The Health Care Blog

Saving Health Care, Saving America

By BRIAN KLEPPER, DAVID C. KIBBE, ROBERT LASZEWSKI and ALAIN ENTHOVEN So far, Congress' response to the health care crisis has been alarmingly disappointing in three ways. First, by willingly accepting enormous sums from health care special interests, our representatives...
October 30, 2009 in Brian Klepper, Corruption, Current Affairs, David Kibbe, Marketplace, Policy, Policy/Politics, primary care, Reform, The Industry, Transparency | Permalink | Comments (46)

Not Really an Option

By GARY NISSEN To: Executives leading U.S. Hospitals The public option appears to back in the national dialogue and I’m wondering how concerned you all are about that. After all, many of you have been quite successful at minimizing the...
September 13, 2009 in Economics, Hospitals, Public Option, Reform, The Industry | Permalink | Comments (16)

Winners and Losers - Strategy in a Post-Reform World

By BILL KRAMER Most health policy experts are focusing on the daily ups and downs in the political battles over health reform. Within the health care industry, however, there is a buzz about who will be the winners and losers...
September 4, 2009 in Health Plans, Reform, The Industry | Permalink | Comments (29)

Health Reform Bills Would Be Great For the Business Of Health Care

By ROBERT LASZEWSKI Editors Note: This piece by veteran THCB contributor, Robert Laszewski, first appeared on Kaiser Health News. The piece is republished here with permission. Have you noticed how none of the big health care business special interests is...
August 29, 2009 in Public Option, Reform, Robert Laszewski, The Industry | Permalink | Comments (17)

Finally, A Reasonable Plan for Certification of EHR Technologies

By DAVID C. KIBBE and BRIAN KLEPPER A caution to readers: This post is about methods for certifying Electronic Health Record (EHR) technologies used by physicians, medical practices, and hospitals who hope to qualify for federal incentive payments under the...
August 4, 2009 in Brian Klepper, David Kibbe, HHS, Marketplace, Meaningful Use, Policy, Policy/Politics, Reform, Technology, The Industry, Web/Tech | Permalink | Comments (28)

Why Congress Should Consider Bob Laszewski's Health Care Affordability Model

By BRIAN KLEPPER Over the last few months, I have become increasingly disheartened over the prospects for meaningful health care reform. First, the process is terribly conflicted, and it shows. In the first quarter of 2009, the Center for Responsive...
July 9, 2009 in Affordability Model, Brian Klepper, Current Affairs, Marketplace, Policy, Policy/Politics, Reform, Robert Laszewski, The Industry | Permalink | Comments (40)

No Country for Old Men

By JEFF GOLDSMITH As we enter summer, the health reform process is moving into its Newtonian phase: irresistible forces meeting immovable objects. In both health cost and access, the trend is not our friend. There is ample evidence not only...
July 6, 2009 in Jeff Goldsmith, Marketplace, Medicare, Obama administration, Policy/Politics, Reform, The Industry | Permalink | Comments (57)

Preventing Extortion

By JACK CHURCHILL The debate about a public health insurance option mirrors the debate about public power in the 1920’s and 30’s. The arguments then were very similar to the arguments we hear today. The principal issue then was whether...
July 2, 2009 in AMA, Economics, History, Supreme Court, The Industry | Permalink | Comments (4)

Unions May Get a Pass on Health Care Benefits Tax

By ROBERT LAWSZEWSKI There is a major bipartisan effort going on in the Senate Finance Committee to reform the health care system. Reportedly, one of the elements of that effort may be a tax on "gold plated" health insurance benefits...
June 29, 2009 in Economics, Robert Laszewski, Senate Finance Committee, The Industry, Unions | Permalink | Comments (6)

The EHR TimeBar: A New Visual Interface Design

By RICK WEINHAUS, MD The EHR TimeBar functions as a high-level overview of the patient record, as a query device, and as an intuitive navigation tool. Each EHR file (event) for the patient is represented by an icon. The set...
June 26, 2009 in Electronic Medical Records, evidenced-based medicine, Policy, Policy/Politics, Technology, The Industry, Web/Tech | Permalink | Comments (6)

A Dream of Reason

By BRIAN KLEPPER and DAVID KIBBE The dream of reason did not take power into account...Modern medicine is one of those extraordinary works of reason...But medicine is also a world of power. -Paul Starr, The Social Transformation of American Medicine,...
June 22, 2009 in Brian Klepper, Consumers, David Kibbe, e-patients, Electronic Medical Records, Policy, Policy/Politics, The Industry, Transparency, Web/Tech | Permalink | Comments (8)

The Health Industry's Achilles Heel

By BRIAN KLEPPER and DAVID C. KIBBE "You never want a serious crisis to go to waste." - Rahm Emanuel, White House Chief of Staff Timing matters. The health industry has demonstrated steadfast resistance to reforms, but its recently diminished...
June 10, 2009 in Brian Klepper, David Kibbe, Health Plans, Obama administration, Policy, Policy/Politics, Quality, The Industry, Transparency | Permalink | Comments (15) | TrackBack

Data-Driven Health Care: An Interview with Jerry Reeves, MD

An under-the-radar debate is occurring in health care between those who say data shows that practice variations across the land are “unwarranted” and those who maintain that such variation is inevitable given socioeconomic population differences and cost of practice differences...
June 8, 2009 in Dartmouth Atlas, Economics, evidenced-based medicine, Health Plans, Obama administration, Patient Safety, Physicians, Policy/Politics, primary care, Quality, The Industry, Transparency | Permalink | Comments (17)

The National HIT Organizations - How it All Works

By John Halamka Several blog readers have asked me to take a fresh look at all the organizations related to ARRA and explain how it all works. Here's my understanding: Office of the National Coordinator The Obama administration's ONC is...
June 8, 2009 in Health Plans, The Industry | Permalink | Comments (2)

An Open Letter to the New National Coordinator for Health IT: Part 3 -- Certification As The Elephant in Health IT's Living Room

By DAVID C. KIBBE and BRIAN KLEPPER In the first and second parts of this series we talked about how and why there is no universal definition for the term "EHR." Instead there is a legitimate, growing debate about the...
May 8, 2009 in Brian Klepper, David Kibbe, e-patients, Electronic Medical Records, Health 2.0, Obama administration, Online Communities, Policy, Policy/Politics, Quality, Technology, The Industry, Transparency, Web/Tech | Permalink | Comments (20)

Roni Zeiger on what Google Health is doing next

By Matthew Holt For those of you who weren't at Health 2.0 Meets Ix to hear from the mouths of the four horsemen (Halamka, Sands, Zeiger & deBronkhart) here is Google's Roni Zeiger’s version of what went wrong with the...
April 28, 2009 in Electronic Medical Records, Health 2.0, Technology, The Industry | Permalink | Comments (9)

An Open Letter to the New National Coordinator for Health IT - Untying HITECH's Gordian Knot: Part 1

By DAVID C. KIBBE & BRIAN KLEPPER Congratulations to David Blumenthal on being named National Coordinator for Health Information Technology (ONCHIT). Dr. Blumenthal will be the person most responsible for the rules and distribution of the American Recovery and Reinvestment...
April 26, 2009 in Brian Klepper, David Kibbe, Electronic Medical Records, Policy, Policy/Politics, The Industry, Transparency, Web/Tech | Permalink | Comments (19)

An Open Letter to the New National Coordinator for Health IT: Part 2 - Opening the Aperture of Innovation

By DAVID C. KIBBE & BRIAN KLEPPER One of the important decisions before Dr. Blumenthal and his colleagues at ONC and HHS is whether the national health information network will be one of closed appliances that bundle together proprietary hardware,...
April 22, 2009 in Brian Klepper, David Kibbe, Electronic Medical Records, Policy, Policy/Politics, The Industry, Transparency, Web/Tech | Permalink | Comments (21)

Following the Science To A New Era In Medicine

By WILLIAM BESTERMANN, MD "The current care systems cannot do the job. Trying harder will not work. Changing systems of care will." Crossing the Quality Chasm, Institute of Medicine, 2001 Medical leadership in the United States has not yet come...
April 20, 2009 in evidenced-based medicine, Physicians, prevention, primary care, Quality, The Industry | Permalink | Comments (4)

A Self-Fulfilling Prophecy: The Continuity of Care Record Gains Ground As A Standard

By BRIAN KLEPPER We live in a time of such great progress in so many arenas that, too often and without a second thought, we take significant advances for granted. But, now and then, we should catalog the steps forward,...
April 10, 2009 in Brian Klepper, Consumers, David Kibbe, Electronic Medical Records, Google, Health 2.0, Personalized Medicine, Policy, Policy/Politics, Technology, The Industry, Transparency, Web/Tech | Permalink | Comments (21)

Will CIGNA Remake The Health Plan Marketplace?

By BRIAN KLEPPER America’s health plans are floundering. If their job has been to provide the nation’s mainstream families with access to affordable care (let’s leave quality out of it for the moment), they have failed miserably, though they were...
March 30, 2009 in Brian Klepper, Health 2.0, Health Plans, Marketplace, primary care, The Industry | Permalink | Comments (15)

A Sticky Solution to a Sticky Problem

By ALISTAIR ROCK “Don’t pull the knot tight,” the philosopher Ludwig Wittgenstein once warned, “before being sure you have got hold of the right end.” Those who hope to sort out the tangle of health care spending would do well...
March 16, 2009 in Health 2.0, Health Plans, Marketplace, Technology, The Industry, Web/Tech | Permalink | Comments (23)

Is the Healthcare Economy Rightsizing?

By Brian Klepper and David C. Kibbe More than at any time in recent memory, powerful forces are buffeting the health care sector. We are in the midst of profound upheaval, driven by market and policy responses to the industry's...
March 12, 2009 in Brian Klepper, Current Affairs, David Kibbe, Economics, Health Plans, Marketplace, Medical Devices, Policy, Policy/Politics, The Industry | Permalink | Comments (33)

A Broker's Lament: We Brought This On Ourselves

By JOHN SINIBALDI A huge segment of the American population is simply far too strapped to ever afford the premiums and costs associated with health insurance/health care as it is structured today. It isn't the employees of government (local, county,...
March 7, 2009 in Economics, Health Plans, Marketplace, Obama administration, Policy/Politics, Small Business, The Industry | Permalink | Comments (61)

Five Recommendations for an ONC Head Who Understands Health IT Innovation

By David C. Kibbe, Brian Klepper and John Moore. Now that the legislative language of the HITECH Act -- the $20 billion health IT allocation within the economic stimulus package -- has been set, it's time to identify a National...
March 6, 2009 in Brian Klepper, Current Affairs, David Kibbe, Electronic Medical Records, evidenced-based medicine, Health 2.0, Physicians, Policy, Policy/Politics, primary care, public health, Quality, Technology, The Industry, Transparency, Web/Tech | Permalink | Comments (14)

The AMA Wins a Round Against Accountability and Patient Information

By Brian Klepper On January 30th, a 3-judge DC appeals court overturned a lower court decision that would have forced public release of Medicare physician data. Writing for the majority in a split 2-1 judgment, Circuit Judge Karen LeCraft Henderson...
February 6, 2009 in Brian Klepper, Consumers, Current Affairs, Health Plans, Policy, Policy/Politics, Quality, Technology, The Industry, Transparency | Permalink | Comments (12)

CEOs' Urgent, Shared Commitment to Change

By Gary S. Kaplan A few weeks ago, I joined five of my peers in health care leadership throughout the country to help launch Health CEOs for Health Reform, a coalition dedicated to transforming health care and creating a more...
January 27, 2009 in Current Affairs, Marketplace, Policy, Policy/Politics, Quality, The Industry | Permalink | Comments (25)

Dr. George Lundberg for Surgeon General

By Brian Klepper The report that Mr. Obama's Surgeon General choice might be neurosurgeon and CNN medical correspondent Dr. Sanjay Gupta produced an upwelling of strong opinion, particularly in the medical community. Some argued that Dr. Gupta has clearly demonstrated...
January 25, 2009 in Brian Klepper, Current Affairs, JAMA, Physicians, Policy/Politics, public health, The Industry, Transparency | Permalink | Comments (17)

Five "Shovel-Ready" Health Care Reforms

By Brian Klepper & David C. Kibbe Microsoft Health Vault's leader Peter Neupert has a wonderful blog post that makes two important points really well. One message is that health care reform is about the outcomes, not the technology. We...
January 21, 2009 in Brian Klepper, David Kibbe, evidenced-based medicine, Health Plans, Marketplace, Obama administration, Physicians, Policy, Policy/Politics, primary care, Quality, Technology, The Industry, Transparency, Web/Tech | Permalink | Comments (18)

Health care wins in initial stimulus package

By Sarah Arnquist Responding to calls for Washington to take swift action in the face of the bleakest economy in decades, the House of Representatives released a $825 billion package last week designed to stimulate the economy. The early version...
January 19, 2009 in Economics, The Industry | Permalink | Comments (7)

As Medical Tourism Grows, Hold On We're In For a Wild Ride

By Bob Wachter Until now, medical tourism has been a curiosity, iconic “Wow, Look How Flat the World Is Becoming,” fodder for stories on 60 Minutes. But as health insurers and employers get into the act, get ready for some...
January 17, 2009 in Bob Wachter, Health Plans, International, Physicians, The Industry | Permalink | Comments (25)

My top 10 rules for Email Triage

By John Halamka I receive over 600 email messages each day (with virtually no Spam, so they are all legitimate) and respond to most via Blackberry. How do I triage 600 messages? I use these 10 rules to mentally score...
January 14, 2009 in Technology, The Industry, Web/Tech | Permalink | Comments (2)

Confessions of a Cultural Anthropologist: The Cause and Cure of High Health Costs

By Richard Reece Today’s medical students are being inducted into a culture in which their profession is seen increasingly in financial terms. Add in such pressures as the need to pay off enormous debts, and it is not surprising that...
January 13, 2009 in Marketplace, Physicians, primary care, Quality, Technology, The Industry, Web/Tech | Permalink | Comments (13)

New NRC Report Finds "Health Care IT Chasm," Seeks New Course Toward Quality Improvement and Cost Savings

By DAVID C. KIBBE Like the Institute of Medicine's (IOM) 2001 counterpart report, "Crossing the Quality Chasm," a new report from the National Research Council of the National Academies is complex, full of new ideas assembled from multiple disciplines, and...
January 12, 2009 in Electronic Medical Records, Marketplace, Obama administration, Policy, Policy/Politics, Quality, The Industry, Web/Tech | Permalink | Comments (20)

"The Innovator's Prescription": Christensen's Book Offers Insightful Dx, Unrealistic Rx

By Vince Kuraitis and David C. Kibbe Being big fans of Clay Christensen and his theory of disruptive innovation (DI), we have been awaiting his just-released book The Innovator’s Prescription: A Disruptive Solution for Healthcare . The book is co-authored...
January 8, 2009 in Economics, Electronic Medical Records, Health Plans, Policy, Policy/Politics, Technology, The Industry | Permalink | Comments (8)

Let's Reboot America's Health IT Conversation Part 2: Beyond EHRs

By DAVID KIBBE and BRIAN KLEPPER Yesterday we tried to put EHRs into perspective. They're important, and we can't effectively move health care forward without them. But they're only one of many important health IT functions. EHRs and health IT...
January 6, 2009 in Brian Klepper, David Kibbe, Health 2.0, Technology, The Industry, Transparency, User Generated Content, Web/Tech | Permalink | Comments (9)

Let's Reboot America's HIT Conversation Part 1: Putting EHRs in Context

By DAVID C. KIBBE & BRIAN KLEPPER Kibbe & Klepper are back with an update to their pre-Christmas piece on EHRs and the forthcoming Obama Administration's investment policy towards them. Lest you think that this is just a small group...
January 5, 2009 in Brian Klepper, David Kibbe, Health 2.0, Obama administration, Policy, Policy/Politics, The Industry, Transparency, User Generated Content, Web/Tech | Permalink | Comments (7)

The Broken Window Effect

By JOHN HALAMKA As an adult I've returned to various locations from my childhood and found the white picket fences, station wagons, and neighborhood shops transformed into rough, run down, and unsafe neighborhoods. This did not happen overnight. What happened...
January 5, 2009 in The Industry | Permalink | Comments (6)

Health and health care in 2009 - a year of managing risks and wild cards

By Jane Sarasohn Kahn As we inevitably do this time of year, we prognosticate about the new year. This time around, it's a toughie: there are too many uncertainties that preclude us from doing a straight-line forecast for 2009, especially...
December 30, 2008 in Economics, Jane Sarasohn-Kahn, The Industry | Permalink | Comments (0)

An Open Letter to the Obama Health Team

By David C. Kibbe & Brian Klepper It seems likely that the Obama administration and Congress will spend a significant amount on health IT by attaching it as a first-order priority to the fiscal stimulus package. We take the President-elect...
December 19, 2008 in Obama administration, Physicians, Technology, The Industry, Web/Tech | Permalink | Comments (48)

Shifting costs from public to private payers

By Charlie Baker The other day, the American Hospital Association, the Blue Cross / Blue Shield Association, Premera Blue Cross and America’s Health Insurance Plans (FYI - HPHC is a member and I’m on the Board of AHIP) released a...
December 12, 2008 in Charlie Baker, Economics, Policy, The Industry | Permalink | Comments (22)

Confessions of A Physician EMR Champion, Part 2: Empowering Health IT for the Connected Medical Home

By David C. Kibbe In a post here three weeks ago, I explained that I am engaging physician audiences in a conversation about participatory medicine, using a talk and presentation entitled "Confessions of a Physician EMR Champion.” I “confess” my...
December 8, 2008 in Electronic Medical Records, Policy, Technology, The Industry | Permalink | Comments (9)

Extracting more value from the health care dollar

By Sarah Arnquist Americans spend more money on health care than any other nation, but get far less in return, say multiple health care executives in Sunday's Washington Post. That's not news to readers of this blog, but probably is...
December 2, 2008 in Consumers, evidenced-based medicine, Policy, Sarah Arnquist, Technology, The Industry | Permalink | Comments (1)

Open Wide: Here comes the change you thought would never happen

By Jeff Goldsmith The morning after the election, I posted a speculative blog in Health Affairs on three possible scenarios for President-elect Obama’s implementing health reform: folding it into a bold, ambitious emergency legislative package (Complete the New Deal), carving...
November 25, 2008 in Economics, Election 08, Jeff Goldsmith, Marketplace, Obama, Obama administration, Policy, Policy/Politics, The Industry | Permalink | Comments (22)

Small Business Coverage: A Report from the Trenches

By Brian Klepper John Sinibaldi, a well-respected health insurance agent in St. Petersburg, Fla., has become prominent in Florida's broker community because he counsels and services a large book of small business clients and studiously tracks the macro trends that...
November 25, 2008 in Brian Klepper, Economics, Health Plans, The Industry | Permalink | Comments (4)

Health care costs are crippling small businesses

By John Sinibaldi I've got news for the folks doing the International Foundation of Employee Benefit Plans' survey: Smaller businesses, especially those defined as true small businesses with two to 50 full-time employees, are strapped beyond belief when it comes...
November 25, 2008 in Health Plans, Marketplace, The Industry | Permalink | Comments (4)

America's CEOs set priorities for Obama Administration

By Brian Klepper This past Monday and Tuesday, The Wall Street Journal convened an extraordinary conference of about 100 CEOs to develop and recommend issue priorities for the new Administration. (See the participant list here.) This meeting brought together the...
November 21, 2008 in Brian Klepper, Conferences, Economics, Quality, The Industry, Transparency | Permalink | Comments (11)

The Changes We Need

By Brian Klepper These are, as the Chinese curse reputedly called them, interesting times. If the burst of new Democratic health care reform proposals is any indication, a fresh breeze of the Obama campaign's "Yes We Can" optimism is blowing...
November 18, 2008 in Brian Klepper, Marketplace, The Industry | Permalink | Comments (15)

Can Health Plans Explain Why They Aren't Re-Empowering Primary Care?

By Brian Klepper & David Kibbe Sometimes a whisper is more powerful than a shout. Here's a cartoon from Modern Medicine that shows a Medical Home counseling session between a primary care physician (PCP), a specialist and the health plan....
October 30, 2008 in Brian Klepper, Economics, Physicians, prevention, primary care, The Industry | Permalink | Comments (29)

Health Wonk Review Is Up!

Over at Health Blawg, David Harlow has a special and particularly entertaining "Samhain" edition of Health Wonk Review. Pull out your costumes and head on over for some treats!
October 30, 2008 in The Industry | Permalink | Comments (0)