Great Britain’s electronic health records project is severely off schedule and off budget. The problems of that project, however, are not necessarily likely to be replicated in America’s push to get more IT in health care.
Our Memorial Day Potpourri, celebrating health information such as the growth of high-deductible plans, physician starting salaries, benefit design for high-cost conditions, why emergency room physicians order tests, the use of telehealth for heart failure patients and sources of physician pay.
As noted in yesterday’s post, the Trustees of the Medicare Hospital and Supplementary Funds recognized the inadequacy of the official projections of Medicare’s financial condition, and therefore had an alternative, and bleaker, scenario prepared.
The Medicare Trustees have released the 2011 report on the status of the Medicare funds, indicating that they will be exhausted sooner than anticipated, due both to the recession and higher spending.
An index that tracks medical spending shows that while per capita spending continues to rise, the rate of growth has slowed, particularly for Medicare. Hospital spending continues to be the fastest growing category.
An article in JAMA discusses research on the use of remote monitoring teams in intensive care units, finding significant benefits in consistency and quality of care and likely lower costs.
Once more into the world of health care to find nuggets of useful information, this week including the legality of wellness programs, the switch to ICD-10, pragmatic trials, the status of the workers’ comp industry, consumer health care sentiment, and hospital ER strategies.
Notwithstanding clear research demonstrating the percutaneous coronary intervention has no significant outcomes advantages over medical therapy, almost no change in practice patterns has been observed, suggesting that doctors are seeking to maintain their incomes.
A Health Affairs article discusses health care for elderly persons living in retirement communities and how various models might help improve care coordination and reduce spending.
An editorial in the Journal of Managed Care Pharmacy illustrates common pitfalls in creating guidelines based on certain kinds of research and explains why cause and effect can often be wrongly inferred in the absence of randomized trials.
The 2011 Milliman Medical Index was released, showing a 7.3% increase for a family of four covered by an employer sponsored PPO plan. Premium share and other out-of-pocket payments continue to rise faster than overall cost and unit prices, especially for hospital services, are the main source of the continued higher spending.
Another Potpourri, this week delivering factoids on drug companies’ use of technology to reach physicians, waiting times in Massachusetts, use of atypical antipsychotics in nursing homes, unnecessary colonoscopies, EMRs and productivity, and a stupid FDA ruling.
Malpractice reform is stymied at the federal level and state efforts appear to have run out of steam, despite the likelihood that reform would significantly reduce wasteful spending. New approaches are being tested but their effect is uncertain.
CMS’ proposed rule and explanations for hospital payments for 2012 are lengthy but as usual give a great background on the issues that go into the payment elements. Hospital payments are slated for at best a very modest increase.
A new report surveyed physician practices on their experience with eprescribing systems, finding that while use was increasing some features were not often accessed because of system design and information adequacy and accuracy concerns.
A brief from the Agency for Healthcare Research and Quality looks at hospital charges in the United States, which accounted for 31% of total health care expenditures. Spending by payer and condition are detailed.
Another edition of the Potpourri focuses on CMS and telemedicine, informal caregiver stress, wellness program results, emergency room visits, happiness and suicide, and sources for consumer health information.
New research examines the need to use care guidelines carefully, showing the danger of using generalized rules for all patients, and the benefit of tailoring those rules for individual circumstances.
A Kaiser Family Foundation report analyzes health care spending across a number of nations, confirming that we spend a lot more than most developed countries and that our growth rate for health expenses has been higher and continues to be higher than that of these other nations.
Research published in JAMA examines the extent to which patients’ health literacy is associated with heart failure outcomes, finding a connection in the case of all-cause mortality, but not with hospitalizations.
A WSJ article examines the likelihood that the myriad of health care cost control measures embedded in the reform law will actually reduce costs, concluding that it is unlikely they will, based on history here and in other countries.