Commentary Archives for October 2010
2010 Potpourri XL
Is there anything scary about health care? Yes if you have to pay for it! Nothing scary about our Potpourri, just soothing health care nuggets, covering alternative therapies for back pain, CBO’s view on the reform law, peer interaction to help manage diabetes, diabetes prevalence, Massachusetts physician information, accountable care organizations, bias in clinical trial results and the effects of the health law on employer provided insurance.
Paper on Accountable Care Organizations
CSC put out a White Paper on Health Information Requirements for Accountable Care which examines the necessary functions an effective ACO will have and what health information technology will be needed to support those functions.
Home Is Where the Care Is
The complexity and rate of change in health care sometimes makes spotting major trends difficult. One appears to be growth of home-based diagnostic and therapeutic care. An article in the New England Journal of Medicine discusses drivers for this trend.
GAO Report on DOD EHR
The Department of Defense and the Veterans Administration spend a lot of money on health care and health information technology, sometimes earning kudos. But there are a lot of problems. The GAO puts out a report on DOD’s Electronic Health Record Initiative, which should make the agency blush with shame.
Nursing Home Resident Hospitalizations
There is so much health spending in the United States that it is sometimes hard to isolate the big buckets. Nursing home residents have very high medical costs and many questionable hospitalizations. A KFF report examines reasons why.
ICD-10 Is Coming
Two papers discuss some of the costs and issues surrounding the impending implementation of the ICD-10 classification and coding system. When there are so many other health information system projects and requirements at the same time, this one will add a significant burden for payors and providers.
2010 Potpourri XXXIX
The leaves disappear from the trees but our Potpourri is eternal, this week entertaining you on projected drug spending next year, prescription abandonment rates, avoiding hospitalizations for home care patients, anticipating the effects of the health law on employer-provided health insurance, the NAIC’s final action on the MLR and hospitals views on their ability to achieve the meaningful use incentives.
Home Testing of Blood Thinning Medication
Research reported in the NEJM looked at differences in quality of care for patients who either tested themselves at home or were tested in a clinic to guide the administration of warfarin, a blood thinning drug. The results indicate home testing is as good as clinic testing.
Third Quarter VC Activity
Venture capital has been critical to the creation of innovative health care products and services, as well as to the good jobs the companies offering those products and services provide. Funding continued to be sluggish in the third quarter.
Process of Care and Health Outcomes
As the use of pay-for-reporting and pay-for-performance grows, there is more research into whether care processes being measured are really related to ultimate health outcomes. A new article says not necessarily.
Medicaid Health Plan Administrative Costs
The reform debate and its aftermath focused a lot of attention on health plans’ administrative expenses, particularly whether they were devoting too much of total premium to profits. A new report looks at expense trends for Medicaid managed care plans.
IOM’s Report on Nursing
The Institute of Medicine’s report on The Future of Nursing discusses many issues, but one that catches the eye relates to the role of restrictions on nurse scope of practice in impeding better access and lower costs.
2010 Potpourri XXXVIII
More health care tidbits in this week’s potpourri, including medication adherence; the benefits of workplace wellness programs; the costs to employers of obesity; hospital prices in Oregon; reimbursement methods for drugs and potential savings from health IT.
Physician Use of Email
A recent survey and study examine physicians’ use of email to interact with their patients, finding very low rates of use, due to reimbursement and other concerns, as well as limited technical access. Expanded use could help reduce costs.
More Group Purchasing Organization News
A medical device manufacturers’ trade association publishes sponsored research on the effect of GPOs on costs, concluding that hospitals would be better off to buy directly from the manufacturers or to restructure how GPOs are paid.
Why Do We Have Worse Survival Rates?
Health spending is high in the United States compared to other industrial countries. Quality, based on health outcomes such as survival or mortality, appears to be worse. A new article probes the reasons why, but may have some flaws.
Health Affairs Articles on Malpractice
Because of political considerations, medical malpractice and its health spending effects is a controversial topic. A recent issue of Health Affairs carried several articles on this topic.
Grand Junction’s Low Health Spending
There appears to be significant variation in per capita health spending around the United States. The low-cost areas could provide valuable lessons to the rest of the country and a NEJM perspective examines the experience of Grand Junction.
2010 Potpourri XXXVII
The regular weekend lineup of health care news, including doctors trying to limit nurse anesthetists’ practices; text messaging for teenager dermatitis patients; Hewitt’s cost projections for 2011; physicians and the internet; how to calculate MLRs and use of incentive pay for physicians.
Watch Out for those HIT Systems
Spurred by government funds and regulations, the medical world is rushing to implement electronic records and other functionality. The consequences may not always be great, as a recent study suggests.
Quality of Care and Patient Satisfaction
There has been a major push to expand measurement of provider quality, as defined by process of care and outcomes. A study suggests that having good quality doesn’t necessarily mean patients will be more satisfied.
Can Online Care Reduce Other Visits
Enthusiasm abounds regarding new forms of physician encounters, such as phone, email and video visits. A pilot study from the Mayo Clinic suggests that such visits may reduce in-person encounters and save money.
Uwe Reinhardt on Cost Control
Uwe Reinhardt is one of the wise old men of health care economics and policy. The New York Times has a recent blog column by him in which he reviews the perennial issues blocking real change in regard to health cost control.
GAO Group Purchasing Organization Report
Hospitals and other providers often use group purchasing organizations to facilitate obtaining goods and services at better prices and other terms. A GAO report looks at some of the business practices of these organizations.
2010 Potpourri XXXVI
The days shorten but the potpourri stays strong, this week including information on the safety of FDA-cleared devices; medication adherence; genetic tests; the FDA and CMS working together to review products; state all-payer databases and the increasing control of physician practices by hospital systems.
CBO Report on Medicare and Generic Drugs
A Congressional Budget Office Report finds that Medicare Part D and its beneficiaries have accrued very significant savings, about 55%, from use of generic drugs and that more savings may be available in the near future.