MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'health care policy'. Sat, 03 Sep 2011 01:59:19 +0100 http://www.medworm.com/index.php?rid=5159351&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FdflHJn4aeTM%2Fbundled-payments-for-care-improvement-initiative-announced-by-cms-center-for-innovation.html Many health care provider organizations have not been overly eager to jump onto the Accountable Care Organization (ACO) bandwagon, citing high startup costs and uncertain returns on investment given the complexity of the program.  Well, recently, the CMS Center for Innovation has announced the Bundled Payment for Care Improvement initiative.  This initiative incorporates elements of earlier CMS demonstration projects -- the gainsharing demos and ACE (acute care episode) bundled payments demonstrations which the HealthBlawger has helped a number of clients around the country qualify for in the past -- and builds on the broad authority granted to the CMS Center for Innovation under health reform. The advantages to proceeding with a Bundled Payment for Care Improvement project include the... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=5159351 Thu, 25 Aug 2011 11:17:08 +0100 5159351 http://www.medworm.com/index.php?rid=5130872&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FX8JuuH6We8U%2Fpartners-health-care-acquiring-neighborhood-health-plan-the-800-pound-gorilla-and-the-fig-leaf.html Partners Health Care (the dominant provider network in Greater Boston) and Neighborhood Health Plan (a local mostly-Medicaid HMO) just announced that the former intends to acquire the latter, and maintain it as a separate operating entity.  No money will change hands between the parties, but an unspecified amount of money will be given by Partners as grants to community health centers where NHP members receive much of their health care services. Gary Gottlieb, CEO of Partners, graciously allowed that it would not seek to interfere with the current referral patterns of NHP members to the two local safety-net hospitals (which get disproportionate share hospital payments; Partners hospitals do not). The deal is contingent on several layers of regulatory review, including review by the Commo... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=5130872 Sun, 14 Aug 2011 20:35:15 +0100 5130872 http://www.medworm.com/index.php?rid=5096097&cid=t_99849_85_f&fid=34967&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fdocisinblog%2FwNlq%2F%7E3%2FJj4POHfFcZQ%2F Well, now, isn’t that special… Forbes reports on a new investment vehicle, tailor-made for the get-rich-quick crowd: Playing The Odds: Hedge Funds Finance Medical Malpractice Claims: An entirely new industry has cropped up in recent years as trial lawyers set their sights on making money off physicians, corporations and other targets–particularly financing malpractice suits through hedge funds. In 2010, hedge funds invested $1 billion in these types of suits, much of it for medical malpractice cases… … the rewards can be remarkable for investors, which is why dollars are flowing into these hedge funds. Payouts can result in tens of millions of dollars. George Soros, call your office… Having milked all the money they can from sub-prime mortgages, deriva... The Doctor Is In blogs http://www.medworm.com/rss/comments.php?id=5096097 Wed, 03 Aug 2011 21:27:09 +0100 5096097 http://www.medworm.com/index.php?rid=5069597&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2F-8F6F2av9PI%2Frural-health-white-paper-released-by-unitedhealth-group-think-tank.html The UnitedHealth Center for Health Reform and Modernization released a white paper today on Modernizing Rural Health Care.  To quote from the UHG presser, [The paper] projects an increase of around 5 million newly insured rural residents by 2019 – even as the number of physicians in rural America lags Quality of care is rated lower in rural areas in 7 out of every 10 health care markets; both physicians and consumers in rural areas more likely to rate quality of care lower than those in urban and suburban markets Innovations in care delivery – particularly telemedicine and telehealth – can absorb future strain on rural health care systems The paper inventories the current state of health care for the 50 million Americans living in a rural setting -- and it's not pretty.�... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=5069597 Wed, 27 Jul 2011 03:23:08 +0100 5069597 http://www.medworm.com/index.php?rid=5062347&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FVbefN6-mntM%2Fhealth-information-technology-tweeps-to-watch-the-hit100-list.html Michael Planchart, aka @theEHRguy, put out the call last month for nominations to the #HIT100, intended to be a list of key health IT folk engaged in social media.  The crowdsourced #HIT100 list -- Michael tabulated the nominations -- is posted on several blogs, including @nateosit's (linked to above).  Keith Boone (aka @motorcycle_guy put together a twitter list of all #HIT100 nominees.  (Nate and Keith both ended up near the top of this list.) Update 7/25/2011:  Nate reports that Keith's final list is more accurate.  Many folks I interact with on a regular basis on line and in real life are on this list, and I am honored to be included in it as well.  (Check out this photo of Keith wearing a @reginaholliday jacket from The Walking Gallery at the tweetup I organized w @bobcoffield... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=5062347 Mon, 25 Jul 2011 16:26:38 +0100 5062347 http://www.medworm.com/index.php?rid=5057810&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2Fs59FGFWkjts%2Fhealth-care-social-media-getting-health-care-providers-off-the-dime.html I had the opportunity to share some thoughts recently aimed at getting health care providers off the social media bench and into the game in a new online community / group blog, HealthWorks Collective.  I invite you to check out the community at large, hosted at Social Media Today, and to check out my post there, in particular.  I opened with one of my favorite explanations of why health care provider organizations should be involved in social media.  If you are interested in learning more, please watch this space for announcements of upcoming webinars and speaking engagements (some are listed here), and feel free to contact me if you'd like to arrange to have the HealthBlawger present to your group, or facilitate a retreat.  David HarlowThe Harlow Group LLCHealth Care Law and Consult... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=5057810 Fri, 22 Jul 2011 19:18:36 +0100 5057810 http://www.medworm.com/index.php?rid=5028631&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FrNePQpCmHgk%2Fhealth-insurance-exchange-regulations-are-out-and-they-make-me-feel-like-a-visitor-from-the-future.html Health Insurance Exchange regulations were released by HHS yesterday -- in a DC hardware store, for local color and homespun truths -- with a go-live date of January 1, 2014, per the Affordable Care Act, and a key interim approval deadline of January 1, 2013, by which date each state needs to demonstrate that it has its act together and is on a glide path to the go-live date.  Despite the rancorous opposition to the ACA (consider, for example, the views of the Virginia Attorney General -- who is leading a multi-state charge against the individual mandate -- expressed at the American Health Lawyers Association Annual Meeting last month, where he was an invited keynote speaker, and later tweeted a tone-deaf assessment of the audience and an unkind skewering of a questioner who didn't share ... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=5028631 Tue, 12 Jul 2011 15:11:10 +0100 5028631 http://www.medworm.com/index.php?rid=5028632&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2Fj1wDO3_RgCk%2Fhealthcare-associated-infections-what-is-the-message-and-what-can-we-do-about-them.html   The good people at GE and JESS3 have come up with an HAI infographic.  It's pretty, and it conveys the horrible information that many of us already know -- healthcare associated infections kill about 100,000 people a year, and add $35 billion a year to our collective health care bill (here in the US of A); 5% of hospital inpatients end up with an HAI. So what do we expect the world to do with this infographic?  The FDA has rolled out new cigarette package warnings, including graphic photos, that are presumably intended to so sicken potential purchasers of cigarettes that they drop the pack of cigarettes and run screaming from the counter.  In more measured terms, the FDA says: The introduction of these warnings is expected to have a significant public health impact by decreasing... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=5028632 Fri, 08 Jul 2011 18:18:39 +0100 5028632 http://www.medworm.com/index.php?rid=5008414&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2F5bURn4uodAs%2Fsgr-in-the-mpfs-again-duck-season-wabbit-season-doc-season.html It's doc season again, that time of year when the sustainable growth rate rules are trotted out, and physicians are informed that they will face catastrophic rate reductions courtesy of Medicare (29.5%, effective January 1, 2012, per the July 1 announcement).  There will be much breast beating about how we've gotten into this fine mess, and what we should cut instead in order to maintain physician reimbursement levels (suggestions I've seen range from cutting the defense budget to eliminating Medicare coverage for dialysis).  Docs will say they've had enough and are opting out of Medicare.  We can look back to MedPAC recommendations on how to fix this so we don't need an annual doc fix, or look forward to a permanent fix, for which Don Berwick made an impassioned plea, even as he annou... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=5008414 Thu, 07 Jul 2011 16:40:12 +0100 5008414 http://www.medworm.com/index.php?rid=5008415&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Fhealthblawg.typepad.com%2Ffiles%2Fregina-herzlinger-on-healthblawg-w-david-harlow-07-2011.mp3 I spoke with Harvard Business School professor Regina Herzlinger this week about health reform – the good, the bad and the ugly – touching on ACOs and demonstration projects under the Affordable Care Act; innovations coming down the pike in the private sector either because of the law or because of market forces; social media in health care; and two key fixes to the ACA that she believes are absolutely necessary in order to make it work, or work as best it can. First of all, she expressed her delight at the passage of a federal law nudging us ever closer to universal coverage, combined with dismay at its failure to address rising costs (noting that we're looking at policies yielding an accumulated Medicare deficit of $90 trillion, as compared to an annual GDP of $12-14 trillion) and a... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=5008415 Thu, 07 Jul 2011 15:39:44 +0100 5008415 http://www.medworm.com/index.php?rid=4976011&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FgOiD_T8Xjis%2Ftweets-from-american-health-lawyers-association-annual-meeting-2011.html Here's a window into the American Health Lawyers Association Annual Meeting this week in Boston: Tweets by me and a few others from the event.  If you are within range of Boston and would like to join health lawyers, health IT, health care social media, Health 2.0 and related communities for a tweetup, we'd like to see you, after the social media sessions at the Annual Meeting (whether or not you are attending the Annual Meeting).  Feel free to read more more about the social media sessions (I'll be speaking on the subject this afternoon) and please RSVP to the #AHLABostonTweetup invite if you can join us at 5:30.   <a href="http://www.coveritlive.com/mobile.php?option=com_mobile&tas... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4976011 Tue, 28 Jun 2011 06:18:17 +0100 4976011 http://www.medworm.com/index.php?rid=4976010&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2F34OX0bwEwBo%2Fdavid-harlow-presents-social-media-session-at-american-health-lawyers-association-annual-meeting.html I am speaking today at the American Health Lawyers Association annual meeting on the uses of social media by attorneys. I am sharing two versions of my slides from this session: one that is text-rich and full of useful links, and one that is much nicer to look at and more engaging for a live audience. Enjoy one or both, and let me know what you think in the comments.  If you are off-site, please tweet a shout-out to me @healthblawg tagged #AHLABoston a little after 3 p.m. ET, so we can show the folks in Boston the reach of Twitter, and let us know where you're tweeting from. AHLA Annual Meeting 2011 Social Media Legal Marketing Resources by David Harlow View more presentations from David Harlow. AHLA Annual Meeting 2011 Social Media for Lawyers by David Harlow ... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4976010 Tue, 28 Jun 2011 05:56:01 +0100 4976010 http://www.medworm.com/index.php?rid=4968661&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2Fxx0GnFs4A0k%2Fmassachusetts-healthcare-reform-experiment-analyzed-attoney-general-martha-coakley-are-we-ready-for-global-payment-.html Massachusetts Attorney General Martha Coakley released her office's second annual report, An Examination of Health Care Cost Trends and Drivers (PDF; see also press release), which contains a wealth of critical data analysis -- and also highlights how little we know about certain things -- providing some important context for the discussion of the proposed Part III of Massachusetts health reform, a bill filed by Governor Patrick which would create all-payor ACOs and a system of global payments. At this late date, few would argue against a move a way from fee-for-service reimbursement for health care, or adding quality metrics to the mix, and tying financial rewards to providers to their performance measured against these metrics.  (Consider the Massachusetts Blue Cross Blue Shield ACQ (a... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4968661 Fri, 24 Jun 2011 17:50:55 +0100 4968661 http://www.medworm.com/index.php?rid=4968662&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FJsCTlY3xPP4%2Fspeaking-engagements-health-care-social-media-acos-and-more.html I spoke recently at a MassMEDIC conference about the FDA and social media, and on a webinar presented by the Mayo Clinic Center for Social Media (with which I am associated, as a member of its external advisory board) and Ragan Communications, and I will be speaking at a number of upcoming conferences.  It occurred to me that it would be worthwhile to share information about these events for those who may be interested. Feedback I've received from some program participants is that topics covered in an hour-long session on health care social media sometimes get short shrift.  For those who may be interested in more in-depth treatment of some issues, I'll call to your attention the webinar series to be held in mid-July (four hours over two days).  Let us know about any particular areas o... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4968662 Thu, 23 Jun 2011 04:58:49 +0100 4968662 http://www.medworm.com/index.php?rid=4953082&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FPE8g9xAh860%2Ftweetup-at-the-ahla-annual-meeting-in-boston.html Come join Bob Coffield (@bobcoffield) and me, together with other speakers, attendees and camp followers from the American Health Lawyers Association, for a tweetup next Tuesday, June 28, 2011, at 5:30 or so at BrasserieJO, at the Colonnade Hotel, 120 Huntington Avenue, Boston.  We hope to introduce the AHLA to some members of Boston's Health 2.0 community and other folks interested in all (or some) things healthcare, legal and/or social media. Check out the TwtVite, let us know if you'll be joining us, and spread the word. As Bob posted earlier today: The TWEETup follows an afternoon of health care social media and the law sessions held as a part of the AHLA Annual Meeting. For full details of the sessions and registration information check out the AHLA Annual Meeting schedule here (P... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4953082 Tue, 21 Jun 2011 20:49:31 +0100 4953082 http://www.medworm.com/index.php?rid=4893643&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2F2B2X0b39ekw%2Faco-pgp-demonstration-cms-dont-kick-a-unicorn-when-its-down.html There has been a significant outcry against the proposed ACO regs: everything's wrong and nothing's right about them, or so some would have us believe.  (The comment period is still open, and CMS is still soliciting input; much of the outcry is a form of posturing and negotiation ... not that there's anything wrong with that.) Today's "nattering nabobs of negativism" focus on: the estimated price tag for complying with the regulatory requirements (IT and other infrastructure incuded), the slim chance of success by ACOs in righting the wrongs of decades of bloat in the health care system, the premature pledging of allegiance to an idea only partly proven through the PGP demo, the likelihood of failure due to the whole endeavor's being tied to FFS reimbursement, on the one hand, and due to... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4893643 Fri, 03 Jun 2011 12:40:18 +0100 4893643 http://www.medworm.com/index.php?rid=4893644&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FSki4I6PoVRM%2Fhipaa-disclosure-accounting-rules-nprm-revisited-per-the-hitech-act.html HIPAA regulations long on the books require that covered entities (i.e. health care providers, payors and clearinghouses) provide patients with accounting of disclosures of their protected health information (PHI) for any purpose other than treatment, payment or health care operations (TPO). The HITECH Act upped the ante, requiring accounting of disclosures of PHI for TPO as well.  Regs implementing this requirement were to be keyed off of the meaningful use regs, and they have now arrived. Stage 1 Meaningful Use requirements do not include EHR capability to track PHI disclosures made for TPO purposes (though that capability was in the draft requirement for Stage 1), potentially making the process more manual than it ought to be.  In addition, despite the fact that patients and patient a... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4893644 Wed, 01 Jun 2011 16:40:13 +0100 4893644 http://www.medworm.com/index.php?rid=4883724&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2Fm16_TJ37BMQ%2Fonc-federal-health-it-strategic-plan-comments-filed-on-behalf-of-the-society-for-participatory-medic.html We e-patients are an impatient lot, and therefore we may not be big fans of the Five-Year Plan approach to creating change.  The Office of the National Coordinator for Health IT released a draft federal health IT strategic plan in late March, via blog post (the plan itself is linked to from the post; a copy is posted here). The ONC post says: The Plan demonstrates how we will build off the foundation of meaningful use to unlock the power of information to: Enhance our ability to study care delivery and payment systems Empower individuals to improve and participate more in their care Improve care, efficiency, and population health outcomes, through tools such as clinical decision support, real- time feedback of performance to clinicians, and targeted public health campaigns The... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4883724 Tue, 31 May 2011 14:01:00 +0100 4883724 http://www.medworm.com/index.php?rid=4841689&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FZ9Inn_LpIEY%2Fwhy-do-10-of-cancer-patients-on-oral-meds-stop-taking-them-.html Ten percent of cancer patients failed to fill their initial prescriptions for oral anti-cancer drugs, according to a new study published jointly today in the Journal of Oncology Practice (JOP) and American Journal of Managed Care (AJMC)[, based on data]... Read the full post on HealthBlawg. (Source: HealthBlawg :: David Harlow's Health Care Law Blog) HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4841689 Wed, 18 May 2011 02:36:35 +0100 4841689 http://www.medworm.com/index.php?rid=4841690&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FFtmKA-h810c%2Fis-the-aco-doa-reasonable-minds-can-improve-the-draft-regulations.html In the current all-ACO, all the time, health care policy news cycle, we've been inundated with declarations that the ACO is dead, because a handful of big boys say they don't want to play. Today, CMS announced that it is... Read the full post on HealthBlawg. (Source: HealthBlawg :: David Harlow's Health Care Law Blog) HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4841690 Tue, 17 May 2011 19:35:33 +0100 4841690 http://www.medworm.com/index.php?rid=4820976&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FY1gJh4slHcI%2Ffda-social-media-david-harlow-presentation-at-massmedic.html This study captures a snapshot of the the way we use the internet to solve health problems -- and many, if not most, of us are doing that one way or another.  Research conducted by Susannah and the Pew Internet & American Life Project can help folks tailor messages and tactics to be used in the deployment of health care social media -- both in the realm of health care and in the realm of pharma and devices.  Perhaps some day (soon!), the FDA will call on resources such as the Pew Research Center to turn around some illuminating studies within a short timeframe.  Until then, we're stuck with the pushmi pullyu approach to social media in the FDA-regulated space --regulators and the regulated community looking away from each other and not.  (Another aspect of this approach: the FDA us... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4820976 Fri, 13 May 2011 11:45:00 +0100 4820976 http://www.medworm.com/index.php?rid=4734298&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2Fhr-rV71sI-c%2Fhealth-care-social-media-policies-facebook-misstep-costs-ri-physician-fine-job.html In recent years many health care providers and managers have told me, time and again, that the health care world is accustomed to managing confidential patient information, and therefore doesn't need much in the way of social media training and policy development.  This week brings news that should make those folks sit up and take notice.  A physician in Rhode Island, who was fired for a Facebook faux pas, has now been fined by the state medical board as well.  The physician posted a little too much information on Facebook -- information about a patient that, combined with other publicly available information, allowed third parties to identify the patient.  The details of the story are available here and here. The key takeaway from this story -- and the Johnny-come-lately approach to ... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4734298 Thu, 21 Apr 2011 14:34:10 +0100 4734298 http://www.medworm.com/index.php?rid=4734261&cid=t_99849_113_f&fid=34631&url=http%3A%2F%2Fehealth.johnwsharp.com%2F2011%2F04%2F19%2Fprevention-and-lifestyle-changes-potential-for-health-care-reform%2F Dean Ornish Today I heard Dean Ornish speak and came aware more convinced that prevention of disease through lifestyle changes can have a major impact on the future of health. Particularly, the potential impact on the epidemic of diabetes in the US is huge. We all have heard about how more and more of our population is becoming obese and the subsequent increase in diabetes and metabolic syndrome. If lifestyle changes can prevent even 10 or 20 percent of the progression to these serious conditions, imaging the impact on quality of life, work productivity and healthcare costs. This Thursday, Cleveland Clinic and Slate magazine will co-host a summit on Childhood Obesity. Not only that, but he notes research on his website, Preventive Medicine Research Institute, that there is a potential impa... eHealth blogs http://www.medworm.com/rss/comments.php?id=4734261 Tue, 19 Apr 2011 21:15:29 +0100 4734261 http://www.medworm.com/index.php?rid=4670203&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FEuBxzB-YbdY%2Faccountable-care-organization-aco-regulations-first-look.html ACO regulations and related federal issuances hit the street last Thursday, after several months of waiting -- from CMS, OIG, FTC, DOJ and IRS.  They cover the waterfront, ranging from the central regulation defining the structure and workings of the ACO, to  limited Stark self-referral ban and anti-kickback statute waivers in the fraud and abuse arena, to new frameworks for antitrust analysis, to rules governing joint ventures involving taxable and tax-exempt organizations.  I had the opportunity to discuss the regs the day after they were issued on a special edition of the Blog Talk Radio show, ACO Watch, hosted by Gregg Masters (@2healthguru).  Gregg's guests included Mark Browne (@consultdoc), Vince Kuraitis (@VinceKuraitis), Jaan Sidorov (@DisMgtCareBlog) and yours truly (@health... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4670203 Sun, 03 Apr 2011 14:07:31 +0100 4670203 http://www.medworm.com/index.php?rid=4664312&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FwCXPiE0r0eI%2Faccountable-care-organization-proposed-regulations-released-for-public-comment.html The long-awaited ACO regulations were released by CMS in draft form today, accompanied by a series of conference calls for different constituencies.  Here is a mirrored copy: Medicare Program; Medicare Shared Savings Program: Accountable Care Organizations - Proposed rule. // <![CDATA[ // <![CDATA[ // <![CDATA[ // <![CDATA[ // <![CDATA[ // <![CDATA[ // <![CDATA[ // <![CDATA[ // <![CDATA[ (function() { var scribd = document.createElement("script"); scribd.type = "text/javascript&... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4664312 Fri, 01 Apr 2011 07:10:32 +0100 4664312 http://www.medworm.com/index.php?rid=4626900&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2F5lFwrspL-kI%2Fsocial-media-in-health-care-david-harlow-quoted-in-recent-articles.html Recent health care social media articles in the American Academy of Physician Assistants magazine, PA Professional (Social Media for Health Professionals - Avoiding the Pitfalls) and in SELF magazine (The Health Dangers of Facebook Posts) feature my advice to health care providers and the general public on the careful use of social media in the health care context.  In addition, it is important to note that social media does not exist in a siloed environment.  As I said to the PA Professional reporter, "In this day and age, you can't be patient-centered and promote patient engagement without using social media tools."  The key is to use them effectively and safely.  For more on the subject, see these HealthBlawg posts and resources on health care social media David HarlowThe Harlow G... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4626900 Wed, 23 Mar 2011 20:02:00 +0100 4626900 http://www.medworm.com/index.php?rid=4622324&cid=t_99849_113_f&fid=34631&url=http%3A%2F%2Fehealth.johnwsharp.com%2F2011%2F03%2F22%2Fhearing-atul-gawande-speak-about-checklists-and-health-policy%2F Atul Gawande Just returned from live tweeting of Atul Gawande at Cleveland Clinic Ideas and full of quotes and ideas. For instance, the evidence is building for use of checklists showing significant reduction in mortality and complications so that he states that if there was a drug that showed this kind of effect it would be adopted immediately, even faster than Viagra. Gawande also discussed two of his well known New Yorker articles: The Cost Conundrum - What a Texas town can teach us about health care The Hot Spotters: Can we lower medical costs by giving the neediest patients better care? In the end, he challenged the audience and the country to find one hospital which could reduce costs while not causing harm to set a model. He predicted that in the coming hospital wars, the ones w... eHealth blogs http://www.medworm.com/rss/comments.php?id=4622324 Wed, 23 Mar 2011 00:50:26 +0100 4622324 http://www.medworm.com/index.php?rid=4622346&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FE8rEfKQoxlA%2Fwho-owns-patient-data-the-walgreens-edition.html Walgreens is being sued by customers who are not happy that their prescription information – even though it has been de-identified – is being sold by Walgreens to data-mining companies.  The data privacy and security concerns surrounding the transfer of de-identified data are significant.  To “de-identify” what is otherwise protected health information under HIPAA, some outfits will simply strip data of 18 types of identifiers listed in federal regulations.  However, the relevant regulation (45 CFR 164.514(b)(2)(ii)) also provides that this only works if “the covered entity does not have actual knowledge that the information could be used alone or in combination with other information to identify an individual who is a subject of the information.” Thus, the problem with thi... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4622346 Tue, 22 Mar 2011 02:20:09 +0100 4622346 http://www.medworm.com/index.php?rid=4615243&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FJNZ-0UqD4To%2Fdirect-project-reaches-critical-mass-interoperability-on-the-horizon.html The ONC announced today that the Direct Project now has commitments from about sixty health care and health IT organizations to support its vision of secure direct messaging of health information.  Given the level of support across twenty states, a number of integrated delivery systems and many EHR vendors, the Direct Project will allow for secure health information messaging for up to 160 million Americans.  Specifications for the Direct Project are now final, and draft documentaiton is available, too.  (For more information, see the anouncement about the widespread adoption of the Direct Project, complete with links to more detail on its website.  For further background, see the Direct Project's earlier announcement of its first live secure transmission of medical records.  For a ... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4615243 Mon, 21 Mar 2011 13:45:15 +0100 4615243 http://www.medworm.com/index.php?rid=4605917&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2Fi-01zzjbNUg%2Fpartisan-politics-it-was-ever-thus.html To those of you out there who are horrified by the depths to which our elected representatives in Washington and in the states have recently sunk in the pursuit of partisan goals, let me say: there's nothing new under the sun. Exhibit A: The emails I keep getting from the Health Care Compact Alliance, an outfit that seems to be a darling of Tea Party adherents, which has latched onto the idea of the interstate compact as a a way to generate sufficient pressure on Congress to repeal health reform, which it could do by ratifying the interstate compact. This is of course too clever by half. In order to work, most states must enact legislation supporting the compact (not very likely) and then Congress must ratify it. (Psst: The very neutrally-entitled bill "To repeal the job-killing health c... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4605917 Thu, 17 Mar 2011 22:52:21 +0100 4605917 http://www.medworm.com/index.php?rid=4592508&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FQiaI8SEw5AU%2Fhealthnet-and-hipaa-again-so-does-hipaa-work.html HealthNet either lost, or had stolen from it, computer hard drives with PHI of 1.9 million subscribers that had been in a California facility.  This latest HealthNet data security breach, which may have included names, Social Security numbers, addresses, health information and financial information comes a little over a year after a widely-reported data security breach by HealthNet in Connecticut which resulted in the first state Attorney General action under the HIPAA amendments contained in the HITECH Act.  HealthNet is notifying affected individuals and is offering two years of no-cost credit monitoring and fraud resolution services, and credit restoration and identify theft insurance as needed. It's both surprising and unsurprising that this has happened again to HealthNet.  In the... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4592508 Tue, 15 Mar 2011 19:19:03 +0100 4592508 http://www.medworm.com/index.php?rid=4580971&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FzNuaBRS5t4o%2Fdavid-harlow-quoted-in-ama-american-medical-news-story-on-daily-deal-websites.html Groupon, LivingSocial and other daily deal websites are being used by health care providers -- though thus far mostly by those that are not covered by traditional commercial or governmental health insurance (e.g., dental, chiropractic, acupuncture services).  Read the American Medical News story on Groupon, where I was quoted, and please take a look at my blog post on the subject as well -- at the Mayo Clinic Center for Social Media blog -- entitled: Groupons for Health Care Services: No-Brainer or Legal Minefield?  In that post, I observed: There are a number of legal issues, and their resolution will depend, in part, on where you are situated, since many of the relevant rules are state laws, which vary.  For example: Groupon collects 50% of the price of the groupon as its fee; is th... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4580971 Mon, 14 Mar 2011 00:48:42 +0100 4580971 http://www.medworm.com/index.php?rid=4545046&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2F022E30UK3-k%2Fmedicaid-busting-the-budget-buster-with-real-innovation-or-rearranging-the-deck-chairs-on-the-titani.html Medicaid has been front and center this week as President Obama addressed the National Governors Association, and several governors testified before the House Energy and Commerce Committee.  Obama told the governors that he supports the Wyden-Brown bill, which would accelerate the availability of waivers under the Affordable Care Act, so that states would not have to first create health insurance exchanges under the law, and then have the right to dismantle them and replace them with other mechanisms to achieve coverage goals of the law without additional cost to the federales.  (See Wyden-Brown fact sheet)  The sponsors' home states, Oregon and Massachusetts would otherwise have to dismantle parts of their own health reform efforts in order to align with the federal mandates.  (Wyden... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4545046 Thu, 03 Mar 2011 22:30:45 +0100 4545046 http://www.medworm.com/index.php?rid=4532332&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FbC1QuIaSDxA%2Fputting-patients-into-menaningful-use-regulators-and-providers-are-catching-up-with-e-patients.html The Health Research Institute at PricewaterhouseCoopers released a report last week entitled Putting patients into "meaningful use." It begins with the anecdote I've blogged about previously regarding a diagnosis by Facebook in lieu of a PHR, which some have highlighted as a great success for social media in health care. I am much less sanguine on that front. The PwC report, of course, has much more than that story in it; here are the key takeaways, backed up with some survey data and interviews: Engaging external constituents may postpone achievement of "meaningful use." Patient awareness of and access to available health IT tools is low; social, expectation, and education hurdles also exist. Patient engagement in "meaningful use" is still low, despite consumer interest. "Meaningful ... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4532332 Tue, 01 Mar 2011 15:40:00 +0100 4532332 http://www.medworm.com/index.php?rid=4517237&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FAzBqEbNiTwg%2Fmass-general-ocr-hipaa-1-million-dollar-settlement-or-the-medical-records-that-never-returned.html   OCR announced today that Massachusetts General Hospital settled a HIPAA violation claim, without admitting liability, for $1 million and an agreement to revamp procedures for taking patient records off premises.  The case involved a stack of paper records left on the T (Boston's subway) consisting of protected health information for a couple hundred patients, including patients on the HIV service.  (As an aside, HIV records are subject to super-deluxe Rube Goldberg-esque privacy protections in Massachusetts -- they need to be flagged so that patients can sign an additional release before they are shared, since even the fact of testing is private, though in my humble opinion the flagging vitiates some of the privacy we want to afford these records). For those of you keeping score a... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4517237 Fri, 25 Feb 2011 03:16:47 +0100 4517237 http://www.medworm.com/index.php?rid=4517238&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FAn_6nUBQAZo%2Fdavid-harlow-interviewed-on-social-media-for-health-care.html Last month, Elissa Weitzman and others, researchers at the Children's Hospital Boston informatics program, published a paper in the Journal of the American Medical Informatics Association entitled "Social but safe? Quality and safety of diabetes-related online social networks," finding that only half of the ten communities they surveyed presented content consistent with diabetes science and clinical practice.  The study found that the quality of clinical information, as well as privacy policies, varied significantly across these sites, and that some of the sites were wanting in terms of scientific accuracy, safeguards such as personal health information privacy protection, effective internal and external review processes, and appropriate advertising.  (See InformationWeek for more.)  I... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4517238 Thu, 24 Feb 2011 04:55:30 +0100 4517238 http://www.medworm.com/index.php?rid=4512469&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2F9IgldPbFntI%2Fhipaa-cmps-whats-the-point.html Yesterday, the federales announced: HHS Imposes a $4.3 Million Civil Money Penalty for Violations of the HIPAA Privacy Rule.  The OCR Notice of Final Determination was issued to Cignet Health of Maryland, a health plan that had not responded to members' requests for records, had not responded to OCR's requests for records once compaints had been filed with OCR, had not responded to a subpoena, and did not even bother to defend itself in federal court when OCR filed for a court order to enforce the subpoena.  I've written about the rule that allows HHS to go for fines of up to $1.5 million per offense where the covered entity's noncompliance is willful.  This is the first example of that rule being tested to the max. OK.  We get it.  The government is Very Serious about HIPAA and HITE... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4512469 Wed, 23 Feb 2011 15:18:07 +0100 4512469 http://www.medworm.com/index.php?rid=4489784&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FszZjnknpMYs%2Fmassachusetts-health-reform-part-iii.html Today, Massachusetts Governor Deval Patrick filed health care reform legislation that, if enacted, will take the Commonwealth to the next level, taking the third step in the process that began in 2006 with the universal coverage law, and continued in 2008 with the legislation directed at containing cost and improving quality.  One of the provisions of the 2008 law established a special commission on the health care payment system that shall investigate reforming and restructuring the system to provide incentives for efficient and effective patient-centered care and to reduce variations in the quality and cost of care. The 2009 report of the special commission on the health care payment system was followed in 2010 by a report by the Office of the Attorney General and legislative hearin... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4489784 Fri, 18 Feb 2011 04:11:34 +0100 4489784 http://www.medworm.com/index.php?rid=4477885&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2Ffo8JZajtT1I%2Faqc-to-aco-as-goes-massachusetts-so-goes-the-nation.html About four years ago here in Beantown, survivors of the last big ill-conceived or poorly-executed (depends who you ask) wave of health care management and finance innovation were kicking around for a new approach to aligning payor and provider incentives, focusing on quality and cost containment. To hear Andrew Dreyfus, CEO of Blue Cross Blue Shield of Massachusetts, tell the story, the Blues wanted to address both quality and cost, and therefore (after looking in vain for a model elsewhere that could be transplanted to Massachusetts) developed the Alternative Quality Contract, or AQC, which features a global payment model hybridized with substantial performance incentives, plus design features intended to lower the cost of care over time. Many of the features put in place under the AQC w... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4477885 Mon, 14 Feb 2011 14:38:45 +0100 4477885 http://www.medworm.com/index.php?rid=4460037&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2F3iWw5K6q5Q8%2Fmeasuring-patient-experience-of-care.html There is a growing recognition within the medical-industrial complex that the patient is a key element of the enterprise, and that patient satisfaction, patient experience, patient engagement, patient activation, patient-centeredness are very important.  Some research shows that patient activation yields better patient outcomes, and that patient activation can be measured. Patient-centeredness and patient engagement are two of the key metrics to be used by the feds in describing Accountable Care Organizations (ACOs), if the internecine battles within government are resolved soon enough to actually release draft ACO regulations in time to allow for sufficient advance planning for the January 2012 go-live date.  (Wearing one of my many hats, I've had the opportunity to submit a response t... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4460037 Thu, 10 Feb 2011 04:05:44 +0100 4460037 http://www.medworm.com/index.php?rid=4399655&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FirOxXRmyUKA%2Fvalue-based-design-massachusetts-patrick-union.html The high cost of public sector health insurance benefits -- the albatross around the neck of many a mayor or town manager around the Commonwealth of Massachsuetts and around the country -- has once again attracted the attention of Governor Deval Patrick.  Late last week, he announced that his SFY 2012 budget proposal will include a 7% cut in local aid (state payments to cities and towns), and that he will be looking for a legislative fix to the high cost of local government health insurance premiums.  He was short on specifics, saying he's learned his lesson about being too directive in such matters, and will wait to see what emerges from the legislative process, but the outlines of what he's looking for are clear:  All municipal employees are to be insured through the state employee he... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4399655 Tue, 25 Jan 2011 15:45:18 +0100 4399655 http://www.medworm.com/index.php?rid=4355798&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FtU3q8Nwqd8A%2Fdavid-harlow-guest-on-lawyer2lawyer-podcast-on-massachusetts-health-reform-issue.html I am a guest on the latest edition of Lawyer2Lawyer, a podcast talk show on the Legal Talk Network hosted by fellow Bay State blawger Bob Ambrogi and Golden State lawyer Craig Williams, discussing aspects of the Massachusetts health reform plan, national health reform, and the lawsuit brought by their other guest, Michael Merlina, who is representing himself in seeking to overturn the denial of his application for a hardship exception from the individual mandate portion of the Massachusetts law.  He and his wife are being fined a little under $2000 because he says they can't afford a policy that would cost them a little over $5000.  Thus far, he reports that the state agency that denied his application has been ordered to review it again and provide a detailed response.  To listen to th... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4355798 Sun, 16 Jan 2011 15:11:54 +0100 4355798 http://www.medworm.com/index.php?rid=4338079&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FovujPUvWvyg%2Fpatient-engagement-and-public-dialogue-the-society-for-participatory-medicine.html I am cross-posting my inaugural post as Public Policy Committee Chair for the Society of Participatory Medicine, which went up last week on the Society's blog -- which I commend to all of you -- e-patients.net. I am delighted to offer my first report as Public Policy Committee Chair for the Society of Participatory Medicine.  I encourage all of you who are not yet Society members to join, and I encourage new and old members to consider volunteering to help with the wide range of public policy issues facing us today. Over the past couple of months, the Public Policy Committee has gotten its sea legs; we are beginning to add the Society’s voice to the national discourse on patient engagement in a formal manner.  As planning for health reform and related initiatives becomes more concret... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4338079 Mon, 10 Jan 2011 15:48:02 +0100 4338079 http://www.medworm.com/index.php?rid=4326947&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2F4lx3lcbxdHg%2Fhealth-care-social-media-workshop-on-the-web-four-part-webinar-starts-january-26.html You’re invited to join Jamie Verkamp, of the health care marketing consultancy (e)Merge, and me, for a 4 part webinar series specifically tailored to healthcare organization leaders.  These workshops begin Wednesday, January 26, and will meet weekly for four weeks. Objective: To thoroughly communicate to healthcare leaders the power of engaging and interacting with patients, strengthening the experience and attracting new patients, through social media tools online, in a manner that is appropriate, effective and HIPAA compliant. Methodology: A four-part video and audio webinar workshop series starting by introducing practice leaders to the power of engaging patients through social media tools, to creation and implementation of YOUR social media strategy and guided online account set-u... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4326947 Mon, 10 Jan 2011 04:03:31 +0100 4326947 http://www.medworm.com/index.php?rid=4318409&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FhkSDEDbiKZ8%2Fdavid-harlow-quoted-in-telemedicine-article-in-ma-medical-law-report.html Telemedicine is one of the mechanisms currently being explored as a means of spreading around our unevenly distributed supply of clinicians, and to increase patient convenience.  Adoption of the technology is in its early stages, largely due to failure of most payors to pay for remote consultations.  I spoke recently with MA Medical Law Report about managing the risks of practicing telemedicine.  Please have a look at the lead article in the current edition, and consider the privacy, security, continuity of care, licensure and technological issues that may arise even if reimbursement were not an issue at all. David HarlowThe Harlow Group LLCHealth Care Law and Consulting   (Source: HealthBlawg :: David Harlow's Health Care Law Blog) HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4318409 Fri, 07 Jan 2011 04:34:30 +0100 4318409 http://www.medworm.com/index.php?rid=4318410&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FTUSQTN0muO8%2Faccountable-care-organizations-the-emperor-has-no-clothes-or-jeff-goldsmiths-plan-b.html The current all-ACO issue of Health Affairs includes a piece by Jeff Goldsmith entitled: Accountable Care Organizations: The Case For Flexible Partnerships Between Health Plans And Providers.  It is a proposal for how private sector health plans ought to pay for services, in order to save us all from what Goldsmith sees happening in the near future thanks to the Gold Rush mentality among health care provider organizations working to become ACOs before they've been defined in regulation.  He begins with a précis of how we've gotten into the health care market mess we're in, touching on the concentration of market power in horizontally and vertically integrated health care provider organizations, payors and providers mudwrestling over fee-for-service reimbursement rates, and the rise of ... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4318410 Thu, 06 Jan 2011 13:28:38 +0100 4318410 http://www.medworm.com/index.php?rid=4277874&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2F8bXem7TfRhs%2Fdavid-harlow-quoted-in-ama-american-medical-news-story-on-geolocation-apps.html As health care providers continue to wonder whether and how they should add social media to their mix of communications tactics, new tools -- and new uses for those tools -- continue to sprout up.  I'm quoted in the current edition of American Medical News in a story that looks at the question of whether and how health care providers should use geolocation services (e.g., Foursquare, Gowalla) as additional channels through which they may communicate with patients, colleagues and referral sources -- or through which they may encourage patients and others to communicate among themselves. I've touched on this issue in recent presentations on health care social media, and have noted that even "checking in" on line at an STD clinic -- an activity discounted by Mark Scrimshire in the article ... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4277874 Tue, 21 Dec 2010 16:59:37 +0100 4277874 http://www.medworm.com/index.php?rid=4249120&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2F1KbmMbio8qk%2Ffacebook-saves-womans-life-newt-gingrich-and-reality-based-healthcare-systems-planning.html I've seen at least half a dozen links to the op-ed coauthored by Newt Gingrich and neurosurgeon Kamal Thapar about how the doctor used information on Facebook to save a woman's life. (It was published by AOL News. Really.)  In brief, a woman who had been to see a number of different health care providers without getting a clear diagnosis showed up in an emergency room, went into a coma and nearly died.  She was saved by a doctor's review of the detailed notes she kept about her symptoms, etc., which she posted on Facebook.  The story is vague on the details, but apparently her son facilitated getting the doc access to her Facebook page, and the details posted there allowed him to diagnose and treat her condition.  She recovered fully. Newt and Dr. Thapar wax rhapsodic about how Facebo... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4249120 Fri, 10 Dec 2010 14:29:54 +0100 4249120 http://www.medworm.com/index.php?rid=4233266&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2Fw8F-cdbZISA%2Fthe-benefits-package-a-new-employee-benefits-blog-carnival.html The inaugural edition of The Benefits Package is up at Evan Falchuk's See First.  It's a new employee health benefits blog carnival that merits your attention, as employers and other purchasers of health care services work to contain costs in a post-ACA world.  Dig in, learn from the cadre of health care bloggers represented there, and join the conversation.  David HarlowThe Harlow Group LLCHealth Care Law and Consulting   (Source: HealthBlawg :: David Harlow's Health Care Law Blog) HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4233266 Mon, 06 Dec 2010 14:59:00 +0100 4233266 http://www.medworm.com/index.php?rid=4225243&cid=t_99849_87_f&fid=38962&url=http%3A%2F%2Fwww.healthbeatblog.com%2F2010%2F12%2Fslow-medicine.html Below, Kent Bottles, M.D. reflects on the difference between “slow medicine” and what he calls “UCLA medicine.” (For the full post, see “Kent Bottles’ Private Views” )“I have been thinking about the difference between slow medicine and UCLA medicine. It has made me realize how complex and difficult it is to transform American health care so that we lower per-capita cost and increase the quality of our lives. And yet we must achieve these two goals.“Slow medicine is practiced by a small, but growing subculture whose pioneer and spokesperson is Dr. Dennis McCullough, author of the book My Mother, Your Mother: Embracing ‘Slow Medicine,’ The Compassionate Approach to Caring for Your Aging Loved Ones. Slow medicine is a philosophy and set of practices that believes in a co... Health Beat blogs http://www.medworm.com/rss/comments.php?id=4225243 Fri, 03 Dec 2010 22:03:46 +0100 4225243 http://www.medworm.com/index.php?rid=4200623&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FpWWfBHMiss0%2Fengage-with-grace.html As patients, as family members, as friends, as health care providers, we have all faced end-of-life issues at one time or another, and we will face them again.  And again.  This weekend, the "Engage With Grace" message is being broadcast virally, through a "blog rally," at a time when many people are with family and friends over the long weekend.  The point is: we all need to have the potentially uncomfortable conversation with people close to us about what kind of treatment we would want, and they would want, if incapable of making or communicating health care decisions.  CNN ran a story on Engage With Grace yesterday. End-of-life decision-making has long been an issue of great personal and professional interest to me, and I am proud to have played a role in having out-of-hospital D... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4200623 Wed, 24 Nov 2010 21:00:00 +0100 4200623 http://www.medworm.com/index.php?rid=4190287&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2Fes001VGqoHg%2Fhealth-care-reform-what-price-progress-1.html There's a lot of breast-beating going on out there regarding recent "shocking" behavior by many health care provider organizations.  Believe it or not, all across the nation, health care providers are seeking to affiliate/acquire/be acquired in the hopes of creating more efficient, more comprehensive provider networks, which can survive and flourish under new reimbursement regimes designed to squeeze inefficiencies out of the system in an effort to achieve the much-vaunted triple aim of providing high quality health care to ensure population health at a reasonable cost.  This thread was picked up in Robert Pear's Sunday New York Times piece, Consumer Risks Feared as Health Law Spurs Mergers, which focuses on concerns that prices will go up as health care providers consolidate and gain g... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4190287 Mon, 22 Nov 2010 17:50:04 +0100 4190287 http://www.medworm.com/index.php?rid=4183385&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2F5yuEUj5711I%2Fdavid-harlow-keynotes-on-health-care-social-media-and-the-law-at-annual-healthcare-and-the-internet-.html I attended the 14th Annual Healthcare and the Internet Conference in Las Vegas this week, and gave a keynote presentation entitled: "Health Care Social Media - The Lawyers Don't Always Say No" in which I discussed the reasons for health care providers to engage with their constituencies via social media -- both from a business perspective and from a regulatory perspective (ACO rules and future phases of Meaningful Use rules effectively demand a response from providers involving social media), and how to do it without getting into trouble (there are a variety of HIPAA, other privacy, liability, anti-kickback and fraud and abuse issues to keep in mind when planning for patient engagement through social media). Here are the slides from my talk: Health Care Social Media - The Lawyers Don't Al... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4183385 Fri, 19 Nov 2010 16:53:27 +0100 4183385 http://www.medworm.com/index.php?rid=4159329&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FY64Cv7CsCEw%2F2011-mpfs-and-2011-hopps-asc-fee-schedules-finalized-by-cms.html The final Medicare physician fee schedule, Hospital Outpatient PPS and Ambulatory Surgery Center fee schedules for 2011 were released by CMS last week.  They will be formally published in the Federal Register later this month. As usual, the fee schedules include a fair number of regulatory amendments that are not, strictly speaking, fee schedules, which you can read about at the links above.  A number of the changes are driven by the ACA -- e.g., elimination of out-of-pocket costs for most preventive care. Top of mind on the physician side is the SGR formula-driven pay cut, included in the 2011 MPFS regulation: about a 25% cut for physician reimbursement is now on its glide path to being effective December 1, with a slight additional cut to be effective January 1.  As I wrote last wee... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4159329 Thu, 11 Nov 2010 17:54:58 +0100 4159329 http://www.medworm.com/index.php?rid=4155290&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FuocO2vqi--M%2Fsocial-media-policy-adopted-by-the-american-medical-association.html Earlier this month, the AMA announced that it has adopted a social media policy at its mid-year meeting. It will soon be posted on the AMA website; the full text, provided to HealthBlawg by AMA staff, is set forth at the end of this post.The key to understanding the AMA perspective lies in the title of the policy: Professionalism in the use of social media. The front matter recognizes the utility of social media and focuses on the key issue of concern for the Association: Social media "create new challenges to the patient-physician relationship."Most elements of the policy are commonsensical, and represent the extension of existing norms into the social media space: Don't post identifiable patient information online.Safeguard physician personal privacy online, understanding that anything ... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4155290 Wed, 10 Nov 2010 20:30:21 +0100 4155290 http://www.medworm.com/index.php?rid=4151980&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2F33NVHEUOWTA%2Foig-issues-roadmap-for-new-physicians-a-guide-to-avoiding-fraud-and-abuse.html In October, the Office of Inspector General issued a report on Fraud and Abuse Training in Medical Education, finding that 44% of medical schools reported giving some instruction in the anti-kickback statute and related laws, even though they weren't legally required to do so. (As an aside, do we really live in such a nanny state? Over half of all medical schools don't teach their students anything about this issue -- because nobody's making them -- even though it is an issue that looms large in the practice of medicine.)  On a more positive note, about 2/3 of institutions with residency programs instruct participants on the law, and 90% of all medical schools and training programs expressed an interest in having dsome instructional materials on the subject of the anti-kickback statute, p... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4151980 Mon, 08 Nov 2010 14:33:16 +0100 4151980 http://www.medworm.com/index.php?rid=4133705&cid=t_99849_87_f&fid=38962&url=http%3A%2F%2Fwww.healthbeatblog.com%2F2010%2F11%2Fpost-election-analysis-expect-few-changes-in-reform-legislation.html Today, unemployment threatens the hopes and lives of millions of Americans. Recent graduates can’t find jobs. Families that need two paychecks are living on one. Households that depended on one paycheck have none. More than nine million Americans who need a full time job are working part-time.  Many who have jobs are “working scared.”  They haven’t had a raise for years, and don’t dare ask for one.  They live with the constant fear that, without warning, they will join the ranks of the unemployed. The economy remains sluggish; there is little hope that the private sector will begin to generate the jobs this country needs.Over the past two years, many of us pinned our hopes on healthcare reform. If we could just manage that, it would be a sign that we, as a natio... Health Beat blogs http://www.medworm.com/rss/comments.php?id=4133705 Thu, 04 Nov 2010 20:01:32 +0100 4133705 http://www.medworm.com/index.php?rid=4133945&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FQa8wXU-aVSA%2Fswing-to-the-right-the-election-and-its-effects-on-health-reform.html Like Tom Friedman, who lampooned some of this year's unreasonable campaign rhetoric in a recent column, I too would be in favor of reality-based political campaigns ... but that seemed to be too much to ask for this year.  Instead of truth, we now have truthiness.  The joke news shows (and their joke political rallies) seemed to be more popular than the evening news.  (I wish Jon Stewart and his 200,000 fans on the Washington Mall last weekend had stayed home, canvassing for their candidates of choice.)  Fact-checkers told us that many political ads this season were in the "barely true" or "pants on fire" zones according to the Truth-O-Meter.  But in the end, the buzzwords seem to have worked their magic, and many "insiders" are out, and "outsiders" are in.  The angry and the impatie... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4133945 Wed, 03 Nov 2010 05:07:10 +0100 4133945 http://www.medworm.com/index.php?rid=4119222&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FGlM8uPW2xxE%2Fdavid-harlow-will-be-a-keynote-speaker-at-the-14th-healthcare-internet-conference-november-15-17-in-.html I will be speaking on the legal issues surrounding health care social media at the upcoming 14th Annual Healthcare Internet Conference.  Some health care executives are concerned that involvement with social media on behalf of their organizations can lead only to ruin: HIPAA and malpractice liability, employment issues and other concerns lead many providers to ignore social media entirely.  Well, as I'll be explaining at the conference, the lawyers don't always say no, and there are a number of good reasons to get involved.  Health care providers that do not have a social media presence (yet) should all begin to monitor online channels, including social media channels, to learn what is being said about them -- so that they can begin to respond in real life (IRL).  Before jumping into ... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4119222 Fri, 29 Oct 2010 15:02:46 +0100 4119222 http://www.medworm.com/index.php?rid=4119163&cid=t_99849_113_f&fid=34631&url=http%3A%2F%2Fehealth.johnwsharp.com%2F2010%2F10%2F28%2Fhealth-care-is-coming-home%2F In the New England Journal Journal of Medicine this week, a perspective article by a Cleveland Clinic physician, promotes the future of home care. Dr. Landers notes five major forces driving healthcare to the home. 1. Aging of the population 2. Epidemics of chronic disease 3. Technological advances 4. Health care consumerism 5. Escalating health care costs In the conclusion of the article, he notes this as a long term trend perhaps taking decades. My view as a technology optimist, is that the combination of these forces will result in a faster pace of change with high tech home care being an integral part of the medical home. (Source: eHealth) eHealth blogs http://www.medworm.com/rss/comments.php?id=4119163 Fri, 29 Oct 2010 02:45:49 +0100 4119163 http://www.medworm.com/index.php?rid=4105816&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FoWmt5JQ5BeI%2Fconnected-health-symposium-2010.html I attended the Connected Health Symposium last week in Boston. I enjoyed many of the sessions (sometimes wished I could have attended two simultaneously, though the livetweeting helped on that front), and as usual enjoyed the hallway and exhibit floor conversations too.  As is often the case at conferences these days, I had the opportunity to meet several on-line connections in real life for the first time.  (I will not attempt to give a comprehensive report of the symposium here; please see the livetweeting archive linked to above and other reports to get a sense of the rest of the event.) This year's exhibit floor included a diverse mix of distance health tools.  Most striking from my perspective was the fact that most of these tools do one of two things: Enable patient-clinician vi... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4105816 Mon, 25 Oct 2010 16:41:01 +0100 4105816 http://www.medworm.com/index.php?rid=4065461&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Fhealthblawg.typepad.com%2Ffiles%2Fhealthblawg-ruth-balser-interview-100410.mp3 The Massachusetts health reform experience is often cited as a model for key aspects of the federal health reform law - the Affordable Care Act.  To gain some insight into the origins of the Massachusetts health reform law, and to explore current experience with implementation, I spoke with Rep. Ruth Balser, a legislative leader and supporter of the health reform laws in Massachusetts.   The audio file of my interview with Rep. Ruth Balser (about 25 minutes long) is available for listening or download.  A full transcript is at the end of this post (and in the linked Massachusetts State Rep. Ruth Balser interview transcript). David HarlowThe Harlow Group LLCHealth Care Law and Consulting HealthBlawg :: David Harlow’s Health Care Law BlogInterview of Massachusetts State Repr... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4065461 Wed, 13 Oct 2010 05:50:48 +0100 4065461 http://www.medworm.com/index.php?rid=4036772&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FmSY0Ec6RZEE%2Faco-workshop-the-feds-commit-to-making-accountable-care-organizations-work-with-safe-harbors-waivers.html Don Berwick kicked off the day-long Accountable Care Organization (ACO) Workshop and Listening Session, co-hosted by the FTC, CMS and the OIG, with a short, stirring speech that touched on his Triple Aim for health care: better care for individuals, better health for populations and reduced per-capita costs.  He committed the government to interpreting applicable statutes "wisely, so as not to impede the development of ACOs."  That sums up the reason this workshop was so eagerly anticipated.  Health care providers are extremely eager to become ACOs - though the term has yet to be fully defined - yet are extremely concerned about the potential to have specific ACO arrangements identified as illegal by the FTC, the OIG or CMS because the arrangements violate antitrust law, Stark, anti-kic... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4036772 Wed, 06 Oct 2010 04:16:06 +0100 4036772 http://www.medworm.com/index.php?rid=4027241&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FK2wx9VttOGM%2Fmhealth-markets-and-cold-hard-cash.html Last month, PricewaterhouseCoopers issued a report, Healthcare Unwired, examining the market for mobile health monitoring devices, reminder services, etc. among both health care providers and the general public.  One of the big take-away points seems to be that 40% of the general public would be willing to pay for mobile health, or mHealth, devices or services ranging from reminders to data uploads; and the reaction by insiders is either joy (40% is good) or dismay (40% is not enough).  PwC estimated the mHealth market to be worth somewhere between $7.7 billion and $43 billion per year, based on consumers' expressed willingness to pay. Deloitte recently issued a report on mPHRs, as well -- and there is tremendous interest in this space, as discussed in John Moore's recent post over at Ch... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4027241 Sun, 03 Oct 2010 15:46:27 +0100 4027241 http://www.medworm.com/index.php?rid=4018174&cid=t_99849_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2Fe4m8BjFNwjE%2F You are Invited to a CONFERENCE CALL WITH SURGEON GENERAL REGINA BENJAMIN Date: Friday, October 1, 2010 Time: 11 AM Eastern, 10 AM Central, 9 AM Mountain, 8 AM Pacific Dial in information: 1-888-283-2975 Passcode: 1862596 Join Surgeon General Regina Benjamin on the conference call to learn about two historic opportunities created by the Affordable Care Act: The National Prevention, Health Promotion and Public Health Council, chaired by Dr. Benjamin and composed of senior cabinet-level officials across federal agencies, and the development and implementation of the National Prevention and Health Promotion Strategy. Dr. Benjamin is conducting this outreach call to engage the public and professionals in the  development of the National Prevention and Health Promotion Strategy. Join her in ... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=4018174 Thu, 30 Sep 2010 19:54:54 +0100 4018174 http://www.medworm.com/index.php?rid=4013595&cid=t_99849_155_f&fid=38412&url=http%3A%2F%2Fpathlabmed.typepad.com%2Fsurgical_pathology_and_la%2F2010%2F09%2Fthe-informed-patient-column-by-laura-landro-from-yesterdays-wall-street-journal-september-27-2010-has-an-interesting-repor.html The Informed Patient column by Laura Landro from yesterday's Wall Street Journal (September 27, 2010) has an interesting report entitled, "What the Doctor Missed" which discusses how analysis of malpractice claims is informing efforts to improve medical practice. The issue of diagnostic errors due to missed or delayed diagnoses should be of particular interest to pathologists.  The article doesn't explicitly state this but poor communication (patient-to-physician, physician-to-patient, PCP-to-physician/specialist, etc.) seems to me a major factor in lawsuits and a major contributing factor in diagnostic errors.  How can we more effectively communicate our findings to non-pathologists?  I especially note reference the article makes to breast cancer.&#0160... The Daily Sign-Out blogs http://www.medworm.com/rss/comments.php?id=4013595 Tue, 28 Sep 2010 19:25:20 +0100 4013595 http://www.medworm.com/index.php?rid=4013321&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2Fulbc5SYkKHI%2Fself-referral-disclosure-protocol-redux-if-it-aint-broke-dont-fix-it.html The OIG scrapped its old self-referral voluntary disclosure program in 2009 (it dated back to 1998, and was revisited in 2008), and the PPACA mandated that it be replaced.  Just like clockwork, on the deadline for its promulgation, the OIG obliged, and the new Self-Referral Disclosure Protocol is now posted and effective. The new protocol could be clearer, and could offer more comfort -- but it doesn't.  Makes one pine for the old policy's clarity: in the old days, voluntary disclosure bought you a discounted fine for Stark violations -- not like the new protocol's wishy-washy maybe-we'll give-you-a-discount language.  The new protocol also fails to help a provider seeking to disclose past wrongs voluntarily in dealing with the Federales on a number of fronts simultaneously (e.g., for ... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4013321 Tue, 28 Sep 2010 14:02:00 +0100 4013321 http://www.medworm.com/index.php?rid=4003327&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2Fw4GyXWLGGW0%2Fmassachusetts-health-care-payment-plan-gets-renewed-attention-global-payments-to-replace-fee-for-ser.html Federal health reform and Massachusetts health reform may find a point of convergence in the development of ACOs (accountable care organizations) and the payment mechanisms that will make them tick (or hum, or do whatever it is that we want them to do).  The Federales will be holding a listening session next week on the issues raised by ACOs across the HHS and FTC landscapes.  Meanwhile, back in Boston, the inner circle of health care regulators and the regulated community are busy hashing out an approach to global payments that could be ready for prime time by January 1. The need for payment reform in Massachusetts has been well-documented -- see the health care market report from the AG's office, as well as an earlier report on the imperative to keep insurance risk on insurers and pla... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4003327 Mon, 27 Sep 2010 21:24:22 +0100 4003327 http://www.medworm.com/index.php?rid=3994085&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FkiWCGPxo8B0%2Fdavid-harlow-honored-with-rx-for-excellence-award-from-massachusetts-medical-law-report.html Massachusetts Medical Law Report is honoring me this week with an Rx for Excellence award, as one of its "Heroes From the Field."  I am, indeed, honored by the recognition, and honored to be in the company of my fellow award recipients.  Please check out the list at the link above, and follow the good work that all of these fine folks have been doing around the Commonwealth. David HarlowThe Harlow Group LLCHealth Care Law and Consulting (Source: HealthBlawg :: David Harlow's Health Care Law Blog) HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3994085 Wed, 22 Sep 2010 15:11:04 +0100 3994085 http://www.medworm.com/index.php?rid=3980903&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FwWLX0hXxlII%2Fdavid-harlow-named-to-advisory-board-for-the-mayo-clinic-center-for-health-care-social-media-crowdso.html At the invitation of Lee Aase, I have joined the advisory board for his new initiative, the Mayo Clinic Center for Health Care Social Media.  I am honored -- and delighted -- to be part of the dynamic group of leading thinkers and practitioners of this art and science that Lee has assembled.  I encourage you to follow the links to their twitterfeeds and blogs via the advisory board link above.  You will be well-rewarded for your investment of time.  Lee is crowdsourcing nominations for the remaining seats on the advisory board.  Please help us out -- let us hear from you. David HarlowThe Harlow Group LLCHealth Care Law and Consulting (Source: HealthBlawg :: David Harlow's Health Care Law Blog) HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3980903 Fri, 17 Sep 2010 15:43:13 +0100 3980903 http://www.medworm.com/index.php?rid=3969193&cid=t_99849_155_f&fid=38412&url=http%3A%2F%2Fpathlabmed.typepad.com%2Fsurgical_pathology_and_la%2F2010%2F09%2Fimpact-of-reform-on-health-insurance.html A couple of timely articles that I came across today regarding unanticipated consequences already beginning to emerge following passage of reform legislation of U.S. healthcare earlier this year.  The first from strategy+business (Harvard Business Review) is interesting in its take on the system possibly evolving to a more "consumer-centric" system (as opposed to the current system where plans are marketed to employers).  The second is a more pessimistic long-term view on the overall costs of healthcare. strategy+business WSJ Aetna Inc., some BlueCross BlueShield plans and other smaller carriers have asked for premium increases of between 1% and 9% to pay for extra benefits required under the law, according to filings with state regulators. These and other insurers s... The Daily Sign-Out blogs http://www.medworm.com/rss/comments.php?id=3969193 Tue, 14 Sep 2010 18:31:21 +0100 3969193 http://www.medworm.com/index.php?rid=3965676&cid=t_99849_147_f&fid=39264&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDoctorsWithoutFootprints%2F%7E3%2FbrQmbq2x-4Q%2Fyour-patients-rating-of-your-services.html Starting in October, 2010, Consumer Reports will be publishing reviews of surgical groups (specifically - bypass surgery) both in print and online. If you haven't already set an hour aside to Google your practice or medical group because you didn't think that user reviews of your services on social media sites were that important, please heed the call. Consumers are casually publishing opinions and reviews of everything from taco stands to the comfort of movie theater seating to... the quality of your surgical skills. While Consumer Reports has developed their score system on factual data (see below for source), this is definitely an indication that consumers are researching their healthcare providers more thoroughly, and the demand for trustworthy recommendations about physicians is being... Doctors Without Footprints blogs http://www.medworm.com/rss/comments.php?id=3965676 Tue, 14 Sep 2010 12:42:26 +0100 3965676 http://www.medworm.com/index.php?rid=3942881&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FkWg4LfO-GBo%2Foig-imaging-preauthorization-may-be-handled-by-hospital-for-referring-docs-and-patients.html The OIG released an advisory opinion at the end of last month OK'ing a hospital's proposal to provide insurance pre-authorization srevices free of charge to patients and physicians.  This is an issue that has long vexed folks in the imaging world.  Clearly, this is a free service provided to referral sources (to the extent they are obligated by contract with third party payors to obtain the pre-authorization before referring a patient for an MRI, for example), so why is the OIG OK with it?  In the opinion, the OIG blesses the arrangement for four reasons: The arrangement doesn't target specific referring docs, so the pre-authorization service will be provided for patients of docs who are contractually bound to handle it themselves, as well as for patients of those who aren't, and t... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3942881 Tue, 07 Sep 2010 18:17:13 +0100 3942881 http://www.medworm.com/index.php?rid=3865339&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2F0WzQCo-80LM%2Fprivacy-and-security-of-patient-records-the-lesson-of-the-weakest-link.html The Queen of Soul famously wailed about being a link in a chain of fools.  Today's lead story in the Boston Globe tells us about another sort of link in the chain -- the weakest link in the chain of custody of patient records.  In brief, a pathology billing service bought out by another service apparently dumped all records more that a year old in a town dump; a Globe photographer taking out his own trash noticed that the paper records (which he was looking at because he thought they ought to be recycled rather than dumped) had identifiable patient data and represented at least four hospitals from across Eastern Massachusetts.  Clearly, these records ought to have been shredded or otherwise destroyed before disposal.  Assuming they had some airtight contracts in place, the hospitals in... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3865339 Fri, 13 Aug 2010 16:49:13 +0100 3865339 http://www.medworm.com/index.php?rid=3816439&cid=t_99849_105_f&fid=39124&url=http%3A%2F%2Fwww.jeffreymlevinemd.com%2Fmds-3-0-will-change-resident-assessment%2F Hear ye!  Hear Ye!  RAPs are out!  CATs and CAAs are in! I chuckle as I write this blog post knowing that few of my regular readers will understand, and have probably clicked off by now.  But the few of you who remain know how important this topic is to long-term care.  On October 30, 2009 CMS finally [...] (Source: Jeffrey M. Levine MD | Geriatric Specialist | Wound Care | Pressure Ulcers) Jeffrey M. Levine MD | Geriatric Specialist | Wound Care | Pressure Ulcers blogs http://www.medworm.com/rss/comments.php?id=3816439 Tue, 03 Aug 2010 16:00:26 +0100 3816439 http://www.medworm.com/index.php?rid=3786119&cid=t_99849_85_f&fid=34967&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fdocisinblog%2FwNlq%2F%7E3%2FDOFlYk7Ur44%2F   It has been clear since the passage of Obamacare, with its ludicrous economic projections and Enron-accurate accounting, that the outcome of this gargantuan medical gewgaw will be enormous shortfalls in funding for healthcare. The long-term consequences of its financial chicanery are legion, from spiraling deficits, to drastic cutbacks in funding to hospitals and health care providers , to the hyperbolically-described “death panels”: restrictions in payment for health care services as determined by faceless bureaucrats, based on cost considerations masquerading under the paper-thin guise of “medical consensus.” One of the most disastrous aspects of this plan, both economically and practically, has been the decision to provide coverage for the low-income unins... The Doctor Is In blogs http://www.medworm.com/rss/comments.php?id=3786119 Sun, 25 Jul 2010 07:39:46 +0100 3786119 http://www.medworm.com/index.php?rid=3753923&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FVcpI21OUncI%2Fmeaningful-use-the-final-rule.html Meaningful use was given its final definition yesterday, in the meaningful use final rule released by HHS.  Secretary Sebelius, CMS Adminsitrator Berwick, ONC chief Blumenthal and the two Reginas spoke -- U.S. Surgeon General Regina Benjamin, and Regina Holliday, whose late husband's last days were complicated by the failure of health care facilities to release and share health records.  Berwick, in his first full day on the job as CMS Adminstrator, waxed rhapsodic about the pleasures of practicing as a pediatrician at Harvard Community Health Plan using its pioneering electronic health record system.  (Years later, I am still a patient at Harvard Vanguard Medical Associates, which used to be part of HCHP, and I am still spoiled by the EHR system there.)  Blumenthal and Benjamin also s... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3753923 Wed, 14 Jul 2010 19:27:14 +0100 3753923 http://www.medworm.com/index.php?rid=3737119&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2F8KU7LFg7rGg%2Fonc-announces-hitech-amendments-to-hipaa-privacy-security-and-enforcement-rules.html The federales announced a new set of HIPAA regulations today (to be published in the Federal Register on July 14) in a press conference featuring Kathleen Sebelius (HHS Secretary), Georgina Verdugo (HHS OCR Director) and David Blumenthal (ONC Director).  The HIPAA changes are essentially mandated by the HITECH Act.  From the HHS presser:The proposed rule announced today would strengthen and expand enforcement of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy, Security, and Enforcement Rules by:expanding individuals’ rights to access their information and to restrict certain types of disclosures of protected health information to health plans; requiring business associates of HIPAA-covered entities to be under most of the same rules as the covered ... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3737119 Fri, 09 Jul 2010 03:31:57 +0100 3737119 http://www.medworm.com/index.php?rid=3733053&cid=t_99849_87_f&fid=36050&url=http%3A%2F%2Fblisstree.com%2Flive%2Fshould-obama-bypass-senate-to-appoint-health-care-official%2F President Obama announced yesterday that he will bypass congress to appoint Dr. Donald M. Berwick as administrator of the Centers for Medicare and Medicaid Services. The decision, called a “recess appointment”, is going through while senate is in recess, which many find surprising because it’s only in recess for a short amount of time. White House communications director Dan Pfeiffer said that the appointment is needed to carry out the new health care law, which calls for big changes in both Medicare and Medicaid, affecting about 1/3 of all Americans. The New York Times quoted his statement that “many Republicans in Congress have made it clear in recent weeks that they were going to stall the nomination as long as they could, solely to score political points.”... Breastfeeding 1-2-3 blogs http://www.medworm.com/rss/comments.php?id=3733053 Wed, 07 Jul 2010 19:33:41 +0100 3733053 http://www.medworm.com/index.php?rid=3718433&cid=t_99849_105_f&fid=39124&url=http%3A%2F%2Fwww.jeffreymlevinemd.com%2Felizabeth-ayello-on-deep-tissue-injury-coding%2F Another guest post by Elizabeth A. Ayello, PhD, RN, ACNS-BC, CWON, MAPWCA, FAAN. I was pleased with the response to my first guest post on Dr. Levine’s healthcare blog.  One question in particular regarding suspected deep tissue injury (sDTI), written by Laura DiGiulio CWOCN, particularly deserves comment.  Laura asked: “I would like some guidance about how to [...] (Source: Jeffrey M. Levine MD | Geriatric Specialist | Wound Care | Pressure Ulcers) Jeffrey M. Levine MD | Geriatric Specialist | Wound Care | Pressure Ulcers blogs http://www.medworm.com/rss/comments.php?id=3718433 Thu, 01 Jul 2010 01:18:52 +0100 3718433 http://www.medworm.com/index.php?rid=3699584&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FFaUUWbRT4o4%2Fhealthblawg-nominated-to-lexisnexis-top-50-blogs-in-their-insurance-law-community.html Thanks, LexisNexis, for this honor.  Everybody else, head over to the Top 50 Blogs post, register, and post a comment endorsing HealthBlawg.  While you're there, check out the other nominees, including the blogs of fellow Health Wonks Hank Stern and Joe Paduda. David HarlowThe Harlow Group LLCHealth Care Law and Consulting (Source: HealthBlawg :: David Harlow's Health Care Law Blog) HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3699584 Fri, 25 Jun 2010 21:06:56 +0100 3699584 http://www.medworm.com/index.php?rid=3679828&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Fhealthblawg.typepad.com%2Ffiles%2Fmike-barber-interview-w-david-harlow-on-healthblawg-062010.mp3 What if you could improve health care across the three intransigent parameters of cost, access and quality by 15%?  That's the challenge GE has set out for itself in the form of its current five-year Healthymagination campaign, and it's investing $6 billion in the effort.  I caught up with GE's VP for Healthymagination, Mike Barber, recently, and I invite you to listen in on our conversation about GE's efforts in the US and globally, within GE's health care business unit and beyond, to roll out this major investment -- which, obviously, GE expects to yield a return in the future.The audio file of my interview with Mike Barber (about 20 minutes long) is available for listening or download:  A full transcript is at the end of this post (and in the linked Mike Barber, VP, Healt... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3679828 Mon, 21 Jun 2010 03:07:01 +0100 3679828 http://www.medworm.com/index.php?rid=3676757&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FyRMSYqtyZV8%2Ffinal-ehr-certification-rule-announced-by-onc.html A surgeon can’t operate without the proper equipment. A clinician can’t achieve meaningful use of electronic health records without an EHR that is designed to improve patient care and practice efficiency. -- David BlumenthalToday, David Blumenthal, Steve Posnack and Carol Bean of the ONC announced the publication of the final (albeit temporary) EHR certification rule.  The actual publication date in the Federal Register will be June 24. (Here is the display copy of the EHR Certification Rule; a permanent rule will be forthcoming later this year.)The technical standards were glossed over on a conference call with ONC this afternoon; the focus, instead, was on getting testing and certification rolling.  Organizations or consortia may apply for recognition as testing and/or certific... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3676757 Fri, 18 Jun 2010 19:59:14 +0100 3676757 http://www.medworm.com/index.php?rid=3671827&cid=t_99849_113_f&fid=34631&url=http%3A%2F%2Fehealth.johnwsharp.com%2F2010%2F06%2F17%2Fcuring-cancer-clinical-trials%2F The Institute of Medicine has issued another groundbreaking report, this time on cancer clinical trials. An editorial about the report in the New England Journal of Medicine titled, Cancer Clinical Trials — A Chronic but Curable Crisis, makes some bold statements, such as, “the program is bloated, cumbersome, inefficient.” Slow approval processes with multiple layers and poor recruitment levels are symptomatic. Recommended changes include improving: the speed and efficiency of the design, launch, and conduct of trials; innovation in science and trial design; trial prioritization,selection, support, and completion; and incentives for patient and physician participation The full IOM report lays out participation of key stakeholders, particularly patients and physicians. The e... eHealth blogs http://www.medworm.com/rss/comments.php?id=3671827 Fri, 18 Jun 2010 02:55:13 +0100 3671827 http://www.medworm.com/index.php?rid=3672068&cid=t_99849_155_f&fid=38412&url=http%3A%2F%2Fpathlabmed.typepad.com%2Fsurgical_pathology_and_la%2F2010%2F06%2Flow-expectations-for-future-of-clinical-data-mininga-study.html I picked this up from Fierce Health IT newsletter: Anvita Health commissioned a newly released HIMSS Analytics study on clinical data mining. HIMSS Analytics convened a focus group of CMOs and and CMIOs of provider and payer organizations for the report.Payers and providers alike generally don't often employ clinical data for real-time decision-making, in part because information is in so many disparate formats, some important data elements are missing and because they believe the costs generally outweigh the benefits. "These challenges are consistent with what we've seen and heard from our payer and provider customers," Noffsinger explains. "Interoperability of data is a hurdle, but it's not insurmountable.""A key finding for us was that both p... The Daily Sign-Out blogs http://www.medworm.com/rss/comments.php?id=3672068 Wed, 16 Jun 2010 20:30:00 +0100 3672068 http://www.medworm.com/index.php?rid=3659039&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FXMnHSRgDRI4%2Fblawg-review-268.html "In my many years I have come to a conclusion that one useless man is a shame, two is a law firm, and three or more is a congress." -- John Adams*Welcome to the Flag Day 2010 edition of Blawg Review, the weekly law blog carnival.  If you need to get your bearings, feel free to peruse previous HealthBlawg-hosted editions of Blawg Review: #88, #129, #154 and #211.John Adams is a person of interest for this edition, because he made his home in Quincy, MA.Quincy is a point of interest because not only did Adams give it to his son as a middle name, it also happens to be the home of the longest-running Flag Day parade and celebration in these United States.  (It was rained out this year, but check out the, um, boring video of last year's parade.)Quincy is also the home of the granite quarrie... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3659039 Mon, 14 Jun 2010 04:50:53 +0100 3659039 http://www.medworm.com/index.php?rid=3652513&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2F7m7W28qpGY8%2Fblog-carnival-trifecta.html It's a Health Wonk Review week -- the latest, "killer," edition of the biweekly blog carnival for health wonks is up, courtesy of Tinker Ready at Boston Health News.  The weekly carnivals are worth a read, too, of course: the lawyers' Blawg Review at Spam Notes and the medbloggers'  Grand Rounds at MDiTV.Tune in again next Monday, when Blawg Review returns to HealthBlawg - the home of hipness. David HarlowThe Harlow Group LLCHealth Care Law and Consulting (Source: HealthBlawg :: David Harlow's Health Care Law Blog) HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3652513 Thu, 10 Jun 2010 19:17:35 +0100 3652513 http://www.medworm.com/index.php?rid=3635837&cid=t_99849_105_f&fid=39124&url=http%3A%2F%2Fwww.jeffreymlevinemd.com%2Felizabeth-ayello-blogs-on-revised-mds%2F Guest Post by Elizabeth A. Ayello, PhD, RN, ACNS-BC, CWON, MAPWCA, FAAN. Are you ready for the changes in MDS 3.0, Section M: Skin Condition? Having just developed the slide materials and provided the instruction on this for the CMS “Train the Trainer” programs in April 2010, I strongly believe that because section M is expanded [...] (Source: Jeffrey M. Levine MD | Geriatric Specialist | Wound Care | Pressure Ulcers) Jeffrey M. Levine MD | Geriatric Specialist | Wound Care | Pressure Ulcers blogs http://www.medworm.com/rss/comments.php?id=3635837 Mon, 07 Jun 2010 12:56:14 +0100 3635837 http://www.medworm.com/index.php?rid=3607633&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FqzpOgmWV1IU%2Fsocial-media-summit-2010-june-3-sponsored-by-mass-tlc-at-microsoft-nerd.html I'll be facilitating one of the breakout sessions at the Massachusetts Technology Leadership Council's Social Media Summit 2010 next Thursday - and the rest of the program looks pretty darn good, too.  Check out the agenda, and I hope to see you there.  If you can't make it in person, follow along on Twitter. David HarlowThe Harlow Group LLCHealth Care Law and Consulting (Source: HealthBlawg :: David Harlow's Health Care Law Blog) HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3607633 Fri, 28 May 2010 04:16:18 +0100 3607633 http://www.medworm.com/index.php?rid=3538253&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FJsTiCYleTIA%2Fhit-incentives-in-massachusetts-less-carrot-more-stick.html Health care providers all over the country are all worked up because they say that the federales' regulations on meaningful use of certified EHRs go too far, too fast.  They should be glad they're not in Massachusetts, where EHR use will soon be required as a condition of licensure of physicians, hospitals and community health centers.  The word got out, thanks to Secretary of Health and Human Services JudyAnn Bigby, who spoke at last week's HIT conference hosted by Governor Deval Patrick and the MA Health Data Consortium.  This seemed to be news to some folks out there, but these requirements are deep in the heart of Part II of the Massachusetts health reform law (Chapter 305 of the Acts of 2008).  Much of the coverage in August 2008 didn't mention the EHR-for-licensure provisions, bu... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3538253 Thu, 06 May 2010 00:54:04 +0100 3538253 http://www.medworm.com/index.php?rid=3526840&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Fhealthblawg.typepad.com%2Ffiles%2Fgeorge-pantos-hpm-institute-healthblawg-interview-with-david-harlow-042110.mp3 Health care costs are a perennial issue for employers and employees.  There are a variety of approaches out there designed to improve health status and health outcomes and reduce costs at the same time.  Proponents of a variety of approaches have been featured here on HealthBlawg in the past.  I recently had the opportunity to speak with George Pantos, of the Healthcare Performance Management Institute, a brand-new organization on the scene, founded by a group of folks who have developed tools for managing these costs. The audio file of my interview with George Pantos (about 20 minutes long) is available for download/podcast.  A full transcript is at the end of this post (and in the linked George Pantos, Executive Director, Healthcare Performance Management Institute, HealthBlaw... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3526840 Mon, 03 May 2010 03:16:33 +0100 3526840 http://www.medworm.com/index.php?rid=3508216&cid=t_99849_105_f&fid=39124&url=http%3A%2F%2Fwww.jeffreymlevinemd.com%2Fhigh-tech-devices-for-older-patients%2F A substantial multi-billion dollar industry in implantable cardiac devices has emerged in recent years.  Technologies such as cardiac defibrillators (ICDs) and cardiac resynchronization therapy (CRT) devices are being implanted in many people who may not need them, and one of the biggest markets is the elderly.  A recent paper published in the Archives of Internal Medicine [...] (Source: Jeffrey M. Levine MD | Geriatric Specialist | Wound Care | Pressure Ulcers) Jeffrey M. Levine MD | Geriatric Specialist | Wound Care | Pressure Ulcers blogs http://www.medworm.com/rss/comments.php?id=3508216 Mon, 26 Apr 2010 14:19:31 +0100 3508216 http://www.medworm.com/index.php?rid=3504996&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FDN-L1oh3I1U%2Ffake-facebook-profiles-and-other-portents-of-the-end-times.html One issue up for discussion in this evening's free-form health care social media tweetchat was the fake Facebook page of eSara Baker, posted as a form of marketing for a company providing online health-related services (which sound like typical patient portal stuff like scheduling appointments and accessing test results).  The page prominently states: "If you haven't uncovered our secret yet, here it is: Sara isn't a real person." The identity of the company and the services provided are not at issue here.  The issue discussed in the #hcsm tweetchat was whether using social media to market a health care service through the use of a fabricated profile was unethical and/or harmful to authentic uses of social media for health care. I disagree with some of my #hcsm cohorts who twee... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3504996 Mon, 26 Apr 2010 03:04:59 +0100 3504996 http://www.medworm.com/index.php?rid=3499164&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2Fz9pni8O1CPk%2Fhealth-care-social-media-comes-to-the-massachusetts-hospital-association.html The Massachusetts Hospital Association presented a health care social media program today featuring two leading evangelists and strategists -- who also happen to be compelling speakers: Larry Weber and Lee Aase.  The MHA is getting its own social media presence off the ground, and the hospitals represented at the meeting are at various stages of social media adoption and use. The show-and-tell and war stories resonated with the audience, and a number of attendees were resolved to pick up flip cameras and integrate video into their social media offerings.  As the token lawyer in the room, I was asked if stand-up video interviews could be posted by virtue of getting electronic releases; since a digital signature is a signature these days under the law, I said yes.  The truth is, digiti... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3499164 Fri, 23 Apr 2010 11:41:02 +0100 3499164 http://www.medworm.com/index.php?rid=3490728&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FN0rw9xKpgWg%2Ffda-radiation-therapy-emitting-equipment-regulation-ehr-device.html Earlier this month, the FDA released a letter announcing a new focus on radiation-emitting products.  Here's the core of the letter:In order to reduce the number of under-doses, over-doses, and misaligned exposures from therapeutic radiation the FDA is taking several steps to improve the safety and safe use of certain radiation therapy devices. Analyses of Medical Device Reports (MDRs) revealed device problems that appear to be the result of faulty design or use error that could be mitigated by the incorporation of additional safeguards. Between December 31, 1999, and February 18, 2010, FDA received 1,182 MDRs associated with the use of radiation therapy devices. Of these MDRs, linear accelerators accounted for 74%, radiation therapy treatment planning systems (RTP) accounted for 19%, and... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3490728 Wed, 21 Apr 2010 13:59:06 +0100 3490728 http://www.medworm.com/index.php?rid=3487195&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FqwfebZK_bx0%2F2011-ipps-draft-rule-released-by-cms-good-news-bad-news.html The good news is that the acute hospital market basket update in Medicare payment proposed in the 2011 IPPS draft rule released by CMS on April 19 (to be published in the Federal Register on May 4) is 2.4% (subject to revision based on data clarifications in the final rule).  The bad news comes in two parts.  First, the 2.4% includes 2% for RHQDAPU compliance, and there are a number of new measures to report.  Second, and even worse, is that the rule also includes a -2.9% adjustment (yes, Virginia, a net cut of 0.5%) to account for part of the anticipated overpayment resulting from zealous documentation of claims under the relatively new MS-DRG system.  CMS gave hospitals a bye last year, when this adjustment was supposed to start.  Part 2 of the adjustment is supposed to be... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3487195 Tue, 20 Apr 2010 00:27:52 +0100 3487195 http://www.medworm.com/index.php?rid=3471893&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FV8chGkdkGmo%2Fhealth-wonk-review.html I'm not a superstitious man, but April 15th is fraught with doom, linked as it is to death and taxes ... among other themes, as we will explore in this edition of Health Wonk Review.  For that reason, and due to the happy accident that this edition is the fifth that I have hosted (Joe Paduda thought it was the umpteenth; I know, I know, we lawyers have a way with words ... but there have only been 1, 2, 3, 4 others), I'm opening this post under the protective auspices of a khamsa, a five-fingered good luck talisman, or amulet, designed to ward off the evil eye. Will Rogers once said: "The income tax has made liars out of more Americans than golf."  Honesty is, they say, the best policy.  On the flipside, though, last week Roy Poses questioned the de-linking of ethics from pecu... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3471893 Thu, 15 Apr 2010 09:16:39 +0100 3471893 http://www.medworm.com/index.php?rid=3448890&cid=t_99849_105_f&fid=39124&url=http%3A%2F%2Fwww.jeffreymlevinemd.com%2Fhow-will-health-care-reform-affect-geriatrics%2F The Patient Protection and Affordable Care Act (HR 3590) purports to contain provisions that will provide for better care for America’s seniors and add stimulus to growth of the field of Geriatrics.  One wonders, however, whether this historic bill will have true impact in stemming the flow of medical doctors away from caring for the [...] (Source: Jeffrey M. Levine MD | Geriatric Specialist | Wound Care | Pressure Ulcers) Jeffrey M. Levine MD | Geriatric Specialist | Wound Care | Pressure Ulcers blogs http://www.medworm.com/rss/comments.php?id=3448890 Wed, 07 Apr 2010 15:06:41 +0100 3448890 http://www.medworm.com/index.php?rid=3443808&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Fhealthblawg.typepad.com%2Ffiles%2Fhealthblawg-interview-earl-jones-svp-ge-healthcare-it-ehealth-040110-1.mp3 GE Healthcare IT has been working in the years leading up to the HITECH Act on a number of initiatives to enable meaningful use of health care IT -- or as Senior VP and General Manager of eHealth Earl Jones puts it, building the "connected health care ecosystem."In what may be seen as either a pragmatic move or a revolutionary one, GE is developing tools that allow for communication across health care IT systems -- not just connecting one GE Centricity installation with another -- but acting as a technology-agnostic bridge for information across health care IT systems and across health systems.  While Jones notes that we're in the early stages of linking isolated lily pads across the surface of a pond, GE is developing tools that not only facilitate interoperability, but also facilitate t... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3443808 Wed, 07 Apr 2010 02:53:32 +0100 3443808 http://www.medworm.com/index.php?rid=3443792&cid=t_99849_113_f&fid=34631&url=http%3A%2F%2Fehealth.johnwsharp.com%2F2010%2F04%2F06%2Fgroup-on-information-resources-gir-leadership-institute%2F I have been invited to attend this leadership institute of the American Association of Medical Colleges. This “provides IT leaders the information and tools to understand how to excel at the nexus of academic, research, and clinical systems to support organizations as they move to more integrated and data driven models.”  The five day institute in July is limited to 30 through a competitive process; I was nominated by my department chairman. I am looking forward to this interactive program. If anyone has participated or will be attending this summer, I’d like to hear from you. (Source: eHealth) eHealth blogs http://www.medworm.com/rss/comments.php?id=3443792 Wed, 07 Apr 2010 01:57:44 +0100 3443792 http://www.medworm.com/index.php?rid=3437768&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FpQ7ENGfaD6U%2Fhealth-reform-enacted-healthblawger-punked-by-potus.html As regular readers of HealthBlawg are well aware, I had my doubts that el Presidente could pull it off once the Dems lost Kennedy's Senate seat, but he did manage to rally the troops and get the sausage version of health insurance reform enacted.  Nothing to sneeze at, but it's only a first step -- health insurance reform, not a full health reform package as promised during the campaign.  Nevertheless, the steps to be taken towards implementation of health reform remain the same -- even though we do have legislation in place, and a nominee (finally) -- Don Berwick -- to head CMS.  (See more on the pros and cons of Berwick's nomination, and a podcast interview with Berwick here on HealthBlawg from about 18 months ago.)  In brief, with or without the legislation -- and many, many... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3437768 Sun, 04 Apr 2010 20:39:29 +0100 3437768 http://www.medworm.com/index.php?rid=3429272&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FvaxHwF57DRs%2Fblog-carnivals-next-health-wonk-review-right-here-on-april-15.html This week, health reform looms large in the minds of blog carnival hosts.  Evan Falchuk's health reform edition of Grand Rounds is up at his See First blog.  Rich Elmore hosts the current Health Wonk Review at his Healthcare Technology News (check out the flying pigs photos and more; cf. the HealthBlawger's "First Hundred Days" edition of Blawg Review for another reference to flying pigs). The next edition of Health Wonk Review will be hosted right here on April 15th.  The themes we will be exploring in that biweekly exegesis of health wonkery include the following: Metaphors Lying Song (esp. the blues) Art (esp. painting, drawing) Inventors and their contraptions Fast food Liberation Cosmetic surgery/medical spas Impressionist 19th century novels Immenseness Mortality Rac... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3429272 Thu, 01 Apr 2010 15:08:58 +0100 3429272 http://www.medworm.com/index.php?rid=3382922&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Fhealthblawg.typepad.com%2Ffiles%2Fpeter-neumann-healthblawg-interview-david-harlow-031610.mp3 The national debate on health care reform is currently focused on health insurance reform -- coverage, one of the proverbial three legs of the health care reform stool: coverage, cost and quality.  In order to bend the cost curve -- no matter what the approach to health care reform: be it federal legislation, state initiatives, federal pilots and demonstration projects, and/or private sector initiatives -- most would agree that we need a rational approach to cost-effectiveness research, or comparative effectiveness research that we can all rely upon.  Anyone who embarks on a search for such an approach will soon find Peter Neumann's Center for the Evaluation of Value and Risk in Health at the Tufts University Medical Center and the CEVR's Cost-Effectiveness Analysis Registry.  I spoke w... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3382922 Fri, 19 Mar 2010 13:05:29 +0100 3382922 http://www.medworm.com/index.php?rid=3382821&cid=t_99849_87_f&fid=38962&url=http%3A%2F%2Fwww.healthbeatblog.com%2F2010%2F03%2Fhighlights-from-the-reconciliation-bill-and-maggies-comments-on-the-changes.html Overall, the changes in the reconciliation bill will make the Senate bill more progressive—and fairer.My prediction: the bill will pass. Those who oppose universal coverage are becoming angrier, louder, more abusive, and more frantic. This is because they realize that they are losing, and now they are just flailing about.This evening (Thursday) I heard Bart Stupak acknowledge, on “Hardball with Chris Matthews”, that while the Democrats may not have the votes today, by Sunday, they could well have them. On this, I agree with Stupak.Below, the details of the new bill, and my comments in red. Under the new reconciliation bill: Low-income and middle-income families will have an easier time affording premiums. The tax credits for health insurance premiums are more generous for ... Health Beat blogs http://www.medworm.com/rss/comments.php?id=3382821 Fri, 19 Mar 2010 01:39:29 +0100 3382821 http://www.medworm.com/index.php?rid=3382757&cid=t_99849_85_f&fid=34967&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fdocisinblog%2FwNlq%2F%7E3%2FSwCBSConYCI%2F In my prior post I highlighted some of the problems with Medicaid, the joint state and federal health coverage for the poor. In case you might think that physicians won’t participate simply because the reimbursement is so poor (which would certainly be reason enough), check this out, from my state medical society today: The WSMA has complained to both the Centers for Medicare and Medicaid Services (CMS) Region X and the Washington Department of Social and Health Services (DSHS) about the egregiously burdensome requests made of physicians’ practices by the Audit Medicaid Integrity Contractor (MICs). CMS has awarded the Medicaid audit contract for Washington to Health Management Services (HMS) of Irvine, Texas. HMS is making unrealistic requests of practices in preparation of &#8... The Doctor Is In blogs http://www.medworm.com/rss/comments.php?id=3382757 Thu, 18 Mar 2010 20:57:16 +0100 3382757 http://www.medworm.com/index.php?rid=3374222&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FCfqn1wiNksk%2Fmassachusetts-health-care-cost-trends-hearings-yield-data-stir-heated-debate-.html   The Massachusetts Division of Health Care Finance and Policy and the Attorney General's Office are holding three days of hearings this week on health care cost trends.  You may wish to get up to speed by taking a look at the HealthBlawger's earlier review of preliminary reports on Massachusetts health care cost trends and positioning by key participants.  There is a comprehensive collection of preliminary reports and testimony on the Commonwealth's website. Tuesday's Boston Globe reported that Harvard Pilgrim Health Care (one of the Big Three not-for-profit insurers here) released hospital payment data confirming what the AG's office had previously reported (and what has been widely surmised or known for years) -- namely, that certain hospitals get paid substantially more for the s... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3374222 Wed, 17 Mar 2010 17:02:45 +0100 3374222 http://www.medworm.com/index.php?rid=3374223&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FGoZmGo7u-GA%2Fdavid-harlow-quoted-on-electronic-health-records-implementation-and-incentives-in-mass-medical-law-r.html Just a few days before the comment period closed on the draft regulations defining meaningful use (see all meaningful use comments), the Massachusetts Medical Law Report ran a piece on the HITECH Act incentives for implementation of electronic health records systems, quoting me and a couple other usual suspects.  I highlighted some shortcomings in the proposed rule, and also noted that health care providers need to be implementing EHRs not just for the stimulus kicker ... that alone is not worth it:[T]he regulation calls for all physicians to use e-prescribing 75 percent of the time by 2012.David Harlow, a Newton-based lawyer and health care consultant, said that this won’t be an easy task, noting that Massachusetts is considered a leader in e-prescribing even though only 10 percent of ... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3374223 Wed, 17 Mar 2010 00:46:42 +0100 3374223 http://www.medworm.com/index.php?rid=3374073&cid=t_99849_85_f&fid=34967&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fdocisinblog%2FwNlq%2F%7E3%2FeDQ_OBUBQX8%2F From the New England Journal of Medicine, a recent physician survey on the effects of the pending health care reform legislation on physician supply: Key Findings Physician Support of Health Reform in General • 62.7% of physicians feel that health reform is needed but should be implemented in a more targeted, gradual way, as opposed to the sweeping overhaul that is in legislation. • 28.7% of physicians are in favor of a public option. • 3.6% of physicians prefer the “status quo” and feel that the U.S. health care system is best “as is. Health Reform and Primary Care Physicians • 46.3% of primary care physicians (family medicine and internal medicine) feel that the passing of health reform will either force them out of medicine or make them want to leave medicine. Health ... The Doctor Is In blogs http://www.medworm.com/rss/comments.php?id=3374073 Tue, 16 Mar 2010 19:55:05 +0100 3374073 http://www.medworm.com/index.php?rid=3362392&cid=t_99849_87_f&fid=38962&url=http%3A%2F%2Fwww.healthbeatblog.com%2F2010%2F03%2Fpelosi-watch-the-final-mile-.html Today House Speaker Nancy Pelosi confirmed that Congressional Democrats are inching "closer" to final votes on health care reform. She declared that Democrats will take   "whatever time is required" to get it finished.  “It won't be very long,” she said, “and we'll be making a real difference in the life of the American people.”Pelosi has also made it clear that the public option will not be in the final legislation, adding “I’m quite sad that the public option is not in there.” Pelosi also noted that she has been for single payer for many years, long before many of the reporters in the room were born.  I, too, have been watching the health care reform battle since the days of the Nixon administration, and I realize how easy... Health Beat blogs http://www.medworm.com/rss/comments.php?id=3362392 Fri, 12 Mar 2010 19:16:53 +0100 3362392 http://www.medworm.com/index.php?rid=3354434&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2F540ouT9hVd4%2Fpatient-safety-not-taught-in-medical-school-lucian-leape-institute-releases-teaching-safe-patient-care.html This report is the first of a planned series of such reports on issues that the Lucian Leape Institute has identified as top priorities in ongoing efforts to improve patient safety. “We are very excited about this initial report of the Lucian Leape Institute,” said Diane C. Pinakiewicz, MBA, President of the Lucian Leape Institute and the National Patient Safety Foundation, “but we recognize that this is just the beginning of a major collaborative effort to see the report’s recommendations through to their full implementation.”Subsequent Institute initiatives will address integration of care across health care organizations and delivery systems; restoration of pride, meaning and joy in professional work; active consumer engagement in patient care; and provision of fully transpare... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3354434 Thu, 11 Mar 2010 05:01:06 +0100 3354434 http://www.medworm.com/index.php?rid=3346554&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Fhealthblawg.typepad.com%2Ffiles%2Fjohn-glaser-partners-cio-podcast-interview-healthblawg-david-harlow-030310.mp3 What does a large health system CIO worry about if his system is already fully up to speed in the day-to-day use of EHRs?  Using them in ways that improve communication of information across a diverse group of clinicians, and that enable the integration of additional interesting and useful data as time goes on -- such as the integration of genetic testing data into the diagnostic and treatment logic built into the EHR.John Glaser explains how Partners uses its EHR system to leverage knowledge for the benefit of patients, and describes some of the ways in which decision support systems are being used today and may be used in the future.  Tools in place at Partners now:[T]here is for example a monthly report put out on dozens and dozens of quality measures and they are coded red, yellow... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3346554 Tue, 09 Mar 2010 12:46:44 +0100 3346554 http://www.medworm.com/index.php?rid=3338441&cid=t_99849_155_f&fid=38412&url=http%3A%2F%2Fpathlabmed.typepad.com%2Fsurgical_pathology_and_la%2F2010%2F03%2Fwhen-disruptive-integration-comes-to-health-care.html When Disruptive Integration Comes to Health CarePosted using ShareThisInteresting article containing an interview with Dr. Jason Hwang co-author of The Innovator’s Prescription: A Disruptive Solution for Health Care (McGraw-Hill, 2009).It got me thinking about niches where "disruptive innovation" may occur in laboratory medicine and pathology.  Please share any thoughts you may have--let's get a conversation started about this!One area is lab testing for wellness or serial monitoring of chronic diseases managed on an outpatient basis.  The traditional hospital-based lab (like mine) just has not evolved to meet these needs.  Your lab may still be focused on inpatient lab testing.  Outreach efforts may want to incorporate marketing for these niches.Ano... The Daily Sign-Out blogs http://www.medworm.com/rss/comments.php?id=3338441 Fri, 05 Mar 2010 19:38:10 +0100 3338441 http://www.medworm.com/index.php?rid=3327080&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FswUaX-REUa0%2Fhimss-in-atlanta-and-online-better-health.html The HIMSS annual convention going on this week in Atlanta is a 30,000-person blowout of epic proportions (and, yes, there was snow there but not in Boston), with many industry announcements, product launches, and meetings and sessions large and small.  There were a ton of blog posts (even a couple of blogger panels - sorry I couldn't participate remotely), and a blizzard of tweets at #HIMSS10.  For some up-close-and-personal looks at products and services brought to the conference, look no further than the Better Health livestreamed video interviews from HIMSS.  @DrVal (Val Jones),  @DoctorAnonymous (Mike Sevilla) and @Blogborygmi (Nick Genes) have been doing a bang-up job broadcasting to those interested well beyond the exhibit halls, and have been taking questions online for the ... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3327080 Wed, 03 Mar 2010 02:19:44 +0100 3327080 http://www.medworm.com/index.php?rid=3318493&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2Fwl7iaC-u-VA%2Frac-david-harlow-quoted-part-b-insider.html The OIG recently reviewed RAC performance to date in identifying fraud (vs. overpayment) and found the RACs wanting.  To be fair, the RACs haven't been trained in identifying Medicare fraud. Part B Insider asked me how providers should prepare for an encounter with a RAC (a "RAC attack"?) and my answer is consistent with what I advise providers on a regular basis:  Be prepared.  Be proactive.  “From my perspective, it is always better to conduct regular internal reviews as part of robust standing compliance and internal audit programs,” Harlow says. “If these compliance reviews and audits are carried out thoroughly, the results may be used in challenging or appealing RAC reviews.” When applicable, providers should initiate self-disclosure of fraudulent billing uncovered by ... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3318493 Mon, 01 Mar 2010 03:58:49 +0100 3318493 http://www.medworm.com/index.php?rid=3318495&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Fhealthblawg.typepad.com%2FDave%2520Fischer%2520MITA%2520HealthBlawg%2520Interview%2520with%2520David%2520Harlow%2520022510.mp3 MITA Executive Director Dave Fischer spoke with HealthBlawg last week about industry efforts to control radiation dose in diagnostic radiology modalities such as CT.  A congressional hearing on radiation dose control took place the day after we spoke, and the FDA will be holding a hearing on diagnostic radiology issues in late March.  Earlier last week, timed in part perhaps because of the upcomng congressional committee hearing, MITA kicked off the dose check initiative, a tool for manufacturers and providers to use in better regulating diagnostic imaging radiation dose, which Dave Fischer describes in our interview.  He also referred to the CMS demonstration project on appropriateness of imaging services now underway, authorized by MIPPA.   It now seems surprising that there ... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3318495 Sun, 28 Feb 2010 22:39:57 +0100 3318495 http://www.medworm.com/index.php?rid=3314705&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2Frt9vLsiqvjw%2Fmpfs-in-crisis-holding-of-claims-for-services-paid-under-the-2010-medicare-physician-fee-schedule.html Days of Future Passed (or: deja vu all over again).  Late Friday, after business hours, CMS pushed the following announcement via its physician information listserv: The Centers for Medicare & Medicaid Services (CMS) is working with Congress, health care providers, and the beneficiary community to avoid disruption in the delivery of health care services and payment of claims for physicians, non-physician practitioners, and other providers of services paid under the Medicare physician fee schedule. As you are aware, the Department of Defense Appropriations Act of 2010 provided a zero percent (0%) update to the 2010 MPFS effective for dates of service January 1, 2010, through February 28, 2010.  We believe Congress is working to avoid the negative update that will take effec... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3314705 Sat, 27 Feb 2010 01:49:03 +0100 3314705 http://www.medworm.com/index.php?rid=3420513&cid=t_99849_105_f&fid=39124&url=http%3A%2F%2Fwww.jeffreymlevinemd.com%2Fretooling-for-an-aging-america%2F This study was commissioned by the Institute of Medicine (IOM) and put together by the Committee on the Future Health Care Workforce for Older Americans chaired by John W. Rowe.  The document presents an analysis of America’s [...] (Source: Jeffrey M. Levine MD | Geriatric Specialist | Wound Care | Pressure Ulcers) Jeffrey M. Levine MD | Geriatric Specialist | Wound Care | Pressure Ulcers blogs http://www.medworm.com/rss/comments.php?id=3420513 Mon, 22 Feb 2010 13:00:17 +0100 3420513 http://www.medworm.com/index.php?rid=3311793&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Fhealthblawg.typepad.com%2Ffiles%2Fwayne-burton-cyndy-nayer-healthblawg-interview-part-ii-020510.mp3 Today we bring you Part II of my conversation with Wayne Burton and Cyndy Nayer of the Center for Health Innovation, where we get into some specific examples of successful programs.  The Center represents over 40 million lives, and brings together employers and providers to focus on a limited number of levers targeted at health and wellness - rather than health care.  The ROI of wellness efforts in the workplace is pegged at nearly 300% in a recent Health Affairs article by Karen Baicker et al. and accompanying Health Affairs blog post by Jaan Sidorov - one of my fellow "Health Wonks."  Clearly this is an area that demands our attention.  The audio file of Part II of my interview with Wayne Burton and Cyndy Nayer (about 20 minutes long) is available for download/podcast.  A full trans... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3311793 Wed, 10 Feb 2010 00:10:58 +0100 3311793 http://www.medworm.com/index.php?rid=3311794&cid=t_99849_114_f&fid=34648&url=http%3A%2F%2Fhealthblawg.typepad.com%2Ffiles%2Fwayne-burton-and-cyndy-naylor-healthblawg-interview-part-i-020510.mp3 I recently spoke with Wayne Burton, MD and Cyndy Nayer.  Cyndy is co-founder and President of the Center for Health Value Innovation; Wayne is a member of the Board of Strategic Advisors, and former longtime Corporate Medical Director of JP Morgan Chase.  The Center focuses on sharing evidence of improved health and economic outcomes through value-based designs.  In the current environment, this sort of private-sector focus on value-based health improvement and cost savings is critical.  Given the recent collapse of health reform inside the Beltway, now is the time for organizations such as the Center to prove themselves and their approaches, by demonstrating that they are able to "bend the cost curve" while improving health indicators, and ensure that efforts to do so yield a sign... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3311794 Tue, 09 Feb 2010 22:32:39 +0100 3311794 http://www.medworm.com/index.php?rid=3420516&cid=t_99849_105_f&fid=39124&url=http%3A%2F%2Fwww.jeffreymlevinemd.com%2Fageism-the-new-york-times-and-geriatric-medicine%2F After reading an article entitled “The Geezers’ Crusade” by columnist David Brooks in the Op-Ed pages of the New York Times last week I felt compelled to comment on it.   The article begins on an encouraging note, pointing out how society’s views of human aging are evolving from negative to optimistic.  Once viewed as a [...] (Source: Jeffrey M. Levine MD | Geriatric Specialist | Wound Care | Pressure Ulcers) Jeffrey M. Levine MD | Geriatric Specialist | Wound Care | Pressure Ulcers blogs http://www.medworm.com/rss/comments.php?id=3420516 Tue, 09 Feb 2010 15:03:07 +0100 3420516 http://www.medworm.com/index.php?rid=3200450&cid=t_99849_87_f&fid=38962&url=http%3A%2F%2Fwww.healthbeatblog.com%2F2010%2F01%2Fin-the-wake-of-the-mass-massacrebipartisan-reform-or-the-senate-bill.html Let’s begin by addressing  some of the myths:First, the Massachusetts vote was not a “Massacre”: Brown won 51 percent of the vote.Secondly, this was not a referendum which shows that the public opposes  health care reform. Among Massachusetts’ voters who said health care was their top issue, 53 percent voted for Democrat Martha Coakley reports JoAnne Kenen, over at the New America Foundation’s New Health Dialogue. Kenen understands politics better than most health care commentators: for more than a decade, she covered Congress for Reuters.  Ignoring what the pundits are saying about “the Massachusetts message”, Kenen took a look at the facts:  “Jill Lawrence at Politics Daily crunched some Massachusetts numbers  and discovered that “a solid ... Health Beat blogs http://www.medworm.com/rss/comments.php?id=3200450 Fri, 22 Jan 2010 20:34:37 +0100 3200450 http://www.medworm.com/index.php?rid=3185264&cid=t_99849_85_f&fid=34967&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fdocisinblog%2FwNlq%2F%7E3%2FJUiuJ9r52vM%2F As the Democrats in Congress press forward in blind determination to pass their health care reform legislation come hell or high water, the pernicious effects of the legislation are increasingly becoming evident to anyone who takes the time to dig into its details. Though our Congressional representatives cannot seem to find the time to read these gargantuan, 2000-page bills, busy as they are padding their pockets with filthy lucre from lobbyists and interest groups, those at the state level who are will be responsible for picking up the credit card bills from this monomaniacal spending spree are starting to sweat. Even the Blue states — no strangers to fantasy spending budgets, punitive taxes, and political giveaways — can see the handwriting on the wall. Out here in scenic Wa... The Doctor Is In blogs http://www.medworm.com/rss/comments.php?id=3185264 Tue, 19 Jan 2010 14:11:45 +0100 3185264 http://www.medworm.com/index.php?rid=3137477&cid=t_99849_85_f&fid=34967&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fdocisinblog%2FwNlq%2F%7E3%2F_HxnWfVN9s4%2F The blogs have been abuzz about the big news from Arizona: The Mayo Clinic in Arizona will no longer be accepting Medicare patients for primary care. The Mayo Clinic, praised by President Barack Obama as a national model for efficient health care, will stop accepting Medicare patients as of tomorrow at one of its primary-care clinics in Arizona, saying the U.S. government pays too little. More than 3,000 patients eligible for Medicare, the government’s largest health-insurance program, will be forced to pay cash if they want to continue seeing their doctors at a Mayo family clinic in Glendale, northwest of Phoenix, said Michael Yardley, a Mayo spokesman. The decision, which Yardley called a two-year pilot project, won’t affect other Mayo facilities in Arizona, Florida and Minnesota. Ob... The Doctor Is In blogs http://www.medworm.com/rss/comments.php?id=3137477 Sat, 02 Jan 2010 23:28:10 +0100 3137477 http://www.medworm.com/index.php?rid=3133816&cid=t_99849_155_f&fid=38412&url=http%3A%2F%2Fpathlabmed.typepad.com%2Fsurgical_pathology_and_la%2F2009%2F12%2Fdigital-pathology-article-in-cap-today.html Dr. Keith Kaplan at Digital Pathology Blog pointed this one out as a good article discussing the recent FDA meeting regarding whole-slide imaging (WSI) technology.  And he has some informed insights quoted in the article.  The online version of CAP Today has been out and I (again) urge you to check it out--although the hard copy version is probably sitting on your desk somewhere.I reckon that you're take on this article might depend on your reaction to the quote from Ole Eichhorn ot Aperio:"Eichhorn believes that the FDA fears that if it doesn't "get out in front" of digital pathology, there could be a proliferation of non-cleared/non-approved WSI systems "because these devices are useful and valuable.  By the way, that's what we have with ... The Daily Sign-Out blogs http://www.medworm.com/rss/comments.php?id=3133816 Wed, 30 Dec 2009 19:45:27 +0100 3133816 http://www.medworm.com/index.php?rid=3111359&cid=t_99849_85_f&fid=34967&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fdocisinblog%2FwNlq%2F%7E3%2FzZDdR2eKJ-c%2F In the dark of night, appropriately, the Senate last night voted to end debate on its health care reform bill, bringing it to a floor vote. From Commentary magazine comes the following assessment of what will be voted on: The non-reform health-care bill does, to the disgust of liberals, make insurance companies very happy. The government is coercing customers to buy the companies’ products under penalty of prosecution and fine. The non-reform health-care bill does, to the horror of seniors, slash $500B out of Medicare with no conceivable alternative other than rationing to meet its new budget. The non-reform health-care bill does, to the delight of trial lawyers, do nothing to reform the tort system or the problem of defensive medicine. And the non-reform health-care bill does, to the ch... The Doctor Is In blogs http://www.medworm.com/rss/comments.php?id=3111359 Mon, 21 Dec 2009 18:58:01 +0100 3111359 http://www.medworm.com/index.php?rid=3063227&cid=t_99849_85_f&fid=34967&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fdocisinblog%2FwNlq%2F%7E3%2FOP7q9AZtxNE%2F Over at Big Government, we get a glimpse of where ObamaCare will take us: Health Care’s Coming Heart Attack – A Pre-Obama Care Death Panel? I am writing of the Obama Administration’s – regulatory decision – to go ahead with a massive cut in Medicare payments to cardiologists. I emphasize that this is a regulatory decision because it was not made by the Congress legislatively (not that that would be ok) but, instead, it was made by the massive Health and Human Services Department of the US Government. Given the limited resources of the Medicare budget, in order to increase payments to general practitioners (in an effort to attract more such doctors – a good idea), bureaucrats needed to gore somebody’s ox and cardiologists were chosen (a horrible idea). The decision to do so is... The Doctor Is In blogs http://www.medworm.com/rss/comments.php?id=3063227 Sun, 06 Dec 2009 20:26:32 +0100 3063227 http://www.medworm.com/index.php?rid=3524051&cid=t_99849_85_f&fid=39183&url=http%3A%2F%2Fdrbobbs.wordpress.com%2F2009%2F11%2F11%2Fstill-more-aafp-coca-cola-fallout%2F There is now a Facebook page entitled End the AAFP and Coca Cola Collaboration. From the Associated Press: Family doctors group loses members over Coke deal. And there’s an online petition: Family Doctors Against the AAFP-Coca-Cola Partnership. (Source: Dr. Bobbs) Dr. Bobbs blogs http://www.medworm.com/rss/comments.php?id=3524051 Wed, 11 Nov 2009 05:29:00 +0100 3524051 http://www.medworm.com/index.php?rid=2973881&cid=t_99849_85_f&fid=34967&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fdocisinblog%2FwNlq%2F%7E3%2F3P15L9135Fg%2F From the Wall Street Journal, on the passage this weekend of health care legislation in the House:   The bill is instead a breathtaking display of illiberal ambition, intended to make the middle class more dependent on government through the umbilical cord of “universal health care.” It creates a vast new entitlement, financed by European levels of taxation on business and individuals. The 20% corner of Medicare open to private competition is slashed, while fiscally strapped states are saddled with new Medicaid burdens. The insurance industry will have to vet every policy with Washington, which will regulate who it must cover, what it can offer, and how much it can charge. We have little sympathy for the insurers, or for that matter most of the other medical providers who ... The Doctor Is In blogs http://www.medworm.com/rss/comments.php?id=2973881 Mon, 09 Nov 2009 15:19:44 +0100 2973881 http://www.medworm.com/index.php?rid=3524052&cid=t_99849_85_f&fid=39183&url=http%3A%2F%2Fdrbobbs.wordpress.com%2F2009%2F11%2F07%2Fcould-failing-to-get-health-insurance-make-you-a-prisoner%2F According to Michigan Republican Representative David Camp, the answer is yes: When confronted with this same issue during its consideration of a similar individual mandate tax, the Senate Finance Committee worked on a bipartisan basis to include language in its bill that shielded Americans from civil and criminal penalties. The Pelosi bill, however, contains no [...] (Source: Dr. Bobbs) Dr. Bobbs blogs http://www.medworm.com/rss/comments.php?id=3524052 Sun, 08 Nov 2009 04:48:28 +0100 3524052 http://www.medworm.com/index.php?rid=3524053&cid=t_99849_85_f&fid=39183&url=http%3A%2F%2Fdrbobbs.wordpress.com%2F2009%2F11%2F07%2Fred-flag-rules-implementation-delayed-again-again%2F This time it’s pushed back to 1 June 2010. Here’s that AAFP Red Flag one-pager link again. (Source: Dr. Bobbs) Dr. Bobbs blogs http://www.medworm.com/rss/comments.php?id=3524053 Sat, 07 Nov 2009 05:07:49 +0100 3524053 http://www.medworm.com/index.php?rid=3524054&cid=t_99849_85_f&fid=39183&url=http%3A%2F%2Fdrbobbs.wordpress.com%2F2009%2F11%2F03%2Fthe-pause-that-refreshes%2F The American Academy of Family Physicians (AAFP) continues to be the target of criticism in both the blogosphere and conventional media outlets for its partnership with the Coca-Cola company. From The Kansas City Star: [T]he American Academy of Family Physicians…represents about 94,000 doctors who struggle to get their patients to shed excess pounds. From across [...] (Source: Dr. Bobbs) Dr. Bobbs blogs http://www.medworm.com/rss/comments.php?id=3524054 Wed, 04 Nov 2009 04:43:24 +0100 3524054 http://www.medworm.com/index.php?rid=3524055&cid=t_99849_85_f&fid=39183&url=http%3A%2F%2Fdrbobbs.wordpress.com%2F2009%2F11%2F03%2Fobamacare-dead-for-2009%2F Is Obamacare, for the present at least, dead on arrival?  According to ABC News, it is: Senior Congressional Democrats told ABC News today it is highly unlikely that a health care reform bill will be completed this year, just a week after President Barack Obama declared he was “absolutely confident” he’ll be able to sign [...] (Source: Dr. Bobbs) Dr. Bobbs blogs http://www.medworm.com/rss/comments.php?id=3524055 Wed, 04 Nov 2009 03:35:27 +0100 3524055 http://www.medworm.com/index.php?rid=3524056&cid=t_99849_85_f&fid=39183&url=http%3A%2F%2Fdrbobbs.wordpress.com%2F2009%2F10%2F31%2Fwhy-trial-lawyers-will-love-democrat-health-reform-bill%2F Andrew Breitbart’s Big Government website reports that the Pelosi Health Care Bill Blows a Kiss to Trial Lawyers: Section 2531, entitled “Medical Liability Alternatives,” establishes an incentive program for states to adopt and implement alternatives to medical liability litigation. [But]…… a state is not eligible for the incentive payments if that state puts a law [...] (Source: Dr. Bobbs) Dr. Bobbs blogs http://www.medworm.com/rss/comments.php?id=3524056 Sun, 01 Nov 2009 01:00:12 +0100 3524056 http://www.medworm.com/index.php?rid=2876021&cid=t_99849_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2Fymn1_XTNQfs%2F The Congressional Budget Office released a report this week that revealed that the proposed health care bill would not increase the deficit.  But is it that simple? Cato health care policy experts have examined the bill and added up the costs. Here are a few things they have found: Congress has been cooking the books: “When it comes to the health care reform debate…honest budgeting is nowhere to be seen.” Costs will only decrease if we give market forces room to breathe. How some in Congress are hiding the true costs of the health care overhaul. Healthy Competition: What’s Holding Back Health Care and How to Free It Podcast: Do You Smell the Books Congress is Cookin’? (Source: Cato-at-liberty) Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=2876021 Thu, 08 Oct 2009 16:33:40 +0100 2876021 http://www.medworm.com/index.php?rid=2807575&cid=t_99849_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FOR0nsVjEuGI%2F A new T-shirt for Senator Baucus: I worked for six months with half a dozen members of the Senate Finance Committee, and all I got was this lousy 223-page summary of what I hope the new health care bill will look like. Why should evidence even matter in education policy? I mean, we’re doing this for the children. Videos reveal tax-funded organization being used to help those who want to open a brothel and illegally bring underage girls into the United States as “sex workers.” Meet the two 20-something who exposed it. It’s time to narrowly define the mission in Afghanistan. “The United States does not have the patience, cultural knowledge or legitimacy to transform what is a deeply divided, poverty stricken, tribal-based society into a self-sufficient, n... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=2807575 Thu, 17 Sep 2009 19:31:32 +0100 2807575 http://www.medworm.com/index.php?rid=2778397&cid=t_99849_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2F_LO4hmsPRVA%2F Cato health care policy experts Michael D. Tanner and Michael F.  Cannon will live-blog President Obama’s address to Congress, Wednesday night at 8:00 PM EST. Check back here at Cato@Liberty and join us for a discussion of Obama’s proposals. We’ll also post comments on Twitter and take questions after the speech. UPDATE: We’ll be streaming the speech live right here at Cato@Liberty so you can watch the speech and read up-to-the-minute commentary from our health care policy experts. Sign up for a reminder below. Cato Experts Live-Blog President Obama’s Health Care Address (Source: Cato-at-liberty) Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=2778397 Tue, 08 Sep 2009 19:57:21 +0100 2778397 http://www.medworm.com/index.php?rid=2744036&cid=t_99849_85_f&fid=34967&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fdocisinblog%2FwNlq%2F%7E3%2F-xof5BB7b7s%2F Over at First Things, you will find an excellent article on the topic of rationing in health care, written by a clinical oncologist now working for the insurance industry in evaluating claims for medical necessity. Despite what would at first glance raise concerns about being an apologetic for the private insurance industry, this proves to be a well-balanced essay on the difficult choices in allocating scarce health care resources wisely. It is well worth your time to read in its entirety: Confessions of a Health Care Rationer It’s a mistake to think of health care as a right. It is not a right; it is a good. Freedom of speech, by contrast, is a right, as is freedom of religious belief. They are privileges that inure to individuals as a consequence of the primordial right, free will. Tha... The Doctor Is In blogs http://www.medworm.com/rss/comments.php?id=2744036 Sat, 29 Aug 2009 02:04:03 +0100 2744036 http://www.medworm.com/index.php?rid=2712033&cid=t_99849_85_f&fid=34967&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fdocisinblog%2FwNlq%2F%7E3%2FDlOuN2B9yrY%2F I must confess to having had some misgivings about the uproar over Section 1233 of the proposed health care reform bill HR 3200. This section pertains to government payment for counseling on end-of-life options under Obamacare. From Sarah Palin’s ‘death panels” to an endless host of hyperbolic rhetoric about how this counseling is “mandatory” (it’s not) and will inevitably lead to euthanasia, I have felt that much of the discourse is over the top and poorly supported by the text of the bill, and may well prove counterproductive in the long run. This is not to say that there is no reason for concern: the enormous financial strains which the proposed legislation will place on the health care system, combined with a government panel to decide the “app... The Doctor Is In blogs http://www.medworm.com/rss/comments.php?id=2712033 Wed, 19 Aug 2009 01:24:41 +0100 2712033 http://www.medworm.com/index.php?rid=2674214&cid=t_99849_85_f&fid=34967&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fdocisinblog%2FwNlq%2F%7E3%2FiGJ5BypMhfo%2F   If you have a serious case of insomnia, have far too much time on your hands — or have a vested interest in not seeing government take over your health care — then you will want to spend quality time reading the legislation which will change your life, irrevocably and disastrously, forever: HR 3200, “America’s Affordable Health Choices Act of 2009″. Various summaries and commentaries are floating about the web, and while helpful, they are tainted by too much histrionic commentary, often SHOUTED TO MAKE A POINT! which may or may not be be a valid inference from the legislation. Here’s the HTML version with links. So now you can go straight to the source, and judge for yourselves. Even though your elected representatives will try to pass this withou... The Doctor Is In blogs http://www.medworm.com/rss/comments.php?id=2674214 Thu, 06 Aug 2009 09:24:14 +0100 2674214 http://www.medworm.com/index.php?rid=2674519&cid=t_99849_155_f&fid=38412&url=http%3A%2F%2Fpathlabmed.typepad.com%2Fsurgical_pathology_and_la%2F2009%2F08%2Fhealth-reform-revisited.html I can't resist referring to Dr. Keith Kaplan's post today at Digital Pathology Blog which reprints a column from Mike Royko, a famous syndicated Chicago columnist.  Boy, I really miss his columns, although Jon Kass has admirably done a good job following Royko at the Chicago Tribune.  Great find, Keith! (Source: The Daily Sign-Out) The Daily Sign-Out blogs http://www.medworm.com/rss/comments.php?id=2674519 Wed, 05 Aug 2009 15:47:08 +0100 2674519 http://www.medworm.com/index.php?rid=2653637&cid=t_99849_85_f&fid=34967&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fdocisinblog%2FwNlq%2F%7E3%2F862zOaTZxAY%2F The second in a series reviewing the health policy proposals by Newt Gingrich as listed at the Center for Health Information.  ♦ Part 1: Stop Paying the Crooks   We’ve been looking at the health care reform proposals recently put forth by Newt Gingrich at the Center for Health Information. Before moving on to the topic of computerized medical records, a few more points come to mind regarding the whole fraud and abuse problem and its proposed solution. The real problem with the federal health care programs, the seed ground for the vast majority of the fraud problems in health care (and elsewhere), is complexity. Simple systems are hard to defraud. When you buy a box of cereal at the store, and pay the checkout gal your money, there’s no opportunity for frau... The Doctor Is In blogs http://www.medworm.com/rss/comments.php?id=2653637 Thu, 30 Jul 2009 00:43:28 +0100 2653637 http://www.medworm.com/index.php?rid=2648934&cid=t_99849_85_f&fid=34967&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fdocisinblog%2FwNlq%2F%7E3%2Fugs_eKgYsD4%2F Over at the Center for Health Information (HT: Hot Air), Newt Gingrich and Nancy Desmond have proposed a series of principles for reforming our health care system, to wit: 1. Stop Paying the Crooks. First, we must dramatically reduce healthcare fraud within our current healthcare system. Outright fraud — criminal activity — accounts for as much as 10 percent of all healthcare spending. That is more than $200 billion every year. Medicare alone could account for as much as $40 billion a year. 2. Move from a Paper-based to an Electronic Health System. As it stands now, it is simply impossible to keep up with fraud in a paper-based system. An electronic system would free tens of billions of dollars to be spent on investing on the kind of modern system that will transform healthc... The Doctor Is In blogs http://www.medworm.com/rss/comments.php?id=2648934 Wed, 29 Jul 2009 08:14:02 +0100 2648934 http://www.medworm.com/index.php?rid=2645242&cid=t_99849_85_f&fid=34967&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fdocisinblog%2FwNlq%2F%7E3%2FekFX9RkYnZw%2F Over at the Belmont Club, Richard Ramirez has a post citing a proposal by a physician for reform of the health care system. The proposal is thoughtful, with some excellent suggestions (which will never get implemented in today’s environment, sadly). What caught my eye in the comments was a summary of the changes which tort reform has brought about in Texas by a commenter, Leo Linbeck: I’m pretty familiar with tort reform in Texas, as my dad was the founding Chairman of Texans for Lawsuit Reform. TLR started in the mid-1990s after forty years of steadily increasing tilting of the civil justice playing field in favor of plaintiffs. There were two major inflection points in this fight: The 1995 session (with George W. Bush was Governor) Limited punitive damages Reformed joint and ... The Doctor Is In blogs http://www.medworm.com/rss/comments.php?id=2645242 Mon, 27 Jul 2009 19:12:10 +0100 2645242 http://www.medworm.com/index.php?rid=2637759&cid=t_99849_85_f&fid=34967&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fdocisinblog%2FwNlq%2F%7E3%2F7OkIjfTEHHs%2F There’s lot’s of discussion going on about health care lately– very little of substance from our politicians (is anyone surprised?), who are more interested in ramming through a massive government “solution” than actually figuring out what a good solution might be. Here’s some articles worth looking through to get yourself better informed:  ♦ TennCare’s troubling history: Tennessee tried universal coverage with a public option in 1994, similar to what is planned for Obamacare. The result? Employers dumped patients onto the public option; massive cost overruns; doctors ran for the exits due to gawdawful reimbursements; rationing; activists endlessly demanding even more money be poured into the abyss. Hey, let’s try this at the ... The Doctor Is In blogs http://www.medworm.com/rss/comments.php?id=2637759 Fri, 24 Jul 2009 20:33:48 +0100 2637759 http://www.medworm.com/index.php?rid=2614094&cid=t_99849_155_f&fid=38412&url=http%3A%2F%2Fpathlabmed.typepad.com%2Fsurgical_pathology_and_la%2F2009%2F07%2Fhey-buddy-can-you-spare-some-change.html Not my usual but this is getting ridiculously serious.From The Wall Street Journal, July 17, 2009: WASHINGTON -- Congress's chief budget scorekeeper cast a new cloud over Democratic efforts to overhaul the nation's health-care system, telling lawmakers Thursday that the main proposals being considered would fail to contain costs -- one of the primary goals -- and could actually worsen the problem of rapidly escalating medical spending."We do not see the sort of fundamental changes that would be necessary to reduce the trajectory of federal health spending by a significant amount," Douglas Elmendorf, director of the Congressional Budget Office, told the Senate Budget Committee. "On the contrary, the legislation significantly expands the federal responsibility for heal... The Daily Sign-Out blogs http://www.medworm.com/rss/comments.php?id=2614094 Sat, 18 Jul 2009 04:48:55 +0100 2614094 http://www.medworm.com/index.php?rid=2613813&cid=t_99849_85_f&fid=34967&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fdocisinblog%2FwNlq%2F%7E3%2FuCAj91OQ0X8%2F Well, the first details of the long awaited health care plan are now coming out, and the Internet is abuzz with shock and awe about many of its aspects, particularly its high cost, the undermining of private health insurance policies, and the complexity of its administration, manifested in a host of new bureaucratic agencies to bring the joys of government health care into every nook and cranny of your pitiful and meaningless life. One big-picture aspect of this huge transformation in American health care which seems to be receiving little or no attention is its heavy emphasis on preventive medicine. We have been hearing for some time about how preventive medicine will save substantial sums of money and thereby make the overall health care system far less costly. Of course, such rhetoric h... The Doctor Is In blogs http://www.medworm.com/rss/comments.php?id=2613813 Sat, 18 Jul 2009 02:51:28 +0100 2613813 http://www.medworm.com/index.php?rid=2610887&cid=t_99849_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FHn9Z5ivfmb8%2F I was on the Glenn Beck Show yesterday… …talking about this rendering of the House Democrats’ 1,018-page health care plan: That’s you all the way on the left, and your doctor/hospital all the way on the right. What could be simpler? (Source: Cato-at-liberty) Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=2610887 Thu, 16 Jul 2009 15:00:42 +0100 2610887 http://www.medworm.com/index.php?rid=2477538&cid=t_99849_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2Fe8IFYO4hqEg%2F In his speech to the American Medical Association today, President Obama repeatedly denied that he supports “socialized medicine” or “government-run” health care. But what is important is not the terminology, but under the proposal supported by the president, government would control more and more of our health care decisions. Government would compel Americans to purchase health insurance, controlling its content, how much we pay, and the relationships between insurers, doctors, and patients. Government bureaucrats would determine whether Americans receive certain medical services. There may be no better salesman than Barack Obama, but his product is deeply flawed. The so-called “Public Option,” or government-run plan, that President Obama supports wo... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=2477538 Mon, 15 Jun 2009 17:13:24 +0100 2477538 http://www.medworm.com/index.php?rid=2458002&cid=t_99849_85_f&fid=34967&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fdocisinblog%2FwNlq%2F%7E3%2Fv-rOG9at8do%2F Several weeks ago, Washington State logged a solitary but grim statistic: the first assisted suicide under a new law enacted by initiative last November. It seems fitting, therefore, to re-post the following essay, written some five years ago, occasioned by the decision in the Netherlands to legalize euthanasia for children. It is, I fear, a harbinger of things to come, far closer to home.   In the years following the Great War, a sense of doom and panic settled over Germany. Long concerned about a declining birth rate, the country faced the loss of 2 million of its fine young men in the war, the crushing burden of an economy devastated by war and the Great Depression, further compounded by the economic body blow of reparations and the loss of the German colonies imposed by the Treat... The Doctor Is In blogs http://www.medworm.com/rss/comments.php?id=2458002 Sun, 07 Jun 2009 07:30:28 +0100 2458002 http://www.medworm.com/index.php?rid=2347699&cid=t_99849_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2FpUrZ8uM3Wq4%2F The following is a two part post (both parts are included so please read all the way through) that calls attention to an exciting and important new effort to engage everyone in health reform. Do you have a “2 minute rant” you’d like to share with the administration? If so, read on… Introducing h20tv! Indu Subaiya, MD, MBA Co-founder, Health 2.0 Blame it on election fever or my move to the filmmaking capital of the world, LA, but I was recently inspired, along with my amazing conference teammates, to create and launch h20tv, a video channel for Health 2.0. It has been apparent for a while now that we’re hearing a lot more from the community than just feedback on new technologies and we wanted a way to surface that. While technology is still what we live and breathe most days, ... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=2347699 Fri, 17 Apr 2009 12:59:28 +0100 2347699