities in access to care among different demographics throughout the United States and talks to the experts about what can be done.
March 8, 2016
As companies increasingly turn to wellness programs to keep employee health care costs down, some experts say there is little evidence proving the effectiveness of such programs. American Health Line explores the wellness program debate.
March 1, 2016
Experts tell American Health Line there's "a zero percent chance" that Congress will enact President Obama's latest proposal to ease Medicaid expansion in holdout states and the best hope for Medicaid expansion might be a new president. Here's why.
February 23, 2016
Some health care startups have pushed regulatory bounds, raising questions about whether technology innovators can flourish in the highly regulated health care industry. American Health Line takes a closer look at some startups' recent regulatory missteps.
February 16, 2016
American Health Line examines the health care positions of New Hampshire primary winners Donald Trump and Vermont Sen. Bernie Sanders (I).
February 2, 2016
American Health Line compares health care proposals from the top three candidates currently running for president, according to the results of yesterday's Iowa caucus.
December 22, 2015
From the affirmation of another major provision of the Affordable Care Act to the potential consolidation of the health insurance market, it's been a big year for health care. Here are the top players who shook up the industry in 2015.
December 17, 2015
What did people have to say about health care policy in 2015? As the year comes to a close, American Health Line looked back and rounded up the standout quotations of 2015. Which comments made our list? Read below to find out.
December 16, 2015
American Health Line rounds up analysis of some of the biggest health care issues the U.S. faced this year.
December 15, 2015
From Supreme Court cases challenging the Affordable Care Act to the ongoing saga of Medicare's two-midnight rule, American Health Line's coverage in 2015 focused on issues that would most affect U.S. residents and providers. What were the most popular stories among our readers? Look below for American Health Line's top 10 stories of 2015, based on clicks.
December 9, 2015
American Health Line outlines current proposals to address prescription drug access issues from presidential hopefuls and state and federal lawmakers
December 8, 2015
American Health Line takes a look at major federal efforts to target prescription drug accessibility.
November 13, 2015
November 12, 2015
November 5, 2015
Here's a short look at the long road to ICD-10, how the U.S. adapted the World Health Organization's standards, what we see on the horizon with ICD-11 -- and illustrations of some of the American Health Line team's favorite new codes.
November 3, 2015
During the third open enrollment period for the Affordable Care Act, HHS hopes to have 10 million people sign up for health insurance through the exchanges and Medicaid.
With substance use disorders becoming an increasingly pressing issue, potential presidential candidates have begun to weigh in on the matter. Where do the candidates stand?
August 13, 2015
Will the 21st Century Cures Act, which is intended to boost biomedical research and access to treatment, continue to receive widespread support from lawmakers, or could criticism of it result in its downfall?
July 26, 2015
Medicaid expansion continues to be one of the most contentious and followed issues surrounding the Affordable Care Act. While many states have chosen to expand their programs, a number of Republican-led states continue to oppose expansion for various reasons ranging from ideology to cost. Will those states come around?
June 24, 2015
June 4, 2015
Security and privacy experts seemed prescient in predicting that health care data breaches would significantly increase this year. So what are lawmakers doing about it?
May 27, 2015
The replacement for Medicare's sustainable growth rate formula affects not just physicians, but also nurse practitioners, physician assistants, psychologists and other types of providers.
May 5, 2015
March 19, 2015
The Obama administration has stated that the Ebola outbreak is starting to wind down, although much work remains. In this edition of Expert Explanations, American Health Line sits down with Johns Hopkins University's William John Moss to assess the U.S.' initial response to the outbreak and what we can learn going forward.
March 4, 2015
Whether more than eight million individuals in the 34 states that use the federal exchange have insurance in 2016 could hinge on the justices' final ruling, which will come by the end of June.
March 2, 2015
Experts agree that while King v. Burwell is an extremely important case -- the fate of subsidies millions of U.S. residents have used to purchase coverage through the federal exchange hinges on the outcome -- it isn't a particularly novel legal matter. Where they disagree is on the strength of the parties' arguments.
February 25, 2015
February 9, 2015
Funding for CHIP, the Children's Health Insurance Program, expires Sept. 30, 2015. With new coverage options available via the Affordable Care Act, and the typically contentious politics of today, some stakeholders are wondering whether CHIP funding will be reauthorized.
December 16, 2014
The U.S. spends about $2.8 trillion annually on health care, but as a country we aren't particularly sure how well that money is being spent. What we do know is that the U.S. spends far more than any other country but generally does not have better outcomes. So how do we measure quality? And how can we do it better?
December 9, 2014
October 29, 2014
Political races in several states could determine whether those states end up expanding Medicaid. Here's a look at those races and what's at stake.
October 13, 2014
September 30, 2014
Twenty years ago this month, HillaryCare -- the health reform proposal led by then first lady Hillary Rodham Clinton -- was declared dead. Here's a look back at Clinton's attempts to pass reform and the plan's ultimate demise.
August 26, 2014
August 14, 2014
Premiums for health plans sold through the health insurance exchanges are set to increase by 7.5% on average next year across the 27 states -- plus Washington, D.C. -- that have publicly released proposed rates, according to a report by PricewaterhouseCoopers' Health Research Institute.
May 9, 2014
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March 30, 2012
June 19, 2013
American Health Line's last day of publication was December 20, 2019. If you have any questions about your subscription or account, please contact us.
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Jindal did his best Sunday sidestep on Meet the Press when he told host David Gregory that each state should address the health care issue. Then he used a puzzling example:
"I come from one of the most culturally distinct states in the entire country. Mardi Gras is right for Louisiana. It may not work as well in Vermont or other states. The reality is what works in Massachusetts may not be appropriate for another state."
Gregory came back with this observation. "Wait, you're really comparing Mardi Gras to universal health insurance?" Gregory said. And that's Romney's problem with the dodge by his surrogates and himself. What's good for the goose is good for the gander. If something as important as healthcare is proposed as a save all by the Massachusetts Governor, the average citizen has a hard time distinguishing as to why the same plan is, in Romney's opinion, not good for the entire country.
Romney's healthcare quandary increased the following day when the Republican nominee's senior healthcare adviser, Eric Fehrnstrom, stated that Obamacare's individual mandate is definitely a penalty and not a tax. Since the Supreme Court ruling, Republicans have been ballyhooing that the President is raising taxes as part of his healthcare plan.
MSNBC's Chuck Todd, host of The Daily Rundown, put the question directly to Fehrnstrom so there would be no misunderstanding. "So [Romney] agrees with the president... he believes that you shouldn't call the tax penalty a tax, you should call it a penalty or a fee or a fine?" Todd asked.
"That's correct," Fehrnstrom replied.
As the National Journal, a Republican mouthpiece, pointed out: "Fehrnstrom's comments seem to contradict the GOP's strategy since the Supreme Court ruling on Thursday, which is to brand Obama a tax raiser because the law was ruled constitutional as a tax. They also illustrate Romney's dilemma: he cannot brand Obama as a tax raiser without leaving himself vulnerable to similar charges surrounding his days as Governor in Massachusetts."
What the Obamacare plan does is four key things. It establishes exchanges to bring both individuals and small business together to pool their numbers for lower rates. It eliminates pre existing conditions, so that coverage is offered to all who apply. There is the individual mandate, an idea that initially came from a cross section of key Republicans from Newt Gingrich, Senator Bob Dole, and the conservative Heritage Foundation. And there are subsidies built in to cover low income families. Where can you find identical provisions? Why in the Romney-Massachusetts plan of course.
Romney's answer seems to be that you don't have to be a virgin to make the case against promiscuity. But so far, his effort to differentiate between a state approach vs. an encompassing federal plan has received mixed results. In a new CNN/ORC poll published in The Hill, Forty-three percent see the law favorably overall, with 42 percent holding an unfavorable view. Before the ruling, an ABC/Post poll taken last week showed a 36 percent positive view of the law, with a 52 percent negative rating. What these results show is that Obama supporters favor the law while Romney supporters oppose it. So there seems to be little gain for Romney.
Compounding Romney's problem is that, according to a recent Kaiser Foundation poll, 41% of Americans aren't even aware of the Supreme Court ruling upholding Obamacare. So it just could be that Romney is beating a dead horse, and he needs to face up to the fact that he is not going to win the presidency on his healthcare alternatives.
Romney's surrogate, Bobby Jindal, who has made it his mantra in recent months to crisscross the country touting his objections to Obamacare in an all out effort to be picked as the vice presidential nominee, has his own problems back in Louisiana. The New York Times reported that Louisiana has the fastest growing Medicaid population in the nation where some 37% of the state will be on Medicaid by 2019. Just this week, congress cut $650 million from the existing Louisiana Medicaid program. And Jindal has announced he will not participate in the Obamacare Medicaid extension that would have covered 340,000 additional Louisianans, with the state not having to put up one penny for the first three years. He will have his hands full explaining his reasoning to hospitals, the medical community, and to those who will have no choice but to go to a hospital emergency room where the cost is passed on to all Louisiana taxpayers.
The bottom line for Republicans is that healthcare reform is a muddled, confusing and polarizing issue. Those for, and those against, cancel each other out on the campaign trail. Romney's focus, as well as his surrogates' like Jindal, should be directed at one issue, and one issue alone. And it's nothing new. It's an issue that resonates to millions of Americans from all political persuasions. Another Louisianan set out the agenda for victory back in 1992. It applies more so today. The Ragin' Cajun, James Carville said it best. "It's the economy, Stupid!"
"I might be in favor of national healthcare if it required all members of congress to get their heads examined."
Ann Coulter
Peace and Justice.
Jim Brown
Jim Brown's syndicated column appears each week in numerous newspapers and websites throughout the country. You can read all his past columns and see continuing updates at www.jimbrownusa.com. You can also hear Jim's nationally syndicated radio show each Sunday morning from 9 am till 11:00 am, central time, on the Genesis Radio Network, with a live stream at http://www.jimbrownusa.com.
How is Gov. Jindal doing as governor? Share your thoughts
{jvotesystem poll=|7|}

subset: commoncrawl


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Watch on Netflix
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On the streets of San Francisco a team of the Federal Bureau of Investigation's Behavioral Analysis Unit use profiling to catch some of the most horrific serial killers and unidentifiable subjects.
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text:
By Ken Shepherd | April 2, 2010 11:03 AM EDT
Vituperative left-wing radio host Ed Schultz took to the air on Monday and insisted that he hasn't said anything hateful on his MSNBC program in the last year:
Look, we all get carried away in talk radio but I do not think that on 'The Ed Show' on MSNBC in the last year I've said anything *hateful.* Hateful?! ... Hateful stuff? No, no, no, we point out the hateful stuff and sometimes it lands in Psycho Talk.
Oh really, Ed? Yours truly went through our Schultz archive and passed on Ed's greatest hits to EyeBlast.tv video producer Bob Parks, who put together an excellent montage illustrating Schultz's rage against the Right.
You can watch Bob's montage by clicking the play button on the embedded video above at right.


text:
Hairstyles for Women Over 60:
You always need to take your age into consideration when picking out a hairstyle to wear. Find out about hairstyles for women over 60 with help from a distinguished hair care professional in this free video clip.
Expert: Robby LaRiviere
Bio: A beautician extraordinaire, Robby LaRiviere splits his time between Provincetown's Town's West End and the celebrity-filled boulevards of Beverly Hills and Southern California.
Filmmaker: John Wilbers
Series Description: You always need to take the type of hair you have into consideration when both caring for your hair and choosing how to style it. Get hair care advice that you can start using today with help from a distinguished hair care professional in this free video series.


text:
Baba's Gems - E-Book
"Durga Saptashati is not an event which took place. It continuously unfolds in every human being at all times. Different chapters denote different phases of the individual.
All characters in Durga Saptashati are actually traits and qualities within us"
Download 'Durga Saptashati' (PDF)
One of the sadhak from Goa, has beautifully compiled few e-books. Special thanks to him.
These E-books can be viewed on most of the electronic device like iPad. The size is also very small and even if one prints it the output will be crisp and clear now then before.
Bhav Re - contains precious teachings of Babaji
Download 'Bhav Re' (PDF)
Updated January 2012
~ Gratitude to Baba ~


text:
Mitchell Saab's Home Roofing & Siding offers you a wide range of siding installations and other services for your home, apartment, or town house. Call us today to receive a FREE estimate.
As a local, family owned and operated business, we will assist you in any way we can. If your siding has been damaged by a recent storm, our team can provide you with insurance estimates.
Removal and disposal of old siding
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Table of Contents
Chessmasters are a breed of strategists who see life as a game to be won. They are not the armored general leading from the front for the sake of great nations but egotistic tricksters whose greatest glory is a fierce personal victory over another mind as keen as theirs. They always abide by the rules of whatever game they are playing but often exploit loopholes and poor wording to find new avenues that allow them to win whatever the game is. Chessmasters are most often employed in adventuring parties as the brains of the group - coordinating their allies in battle and overcoming whatever non-combat challenges they may face.
A chessmaster is not a strictly mundane character however. There is some impetus behind their supernatural level of perception and coordination that sets them apart from their more mundane peers. This might be a touch of devil's blood in their lineage, a freak genetic mutation that pushes them to the next level of evolution, a born genius that outclasses all his peers by decades, a fateful pact with an outsider for the skill to win their games, a powerful psychic potential, or something else equally as powerful. Whatever the reason it allows them to see myriad possibilities unfold in real time in front of them- a thousand divergent paths containing infinite possibilities that they can use to aid their allies and wreck their opponents. Life's a game right? Play to win.
Hit Dice: d8.
Role: Chessmasters are support characters with a secondary focus on overcoming skill challenges. They are designed to be run by veteran players who understand the rules of Pathfinder on a higher level so they can expertly advise their allies in combat as this plays into their main mechanic. Their primary offensive abilities, known as gambits, expend attacks of opportunity and hamper the enemy. Their primary attribute is Intelligence as this is what the majority of their class features rely on. It may behoove a chessmaster to put points into their Dexterity for the additional attacks of opportunity they provide as well as the boost to their AC given their general lack of armor.
Alignment: Any
For a chessmaster the good/evil axis has little to do with their day to day life and most are of neutral alignment on that axis anyway. Chessmasters are more often judged on the lawful or chaotic aspect of their personality. Chaotic chessmasters will strike to bend and break rules as often as they can and will sometimes straight out cheat to win. Lawful chessmasters tend to try to adhere more strictly to the rules of a challenge and often prefer to outthink their opponents.
Starting Wealth: 5d6 × 10 gp (average 175 gp.). In addition, each character begins play with an outfit worth 10 gp or less.
Class Skills: The chessmaster's class skills are Appraise (Int), Bluff (Cha), Diplomacy (Cha), Disguise (Cha), Escape Artist (Dex), Intimidate (Cha), Knowledge (all), Linguistics (Int), Perception (Wis), Sense Motive (Wis), Sleight of Hand (Dex), Use Magic Device (Cha).
Skill Ranks per Level: 8 + Int Modifier
Class FeaturesTable: The Chessmaster
|Base Attack Bonus
|Fort Save
|Reflex Save
|Will Save
|Chess master, edge, gambits
|Gambit, plot, pragmatic strategist
|Coordination (+1), plot
|Plans within plans
|Gambit, mind games
|Contingency (1/day)
|Coordination (+2)
|Contingency (2/day)
|Coordination (+3), gambit
|Contingency (3/day)
|Coordination (+4), talent
|Checkmate, Contingency (4/day)
Weapon and Armor Proficiency
The chessmaster is proficient with all simple weapons and with light armor. He is not proficient with any other weapons, armor, or any shields.
Edge (Ex)
At 1st level, a chessmaster gains a pool of edge points. Edge points represent the control over a situation he has. At the beginning of each battle he begins with 0 and can hold up to a maximum of 4 + his chessmaster level at any one point. Any points he gains over this maximum are wasted. Edge points can be expended to perform gambits or give his allies benefits for following his orders during their turn. Edge points vanish at the end of combat and can only be gained in tense situations like combat or during particularly intense skill checks.
Chess Master (Ex)
At 1st level, the chessmaster can offer keen and perceptive advice to an ally on what action they should take on their turn. At the start of an ally's (excluding the chessmaster's) turn, the chessmaster suggests a course of action to his ally.
- "Move there so you can flank with Bill the Barbarian" (Move action)
- "Don't you have that potion of cure light wounds?" (Standard action)
- "I'd advise attacking that snake. It only has a few HP left and if you kill that- we won't have to worry about Bill the Barbarian taking damage from it next turn." (Standard)
- "A single attack? No, you are a two-weapon fighter- it'd be best if you just full-round attacked that thing." (Full round)
If his ally follows this suggestion the chessmaster gains 2 edge points. As a free action that can only be made after an ally accepts their advice, they can spend 1 edge point to assign that ally a bonus that lasts until the end of that ally's turn (this edge point may be one he just received). The possible bonuses are:
- The ally gains a +4 insight bonus to their AC against attacks of opportunity. Creatures that make attacks of opportunity against this ally provoke attacks of opportunity for making such an action. These attacks of opportunity resolve after the initial attack of opportunity does. This attack of opportunity does not stack with other abilities that provoke attacks of opportunity such as the barbarian's come get me rage powerAPG.
- The ally gains an insight bonus on attack rolls equal to 1 + 1/4th the chessmaster's level against 1 creature of the chessmaster's choosing
- The ally bypasses 1/2 the chessmaster's level (minimum 1) in DR and twice the chessmaster's level of a single type of resistance (chosen each this this is used) against a single creature of the chessmaster's choosing.
- The ally gains a +10 foot bonus to their move speed if they make a charge, double move, or withdrawal action.
Gambits (Ex)
A chessmaster is a specialist in making genius tactical moves known as "gambits". Gambits represent their ability to set up and execute booby-trap and shepherd enemies into unfavorable situations. Each gambit has a trigger, a set condition in which the gambit may occur, this is described in each gambit's entry. A chessmaster may execute one gambit per round. At 4th level and every 4 levels thereafter they may execute one additional gambit per turn. Gambits are a free action that they may take even if it is not their turn and cost edge to execute, and consume even if they are unsuccessful.
When triggered, a chessmaster must make a gambit check to effect unwilling creatures, rolling 1d20 and adding his chessmaster level + his Intelligence modifier against a DC of 10 + the triggering creature's HD + the higher of creatures Wisdom or Intelligence modifier. Gambits always trigger after the action that triggered them has resolved (unless otherwise noted). Unless otherwise noted the same action cannot trigger multiple gambits, even from different chessmasters.
Gambits require roleplaying however and fail if not described to the GM's satisfaction. A chessmaster must adequately explain how the advice they gave their allies (or enemies) prior to using a gambit lead up to the gambit occurring. A chessmaster should strive to make a new explanation for each use of a gambit, though some repetition is allowed (after all, there are only so many ways to describe setting someone up).
- Set-Up: By moving Bill the Barbarian into flanking position, it distracted the wolf for just a second so I could score a telling blow."
- Hinder: "What Bill the Barbarian didn't know was that when I told him to run over there, I wasn't trying to get him into place. I wanted him to run across those nuts on the ground from the tree above. His feet turned them into sharp little caltrops and I led the wolf right over them!"
- Backfire: "I noticed that when the elf casts a spell she makes rather large gestures with her arms. I placed Bill the Barbarian in front of her not only to put the pressure on her- but to trap her in the corner where she couldn't make quite as large motions with her arms."
- Doom: "The minotaur winced at fire earlier in the fight. I had Bill brandish his flaming greataxe at him not only in hopes of hitting him, but hopefully to cause him to have a lapse of his senses at a critical juncture."
Some gambits have upgraded forms and have an expanded effect if the chessmaster pays more edge. This must be decided upon before making the gambit check. If a particular gambit has more than one upgrade available, multiple upgrades may be applied to it (unless specifically noted in its entry) so long as the chessmaster meets the listed prerequisites.
At 1st level the chessmaster gains the set-up gambit and 2 other gambits that he meets the prerequisites for. At 2nd level and every even level thereafter, a chessmaster gains one additional gambit.
1st Level Gambits
Bait and Switch
- Prerequisite: Chessmaster 1 Cost: 2 edge
- Trigger: An ally or the chessmaster himself is successfully hit by an adjacent enemy. The ally (or chessmaster) and the enemy creature must be of the same size.
- Effect: At the end of the enemy's attack action, it is forced to switch places with the creature it struck. If it struck multiple creatures allied with the chessmaster (including the chessmaster himself) the chessmaster may select which ally it swaps places with. A creature who moves as part of their attack action (such as with Spring Attack or Flyby attack) and does not end their turn adjacent to an enemy they hit cannot be targeted with this gambit.
- Ambush (Chessmaster 8, +4 edge): When the enemy creature swaps places with the ally (or chessmaster) it provokes an attack of opportunity from all allies of the chessmaster who threaten the enemy creature's new square.
- Prerequisite: Chessmaster 1 COST: 3 edge
- Trigger: When an enemy successfully makes a save.
- Effect: The creature must re-roll the save and take the new result. This may only be done to a given creature once per turn.
- Agony (+2 edge): The save is made at a -2 penalty.
- Spirit Shake (Chessmaster 8 +1 edge): If the creature fails, they are shaken for 1d4 rounds. This is a mind affecting fear effect.
- Prerequisite: Chessmaster 1 COST: 2 edge
- Trigger: When an ally successfully hits an opponent with a melee or ranged attack.
- Effect: The creature has its AC reduced by 2 until the end of it's next turn.
- Game Breaker (+2 edge): The creature has its AC reduced by 4, rather than by 2, until the end of its next turn.
- Prerequisite: Chessmaster 1 Cost: 2 edge
- Trigger: When an enemy provokes an attack of opportunity from the chessmaster by moving.
- Effect: If this gambit hits, the creature is forced to end its movement.
- Caltrop (+3 edge): The creature takes 1d4 points of piercing damage and its speed is cut in half for 24 hours (as if they had stepped on a caltrop).
- Prerequisite: Chessmaster 1 Cost: see text
- Trigger: An enemy within 60 feet misses an attack against an ally with a firearm.
- Effect: If this gambit is successful the creature's firearm has its misfire range increased by the amount of edge spent until the weapon misfires or 24 hours pass. (Example: If the chessmaster spends 4 edge, it increases the misfiring on a natural 1 to misfiring on a 1-5). This expanded misfire applies on the attack roll that triggered this gambit.
- Prerequisite: Chessmaster 1 Cost: 4 edge
- Trigger: An enemy within 30 feet misses an attack against an ally other than the chessmaster.
- Effect: If this gambit is successful the creature's weapon takes 3 points of damage per chessmaster level as if the weapon had been sundered. This damage does not bypass hardness.
- Critical Sabotage (see text): This damage bypasses 5 hardness per extra edge point spent on this gambit.
- Prerequisite: Chessmaster 1 Cost: 2 edge
- Trigger: An enemy makes a melee attack against the chessmaster.
- Effect: The chessmaster can make an attack of opportunity against the creature who attacked him. This attack has an insight bonus to attack and damage rolls equal to the chessmaster's Intelligence modifier. This may only be done once per round against a given creature.
- Intimidating Set-Up (Chessmaster 4, +1 edge): If the attack hits the chessmaster may make an Intimidate check as part of the attack, using his Intelligence bonus in place of his Charisma modifier.
- Unexpected Set-Up (Chessmaster 8, +4 edge): If the attack hits the chessmaster may make a Bluff check to feint as part of the attack, using his Intelligence bonus in place of his Charisma modifier.
Trojan Horse
- Prerequisite: Chessmaster 1 Cost: 1 edge
- Trigger: An enemy moves adjacent to the chessmaster or through square threatened by him.
- Effect: The chessmaster may make a Sleight of Hand check, opposed by the creature's Perception, as a free action to place a single palm-sized item from the chessmaster's inventory into their target's as their tage passes. If unsuccessful the item is not placed on the enemy but remains in the hand of the chessmaster. If caught the item is not placed on the enemy but remains in the hand of the chessmaster. The chessmaster must have at least 1 hand free to use this gambit.
- Retrospective Purchase (+2 edge): The item does not have to be from the chessmaster's inventory. It can be any item (or items) whose (collective) value does not exceed 20 gp per chessmaster level. This item may be magical or mundane. The price of the item is deducted from the chessmaster's own stores if he wishes to do this as it represents him retrospectively purchasing an item for just this purpose.
- Riches (+2 edge): The max gold value for the retrospective purchase upgrade is increased to 100 gp per chessmasters level.
- Trigger (+1 edge): The chessmaster may spend 1 edge point as an immediate action to cause an item to trigger as intended (grenades and alchemist fires explode, wands trigger, etc). The chessmaster must be within 30 feet of the target of this gambit to do so.
Weak Point Strike
- Prerequisite: Chessmaster 1 Cost: 1 edge
- Trigger: A creature makes an attack.
- Effect: The creature that hits with the attack that triggered this gambit gains a +2 bonus on that damage roll, this damage is precision damage and isn't multiplied on a critical hit.
- Chessmaster's Pawn (+1 edge): The damage dealt is instead equal to the chessmaster's Intelligence modifier.
- Retroactive Genius (Chessmaster 12, +0 edge): The chessmaster may now apply this gambit after the attack roll is made.
- Critical Blow (Chessmaster 12, +2 edge): The attack gains the benefit of the Improved Critical Feat.
- Felling Blow (Chessmaster 12, +2 edge): The attack increases the critical multiplier of the attack by 1.
- Assured Critical (Chessmaster 16, +2 edge): If the attack threatens a critical hit then it automatically confirms.
4th Level Gambits
- Prerequisite: Chessmaster 4 Cost: 3 edge
- Trigger: When an enemy tries to use a spell or spell-like ability within 60 feet of the chessmaster.
- Effect: The creature must make a Concentration check as if they had just taken the chessmaster's level in damage (this doesn't deal any actual damage). Unlike other gambits, this gambit interrupts an action. Once the casting of the spell has been declared, the chessmaster should roll to see if his gambit affects the enemy.
- Spellforce (+2 edge): Add the chessmaster's Intelligence modifier to the DC of the concentration check.
- Critical Backfire (Chessmaster 16, +5 edge): If the spellcaster fails their concentration check, the spell still goes off but the chessmaster designates the targets of the spell.
Critical Break
- Prerequisite: Chessmaster 4 Cost: 2 edge
- Trigger: An enemy confirms a critical hit against an ally within 30 feet of the chessmaster.
- Effect: The attack is still a critical hit but the multiplier on the damage is reduced to x2 if it is higher. If it is x2 it is reduced to x1 (though is still a critical hit). Unlike other gambits, this ggambit affects the attack while in action. Once the critical hit has been confirmed, but before damage is rolled, the chessmaster should roll to see if his gambit affects the enemy. If so, it affects the damage of the critical hit.
- Critical Negation (+2 edge): The attack is not a critical hit.
- Critical Reversal (Chessmaster 8 ,+4 edge): All allies within 30 feet of the chessmaster gain a +4 bonus to confirm critical hits against this enemy until the end of this next turn.
Evasive Tactic
- Prerequisite: Chessmaster 4 Cost: 2 edge
- Trigger: An attack is made against a creature or the creature must make a Reflex save.
- Effect: The creature being attacked gains a +2 dodge bonus to AC and Reflex saves against that effect, this bonus is increased by 1 per 4 levels the chessmaster possesses. This gambit is resolved before the attack is made.
- Emergency Evasion (+1 edge): The target creature gains the evasion ability (as per the rogue's entry in Chapter 3 of the Pathfinder Core Rulebook) against the effect that triggered this ability.
- Uncanny Advice (+2 edge): If the defender would be denied his Dexterity bonus to AC against that attack, he isn't.
- Opportune Strike (+4 edge): If the attack misses then the attacker provokes an attack of opportunity from one creature who threatens that creature other than the defender.
- Prerequisite: Chessmaster 4 Cost: 1 edge
- Trigger: When an enemy is reduced to its Hit Dice's value or less in HP due to an ally's attack. (A GM should let the chessmaster know when this is the case).
- Effect: The creature is reduced to zero HP. This is death effect.
- Prerequisite: Chessmaster 4 Cost: 2 edge
- Trigger: The chessmaster successfully makes a Bluff check to feint a creature.
- Effect: The chessmaster may forgo the benefits of feinting his opponent to select one creature and render the target of his feint check flat footed against that creature's next attack, so long as it is made within one round.
- And Eat It Too (Chessmaster 8, +2 Edge): The chessmaster retains all the benefits of feinting a creature.
Seeing Eye Strategist
- Prerequisite: Chessmaster 4 Cost: 1 edge
- Trigger: An allied creature makes an attack.
- Effect: The creature uses the chessmasters line of sight for determining concealment, rather than his own.
8th Level Gambits
- Prerequisite: Chessmaster 8 Cost: 4 edge
- Trigger: An enemy attacks an ally of the chessmaster (henceforth referred to as the "primary target") who is adjacent to another ally (henceforth referred to as the "decoy"). The decoy ally must be a valid target for the enemy's attack. The chessmaster himself may be a decoy or primary target but is not required to be either of them. Neither the primary target or the decoy need to be willing creatures.
- Effect: The enemy is forced to retarget his attack action to the decoy if this gambit succeeds. This gambit may only be used on a given enemy creature once per combat.
- Vicious Decoy (Chessmaster 12, +5 edge): The decoy may be an enemy creature rather than an ally of the primary target. This gambit affects the attack while in action. Once the enemy designates the target of his attack action (and in what way he intends to attack, such as if he is employing Power Attack), the chessmaster should roll to see if his gambit affects the enemy. If so, it attack is retargeted to the decoy.
- Prerequisite: Chessmaster 8 Cost: 4 edge
- Trigger: An enemy within 30 feet of the chessmaster readies an action, takes the delay action, or is knocked prone.
- Effect: The creature is staggered for 3 rounds.
- Upgrade (Chessmaster 12, see text): The duration of the effect increases by 2 per additional point of edge spent as part of activating this gambit.
12th Level Gambits
Double Agent
- Prerequisite: Chessmaster 12 Cost: 4 edge
- Trigger: A creature is under the effect of a mind controlling ability
- Effect: The creature immediately makes a new Will save against the ability. If successful the ability immediately ends with no lingering effects. If the ability never allowed for a save then the creature may make a Will save (DC 10+½ the creature's HD + the creature's Charisma modifier) to negate the effect.
- Personal Touch (+0 edge): If the chessmaster was the target of the mind-affecting effect he may activate this gambit, even if the mind controlling effect would otherwise prevent it.
- Sanctity of Mind (+2 edge): This ability allows the target to rid themselves of any mind affecting effect.
- Strength of Mind (+2 edge): The target receives a competence bonus on their Will save equal to the chessmaster's Intelligence modifier.
False Opportunity
- Prerequisite: Chessmaster 12 Cost: 4 edge
- Trigger: A creature makes a melee attack against an ally
- Effect: The creature provokes an attack of opportunity from the target of its attack, this attack of opportunity resolves before the creature's attack does.
Leading Blow
- Prerequisite: Chessmaster 12 Cost: 4 edge
- Trigger: The chessmaster misses with an attack.
- Effect: One creature threatening the creature that the chessmaster missed, other than the chessmaster, may make an attack of opportunity against that creature.
- Blindspot (+2 edge): The target creature is flat footed against this attack of opportunity.
16th Level Gambits
- Prerequisite: Chessmaster 16 Cost: see text
- Trigger: A creature's turn starts.
- Effect: This ability allows the chessmaster to increase or decrease the creature's initiative score by an amount up to his Intelligence bonus for every 2 points of edge he spends on this gambit. Increases to a creature's initiative score take effect on the start of the next round, decreases can put other creatures ahead of him in the initiative order, delaying his turn until those creatures have acted.
- Saw It Coming (+4 edge): If the chessmaster increases the target's initiative then it gains an insight bonus to AC equal to ¼ his level against creatures that act after it in the initiative order.
- Too Slow (+4 edge): If you decrease the target's initiative then it takes a penalty to AC equal to ¼ your level against creatures that act before it in the initiative order.
Plot (Ex)
At 2nd level, a chessmaster can take a moment to plot and plan - granting him 2 + 1 per 4 levels edge points as a standard action. As part of this same standard action he may make a Knowledge check to attempt to identify one creature that he can see. If he succeeds, he gains 2 extra edge points. He may not identify a creature more than once in the same 24 hour period.
If he is at least 4th level, he may attempt to identify all creatures within his field of vision as part of this standard action- making independent Knowledge check for each. For every creature he successfully identifies, he gains 2 edge points.
Pragmatic Strategist (Ex)
At 2nd level, the chessmaster gains a number of extra attacks of opportunity per round equal to his Intelligence modifier.
At 3rd level and every 4 levels thereafter a chessmaster gains a talent from the list below.
Black King/Queen (Ex)
The chessmaster can chose to automatically go second in the initiative order if one of his allies is the first. This can only be done once initiative has been rolled.
Canny Defender (Ex)
While the chessmaster has at least one point of edge, is wearing light or no armor, and is not using a shield, he adds 1 point of Intelligence bonus per chessmaster level as a dodge bonus to his Armor Class. If he is caught fat-footed or otherwise denied his Dexterity bonus, he also loses this bonus.
Epic Mind Games (Ex)
The chessmaster may, when using his mind games ability, force the opponent to make a Will save (DC 10+1⁄2 chessmaster level + his Intelligence modifier) - if the target fails then the chessmaster dictates whether or not the target takes the suggested action. This is a mind affecting-effect. The chessmaster must have the mind games ability to select this talent.
Extra Gambits
The chessmaster gains 2 additional gambits.
Favorite Gambit
Select a gambit with an edge cost greater than 1 and reduce it by 1. This does not impact the edge cost for upgrades on that gambit. This talent may be taken multiple times, each time it applies to a different gambit. This cannot be used on gambits with a base cost of "see text".
Favorite Upgrade
Select an upgrade on a gambit that you have taken the favorite gambit talent for with an edge cost greater than 1 and reduce it by 1. If the cost of the upgrade is 4 or greater- reduce it by 2 instead. This talent may be taken multiple times, each time it applies to a different upgrade. This cannot be used on upgrades with a base cost of "see text".
Foresight (Sp)
A number of times per day equal to his Intelligence modifier, the chessmaster can use augury as a spell-like ability using his chessmaster level as his effective caster level.
Instant Assessment (Ex)
The chessmaster may use his plot class feature as part of an initiative check.
Keep the Momentum (Ex)
When an ally within 30 feet of the chessmaster confirms a critical hit all allies within 30 feet of that ally gain a +4 morale bonus on critical confirmation rolls until an ally with that bonus confirms a critical or the battle ends.
Sicilian Defense (Ex)
When rolling initiative, the chessmaster may select one ally. That ally gains a +2 bonus to the initiative check after all creatures have rolled. Once this has been done, the GM should reevaluate the initiative order. A chessmaster may not use it on himself. This stacks with other sources that boost a character's initiative (such as Improved Initiative).
Tactical Versatility (Ex)
The chessmaster may use gambits that he does not know, so long as he meets the prerequisites for them. Each time he does so he must lower the maximum amount of edge he can hold for the day by half that gambit's cost.
Trickster (Ex)
The chessmaster gains the Improved Dirty Trick feat as a bonus feat. However, rather than the +2 the feat normally gives, the chessmaster gains a +1/3rd level (minimum +2) bonus on dirty trick rolls and as a bonus against dirty tricks. Finally, a chessmaster may expend 1 edge point to extend the duration of his dirty trick by one round. This must be declared before making the combat maneuver roll.
Two Moves Ahead (Ex)
By spending 4 edge at the start of the round as a free action the chessmaster may act in any position in the initiative order he'd like and return to his previous spot in the initiative order on the following round. He may spend an additional 2 edge to gain the effects of a haste spell for the duration of the round.
Coordination (Ex)
At 4th level, all allies that can see and hear the chessmaster gain 1 bonus attack of opportunity per round. This stacks with other sources that give additional attacks of opportunity (such as Combat Reflexes or a high Dexterity modifier). The number of bonus attacks of opportunity this grants improves by 1 at 9th level and every 5 levels thereafter, to a maximum of +4 attacks of opportunity per round at 19th level. These extra attacks of opportunity are not granted to the chessmaster himself, only his allies.
Plans within Plans (Ex)
At 5th level, the chessmaster can grant his allies a small pool of edge points to use gambits. He grants these points by involving his allies in a planning session once per day that takes at least 10 minutes. His allies gain a pool with a maximum of 2 edge points + 2 per 5 levels of the chessmaster (4 at 5th, 6 at 10th, 8 at 15th, and 10 at 20th) and they can only be used when they are within 30 feet of the chessmaster. These points cannot be refreshed in any way other than another planning meeting 24 hours after the previous one. An ally may use any gambit known by the chessmaster using their own full character level as their effective chessmaster level. This has no effect on creatures with an edge pool.
Mind Games (Ex)
At 6th level the chessmaster can give advice to his enemy in the same fashion as he gives advice to his allies. Though this is good advice, it does tend to set the enemy up. At the start of an enemy's turn, the chessmaster can spend 1 edge point to suggest a course of action to an enemy who can comprehend him. This typically is either a swift action, a standard action, a move action, or even a full round action.
If his enemy follows this suggestion, he is playing into the chessmaster's hand and the chessmaster gains 3 edge points. If the enemy refuses his advice, this represents the creature having to change their plans last second or feeling manipulated, never sure if what they are doing is really a trap. This allows the chessmaster to expend 1 edge point as a free action, upon the enemy refusing, to impose a -1 penalty for every 5 levels of chessmaster on all d20 rolls until the end of that creature's next turn.
Contingency (Sp)
At 8th level, once per day a chessmaster can prepare one spell from the wizard/sorcerer list with a spell level equal to 1/4th their chessmaster level (minimum 1st level spell) as if it had been prepared via a contingency spell. This spell uses his chessmaster level as his caster level and remains in effect for their 24 hours or until he regains use of this class feature. While he does not need the reagents for this spell, he does need to take the casting time to prepare it. Preparing a spell in this fashion lowers the chessmaster's maximum edge pool by the level of the spell. Once the spell is expended, or he elects to dismiss the effect as a swift action, his maximum returns to normal. At 12th level and every 4 levels thereafter a chessmaster may prepare 1 additional spell per day in this fashion. He need not prepare all of his contingency spells at the same time and may elect to do so throughout the day. A chessmaster needs at least 6 hours of rest to be able to prepare his contingency spells.
Checkmate (Ex)
At 20th level, the chessmaster gains the following gambit:
Like an Open Book
- Prerequisite: Chessmaster 20 COST: 6 edge
- Trigger: A creature's turn ends.
- Effect: The chessmaster immediately learns the next course of action the creature will take on its next turn. The designated creature must describe their entire next turn to the chessmaster if this gambit is successful. The creature takes these actions unless the conditions on the battlefield change in such a way that would make the actions immediately and obviously harmful, or if an effect dictates that creature's next action for it (such as a dominate monster spell or the chessmaster's epic mind games talent).
- The World's a Stage (+4 edge): The chessmaster may allow a creature to immediately ready an action when he activates this gambit, even if that creature has already taken all of its actions for the round.
A Player's Guide to the Chessmaster
A chessmaster needs edge to make use of his gambits and while giving your allies advice is a great source of edge that doesn't take any actions on your part don't underestimate the usefulness of your plot class feature. The massive amounts of edge you gain from it are well worth the standard action. When selecting gambits be sure to consider your other party members capabilities - make an effort to try to figure out how you would use a gambit with a party member.
Gambits that are useful for most chessmasters include: Doom, Exploit, Weak Point Strike, Evasive Tactic, False Opportunity and Leading Blow. Likewise useful talents include: Canny Defender, Extra Gambits, Favorite Gambit, Favorite Upgrade, Instant Assessment, Tactical Versatility and Two Moves Ahead.
As the avatars of trickster deities, tricksters gain spellcasting abilities that they can use to confound their foes.
|Gonzo 1 and 2 by Little Red Goblin Games
|Gonzo 1 Classes
|The Craven
|The Mime
|The Punk
|The Rockstar
|The Toon
|Gonzo 2 Classes
|Atomic Adept
|Battle Butler
|Chimney Sweep
|Dynamic Warrior
|Henshin Hero
|Magical Girl
|Monster Cowboy
|Multiple Master
|Phantom Thief
|Sparkle Princess
|Thread Maiden
|Prestige Classes
|The Living Bomb
|Other Rules
|Gonzo Feats
|Gonzo Adventuring Gear
|Gonzo Drugs
|Gonzo Magical Weapons and Armor
|Gonzo Wondrous Items
|Giant Robot Rules
|Get Gonzo 1
|Get Gonzo 2


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Experiencing life to the fullest was the adventure worth living and Christopher McCandless set out to live his life with that thought foremost in his mind. He chose to take the road less traveled, altering the lives of those who he came into contact with, and those who have read or seen his story through Into the Wild. Back to the Wild takes us once again on this journey through Chris' original photographs and writings until his tragic death in Alaska.
Chris was a true documentarian, and this book will chronicle that journey with photographs and writings. These writings include correspondence between Chris and Wayne Westerberg, Jan Burres, Russell Fritz and other friends whose lives he touched deeply, even for a short time. The photographs of his odyssey are taken by Chris and are a powerful work of art. They are visual symbols of a life lived passionately and courageously. Chris's vision has at long last been brought to light for the world to see.
Chris' journey is divided into twelve treks, and a preview of each can be found below.
"Back To The Wild: The Photographs And Writings of Christopher McCandless" is also available in DVD format.
This DVD is special in that it brings Chris's experiences through his photographs and writings to the viewer in a different and unique way. Narration by Wayne Westerberg, Jan Burres and Chris's mother Billie will add poignancy to Chris's story through their words about their experiences and memories of this intensely driven and remarkable young man.
All of these elements will paint a portrait of Chris that, like his journey and memory, will never be forgotten.
Below are 2 trailers for the DVD. The first is narrated by Hal Holbrook (who played Russell Fritz known as Ron Franz in the movie "Into The Wild"). The second is narrated by Jan Burres (a friend of Chris aka Alexander Supertramp)


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BirdsEye Viewone solution to the cross-sell problem
Cross-sell has been many banks' mantra for years, along with building customer relationships and share-of-wallet. Dick Kovacevitch, Wells Fargo's previous CEO, led the cross-sell charge with clear goals for relationships per household and share of wallet, stating that he wanted 100% of every customer's business. Countless others have followed in his footsteps, yet the goal remains elusive for most.
In past articles we talked about the sales culture and daily execution as one path to the cross-sell goal. Another is breaking down the silos.
In our on-going quest for better numbers, finer customer profitability information and line-of-business profitability, we have inadvertently helped erect even more silos across our banks. As financial management and measurement sophistication improve, bottom-line focus by line-of-business, department and even branch becomes sharper. As units strive to optimize their performance, the whole becomes less than the sum of the parts, and silo walls grow even higher. Individual units end up doing well and maximizing their bonus, while others falter and the overall enterprise isn't optimized. Two possible losers in this scenario are the customer and the shareholder.
Our business is really about the customer, not about the product or the line of business. Those institutions that elect to be in the business of developing comprehensive solutions to customers' financial needs have a leg up in the marketplace and the Street because they are on the path to break down unnecessary separation. Defining success as 100% of the customer's business is a good point of departure. That, culturally, is the necessary first step (but not the entire solution) toward exceeding cross-sell goals.
An important second step is tying different business lines' success to making the whole greater than the sum of the parts. Specifically, changing incentives to include RECIPROCAL referral expectations. Many institutions currently expect referrals from the retail bank to other parts of their business, most notably commercial banking and wealth management. However, such expectations are often one-sided, and the ramifications for not meeting them are much more serious on the retail side. A good banker might not make their bonus if they missed their referral goals to other parts of the bank, but a star commercial banker is unlikely to be in that position even if they made no referrals to other bank businesses, particularly retail.
Reciprocity is important to send an organization-wide message across business lines that cross-selling and bringing the entire business to bear for every customer is non-negotiable. In addition, including corporate-level performance in bonus calculations helps. For example, tying everyone's bonus to a minimum ROE level helps focus everyone's attention on the same goal: taking care of customers and maximizing shareholder value. While outstanding performers can still make a major part of their bonus, senior management and others are tied at the hip to each other's success.
Cross-goals aren't typically common, but they should be. Reporting cross-referral results monthly by business and by geography, for everyone to see, is a huge motivator in and of itself. In addition, several strategic initiatives can be dedicated to build the cross-sell system-wide, starting by looking at each household (commercial, retail, whatever) as the premier bank asset. Leveraging that asset is the most important goal at all customer touch points. The result will inevitably involve growing relationship-per-household all across the network and improved earnings consistency typically follows.
In recent years, some banks have resorted to client service teams as the best way to break down the silos and fully serve their customers. This works particularly well with the commercial customer base, where teams comprised of commercial bankers, wealth management experts, Treasury Management officers and insurance executives visit customers to develop comprehensive solutions to their needs. Banks who have selected this path realize that the enemy is the internal competition we created, not the competition outside. They have built customer focus through cross-goaling and naming deepening share of wallet as the definition of success.
Banks are not organized well to fully meet customer needs; instead, they are often organized to make their own life more convenient, and they rarely take a look at themselves from the customer's perspective, asking the question: how easy is it to do business with us? Changing the underlying structure to make the bank more customer-centric is a major and costly undertaking. It is possible to make meaningful strides toward that end by instituting a culture change instead.
The balance between individual contribution and corporate success is not easy to strike, but those who do so effectively create win-win combinations for all: customer, shareholder and banker.


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MetroLink schedules and 16 MetroBus routes will be adjusted as part of the quarterly Metro Transit service change, effective Monday, June 25.
Plan Ahead: View MetroLink, MetroBus schedules before they go into effect on June 25.
MetroLink arrival times have not been changed for several years, so riders are encouraged to check the new schedules so they can plan their trips to ensure they are able to maintain timely connections with MetroBus routes.
Metro monitors and reviews feedback from riders and operators, and uses this information and other trip data to update MetroBus routes and transit schedules. The service updates improve on-time performance and MetroLink connections, and are a part of Metro's commitment toward building a better experience for transit riders throughout the region.
For questions or more information, please contact Metro Customer Service between 7 a.m. and 6 p.m., Monday through Friday at 314-982-1406 or 618-271-7879.


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Jennifer Ash and The East-Midlands of England
A warm welcome today to Jennifer Ash, aka Jenny Kane, who's here today to tell us about the settings of her book Edward's Outlaw, which as we see by the cover is historical fiction. It's set in the East Midlands, … Continue reading
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