The Health Care Blog

Healthcare coverage restored -- good for patients, maybe too late for plans

By Matthew Holt

Saint Lisa Girion (and I say that without a smirk on my face!) reports in the LA Times on the latest chapter in the story she started about the ongoing saga of the retroactive cancellations of health insurance by all the big players in the California individual market.

Now Kaiser Permanente (which really should have been above this type of a mess in the first place) has decided to reinstate over a 1,000 of its cancellations, and Health Net, which was fined $9m in arbitration for one cancellation alone, has added a few more. This will intensify the pressure on Wellpoint, United Healthcare, and Blue Shield (the only one still fighting for the right to rescind coverage retroactively) to similarly cave. Kaiser, by the way, is also paying a paltry $300,000 fine. Health Net must be envious.

However, even if the others cave in and reinstate coverage, and pay for claims they previously denied, there are three remaining issues dangling from the controversy.

First, the Department of Managed Healthcare, which brokered the Kaiser deal, only regulates HMOs. Some “insurance” companies, like the Wellpoint and Blue Shield subsidiaries which did some of the cancellations, are regulated by the elected State insurance Commissioner Steve Poizner, who despite the R after his name, has been very aggressive in going after them. Adnd the City Attorney of Los Angeles, Rocky Delgadillo, is suing Health Net and Wellpoint in related cases. So the insurers legal problems with the government certainly aren’t over.

Then there are the lawyers. William Shernoff, the attorney who’s been going after Wellpoint since the stories first came out, told the LA Times that ...

He would tell clients to "accept the reinstatements because that's wonderful to get the medical care -- that is important." But, he added, "as far as damages for past harm, there's no doubt in my mind that the best place for them to get their full damages will be in court rather than in an arbitration process."

In other words, the plans can’t get away with just paying back what they owe. Shernoff is still coming after them for more. And $9 million multiplied by lots of cases smells very tempting to a lawyer who knows he’s on the winning side.

Continue reading "Healthcare coverage restored -- good for patients, maybe too late for plans"

Bitter doc wants more respect for primary care

By Sarah Arnquist

A primary doctor ranted anonymously this weekend on Kevin MD's blog about the lack of appreciation for primary care in his small Midwestern town and predicted its future demise.

The doctor practices in a medical shortage area, where the hospital administration has failed to sufficiently recruit and retain hospitalists. Here's a portion of what he wrote:

"Not surprisingly, the recruitment and retention problem hit the hospitalist program simultaneously. Three hospitalists are now expected to manage 24-hour coverage with no relief in sight. And instead of offering the degree of compensation necessary to bring more physicians on board, the administration exploited the sense of crisis to convince the medical staff to consider opening the doors to Advanced Practice Nurses. This was the only solution, we were told, to the hospitalist shortage. The only way to stop taking extra call for free."

"At this meeting, 100% of the subspecialists voted for allowing APNs to practice in the hospital. 75% of the primary care physicians dissented. The vote was overwhelmingly in favor of the measure. This happened in a system where some primary care doctors are making less than they would if they took a new position in a major city, and more than a couple subspecialists make seven figures. The abandonment of the greater medical good by our specialist friends eager to expand their already-overflowing coffers has filled me with renewed vitriol."

His rant has struck a chord in the medical blogosphere.

Continue reading "Bitter doc wants more respect for primary care"

THCB welcomes our latest sponsor ...

More opportunity for online health management

By Jane Sarasohn-Kahn

Consumers, at least Californians, do a lot of looking for health information on the Internet -- but very little health management.

California HealthCare Foundation (CHCF) has taken a snapshot of Californians' use of the Internet in health care. The profile is presented in CHCF's report, Just Looking: Consumer Use of the Internet to Manage Care.

Topline: insured, more affluent, and younger people use the Internet in health searching.

As the chart at right details, the most popular care-related uses on the Internet include searching for information about conditions and drugs, finding a physician, checking ratings, and looking for claims and benefit information online.

Some 13 percent of Californians are lucky enough to be making appointments online, and 12 percent are filling Rx's online.

Continue reading "More opportunity for online health management"

Health wonk review

It's up at Jason Shafrin's Healthcare Economist.

New demands of 'Millennial patients'

By THCB Staff

"Millennial patients are the first generation of Americans to grow up with the Internet as a pervasive part of their lives. ... They are amazed, bewildered, and ultimately angry with the inability to access their health care services in this way. They cannot understand, and they will not tolerate, this disparity in the ability to manage health care transactions as simply as they manage their financial transactions."

Those are the words of regular THCB contributor Scott Shreeve in an article he wrote for the April issue of MDNG magazine. Shreeve adeptly describes the next generation of patients, whom he calls millennial patients. All at once, he says, they are consumers, providers and partners in managing their health.

Then, he talks about what it means to be a millennial provider in a new technology-dependent world. Shreeve says the health care industry's initial lag in adopting health IT can play out to its advantage -- so long as it hurries up.

"By observing the wider technology adoption patterns in fast-adopting industries like  financial services, we can reliably predict what trends will soon be impacting health care. We can also get a  sense of how consumers, traditionally called patients within health care, will respond as they adopt—and push their providers to adopt — the technologies that will simplify their health care interactions."

THCB is proudly sponsored by CDW Healthcare

 

Continue reading "THCB is proudly sponsored by CDW Healthcare "

Millenson on doc rating

By THCB Staff

And in our continuing efforts to send you everywhere else on the web but here (but still seeing the same authors), up at H&HN's Most Wired Magazine, Michael Millenson is writing about the still emerging and not-there-yet field of physician and hospital social rating sites.

The Innovation xChange

THCB is proud to welcome our latest sponsor: Humana and ChangeNow4Health.com. This site would not be possible without the generous backing of corporate sponsors like Humana. So we'd like to thank them - as well as all of our other wonderful sponsors - for their very kind support.

When you have a moment pop over to Change Now 4 Health and have a look at the very clever innovation contest they've organized. You can send in your brilliant ideas in one of the following four areas: (1). Helping Consumers Make Smarter Health Care Decisions, (2) Simplifying the Business of Health Care, (3.) Preventing Sickness and Maintaining Health, (4.) General Innovations in Health Care. 

You'll also be able to read other people's entries and comment on them. User-Generated Content at its finest! Top finalists will be eligible for three $10,000 prizes and possible additional support from the Humana Innovation Center. The official contest lingo:

Do you want to improve the U.S. health care system? Or at least be part of the much-needed dialogue? If you have ideas or solutions to improve the system, submit your ideas through ChangeNow4Health  Innovation xChange and you can win up to $10,000 or have your ideas published in the e-book, Tomorrow’s Health Care. 

The Innovation xChange is looking for practical ideas and suggestions for improving the health care system. All participants in the system, from providers and health plans to consumers and government, are encouraged to join in the discussion.

All entries submitted on ChangeNow4Health will be open to comments and voting by the coalition’s communities. The top 20 entries will be published in ChangeNow4Health’s e-book, Tomorrow’s Health Care, and up to three finalists will be awarded  $10,000 each.

In addition, Humana Inc., a founding member of the coalition, will consider the top         award-winners for a joint venture with the company’s Innovation Center, to incubate the winning idea and bring it to reality.  Winners will be announced by August 31, 2008.

For more info: ChangeNow4Health.com

Implications of McCain's plan analyzed at Spot-On

By THCB Staff

Over at Spot-On, Matthew predicts what would happen if Sen. John McCain were to win the presidential election this fall, and the Republicans took Congress, and they passed his health plan.

Matthew describes the basic tenets in McCain's plan and their implications in (nearly) jargon-free lingo, and then concludes, "His halfway solution is worse than no change."

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Health 2.0 Consciousness Dawns - Even In Jacksonville, FL!

by BRIAN KLEPPER

Today, Matthew, Michael Millenson and I are converging at a Robert Wood Johnson Foundation conference on public reporting of health care pricing/performance information in Amelia Island, FL, three short barrier islands north of my home in Atlantic Beach. (Always helpful, Michael suggested to the conference organizers that I should be required to walk or take public transportation, to compensate for the fact that everyone else has to come in by airplane.)

In any case, we decided that we might as well seize the opportunity and hold a short symposium on market-based transformation for the Northeast Florida health care and business communities. Dean Chally of the University of North Florida's College of Health graciously arranged the space on their beautiful campus, and so we're set for a 7:30AM, 2 hour conference on Friday May 16th--that's tomorrow.

Michael will talk about public reporting, Matthew will present on the consumer side of H20, and I'll hit H2O business-to-business analytics, the emerging medical home movement, and some wellness/prevention approaches that are gaining traction. Should be a fun morning. If you're in the neighborhood, be sure to drop by and join us.

POST-MORTEM: California health reform

By Sarah Arnquist

The debate over why health reform failed in California sparked up again following the release of a Field Poll in late April that found that nearly three-quarters of California respondents supported Gov. Arnold Schwarzenegger's plan.

Following the poll's release, Schwarzenegger told the Associated Press he's not giving up and will push his $14-billion plan forward. Despite his optimism, most wonks in Sacramento have called it dead at least though 2009.

In a recent column, Sen. Sheila Kuehl, D-Santa Monica, diverts any blame for the reform's failure from the vehemently opposed single-payer coalition, which she leads from her perch as chair of the all-powerful Senate Health Committee and author of the single-payer bill SB 840. Kuehl blames reform's failure the governor's unwillingness to challenge the insurance companies.

"In fact, the Governor's plan appropriately fell," Kuehl writes, "because of the Governor's own reluctance to make the difficult policy decisions necessary for the plan to be in any way affordable to the state as well as to businesses and individuals, but which would have stirred up strong opposition from insurance companies."

Well, not everyone agrees.

Continue reading "POST-MORTEM: California health reform"

A business plan to make pregnancy safer

By Sarah Arnquist

India successfully test launched a ballistic missile last week that could strike Beijing on a moment's notice. Yet, 120,000 women here die annually giving birth.

How does a country with the technology to produce nuclear weapons and launch ballistic missiles also have  the highest maternal mortality rate in the world? It's 10 times higher than China's.

LifeSpring Hospitals Ltd. aims to make a dent in India's abysmal maternal and infant mortality rates by providing high quality care at affordable rates to lower middle-class women. The chain of maternity and children's hospitals officially launched last year and has the ambitious goal of operating more than 30 hospitals in three years.

(I'm volunteering at LifeSpring's corporate office in Hyderabad for two months before heading to grad school.)

LifeSpring charges about $40 for a normal delivery and a two-night stay in its general ward. A private room costs $120. LifeSpring promises its families, who earn about $2 to $4 a day, they won't be inundated with unexpected costs. The prices are posted on the waiting room wall.

LifeSpring isn't a charity. This is a for-profit business that believes making money is the only way to guarantee a sustainable future.

Continue reading "A business plan to make pregnancy safer"

THCB UPDATE

If you haven't had a chance to sign up for THCB UPDATE yet, you really should. You'll get a helpful reminder email from us a few times a week when important posts go up on the site. In the two and a half six months since the service launched more than 700 1,000 1,200 1,300, 2,000  people have signed up, thoroughly surprising me. I've pledged not to divulge any details about the people who sign up, but I can tell you that list reads a bit like a health care who's who. Go on: It's free. It's useful. And people seem to like it. Go visit the sign up page.

Mind your manners

By Paul Levy

Dr. Michael Kahn, from Beth Israel Deaconess' Department of Pyschiatry, has published an article in the New England Journal of Medicine that suggests that doctors enhance their relationship with patients when they deal with patients in a polite manner. Here is a summary on the AOL web site, along with a poll on the issue.

I like this summary: Etiquette-based medicine . . . "would put professionalism and patient satisfaction at the center of the clinical encounter and bring back some of the elements of ritual that have always been an important part of the healing profession."

NEJM has published the entire article as freely available to the public here. This is a very polite thing for them to have done, and I thank them.

Paul Levy is the CEO of Boston's Beth Israel Deaconess Medical Center and blogs regularly at Running a Hospital.

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THCB would not be possible without the generous support of sponsors like Varolii Corporation. Actively engage patients with automated communications. Varolii can help progressively enroll and engage patients into DM&W programs. The result?  Healthier patients and better operational returns. Enjoy the discussion and content on THCB? Take a minute to visit their site. Even better? Write them a quick thank you note.   

iMedix: Social search that creeps me out

By Craig Stoltz

Oh, geez. Deb21 wants to chat again.

Here I am, trying to look up some information about tinnitus – a.k.a. ringing in the ears, a condition which has recently afflicted a member of my family – and Deb21 [I've changed her handle to protect the innocent ] wants to chat. A little photo box pops up on my screen, with the icky solicitation “I’m online! Chat with me now!” There’s even an audible little ping whenever she implores me to spend some time with her.

Welcome to iMedix, a “social search” site in the personal health space.

In concept, social search is powerful: Combine the algorithmically valid but brain-dead health search results of a typical search engine with the “wisdom of the crowds” – the aggregated opinions of real humans who can validate the information they found worthwhile when dealing with the same issue. Add to that the ability to connect with those people, and (goes the theory) you’ve got something good.

Like any 2.0 community, iMedix faces the challenge of creating critical mass: A community with nobody home is in a death spiral from Day One. But building critical mass from scratch is no small task in mid-2008. Early adopters are oversubscribed to social networks and the mainstream hasn’t figured out what all the fuss is about. Every business based on network power needs people. A lot of them. Fast.

Continue reading "iMedix: Social search that creeps me out"

Podcast with Silverlink and IncentOne

By Matthew Holt

Those of you regular THCBers are by now probably bored with me going on about the problems (and opportunities) with incentivizing people in health care to do the right thing. So today Silverlink which does automated voice recognition inbound and outbound calling (FD--they're a THCB advertiser/sponsor) announced a deal with IncentOne, which, surprise surprise, runs incentive programs.

That was interesting enough to get me to bite, so I got Stan Nowak, CEO Silverlink & Michael Dermer, CEO IncentOne, on the phone for a quick podcast interview to explain what they're going to do together.

More on Physician Reimbursement, CMS, the AMA's RVS Update Committee (RUC)

by ROY POSES, MD

(Note by Brian Klepper: At Health Care Renewal, Dr. Roy Poses, a Clinical Associate Professor at Brown University's School of Medicine, writes a consistently excellent blog on health care financial conflict . Both he and I have written extensively - a link to his most recent column is provided below; mine is here - about the obscene sole source advisory relationship that CMS maintains with the conflicted, lopsided and secretive AMA's RVS Update Committee (or RUC).

Essentially, the facts are that the RUC, a proprietary committee within the AMA overwhelmingly dominated by specialists, has been the only advisor to CMS on physician reimbursement for many years. It has consistently urged CMS to increase specialty reimbursement at the expense of primary care.

The result has been to drive medical students into specialties. Over the last five years, the percent of medical school graduates going into Family Practice has dropped from 14 percent to 8 percent. Only 25 percent of Internal Medicine residents now go into office-based practice; the rest become hospitalists or subspecialists.

Here is Dr. Poses' most recent post, reprinted from Health Care Renewal, this time on a recent report from the RUC that makes recommendations for paying physicians under the Medicare's Patient-Centered Medical Home pilot. As you might suspect, this does little to change the current corrosive paradigm.)

We have posted a number of times, (most recently here, and see links to earlier posts) about the RBRVS Update Committee's (RUC) responsibility for Medicare's relatively poor reimbursement of primary care and other "cognitive" physicians' services compared to procedures. This imbalance has rippled through all of US health care, affecting how private insurers and managed care organizations reimburse physicians, and generally how the US systems favors procedures over talking, examining, thinking, diagnosing, prognosticating, deciding, and prescribing and super-specialization over generalism and primary care.

Continue reading "More on Physician Reimbursement, CMS, the AMA's RVS Update Committee (RUC)"

Presidential candidates' health plans

By THCB Staff

As a service to our readers, we've compiled all the presidential candidates' health plans in one place for you to easily access. Soon, we'll have a section of the TCHB devoted to the presidential race and health reform.

Click on the candidate to see his or her full plan for health reform.

 

 

 

 

 

 

 

As the race carries on, we'll bring you updated analysis from the candidate's health advisers, left - and right-leaning wonks and THCB contributors.

Also here is the Kaiser Network's side-by-side comparison of the current candidates' plans for quick reference.

Robert Laszewski's nonpartisan analysis of each candidate's plan previously posted on THCB are here:

• McCain
• Clinton
• Obama

If you're interested in seeing health reform plans of the candidates who dropped out of the race, here's the Kaiser Network's side-by-side comparison.

 

 

Stealth marketing: doctors and public radio

By Sarah Arnquist

Over at Slate, veteran health care journalists Shannon Brownlee and Jeanne Lenzer raise tough questions about the lack of disclosure regarging four doctors' ties to the makers of antidepressants, while they told audiences of public radio stations nationwide that the connections between suicide and antidepressants were largely overblown.

The radio program, Infinite Mind, produced the show in April titled Prozac Nation: Revisited.

Here is writers' nutgraph:

"The radio show, which was broadcast nationwide and paid for in part by the John D. and Catherine T. MacArthur Foundation, had the air of quiet, authoritative credibility. Host Dr. Fred Goodwin, a former director of the National Institute of Mental Health, interviewed three prominent guests, and any radio producer would be hard-pressed to find a more seemingly credible quartet. Credible, that is, except for a crucial detail that was never revealed to listeners: All four of the experts on the show, including Goodwin, have financial ties to the makers of antidepressants. Also unmentioned were the "unrestricted grants" that The Infinite Mind has received from drug makers, including Eli Lilly, the manufacturer of the antidepressant Prozac."

Continue reading "Stealth marketing: doctors and public radio"

Wal-Mart drops drug prices, shakes up market -- again

By Jane Sarasohn-Kahn

Wal-Mart continued its first-mover tactics in health by dropping the price of prescriptions again. This time, the target is maintenance meds, which Wal-Mart will price at $10 for a 90-days supply.

This move puts Wal-Mart squarely in the pharmacy benefits management (PBM) segment vis-à-vis ExpressScripts, Medco, and the big PBM players. The three-month mail order med business is the lucrative turf of PBMs. Wal-Mart's first move into this space was in 2006 when the company priced many 30-day prescriptions at $4, shaking up the industry. I wrote about that market disruption here in January 2008.

Wal-Mart will also offer over 1,000 over-the-counter (OTC) meds for $4 and under. These will all be Wal-Mart's private labels for popular OTC brands.

As the company with the red bulls-eye did the last time Wal-Mart dropped the price of meds, Target responded as a fast follower by saying they, too, will match the Wal-Mart prices for a 90-day supply of drugs. Target's program will expand the assortment of $4 Rx drugs and the 90-day supply of these medications for $10 and private-label OTC medications for $4 or less.

Continue reading "Wal-Mart drops drug prices, shakes up market -- again "

Healthy Americans Act could be the place of compromise for health reform in 2008

  By Robert Laszewski

Health care reform will be hard to do after the November election. I've even called it a long-shot.

Polls clearly show the voters split evenly between the Democratic and Republican approach to health care reform. I can't tell you who will win the presidency, but I am willing to make the bold statement that it will be a close election and neither very different approach to health care reform will enjoy any kind of mandate.

So finding common ground between these very different approaches will be more than tricky.

But we may already have an outline.

Sen. Ron Wyden (D-OR) and Sen. Robert Bennett (R-UT) have crafted a health care reform plan that gives both sides the most important things each are looking for.

Continue reading "Healthy Americans Act could be the place of compromise for health reform in 2008"

Indian docs endorse O.J. and oatmeal

By Sarah Arnquist

PepsiCo maneuvered marketing genius this week by convincing the Indian Medical Association to endorse the health benefits of Tropicana fruit juice and Quaker Oats for three years.

Now, when Indians reach for these products, they'll see a stamp of approval from the IMA. In turn, Pepsi will sponsor IMA events and forums. This so-called noncommercial deal is the first of its kind globally.

The Indian Medical Association, an organization with 175,000  members, is India's equivalent to the American Medical Association. It has received harsh criticism for the deal. The Times of India ran opposing viewpoints Thursday on the endorsement.

"The IMA cannot be seen to be favouring any one corporation over its rivals when it comes to benefits that flow from a healthy diet," the opposing editorial states.

In the IMA's defense, a columnist wrote, "Brand promotions of healthy products of a corporation like PepsiCO -- that's more of a cola company -- will help it diversify its operations in holistic areas that enhance, rather than compromise, public health."

Did Pepsi ghostwrite that?

Ten years ago, the American Medical Association had to backtrack on an agreement to endorse Sunbeam medical supplies after its members responded with fury. The AMA's violation of an unwritten 40-year-old rule against product endorsements caused four top officials to resign.

Continue reading "Indian docs endorse O.J. and oatmeal"

Interview with CEO of Limeade, Henry Albrecht

By Jen McCabe Gorman

Henry Albrecht, CEO of Limeade online employee wellness firm, was nice enough to talk with me on his cell phone in the evening (after 5 p.m. West Coast, 2 a.m. Amsterdam time).

Both of us were banging pots and pans, cooking dinner (him), making coffee (me).There's something comforting about speaking with a high-tech health care executive in such an old-fashioned, "conversational" way.

Thanks again Henry – pleasure to meet you and Limeade.

Continue reading "Interview with CEO of Limeade, Henry Albrecht"

Interview with Joseph Kvedar, Partners Center for Connected Health

By Matthew Holt

Joseph Kvedar is the director of Center for Connected Health, which is part of the Partners HealthCare System's empire in Boston (that's Mass General and the Brigham for you old-schoolers). Joe emceed the conference I spoke at yesterday, and I stopped in for a quick chat with him this morning to get an update on the Center's progress.

If you need an introduction to the Center, its web site is here, a piece Joe  wrote for THCB last year is here and the transcript of a longer interview I did with Joe is here.

Today we had time for a quick catch-up, in which he touches on the state of the EMR initiative at Partners, the wider role of Connected Health within Partners, and the state of their current pilots. Here's the interview (The first minute is a little quiet. My apologies.)

You can also see the details about the Center's symposium (27-28 October). There, you can find out more about Connected Health than you can imagine, and you'll probably see a little flavor of Health 2.0 there, too. We hope to bring a little flavor of the community aspect of Connected Health to the Health 2.0 Conference (October 22-23). Yes, we know they're close together ... but speaking as someone who's been to both, I recommend both highly!

Health Plan Illiteracy: study finds many do not understand their benefits

By Jane Sarasohn-Kahn

Health plan illiteracy is alive and well, according to J.D. Power and Associates. The consumer market research firm's 2008 National Health Insurance Plan Study finds that one in two plan members don't understand their plan.

In this second year of the survey, J.D. Power notes that, as consumers understand the benefits of their Benefit, their satisfaction with the plan increases. Thus, there is a virtuous cycle that happens between a plan and an enrollee when communication is clear and understood.

J.D. Power looked at member satisfaction in 107 health plans throughout the U.S. in terms of seven key metrics: coverage and benefits; choice of doctors, hospitals and pharmacies; information and communication; approval processes; claims processing; insurance statements; and customer service. The survey was conducted in November and December 2007.

Last year, Abt Associates found that most insured workers don't understand simple health plan language. I abstracted some of Abt's findings in this chart that I use in many of my presentations. Health plan illiteracy goes beyond general health illiteracy -- this is people blessed with benefits who don't 'get' them.

Continue reading " Health Plan Illiteracy: study finds many do not understand their benefits"

The virtues of virtual visits

By Jane Sarasohn-Kahn

Rush-Presbyterian Medical Center's Virtual Integrated Practice (VIP) is more evidence that remote health care can improve health outcomes.

At Rush, a team has been refining the VIP model for the past four years. The VIP's objective is to improve chronic disease management for older people by deploying an
interdisciplinary team using communications technology.

The main challenges in primary care for VIP's target patient population are:

• Multiple chronic problems
• Polypharmacy
• Physical disability
• Functional impairment
• Economic stressors

The Holy Grail here is that when these patients are optimally-managed, VIP can identify missed opportunities for primary prevention and avoid eventual disability.

Continue reading " The virtues of virtual visits"

Searching for the price of one appendectomy

By Sarah Arnquist

This month's Philadelphia Magazine ranks the city's top physicians -- a fad nearly all major city magazines have adopted because it attracts great advertising dollars.

But tucked amid the pages of smiling surgeons and OB-GYNs is a gem of a story by the magazine's executive editor, Tom McGrath, in which he takes readers through the maze he encountered while trying to decipher the hospital and insurance bills following his daughter's appendectomy.

After his five-year-old daughter had her appendix out at Children's Hospital of Philadelphia (CHOP), McGrath set out to learn why it was so impossible for him to understand how much his daughter's surgery and hospital stay cost, how much the insurance company was paying, and how much he owed.

"I discovered two things: first, that much of the cost of our health care is determined behind smoked glass, where patients are never invited to look," McGrath wrote. "And second, that in trying to make sense of a single simple case where everything went right, you can learn a lot about what’s wrong with health care in America."

Continue reading "Searching for the price of one appendectomy "

Around the Web in 60 Seconds

By THCB STAFF

NYT Lying - Giving Ourselves The Psychological Push We Need to Reach Future Goals? Or Just Good Old-Fashioned Twisted Fun?

LAT: Food 2.0 - What to eat while Googling

Microsoft: Health 2.0 could eventually "expand Web 2.0 concepts to the entire health ecosystem of payors, providers, employers, consumers, life sciences entities and even the government."

Wired Science: ""With the world teetering on the edge of a full-blown food crisis, it may be time to cut back on biofuel, said Barack Obama yesterday."

MIT Tech Review: The Candidates on Tech

HealthTech: "A Pan-European eHealth Infrastructure Could Revolutionize Healthcare."

SF Chronicle: Medical Tourism is Big...

WSJ: Medical Tourism is Not So Big...

Continue reading "Around the Web in 60 Seconds "

Can “consumerism” work in health care?

By Brian Baum

“Consumerism,” -- free market, open competition - regardless of the term used to describe this market behavior, can the concept of “natural market forces” exist in health care?  It seems as though observers of the health care “market” fall into two distinct points of view:

POV 1:  Consumerism in health care is a train that has already left the station.
POV 2:  Health care is different and true market forces can never prevail because the players' roles are so polarizing, and the “buyer” and the “consumer” are so disconnected.

I suspect that for anyone reading this, you have already checked off your respective point of view. (While the merits of this topic are worth debating, ultimately, time and events will answer this question.)

In the meantime, let's consider the following:

Continue reading "Can “consumerism” work in health care?"

THCB's own correspondent in India

By Sarah Arnquist

Less than a month ago, I quit my job as a newspaper health care reporter and moved to India. No, I wasn't fleeing the dismal atmosphere permeating traditional newsrooms these days (not entirely at least). This was a premeditated step to travel and learn about health care in the world's largest democracy before starting Johns Hopkins Masters in Public Health Program this summer. Oh, and in the meantime, I joined the staff of THCB.

After 16 days in Hyderabad (located in the south-central state of Andhra Pradesh), I've adjusted to the heat, spicy food and traffic, and am now ready to begin some real reporting. Over the next month or two, I'll share what I learn on THCB. I'm particularly interested in the exploding private health sector, the emerging health insurance markets, maternal and child health, and the wide gaps in care between the haves and the have-nots.

If you have any contacts in Hyderabad or suggestions for posts, please feel free to contact me at sarnquist@gmail.com or in the comments section.

MN lawmakers pass bill to ban sharing info on medical debt

By Eric Novack

Perhaps this should be applied to groceries, utility bills, clothing, and, of course, housing…

Oh, wait, that is what the mortgage lending industry was doing for several years.

Two quick Health 2.0 "on tour" conference appearances

By Matthew Holt

Today, Health 2.0 co-founder Indu Subaiya will be moderating a panel at Consumer Health World in Las Vegas (from the Transmarx folks) while tomorrow I’ll be on a panel at the Consumer Connectivity & Web Empowerment Conference (put on by the World Congress) in Boston.

And of course there’ll be a few more sprinkles of Health 2.0 friends and family around the country in the lead up to the Fall meeting in San Francisco, October 22 & 23.

Should Hospitals Install Bar Coding or CPOE First?

By Bob Wachter

Robert Wachter is widely regarded as a leading figure in the modern patient safety movement. Together with Dr. Lee Goldman, he coined the term "hospitalist" in an influential 1996 essay in The New England Journal of Medicine. His most recent book, Understanding Patient Safety, (McGraw-Hill, 2008) examines the factors that have contributed to what is often described as "an epidemic" facing American hospitals. His posts appear semi-regularly on THCB and on his own blog "Wachter's World

This is one of the most commonly asked questions in IT World, and my answer has always been “CPOE first” – largely because that has always been David Bates’s (the world’s leading IT/safety researcher) answer. But I’ve changed my mind. Here’s why.

Before I start, I promised that I’d let you know if I ever blogged on a topic in which I have a financial conflict of interest. On this, I do: I serve as a paid member of the Scientific Advisory Board of IntelliDOT, a company that makes a stand-alone bar coding system. If that freaks you out, stop reading. But recognize that if you had asked me the “bar coding or computerized provider order entry?” question last week, I would have answered “CPOE”.

Continue reading "Should Hospitals Install Bar Coding or CPOE First? "

WSJ analyzes specialist pay

By Eric Novack

On the front page of Today’s Wall Street Journal is an article entitled, “Medical Specialties Hit by a Growing Pay Gap”.

A few passages worth thinking about:

"Many in health-policy circles have focused on how the current health-care payment system is helping create shortages among primary-care doctors, internists and others on the front lines of medicine. But often lost is how the system is endangering some of the country's most highly trained specialties as well."

And later…

"… Medicare implemented a new system to set standard fees for physicians' services and procedures. The system's aims were to clamp down on prices and, ironically, narrow the disparity between the bread-and-butter office visit and more-expensive specialty procedures. (emphasis mine) Over time, private insurers have taken their cue from Medicare to set their reimbursements, too."

And one more…

"Medicare officials say the government program tries to address cost disparities by continually reviewing its fee schedule but says it relies a lot on medical-specialty societies to raise such issues."

"We want to make sure that payment is appropriate and that includes not underpaying," says Terrence Kay, senior adviser to the director of the Center for Medicare Management.

Marrying for health care

By Sarah Arnquist

About 7 percent of Americans recently reported in new Kaiser Health Tracking Poll that someone in their household got married so they could get health benefits. While 7 percent may be a bit high, I have no doubt some people consider health benefits when deciding the timing of their marriage.

I gave similar advice to a friend only a few months back. She had recently moved to Denver with her fiancee, and was temporarily unemployed. She wanted health insurance and could afford to buy it, but she couldn't get it.

Except for seasonal allergies, she's a healthy 26-year-old woman. Allergies were reason enough, however, for two insurers to deny her coverage. Her fiancee's policy only covered spouses. My advice: get married quickly at City Hall and then again eight months later at the planned wedding. (She rejected that idea and found a job after about two months of looking that offered health benefits.)

Under John McCain's proposed health plan, many more people like my friend may be denied coverage. His solution? Create a high-risk insurance pool. But do allergies make my friend high-risk? I don't think so. Where do individuals like her fit in?

Over at the Health Access blog, Anthony Wright describes California's high-risk pool, known as the Managed Risk Medical Insurance Board, or MRMIB. It currently has a waiting list of more than 500 people. Another example of people who want insurance but can't get it.

A Hat Tip to Pediatrician Dr. Benjamin Spock

By Brian Klepper

Here's one of today's entries in The Writers' Almanac, the wonderful daily newsletter sent out by Garrison Keillor on NPR. Parents of boomers like me were big fans of Dr. Spock, treating him with an almost cult-like reverence for his sensible wisdom about child care. He later parted ways with some of his more conservative followers, when he