Posts Tagged “Medical Care”
ShowHide 3rd Party PapersAnnals of Family Medicine: Using knowledge of decision-making psychology to persuade patients to engage in healthy behaviors or to make treatment decisions that foster their long-term goals is ethically justified
Health Affairs: A Survey of Primary Care Physicians in 11 Countries, 2009: Perspectives on Care, Costs, and Experiences
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The Status of Oncology Care
by Kevin Roche on Tuesday, February 26, 2013
An unusually detailed look at one medical specialty is presented in an American Society of Clinical Oncology report which gives a good perspective on issues and trends in clinical oncology.
Tags: Medical Care, Physicians
2012 Potpourri XIII
by Kevin Roche on Friday, April 13, 2012
Our latest Potpourri features the comparative cost of cancer care in the US and elsewhere, the effect of genomics on spending, international practice guidelines, state Medicaid waivers, unintended consequences from patient satisfaction efforts and county health rankings.
Tags: Comparative Effectiveness, Consumers, Health Care Costs, Health Care Quality, Medicaid, Medical Care, Pay For Performance
Medical Homes
by Kevin Roche on Wednesday, December 28, 2011
Another one of the concepts being counted on to help improve health care quality and lower costs in the wake of reform is the “medical home.” An AHRQ draft review finds little evidence on quality effects or cost savings, but also suggests there is promise in the approach.
Tags: Health Care Costs, Health Care Quality, Medical Care, medical home, Physicians
2011 Potpourri XXXXVIII
by Kevin Roche on Friday, December 16, 2011
The holiday season is in full swing, as is the time for bad weather, but nothing can deter the delivery of our Potpourri of health stories, including this week the nocebo effect, use of imaging when a financial interest in the equipment is present, broker commissions and the MLR, present-on-admission indicators, selecting patients for use in performance measuring, and physicians views of health insurers.
Tags: Health Care Costs, Health Care Quality, Health Insurance, Hospital, Medical Care, Pay For Performance, Physicians
2011 Potpourri XXXXIV
by Kevin Roche on Friday, November 11, 2011
The cold is approaching so curl up on the sofa and enjoy the warmth of our Potpourri, this week featuring results from a pay-for-performance program, the effect of the health insurance tax on premiums and employment, the evidence for a stroke treatment, collaborative care for heart disease and physicians views on their practices and health information tools.
Tags: Care Management, Consumers, Evidence-based care, Health Care Reform, Health Insurance, Medical Care, Pay For Performance, Physicians
2011 Potpourri XXXXII
by Kevin Roche on Friday, October 28, 2011
Another brilliant Potpourri, with scintillating health care gems, including revising the FDA’s 510(k) process, the essential benefits package for health exchanges, the future of Medicare Advantage, the lack of labor productivity in health care, variation in elective procedure rates and the OIG’s work plan.
Tags: Care Management, Devices, FDA, Government, Health Care Costs, Health Care Reform, Health Insurance, Medical Care, Medicare, Physicians
2011 Potpourri XXXXI
by Kevin Roche on Friday, October 21, 2011
Another Potpourri, with tidbits on the Medicare Star program results for 2012, pain management, blood pressure management, Massachusetts’ physicians’ views on work and health care, online error reporting and the FDA and CMS parallel medical device review process.
Tags: Care Management, Devices, FDA, Health Insurance, Malpractice, Medical Care, Medicare, Physicians, Telemedicine
Medical Homes
by Kevin Roche on Wednesday, September 7, 2011
The medical home concept lumbers on, sometimes mixed in with the accountable care organization notion. The current status of the concept and issues affecting its ultimate impact are assessed in a new report from the Urban Institute and the Robert Wood Johnson Foundation.
Tags: Care Management, Consumers, Medical Care, Physicians
2011 Potpourri XXXIV
by Kevin Roche on Friday, September 2, 2011
A dazzling review of recent research and other health related nuggets is presented in this latest Potpourri, including potential problems with evidence-based medicine, physician dilemmas in controlling cost, workers’ compensation medical costs, reducing hospital infections, improving heart attack care and the growth of CDHPs.
Tags: Comparative Effectiveness, Consumers, Health Insurance, Hospital, Medical Care, Physicians, Workplace
2011 Potpourri XXIX
by Kevin Roche on Friday, July 29, 2011
Our current Potpourri contains nuggets on use of robotic surgery for prostate cancer, the effect of mandated rebates in Medicare Part D on patient costs, FDA guidance on device modifications, state Medicaid EHR incentive programs, patient understanding of trial data, and use of FQHC’s by Medicaid enrollees.
Tags: Devices, Drugs, EHRs, FDA, HIT, HITECH, Medicaid, Medical Care, Medicare
2011 Potpourri XXVII
by Kevin Roche on Friday, July 15, 2011
A mid-summer’s evening (or weekend) Potpourri, but no heated discussion here, just soothing nuggets of knowledge, including use and misuse of PCI, how to measure blood pressure, CMS and telemedicine, preventing falls, copying and pasting EHR notes, and physicians attitude to work and compensation.
Tags: EHRs, Health Care Costs, Health Care Quality, Medical Care, Medicare, Physicians, Telemedicine
Do Doctors Always Act in Patients’ Best Interest?
by Kevin Roche on Thursday, May 19, 2011
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.
Tags: Health Care Costs, Medical Care, Physicians
Physicians’ Treatment Recommendations
by Kevin Roche on Monday, April 18, 2011
New research published in the Archives of Internal Medicine finds that doctors prescribe different treatments for patients than they would choose for themselves when one choice involves potentially harmful adverse effects but a possibility of a better outcome.
Tags: Consumers, Medical Care, Physicians
Medical Spending in the Last Six Months of Life
by Kevin Roche on Thursday, March 10, 2011
End-of-life care accounts for a very substantial fraction of all health spending and appears to vary geographically, as does much other spending. Research looked at what may determine end-of-life spending and its variation around the country.
Tags: Elder Care, Health Care Costs, Medical Care
2011 Potpourri VIII
by Kevin Roche on Friday, February 18, 2011
The year wears on, winter hopefully draws to a close, and our Potpourri provides nutritious sustenance, this week featuring comparative effectiveness research and personalized medicine, two surveys on hospital progress in implementing EHRs, a patient-centered vision of HIT, the validity of care guidelines, and the use of clinical decision support to control inappropriate imaging.
Tags: Comparative Effectiveness, Consumers, Health Care Quality, HIT, Hospital, Medical Care, Personalized Medicine
2011 Potpourri VI
by Kevin Roche on Friday, February 4, 2011
Our usual end-of-the-week collection of health care tidbits, featuring HIE vendor awards; the point-of-care testing market; what makes medical groups successful; family caregivers and technology; clinical decision software for imaging; health care employee compensation; and communication between primary care and specialist physicians.
Tags: Care Management, Elder Care, HIT, Medical Care, Physicians
2011 Potpourri V
by Kevin Roche on Friday, January 28, 2011
On we go, wading through piles of research to arm you with the most relevant snatches of data, this week featuring geographic variation in the quality of drug prescribing; use of Facebook communities for health purposes; physicians’ hourly wages; medication adherence programs; surgical safety improvement; and using survey data to assess patient satisfaction.
Tags: Consumers, Drugs, Malpractice, Medical Care, Pay For Performance, Physicians, Telemedicine
Spreading Medical Knowledge
by Kevin Roche on Thursday, January 27, 2011
An article in Health Affairs discusses the important topic of disseminating new medical and health care knowledge to physicians and other providers, in this case specifically in regard to comparative effectiveness. Many barriers exist to widespread use of new knowledge and additional techniques are needed to maximize such use.
Tags: Comparative Effectiveness, Health Care Quality, Medical Care, Physicians
One Perspective on Health Care’s Future
by Kevin Roche on Wednesday, January 19, 2011
CSC put out a report giving its vision of the future of health care, with a particular focus on how emerging technologies may reshape wellness, prevention, early disease detection, treatment and how care is delivered.
Tags: Care Management, Health Care Costs, Health Care Quality, HIT, Medical Care, Wellness and Prevention
Medical Home Value Evidence
by Kevin Roche on Wednesday, December 15, 2010
Research continues to accumulate suggesting that the patient-centered medical home can save money while improving care and patient satisfaction. A new report summarizes this evidence, but the applicability of the model across the entire system has yet to be demonstrated.
Tags: Care Management, Medical Care, medical home, Physicians
Workplace Clinics Spread
by Kevin Roche on Tuesday, December 14, 2010
A new report sponsored by a unit of the Robert Wood Johnson Foundation describes the state of workplace clinics and interviews a number of participants to identify trends, challenges and success factors.
Tags: Consumers, Medical Care, Workplace
Cancer Care Variation
by Kevin Roche on Wednesday, November 24, 2010
The Dartmouth Atlas project has issued numerous reports on variation in health spending across the United States. The most recent report focuses on cancer care for terminal patients and once again finds substantial difference in resource use both across and within geographic regions.
Tags: Hospital, Medical Care, Physicians
End-of-Life Care
by Kevin Roche on Monday, November 8, 2010
New research covering aspects of end-of-life care in Canada and the US reveals that costs continue to be high, even though the use of palliative care in the United States has increased significantly.
Obesity Costs
by Kevin Roche on Friday, November 5, 2010
A new report from the National Bureau of Economics adds to the evidence that obesity is related to substantial health expenditures, but primarily concentrated in a few individuals.
Tags: Consumers, Health Care Costs, Medical Care
2010 Potpourri XL
by Kevin Roche on Saturday, October 30, 2010
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.
Tags: Accountable Care Organization, Care Management, Chronic Disease, Disease Management, Health Care Costs, Health Care Reform, Health Insurance, Medical Care, Physicians, Workplace
2010 Potpourri XXXV
by Kevin Roche on Saturday, September 25, 2010
The days are shortening and the light fades, but there is still enough to read our Potpourri, which this week includes two benefit consultants’ views on health care coverage costs for next year, hospice care at end-of-life, insurance premium hikes in Connecticut, Massachusetts health reform outcomes, and how patients’ characteristics affects doctors’ quality ratings.
Tags: Health Care Costs, Health Care Reform, HIT, Medical Care, Pay For Performance, Physicians, Workplace
Trustworthiness of Online Health Information
by Kevin Roche on Tuesday, September 21, 2010
Consumers increasingly look for medical information and advice on the internet. Research, including a recent study relating to childhood health issues, suggests that many times the data given can be erroneous.
Tags: Consumers, HIT, Medical Care
Mobile Health Report
by Kevin Roche on Wednesday, September 15, 2010
Not much is hotter in health care than wireless/mobile functionality and how it may affect many aspects of care delivery and health management. A PWC report looks at trends, opportunities and challenges.
Tags: Medical Care, Mobile, Wireless
Using Nurses Instead of Doctors
by Kevin Roche on Wednesday, September 8, 2010
Research shows that allowing nurse anesthetists to do their jobs without physician supervision does not pose additional risk to patients. Regulations and laws which limit this ability should therefore be eliminated.
Tags: Health Care Costs, Health Care Quality, Medical Care, Regulation
Virtual Hospital Wards
by Kevin Roche on Friday, September 3, 2010
A Commonwealth Foundation Brief describes a “virtual ward” model developed in Great Britain to minimize hospitalizations for chronic disease patients. Early results are encouraging and similar models are being tried in the United States.
Tags: Chronic Disease, Hospital, Medical Care, Telemedicine
Mobile Health and Self Care
by Kevin Roche on Wednesday, September 1, 2010
Deloitte puts out an Issue Brief touting the mobile personal health record as a key to reducing costs, primarily by better chronic condition management. There are a lot of barriers from vision to reality.
Tags: Consumers, Medical Care, Wireless
Emergency Room Use
by Kevin Roche on Tuesday, August 24, 2010
A study discusses trends in the use of emergency rooms. Medicaid beneficiaries are the vast majority of the increase in utilization, which may reflect poor access to primary care or inappropriate health care seeking behavior.
Tags: Health Care Costs, Hospital, Medicaid, Medical Care
2010 Potpourri XXX
by Kevin Roche on Saturday, August 21, 2010
Another selection of medical delights, including a telemedicine study that didn’t show improved outcomes, a telemedicine study that demonstrated the value of teleaudiology, end-of-life care, physician quality measurement, hospital quality measurement, and telemedicine for CHF patients.
Tags: Health Care Quality, Hospital, Medical Care, Physicians, Telemedicine
Accountable Care Organizations
by Kevin Roche on Wednesday, August 11, 2010
A Health Affairs/Robert Wood Johnson Issue Brief examines the accountable care organization concept, particularly as embodied in the recent federal health legislation. While there may be potential, as ACOs are structured for Medicare there will be many challenges on the road to meeting expectations.
Tags: Accountable Care Organization, Health Care Reform, Medical Care, Physicians
End-of-Life Care
by Kevin Roche on Wednesday, August 4, 2010
The New Yorker carries an exceptional article by Atul Gawande on end-of-life care, highlighting irrational reimbursement policies and the difficult decisions that both patients and providers must make.
Tags: Health Care Costs, Health Care Quality, Medical Care, Physicians
More Geographic Variation Research
by Kevin Roche on Monday, August 2, 2010
A study of diagnostic practices for Medicare beneficiaries reveals geographic variations. These variations not only may suggest either under or overuse of diagnostic tests but they can bias other research results and payment methods. A second study suggests that caution should be applied in analyzing regional variation to ensure that all possible sources of the differences are taken into account.
Tags: Health Care Costs, Medical Care, Medicare, Physicians
2010 Potpourri XXVII
by Kevin Roche on Saturday, July 31, 2010
A lot of great items in this week’s potpourri, covering the acquisition of HealthGrades, what encourages men to get screenings, potential cheating on pay-for-performance schemes, the problems of a multi-payer system, improving heart failure care, Canada’s experience with EHRs and autonomous robot surgery.
Tags: HIT, M&A, Medicaid, Medical Care, Pay For Performance, Payor, Wellness and Prevention
Process Measures and Quality Improvement
by Kevin Roche on Wednesday, July 28, 2010
A study in JAMA suggests that process-of-care quality measures, which are frequently used for bonus or penalty reimbursement programs, may have little real relationship to ultimate health outcomes.
Tags: Health Care Quality, Medical Care
2010 Potpourri XXV
by Kevin Roche on Saturday, July 17, 2010
Another week, another potpourri, this time with items on workers’ compensation drug spending, benefit consulting firm mergers, hospital readmissions, geographic variation in spending and use of mobile vans to deliver health care.
Tags: Drugs, Health Care Costs, Hospital, M&A, Medical Care, Workers Compensation
Unconventional Wisdom
by Kevin Roche on Thursday, July 15, 2010
The state of human knowledge is often imperfect and medical treatment provides frequent examples of that. What we think we know often turns out to be erroneous as two recent studies published in JAMA demonstrate.
Tags: Medical Care
Creating New Health Conditions is Costly
by Kevin Roche on Wednesday, July 14, 2010
There are so many sources of the rapid increases in national health spending that it is hard to track them all. A recent article estimates the costs of “medicalization”, the process of turning problems into medical issues which end up incurring health costs.
Tags: Health Care Costs, Medical Care
2010 Potpourri XXIV
by Kevin Roche on Saturday, July 10, 2010
Sitting indoors seeking relief from the summer heat? Here’s a montage of cool and refreshing health care items, including CPOE systems, accountable care organizations, Massachusetts’ reform experience, reducing imaging, and medical management trends.
Tags: Care Management, Government, Health Care Reform, HIT, Hospital, Medical Care
Fireworks Potpourri
by Kevin Roche on Saturday, July 3, 2010
We light up the sky with a scintillating selection of health care bombshells. Okay, maybe not that great, but some hopefully useful info on the VA’s health information system, MRIs and emergency cardiac care, business method and process patents, end-of-life care, actuaries’ views on how to control costs and, of course, more issues in Massachusetts.
Tags: Government, Health Care Costs, Health Care Reform, Health Insurance, Medical Care
Regulation of Laboratories’ Molecular Diagnostic Tests
by Kevin Roche on Friday, July 2, 2010
A critical component of personalized medicine is various molecular diagnostic tests. AHRQ has issued a lengthy report on the state of these tests, examining their quality and clinical utility.
Tags: Government, Medical Care, Personalized Medicine, Regulation
Medicare and Home Infusion
by Kevin Roche on Monday, June 28, 2010
Home infusion of therapeutic agents is increasing, especially as more biologics, which tend to need infusion, are approved for use. GAO looked at how Medicare FFS handles home infusion versus how private plans do.
Tags: Drugs, Medical Care, Medicare
2010 Potpourri XXII
by Kevin Roche on Saturday, June 19, 2010
Another weekend bonanza of health care items, including health insurance premium increases, genetic testing, remote patient monitoring, eye drug coverage by Medicare, emergency room use under the reform law and paying people to take their medicine.
Tags: Drugs, FDA, Health Insurance, Medical Care, Personalized Medicine, Telemedicine
Early Medical Home Demo Evidence Not So Great
by Kevin Roche on Thursday, June 17, 2010
The medical home is one of the hot concepts which is supposed to improve quality and lower costs. Many demonstrations are under way. A special issue of the Annals of Family Medicine reports on one of the largest of these.
Tags: Medical Care, Physicians
Big Effort Needed to Create Informed and Engaged Patients
by Kevin Roche on Tuesday, June 8, 2010
One theory for improving the health care system is to rely on more-informed and engaged consumers to help improve decision-making about treatment options. A recent Health Affairs article suggests there is a long way to go on this goal.
Tags: Consumers, Health Care Costs, Medical Care
Variation in Medicare Spending
by Kevin Roche on Monday, June 7, 2010
Dartmouth Atlas researchers largely created and fueled the perception that the significant variation in use of medical procedures and spending across geographic regions reflects likely unnecessary care. Their latest research focuses on joint replacement.
Tags: Medical Care, Providers
2010 Potpourri XX
by Kevin Roche on Saturday, June 5, 2010
More health care nuggets for the weekend, including personalized medicine, health reform, health insurance premiums, telemedicine, and community health centers.
Tags: Health Care Reform, Health Insurance, HIT, Medicaid, Medical Care, Personalized Medicine, Telemedicine
Heart Failure Hospitalizations
by Kevin Roche on Friday, June 4, 2010
Research reported in JAMA suggests that while lengths of stay and in-hospital deaths for heart failure patients covered by Medicare have fallen, readmissions and out-of-hospital deaths are up. While the authors suggest some cause and effect, that is not likely the case.
Tags: Hospital, Medical Care
Who Uses the Emergency Room
by Kevin Roche on Wednesday, May 26, 2010
One alleged benefit of health reform would be less use of the emergency room by uninsured persons who had no other way to access care. A recent report from the CDC suggests that notion may have been a myth.
Tags: Health Insurance, Medical Care
2010 Potpourri XVII
by Kevin Roche on Saturday, May 15, 2010
Here we go again. The CBO now estimates that the health bill has a number of discretionary spending items in it which will likely add over $100 billion to the costs of the act. (CBO Letter) It is really interesting how a few weeks after the law is enacted, the government suddenly finds several new [...]
Tags: Health Care Reform, Health Insurance, Medical Care, Telemedicine
Group Health’s Medical Home Experience To Date
by Kevin Roche on Thursday, May 13, 2010
The patient-centered medical home is yet another highly touted solutions to health system problems. Several pilot programs of the concept have been underway. Health Affairs reports on the Group Health experience.
Tags: Health Insurance, Medical Care, Physicians
Primary Care–Save Money and Improve Quality?
by Kevin Roche on Wednesday, May 12, 2010
Health Affairs’ theme for the current issue is primary care. An article looks at research on the extent to which primary care improves quality and lowers costs. Ambiguity reigns.
Tags: Medical Care, Physicians
Hospital Readmissions
by Kevin Roche on Thursday, May 6, 2010
A study in JAMA explores hospital readmissions for Medicare beneficiaries, finding that there is significant variation in discharge planning and follow-up, and that early attention to care after discharge leads to lower readmissions.
Tags: Hospital, Medical Care
2010 Potpourri XV
by Kevin Roche on Saturday, May 1, 2010
The latest in our weekend selection of health news and research developments, including any willing provider laws, emergency room visits, the link between insurance and health outcomes, hospital rankings and rising insurance premiums.
Tags: Health Insurance, Hospital, Medical Care, Providers
High Performance Health Systems
by Kevin Roche on Wednesday, April 28, 2010
The Commonwealth Fund, the Health Research & Educational Trust and the American Hospital Association issued an analysis of what contributes to a high performance hospital system in terms of patient safety and outcomes. Culture is paramount.
Tags: Hospital, Medical Care
PWC’s Take on Health Reform Effects
by Kevin Roche on Tuesday, April 27, 2010
Price Waterhouse Cooper has published a number of interesting reports on aspects of health care. They are one of the first large service companies to forecast changes to the health system that might result for the recently passed health law.
Tags: Health Care Reform, Medical Care
Care of Obese Persons
by Kevin Roche on Tuesday, April 13, 2010
A JAMA article reports on a study of whether obese persons receive worse medical care, due to stigmatization of their condition or for other reasons. Despite negative perceptions, it appears that in fact their care is as good as that of non-obese persons.
Tags: Medical Care
Patient Choice of Retail Clinic or Physician Office for Care
by Kevin Roche on Wednesday, April 7, 2010
A survey examines the bases for patients’ preferences for a site of care, in particular what factors would lead them to chose a retail clinic versus a regular physician office when they have a relatively minor health need.
Tags: Medical Care, Physicians
Dying, Disability and Advance Directives
by Kevin Roche on Tuesday, April 6, 2010
Two recent pieces of research shed further light on what commonly happens with individuals’ health status near the end of their lives and on the extent to which people are considering what kind of care they want to receive if they reach medical crisis and whether a patient’s preferences are being respected.
Tags: End of Life, Medical Care
Working Employees and Caring for an Ill Parent
by Kevin Roche on Wednesday, March 31, 2010
As people live longer, and as there are more families with both spouses working, more employees are having concerns about managing the care of an ill parent. A MetLife study examines some of the issues.
Tags: Consumers, Medical Care
How Do Physicians Say “No” to Patients
by Kevin Roche on Thursday, March 11, 2010
Physicians control almost all the utilization and spending in health care. Patients often ask or even demand some health services, which they often don’t need or which are not appropriate for the patient. Research looks at how physicians can persuade patients they don’t need a service or product.
Tags: Consumers, Medical Care, Physicians
More on Regional Spending Variation
by Kevin Roche on Tuesday, February 23, 2010
The New England Journal of Medicine publishes dueling commentaries on geographic and provider spending variations. Having a clear understanding of whether there are providers who render more care with no better outcomes would help formulate reforms to change their behavior.
Nursing and Telemedicine
by Kevin Roche on Friday, February 12, 2010
Two articles describe some of the challenges for nurses in the telemedicine environment. One describes the role nurses play when they are onsite with a patient and the physician is remote and the other discusses how nurses can convey a caring attitude when they are interacting remotely with the patient.
Tags: Medical Care, Telemedicine
2010 Potpourri III
by Kevin Roche on Saturday, January 23, 2010
Healthy health care snacks–concierge medicine, personalized medicine, health care hiring, electronic medical records, Medicaid, disease management–all for your reading pleasure on the weekend.
Tags: Care Management, Chronic Disease, Disease Management, HIT, Medical Care, Personalized Medicine, Physician Practice Models, Physicians
Christmas Potpourri
by Kevin Roche on Friday, December 25, 2009
Happy Holidays, here are a few health care presents for your tree, including defensive medicine, FDA regulation of drug/diagnostic combinations, virtual doctor visits, generic drugs and wireless health. Have a great Christmas.
Tags: Drugs, Medical Care, Personalized Medicine, Wireless
Patents and Health Care
by Kevin Roche on Friday, December 18, 2009
The Supreme Court is likely to review and rewrite the criteria for “process” patents in the next few months. The outcome could affect both service and product companies in the health care industry, encouraging or discouraging innovation, depending on your perspective.
How Does Capitation Affect Care
by Kevin Roche on Thursday, December 17, 2009
A new study suggests that physicians who are paid by capitation for some patients spend less time with those patients. Is that appropriate or inappropriate?
Tags: Medical Care, Physicians
Potpourri VII
by Kevin Roche on Saturday, December 12, 2009
Mercer surveyed employers to ascertain their reaction to the proposed tax on high value insurance coverage. The majority said they would reduce benefits to avoid the tax. Seven percent said they would outright terminate insurance coverage. Of those saying they would reduce benefits, most would do so by raising deductibles and copays. Employers also narrowly [...]
Tags: Drugs, Health Care Reform, Health Insurance, Medical Care, Pay For Performance, Telemedicine
Telephone Depression Intervention Helps After Cardiac Surgery
by Kevin Roche on Friday, November 27, 2009
A Pittsburgh study indicates that a telephone-based depression intervention following CABG surgery improves quality outcomes. Another example of relatively inexpensive method to improve care quality.
Tags: Medical Care, Telemedicine
RWJ Analysis of ACOs
by Kevin Roche on Friday, November 20, 2009
The Robert Wood Johnson Foundation has released a policy brief examining the potential of accountable care organizations to remedy the health system’s ills. The brief concludes that ACOs will not provide short-term improvement, but are worth exploring for their longer-term potential.
Deloitte Issues Update On Retail Clinics
by Kevin Roche on Wednesday, November 18, 2009
Deloitte issues one of its periodic reports on retail clinics, finding that growth has slowed, if not stopped, but payer and consumer acceptance has increased. Deloitte anticipates renewed growth in the near future.
Tags: Medical Care, Retail Clinics
Weekend Potpourri IV
by Kevin Roche on Saturday, November 14, 2009
Another dose of weekend tidbits, covering PAP screenings, health insurer consolidation, Part D plan satisfaction, Rand’s look at the best methods to reduce health care costs, geographic variations in health spending and coughing into cell phones–yes you heard me right.
Tags: Drugs, Guidelines, Health Insurance, Medical Care, Medicare, Pay For Performance
Few Innovations Lower Cost
by Kevin Roche on Thursday, November 12, 2009
A study reported in the Annals of Internal Medicine tried to find medical innovations that significantly lowered costs, with only minor reduction in quality or outcome. Very few were found, which is consistent with innovation, especially technologic innovation, being found to be a major health cost driver in other studies.
Tags: Health Care Costs, Medical Care
Weekend Potpourri III
by Kevin Roche on Saturday, November 7, 2009
Yet another installment of the weekend health care miscellany that you are undoubtedly growing fond of.
Tags: Comparative Effectiveness, Health Care Reform, Medical Care, Personalized Medicine
Comparative Effectiveness and Personalized Medicine
by Kevin Roche on Tuesday, November 3, 2009
The Lewin Group has issued a report on comparative effectiveness research and personalized medicine, indicating the need for integration of the latter into the former.
Tags: Comparative Effectiveness, Medical Care, Personalized Medicine
Weekend Potpourri II
by Kevin Roche on Saturday, October 31, 2009
Another edition of our thrilling, perhaps even chilling collection of health care tidbits for your Halloween edification.
Tags: Care Management, Medical Care
Medical Tourism Update
by Kevin Roche on Thursday, October 29, 2009
Deloitte Touche releases another report on medical tourism, anticipating continued strong growth for the sector as patients become more comfortable with its safety and continue to seek lower-cost health care.
Tags: Medical Care, Medical Tourism
Medicaid Recipients With Chronic Disease
by Kevin Roche on Wednesday, October 28, 2009
The Center for Health Care Strategies release an updated report on Medicaid enrollees with chronic disease, reaffirming how a relatively few patients account for well over half the total program spending.
Tags: Chronic Disease, Government, Medicaid, Medical Care
Harris Poll on Mobile Health Care
by Kevin Roche on Tuesday, October 27, 2009
A Harris poll looks at Americans’ attitudes toward mobile healthcare and finds that those who use health care the most are also the most disengaged from these new technologies.
Tags: Consumers, HIT, Medical Care, Telemedicine
EHRs and Quality
by Kevin Roche on Friday, October 23, 2009
A study finds a modest link between fully functional EHRs and performance on HEDIS quality measures by Massachusetts physicians.
Tags: Health Care Quality, HIT, Medical Care
Rethinking Screenings
by Kevin Roche on Thursday, October 22, 2009
JAMA publishes an article on some common screenings, suggesting a new strategy that would attempt to identify and screen only high risk individuals and would limit treatment to tumors demonstrated to be likely to cause significant disease.
Vita Advisors, LLC New Research Report on Prevention and Wellness Released
by Kevin Roche on Thursday, October 22, 2009
We have released a research report on The Value of Prevention & Wellness. The report describes various preventive interventions and examines methods of valuing these programs and specific research on the value of prevention and wellness activities.
Use of Mobile Health Tools for Chronic Illness
by Kevin Roche on Wednesday, October 21, 2009
The California HealthCare Foundation releases a report on Participatory Health, which provides an introduction to the potential of online and mobile technologies in management of chronic illness.
Tags: Care Management, Chronic Disease, Devices, Medical Care, Telemedicine
More Variation in Spending Research
by Kevin Roche on Monday, October 19, 2009
A study reported in Circulation indicates that California teaching hospitals that utilize more resources in treating heart failure had lower rates of mortality. The study results call into question the methods and findings of some Dartmouth Atlas research. Another report looks at supply and variation in MRI usage.
Tags: Care Management, Health Care Costs, Hospital, Medical Care, Providers
AHA Endorses Workplace Wellness
by Kevin Roche on Friday, October 16, 2009
The American Heart Association issues a comprehensive set of recommendations for improving cardiovascular health through workplace wellness programs, continuing its efforts to prevent acute coronary disease.
Tags: Medical Care, Wellness and Prevention, Workplace, Worksite Health
Brookings Paints New Health System
by Kevin Roche on Friday, October 16, 2009
Brookings forsees a health system which is organized around consumers’ management of their own care, with extensive use of mobile and telehealth technologies, and reimbursement and incentives to encourage widespread adoption of this consumer-centered approach.
Tags: Consumer Directed Health, Consumers, Medical Care, Telemedicine
A Better Way to Deliver Health Care?
by Kevin Roche on Tuesday, October 13, 2009
One way to address our health system challenges may be to change who delivers much of our medical care, creating less reliance on physicians, and to redesign how providers interact with patients and are paid for care.
Genetic Testing Needs Certainty to Be Accepted
by Kevin Roche on Friday, October 9, 2009
Several geneticists examine DTC genotyping and recommend some improvements.
Tags: Consumers, Genomics, Medical Care, Personalized Medicine
How NICE
by Kevin Roche on Wednesday, October 7, 2009
A Nature article explains how Britain’s NICE (National Institute for Health and Clinical Excellence) works.
Second-hand Smoke
by Kevin Roche on Monday, October 5, 2009
New research confirms that second-hand smoke can cause serious health issues for non-smokers.
A Vote For Telemedicine
by Kevin Roche on Thursday, October 1, 2009
Telemedicine has enormous potential to positively affect quality, access and cost issues, but there are barriers that should be addressed as part of health system reform.
Tags: Medical Care, Telemedicine
Clinical Preventive Care Summary
by Kevin Roche on Wednesday, September 30, 2009
The Robert Wood Johnson Foundation has published a review of the cost effects of clinical preventive care measures.
Tags: Health Care Costs, Medical Care, Wellness and Prevention
More Personalized Medicine
by Kevin Roche on Tuesday, September 29, 2009
In another personalized medicine development, researchers at UCLA have identified a way to improve depression treatment.
Tags: Drugs, Medical Care, Personalized Medicine, Pharmaceutical
How Comparative Effectiveness Research Can Increase Costs
by Kevin Roche on Monday, September 28, 2009
A recent drug trial illustrates how comparative effectiveness research may actually facilitate more health care spending.
Tags: Comparative Effectiveness, Drugs, Medical Care, Pharmaceutical
Are Our Health Costs High?
by Kevin Roche on Thursday, September 24, 2009
Researchers associated with the Dartmouth Atlas project reinforce their viewsg on high health costs in a NEJM Perspective.
Inverness Continues to Build Health Management Business
by Kevin Roche on Wednesday, September 23, 2009
Inverness Medical has agreed to acquire Free & Clear, a provider of smoking cessation and other wellness services.
Tags: Disease Management, M&A, Medical Care, Services, Wellness and Prevention
A Stroke of Genius
by Kevin Roche on Tuesday, September 22, 2009
There are times when a medical innovation occurs that looks like a winner from a quality and a cost perspective. Johns Hopkins researchers appear to have found one for the rapid identification of stroke.
Tags: Medical Care, Medical Research
Patients’ Decision-Making
by Kevin Roche on Monday, September 21, 2009
New research reveals complex aspects of patients’ decision-making, depending on how information is presented.
Tags: Consumer Directed Health, Consumers, Medical Care, Patients
A New Study Analyzing Retail Clinic Use
by Kevin Roche on Thursday, September 17, 2009
Rand Corporation has published a study comparing use of retail clinics with emergency room and primary care physician visits.
Tags: Medical Care, Providers, Retail Clinics
A Good Summary on Comparative Effectiveness Research
by Kevin Roche on Wednesday, September 16, 2009
The Rand Corporation has produced a useful summary of information regarding comparative effectiveness research’s potential.
House Calls Returning?
by Kevin Roche on Tuesday, September 15, 2009
The Los Angeles Times reports on a possible return of house calls.
Tags: Care Management, Medical Care, Physicians, Providers
Geographic Variation in Health Spending
by Kevin Roche on Monday, September 14, 2009
Geographic variation in health spending is hot, but the reasons for it are still murky.
Tags: Health Care Costs, Health Care Reform, Medical Care, Providers
Cherry-Picking Trial Results
by Kevin Roche on Saturday, September 12, 2009
A JAMA article suggests that published trial results may not be giving us the full picture.
Measuring Prevention’s Cost Savings
by Kevin Roche on Tuesday, September 8, 2009
A new Health Affairs article suggests a different method to measure cost savings from disease prevention and management efforts.
Tags: Care Management, Chronic Disease, Medical Care, Wellness and Prevention
An Example of the Value of Comparative Effectiveness Research
by Kevin Roche on Friday, September 4, 2009
Research indicates that laparoscopic nerve ablation for chronic pelvic pain is ineffective.
A Screening Illustration
by Kevin Roche on Friday, September 4, 2009
Coronary calcium screening provides an interesting example of the potential benefits, costs and uncertainties surrounding various disease screening opportunities.
Home Medical Testing and the Self-Care Movement
by Kevin Roche on Wednesday, September 2, 2009
Patients are increasingly involved in the management of their own health.
Tags: Care Management, Consumers, Medical Care, Patients
Hypertension Treatment Status
by Kevin Roche on Tuesday, September 1, 2009
There are excellent hypertension treatments available but many Americans don’t know they have the condition and aren’t being treated.
Another Imaging Issue
by Kevin Roche on Monday, August 31, 2009
A new study describes the relatively high doses of ionizing radiation being received by many Americans as a result of imaging procedures.
Tags: Imaging, Medical Care
Personalized Medicine and Anti-platelet Therapy
by Kevin Roche on Friday, August 28, 2009
Pharmacogenomics is at the forefront of personalized medicine development. Recent research indicates promise in anti-platelet therapy guidance.
Tags: Drugs, Genomics, Medical Care, Personalized Medicine, Pharmaceutical
Quality Improvement is Not Easy
by Kevin Roche on Thursday, August 27, 2009
A commentary on Medicare’s experience in attempting to improve the quality of heart failure care demonstrates just how hard it may be to get better outcomes and lower cost.
And Now For Something Completely Different
by Kevin Roche on Saturday, August 22, 2009
An Op-ed suggests we spend too little on healthcare. That may depend on who is paying.
Tags: Health Care Costs, Medical Care
Getting Physicians to Participate in Research
by Kevin Roche on Monday, August 17, 2009
An article examines barriers to physician participation in medical research.
Tags: Medical Care, Medical Research, Pharmaceutical, Physicians, Providers
Another Approach to Managing Chronic Disease
by Kevin Roche on Friday, August 14, 2009
Because chronic disease accounts for a large percentage of total health spending, approaches to managing those diseases are constantly being developed and modified.
The Quality of Health Services Research
by Kevin Roche on Wednesday, August 12, 2009
A recent article questions the validity and utility of much health services research.
CBO Explains Prevention & Wellness Scoring
by Kevin Roche on Monday, August 10, 2009
In a letter to a Congressman, the CBO gives its rationale for how it attributes costs and savings to prevention and wellness programs.
Tags: CBO, Government, Medical Care, Wellness and Prevention
Prevention and Wellness Savings for Medicare
by Vita Advisors on Friday, August 7, 2009
Healthways’ Center for Health Research put our a report estimating that Medicare could save over $100 billion a year if beneficiaries entered the program in better health and maintained good health status.
Tags: Government, Medical Care, Medicare, Wellness and Prevention
Vertebral Fracture Treatment Studies
by Kevin Roche on Thursday, August 6, 2009
Two studies question the value of a vertebral fracture treatment, but more importantly show the utility of comparative effectiveness research.
Tags: Care Management, Comparative Effectiveness, Medical Care
Patient Involvement Is A Key to Real Reform
by Kevin Roche on Wednesday, August 5, 2009
Research and experience continues to confirm the value, in both cost savings and patient satisfaction, of extensive patient involvement in important health decisions.
Tags: Care Management, Consumer Directed Health, Consumers, Medical Care
Lab Companies Rolling Along
by Kevin Roche on Monday, July 27, 2009
The two largest clinical laboratory companies seem to be weathering the recession in good fashion.
Tags: Laboratory, Medical Care, Public Companies
An Interesting Pay-for-Performance Evaluation
by Kevin Roche on Friday, July 24, 2009
An analysis of England’s pay-for-performance system finds improvement but some interesting trends and concerns as well.
Tags: Health Care Reform, Medical Care, Pay For Performance, Physicians
Hospital Trade Association Survey Results
by Kevin Roche on Friday, July 24, 2009
HFMA has released its latest Financila Pulse, describing hospitals’ expectations regarding revenue and other financial results.
Tags: Hospital, Medical Care
VA has IT Woes
by Kevin Roche on Tuesday, July 21, 2009
Often lauded for its health information systems, the VA apparently has significant problems getting projects done on time and on budget.
Tags: HIT, Medical Care
HIT and Privacy Laws
by Kevin Roche on Thursday, July 16, 2009
Health information technology is being pushed as one of the key methods to improve health care and reduce costs, but government itself has created barriers to its adoption and utility.
Tags: HIT, Medical Care, Regulation
Who Is the “Voice” of Physicians?
by Kevin Roche on Wednesday, July 15, 2009
A physician website challenges the AMA’s representation of physicians.
Tags: AMA, Medical Care, Physicians
Another Medical Practice Adopts New Model
by Kevin Roche on Thursday, July 9, 2009
A Seattle-based medical practice has opted out of the insurance payment model for health care.
Tags: Medical Care, Medical Homes, Physician Practice Models
Physician Practice Administrative Costs
by Kevin Roche on Tuesday, July 7, 2009
A Health Affairs article reports a survey on the time and expense involved in physician interaction with health plans.
Tags: Administrative Costs, Health Insurance, Medical Care, Payor
Telemedicine Utility and Barriers
by Kevin Roche on Thursday, July 2, 2009
Experts are recommending greater use of telemedicine in stroke assessment and treatment. There are significant barriers, however, many imposed by government.
Tags: Care Management, Health Insurance, Medical Care, Telemedicine
JAMA Commentary Gives Crux of Cost Control Issue
by Kevin Roche on Wednesday, July 1, 2009
A recent JAMA commentary gives a concise summary of the cost control problems.
Tags: Government, Health Care Costs, Health Care Reform, Medical Care
Republicans Take on Comparative Effectiveness Research
by Kevin Roche on Wednesday, June 17, 2009
Republican Senators have now introduced a bill to essentially gut federal funding or use of comparative effectiveness research, continuing an attack on the proposed expansion of such research for the purpose of controlling costs
Tags: Comparative Effectiveness, Government, Health Care Reform, Medical Care
More on Prevention’s Cost Savings
by Kevin Roche on Sunday, June 14, 2009
The Wall Street Journal article summarized some research results regarding the potential cost savings of prevention and wellness efforts, particularly for persons with chronic diseases. The overall conclusion is that not much money is likely to be saved by such methods, primarily because the cost of these programs when applied to a large population tends to outweigh the health care cost savings which eventually accrue.
Tags: Chronic Disease, Consumers, Disease Management, Medical Care, Wellness and Prevention
AMA Encouraging Use of PHRs
by Kevin Roche on Thursday, June 11, 2009
A pair of recent announcements by the American Medical Association pique one’s curiousity.
Tags: Medical Care, PHRs
“Cheap” Personal DNA Sequencing
by Kevin Roche on Thursday, June 11, 2009
Illumina has announced that for $48,000 a consumer can have their entire DNA sequenced
Tags: Consumers, Genomics, Medical Care, Personalized Medicine
Cost Saving Suggestions
by Kevin Roche on Tuesday, June 9, 2009
Several prominent health industry segments have issued a follow-up statement identifying more specifically where they believe health care cost savings can be achieved.
Tags: AdvaMed, AHA, AMA, Government, Health Insurance, Medical Care, PhRMA
MEDPAC – Medicare Payment Advisory Commission
by Kevin Roche on Wednesday, June 3, 2009
The work of the Medicare Payment Advisory Commission is always worth reading carefully. (Medpac website) It is one of the government groups that seems to do its job with a high degree of professionalism. MEDPAC’s reports contain useful data and it often provide unvarnished analysis and insight into America’s health care cost issues.
Tags: CMS, Medical Care, Medicare
Providers Happy to Help Reduce Health Care Costs—Not!
by Kevin Roche on Tuesday, June 2, 2009
The American Hospital Association and the American Medical Association, in conjunction with a number of physician specialty organizations, have each released statements regarding proposals to help control health care costs by changing, even reducing payments to providers.
Tags: AHA, AMA, Government, Medical Care
One Reason Health Reform Will be Hard
by Kevin Roche on Tuesday, June 2, 2009
An interesting news report on Kaiser Health News gives an indication of why health reform that affects costs will be very difficult. The story details the fight in one New Jersey town over building a new hospital.
Tags: Health Care Costs, Medical Care
Room for Improvement in Preventing Hospital Admissions
by Kevin Roche on Friday, May 29, 2009
The Agency for Healthcare Research and Quality’s (“AHRQ”) Healthcare Cost and Utilization Project released a report in April 2009 outlining hospitalizations that might have been preventable had the patients been receiving appropriate ambulatory care.
Tags: Health Care Costs, Hospital, Medical Care
Cost/Quality Relationship Unclear
by Kevin Roche on Wednesday, May 27, 2009
A study reported in Health Affairs, vol. 28, page 897 (May/June 2009), provides a further input to the question of the relationship, if any, between costs and quality in health care.
Tags: Health Care Costs, Health Care Quality, Hospital, Medical Care, Medicare
Medical Homes No Short Term Panacea
by Kevin Roche on Tuesday, May 26, 2009
The American Academy of Family Physicians has been at the forefront of efforts to re-emphasize the role of primary care physicians in the health system; and has participated in development of the patient-centered medical home as a method for revitalizing primary care.
Tags: Medical Care, Medical Homes
The Value of Care Management
by Kevin Roche on Thursday, May 21, 2009
A recent article in The American Journal of Managed Care (volume 15, page 295, May 2009), described findings from a comparison within the Kaiser Permanente system of patients with diabetes who were subject to a care management program and those who were not.
More Coverage = More Physician Visits = Less Cost?
by Kevin Roche on Thursday, May 21, 2009
A recent story in the Boston Globe raises intriguing questions about the effect of health coverage expansions on physician visits and other services and consequently, costs.
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