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 reform'. Sat, 03 Sep 2011 01:49:07 +0100 http://www.medworm.com/index.php?rid=5181684&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FiJ8gUqxmiYc%2Fhealth-status-children-linked-socioeconomic-status.html I’ve written before about how children from poor families have a higher chance of needing PICU care than do children from more affluent families. Eligibility for Medicaid is a good marker for this; nearly half the population of most urban PICUs is made up of children on Medicaid, even though the national average (it varies a little from state to state) for children on Medicaid is about 25%. So poor kids are more likely to become critically ill.A report from the Robert Wood Johnson foundation, a renowned health policy organization, lays out how poverty correlates so closely to poor health. This chart is the most telling. It measures a somewhat vague quantity, something they call “children in less than very good health.” They obtain this value by surveying parents, so ... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5181684 Fri, 02 Sep 2011 14:00:46 +0100 5181684 http://www.medworm.com/index.php?rid=5181685&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FukKfl4KNhzA%2Freplacing-fee-service-reduce-costs.html In this enlightened era of evidence-based medicine, you’d think that the progressive academics, viziers, and mandarins who are cluttering the policy making commentariat would pay more attention to what was tried before. That should be doubly true if those lessons come from that health care nirvana called Europe, where enlightened central bureaucracies wisely allocate health care for its caffè sipping, plaza strolling and beret adorned citizenry.Case in point is “bundled payment,” which has been underway for several years in the Netherlands. Thanks to this timely New England Journal perspective from Jeroen Struijs and Caroline Baan, readers can get some insight about what is and isn’t known about the topic.Read the rest of Will replacing fee for service really redu... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5181685 Fri, 02 Sep 2011 13:00:37 +0100 5181685 http://www.medworm.com/index.php?rid=5181798&cid=t_99568_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-features-of-a-bundled-payment-for-care-improvement-project%2F2011.09.01 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 inc... Better Health blogs http://www.medworm.com/rss/comments.php?id=5181798 Thu, 01 Sep 2011 21:00:08 +0100 5181798 http://www.medworm.com/index.php?rid=5181735&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F09%2F01%2Fimplementing-health-reform-association-health-plans%2F The Affordable Care Act comprehensively reforms health insurance in the United States.  Its central reform provisions apply to “a group health plan and health insurance issuer offering group or individual health insurance coverage,” that is, to individual, small group, large group, and even self-insured coverage. In fact, however, the ACA does not cover all forms [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5181735 Thu, 01 Sep 2011 20:35:54 +0100 5181735 http://www.medworm.com/index.php?rid=5181689&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2Fe9psMgGuTlw%2Fdisruption-affect-physicians-health-reform.html To paraphrase Clayton Christensen, author of The Innovator’s Dilemma, when discussing healthcare, disruptive forces set the stage for meaningful innovation and consumer cost reductions.This is where we now find ourselves. What percentage of our nation’s GDP is reasonable to spend on healthcare – 15%, 20%, 25%? What adaptations are necessary to maintain high quality for those who now receive it and simultaneously provide access to primary care and preventive services to the ~50 million in the US who are presently uninsured? Can we achieve this dual goal, is it a reasonable goal, a moral imperative, a fiscally practical and prudent consideration? Whatever your political leanings or interpretation of the individual mandate present in the ACA, these are important questions to... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5181689 Thu, 01 Sep 2011 19:00:59 +0100 5181689 http://www.medworm.com/index.php?rid=5181736&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F09%2F01%2Fberwick-to-keynote-health-affairs-briefing%2F Don Berwick, the Administrator of the Centers for Medicare and Medicaid Services, will keynote Health Affairs’ September 8 briefing on controlling health care costs. At the briefing, Health Affairs will release its September 2011 issue, “The New Urgency To Lower Costs.” Topics to be discussed include chronic disease costs and opportunities for savings through prevention; who bears [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5181736 Thu, 01 Sep 2011 14:09:50 +0100 5181736 http://www.medworm.com/index.php?rid=5174586&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F29%2Faco-101-the-basics-of-accountable-care%2F Regarding the subject of “health care reform” during the past year, it is certain that more has been written about, more conferences have been devoted to, and more consultants have been engaged for the topic of “accountable care organizations” (ACOs) than any other.  ACOs are in the spotlight both because of several provisions in the [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5174586 Mon, 29 Aug 2011 18:51:11 +0100 5174586 http://www.medworm.com/index.php?rid=5174570&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FEWfnSVMz1yw%2Fhealth-insurers-idea-century.html I have come up with the idea of the century.  My idea will make your company the richest in the world while attracting millions of new patrons to your credit and debit card services.  I don’t know why no one has done it in the past.  It has made the insurers of America countless billions of dollars and now you can profit as well.  My only request is that you pay me 1% in royalties for bringing this opportunity to you.Ready?  It’s so simple it will knock your socks off.  Under your current company guidelines, your cardholder charges a purchase and takes his merchandise home.  You charge your cardholder interest and charge the merchant a processing fee.  Once the transaction is processed, you pay the merchant the money owed to him.  You make a profit off of interest and fees.Rea... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5174570 Mon, 29 Aug 2011 11:00:21 +0100 5174570 http://www.medworm.com/index.php?rid=5158920&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F25%2Frisk-shifting-in-health-care-and-its-implications-part-two%2F Yesterday, in the first installment of a two-part Health Affairs Blog post, Troyen Brennan and Thomas Lee discussed the shifting of risk they see taking place in the health care system, from insurers and employers to provider and patients. In part two below, Brennan and Lee discuss the implications of this shift for various health [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5158920 Thu, 25 Aug 2011 18:02:47 +0100 5158920 http://www.medworm.com/index.php?rid=5158839&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2F6msiiZ9sX3A%2Fimplementing-affordable-care-act-increase-physician-tension.html It’s really quite an ancient debate: 400 to 500 years before the birth of Christ, on the island of Kos (home of Hippocrates) originates the myth of Aesculapius, god of healing, son of Apollo and the nymph Coronis.As is not unusual in Greek mythology, Coronis meets a violent death, but the infant Aesculapius is saved. He is raised by a wise centaur, becomes skilled in healing arts, and succeeds in bringing a patient back to life. This act threatens Zeus and the god’s ownership of immortality, so Aesculapius is promptly placed among the stars as Ophiuchus, the serpent-bearer.It is the serpent-symbol of medicine (caduceus) that results.Read the rest of Implementing the Affordable Care Act will increase physician tension on KevinMD.com.Category: Policy | Tags: Health reform | 1 com... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5158839 Thu, 25 Aug 2011 15:00:00 +0100 5158839 http://www.medworm.com/index.php?rid=5159351&cid=t_99568_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=5139588&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FD316k-meqTw%2Fcutting-medicaid-cost-long-run.html I usually write about healthcare reform from a pediatrician’s viewpoint, but what grabbed my attention recently was a story my husband, Randy, told me about an adult in his practice – a patient on Medicaid.Randy is a neurologist in a private practice, and Medicaid patients come from every corner of Rhode Island to see him. They make this cumbersome pilgrimage because he is a member of a dying breed: Randy still accepts Medicaid. He does this for $27.  That is not a copay; that is the total per patient reimbursement he gets from the state. It is clearly not a good deal for Randy, who will start losing money about 10 minutes into the visit.  And it is often not a good deal for his patients, who may have to travel a very circuitous route to receive simple, appropriate care. But it is al... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5139588 Fri, 19 Aug 2011 11:00:58 +0100 5139588 http://www.medworm.com/index.php?rid=5139718&cid=t_99568_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F08%2Fnew-rules-will-make-health-insurance-documents-easier-to-understand.html Consumers dread shopping for health insurance and deciphering health insurance documents. We know, because Consumers Union conducted several studies in which we asked consumers how they shop for health insurance, and they told us so. One of the provisions in the Affordable Care Act is going to make this task a little easier by making insurance companies give you standard “health insurance facts”—written in plain English—for every private product they offer, starting in 2012. The information will have the same format for every product, just like the familiar Nutrition Facts label that looks the same whether you’re buying a box of cereal or a can of soup. Whether you get health insurance from your employer or buy on your own, you’ll see the same form. ... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=5139718 Thu, 18 Aug 2011 15:15:00 +0100 5139718 http://www.medworm.com/index.php?rid=5139672&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F18%2Fimplementing-health-reform-informing-consumers%2F One of the most important innovations of the Affordable Care Act (ACA) is that it dramatically increases and improves the information that consumers have available about health insurance and health care.  HHS has already implemented provisions of the ACA requiring insurers to disclose information regarding their medical loss ratios and to publicly justify unreasonable rate [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5139672 Thu, 18 Aug 2011 14:49:06 +0100 5139672 http://www.medworm.com/index.php?rid=5139673&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F17%2Fnarrative-matters-eleanor-clift-on-her-husbands-death-and-end-of-life-issues%2F In the newest Health Affairs Narrative Matters essay, prominent journalist Eleanor Clift writes about her husband Tom Brazaitis and his death from metastatic cancer at age 64. Clift describes the multiple ways in which she and her husband benefited from hospice care, in which Brazaitis spent the last four months of his life. Clift uses [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5139673 Wed, 17 Aug 2011 18:19:54 +0100 5139673 http://www.medworm.com/index.php?rid=5139674&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F16%2Fthe-legal-battle-over-health-reform-analyzing-the-11th-circuit-opinions%2F Editor’s Note: Below, William Sage analyzes Friday’s federal appellate court decision regarding the Affordable Care Act. See Timothy Jost’s earlier post for more on this decision. On August 12, a divided three-judge panel of the US Court of Appeals for the Eleventh Circuit ruled in State of Florida v. Sibelius that the individual mandate contained [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5139674 Tue, 16 Aug 2011 19:40:18 +0100 5139674 http://www.medworm.com/index.php?rid=5130719&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F15%2Fappellate-court-individual-mandate-falls-but-rest-of-affordable-care-act-survives%2F Editor’s Note: Below, Tim Jost analyzes Friday’s appellate decision regarding the Affordable Care Act. Watch for more coverage of this decision and its significance on Health Affairs Blog. One August 12, 2011, in a case brought by 26 states and various private parties, the Eleventh Circuit Federal Court of Appeals handed down the first federal [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5130719 Mon, 15 Aug 2011 18:20:51 +0100 5130719 http://www.medworm.com/index.php?rid=5130872&cid=t_99568_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=5130720&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F13%2Fimplementing-health-reform-medicaid-and-exchange-eligibility-determinations%2F On August 12, 2011, the Department of Health and Human Services issued two notices of proposed rulemaking (NPRMs) in its ongoing efforts to implement the Affordable Care Act (ACA).  The first addresses eligibility for Medicaid and the Children’s Health Insurance Program (CHIP) after the 2014 implementation of the ACA Medicaid expansions.  The second governs eligibility [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5130720 Sat, 13 Aug 2011 23:44:42 +0100 5130720 http://www.medworm.com/index.php?rid=5130721&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F13%2Fimplementing-health-reform-premium-tax-credits%2F On August 12, the Departments of Health and Human Services and Treasury (Internal Revenue Service) issued three notices of proposed rulemaking (NPRM) as part of their continuing effort to implement the Affordable Care Act (ACA). The proposed rules will be formally published in the Federal Register on August 17 for comment. One NPRM issued by [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5130721 Sat, 13 Aug 2011 17:57:55 +0100 5130721 http://www.medworm.com/index.php?rid=5125731&cid=t_99568_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F08%2Fis-obamacare-done-for.html Nope. Earlier today a federal appeals court in Atlanta struck down the most contentious part of the Affordable Care Act—the “individual mandate” requirement that everyone must have health insurance or pay a penalty. But it has no immediate impact on consumers. Here’s why. First of all, the individual mandate part of the law isn’t scheduled to take effect until 2014. And the overall fate of the law will almost certainly be decided before then by the Supreme Court, because another appeals court has previously upheld the constitutionality of the mandate. Indeed, the 2 to 1 decision by a three-judge panel of the 11th Circuit Court of Appeals is only the latest in a series of contradictory judicial rulings on the law. Meanwhile, the many parts of the law that al... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=5125731 Fri, 12 Aug 2011 21:05:00 +0100 5125731 http://www.medworm.com/index.php?rid=5125708&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F12%2Fthe-coming-transformation-of-public-addiction-treatment%2F Provisions of the Affordable Care Act and other recent legislative changes will transform public substance abuse treatment in the United States, substantially increasing the funding, expanding access to care, and better integrating it with other health services. That’s the conclusion of an article by Jeffrey Buck, senior advisor for behavioral health in the Center for [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5125708 Fri, 12 Aug 2011 16:10:57 +0100 5125708 http://www.medworm.com/index.php?rid=5118744&cid=t_99568_113_f&fid=34625&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FNeilVerselsHealthcareItBlog%2F%7E3%2FHw9Eqbe3jNk%2F I definitely ruffled a few feathers with my commentary last month in MobiHealthNews about the arrogance of Silicon Valley when it comes to healthcare and health IT. More importantly, I seem to have provoked exactly the kind of discussion I had hoped for, most notably in the Wireless Health group on LinkedIn. (It’s an open group, so please join if you haven’t already). To date, a link to my story has elicited 53 comments. Some of my favorites: “Whatever the opinion on how Neil chose to wrote the piece he does appear to have started a real conversation. And that my friends is one thing that’s been missing for years. If I had to pick one thing to contribute as someone who’s been at it for over a decade it’s to reiterate there has been a lot of wasted inves... Neil Versel's Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=5118744 Thu, 11 Aug 2011 20:01:50 +0100 5118744 http://www.medworm.com/index.php?rid=5118590&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F11%2Fhealth-spending-projection-spin-cycle-rinse-and-repeat-or-reset%2F One of the annual rituals of Washington’s health policy calendar involves the release of projections for the next ten years of national health spending by actuaries at the Centers for Medicare and Medicaid Services (CMS). It then is followed immediately by desperate efforts by various interest groups and advocacy “analysts” to spin the new numbers [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5118590 Thu, 11 Aug 2011 16:41:21 +0100 5118590 http://www.medworm.com/index.php?rid=5118562&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FgE1x_-qMJ2Y%2Fhealth-reform-iron-triangle-health-care.html When I was in medical school, we had a class on health economics taught by William Kissick. I didn’t pay as close attention as I should have (especially given what I do now). But I remember one thing he stressed. It involved the iron triangle of health care.There are three aspects of health care systems that are essential: quality, cost, and access (thus the triangle). The problem is that they are in competition with each other (that’s the iron part). I can make the health care system cheaper, but that will inevitably require limiting access in some way or letting quality suffer. I increase the quality of the health care system, but that will be expensive or, again, require limiting access to it. And I can increase access to the health care system, but that will cost money, or result i... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5118562 Thu, 11 Aug 2011 14:30:38 +0100 5118562 http://www.medworm.com/index.php?rid=5107443&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FcKQXdfdB4bo%2Fpublics-values-surrounding-fairness-health-inequalities.html There are two camps in America: those who think that health care is a right and those who think that it’s a privilege. Well, perhaps that’s a bit of an oversimplification, but bear with me. Given these two respective positions, what are we to make of the health inequalities that are well documented in the United States? First, we must acknowledge that health is the product of multiple factors such as lifestyle, genetics, and access to health care. In general, these may be lumped into two categories as well: individual-level factors and system-level factors. Both levels may also be sub-divided into modifiable and non-modifiable factors. For instance, we cannot modify the circumstances of our birth, but we can decide whether or not to smoke. Again, bear with my gross oversimplifi... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5107443 Tue, 09 Aug 2011 15:00:02 +0100 5107443 http://www.medworm.com/index.php?rid=5107477&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F09%2Fjulys-most-read-ha-blog-posts%2F Timothy Jost’s series of posts on proposed new federal rules for state health insurance exchanges leads July’s list of most-read Health Affairs Blog posts. Jon Kingsdale’s article on Massachusetts’ efforts to control health care costs is also featured on the list, as are Jeff Goldsmith’s discussion of the effect of health reform on employer-based health [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5107477 Tue, 09 Aug 2011 13:44:43 +0100 5107477 http://www.medworm.com/index.php?rid=5103313&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2F3SagvyKr9p0%2Fbanned-boston-access-psychiatric-care.html Imagine you have severe depression and go to a Boston emergency room for treatment. You are told to follow up with a psychiatrist within two weeks. You have good health insurance, so this shouldn’t be a problem, right?Wrong. In a new study just published in the Annals of Emergency Medicine, we found quite the opposite. Access to outpatient psychiatric care in the greater Boston area is severely limited, even for those with excellent private insurance.We posed as patients insured by Blue Cross Blue Shield of Massachusetts PPO, the largest insurer in the state. We called every BCBS in-network mental health facility within a 10-mile radius of downtown Boston, reporting that we had been evaluated in an emergency department for depression and discharged with instruction to obtain a psychiat... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5103313 Fri, 05 Aug 2011 18:00:34 +0100 5103313 http://www.medworm.com/index.php?rid=5103335&cid=t_99568_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F08%2Fnew-labels-will-help-consumers-evaluate-health-insurance-plans-1.html A new form required by the health-reform law will help millions of consumers better understand how their insurance works, according to a report from Consumers Union, the publisher of Consumer Reports magazine and this web site. The law requires all health insurers in 2012 to explain the basic components of their coverage on a standardized form similar to the nutrition-facts label on foods. The form uses a simple format to explain common terms, such as deductibles, co-payments, co-insurance, and out-of-pockets limits. It also requires insurers to calculate and disclose total patient costs for three hypothetical patient scenarios, allowing consumers to better understand the “bottom line” of what they’d end up paying out of their own pocket if illness struck. The three sc... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=5103335 Fri, 05 Aug 2011 18:00:00 +0100 5103335 http://www.medworm.com/index.php?rid=5103314&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FeCWuo9EYPn0%2Frationing-logical-outcome-incremental.html This post continues my Ten Principles of Affordable Healthcare Reform.Health care changes should be made in small increments, easily understood by the People. Any changes that are made should be made in small increments and they should be cost effective and easily accepted by the public. It is clear at this juncture that we cannot afford the breadth and the scope of “reform” that is being currently proposed; to do so would constitute nothing less than fiscal nymphomania leading to financial suicide. We would not be pushing grandma over the cliff; we would be pushing ourselves along with her.Read the rest of Rationing is a logical outcome, and any changes must be incremental on KevinMD.com.Category: Policy | Tags: Health reform | 4 comments (Source: Kevin, M.D. - Medical Weblog) Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5103314 Fri, 05 Aug 2011 17:00:25 +0100 5103314 http://www.medworm.com/index.php?rid=5103323&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F05%2Fnew-health-affairs-u-s-docs-spend-four-times-more-on-payer-interactions-than-canadians%2F U.S. physician practices spend nearly four times as much per physician as doctors in Ontario dealing with health insurers and payers, says a new study in the August issue of Health Affairs, released yesterday. Most of the difference stems from the fact that Canadian physicians deal with a single payer, in contrast to the multiple [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5103323 Fri, 05 Aug 2011 14:36:24 +0100 5103323 http://www.medworm.com/index.php?rid=5096087&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FGXxhI_B2klA%2Ffree-market-smartphone-apps-teach-medicine-lesson.html So I have a Droid.  I purchased it in July, not long after taking my old flip-phone for an oceanic bath at Hilton Head, SC.  I waffled for a long time.  In fact, I almost purchased a Casio phone that was marketed as water and impact resistant.  ”Mil-spec,” was the phrase used … a phrase which appeals to me as a one-time Air-Guard flight surgeon.  What it meant to me was, “you can’t hurt it.”Still, I was attracted by medical applications and the assorted other cool things a Droid can do.  I mean, my old phone didn’t have a Magic 8 Ball, for crying out loud!  More to the point, my old phone didn’t have Epocrates, or the Emergency Medicine Residents Association Guide to Antibiotic Therapy.  It lacked a flashlight, an MP3 player, a protractor and a s... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5096087 Fri, 05 Aug 2011 13:00:16 +0100 5096087 http://www.medworm.com/index.php?rid=5096092&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FBxKb0TPGGaQ%2Fhope-warnings-states-california-family-physicians.html A guest post from the California Academy of Family Physicians, exclusive to KevinMD.com.Despite the slight upward tick in medical students opting for careers in family medicine over the last two years, efforts aimed at solving the primary care physician shortage are often thwarted by state and federal policy decisions.There is reason for hope, however: The number of medical school applications in California is extraordinarily high. A higher proportion of U.S. medical school graduates have helped to fill all of the available 2011 family medicine slots here. And a successful new “teaching health centers” model of family medicine residency training has been funded by the U.S. Department of Health and Human Services (HHS) to train physicians for work in underserved areas, with one of the... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5096092 Thu, 04 Aug 2011 17:00:10 +0100 5096092 http://www.medworm.com/index.php?rid=5096146&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F04%2Fdeficit-and-debt-politics-a-wake-up-call-for-the-health-care-industry%2F Editor’s Note: Below, Jonathan Oberlander analyzes the implications of the recently enacted agreement to increase the nation’s debt ceiling. See also Joe Antos’ analysis of the same topic on Health Affairs Blog. The 2010 Affordable Care Act (ACA) called for significant Medicare savings.  All told, the Congressional Budget Office projected that the law would trim [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5096146 Thu, 04 Aug 2011 12:22:41 +0100 5096146 http://www.medworm.com/index.php?rid=5096147&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F02%2Fthe-debt-ceiling-deal-kicking-the-can-down-the-road%2F Editor’s Note: Below, Joseph Antos provides his take on Budget Control Act of 2011, which embodies the deal reached by President Obama and congressional leaders to increase the nation’s debt ceiling. See also Jonathan Oberlander’s post on the same topic. Congressional leaders and the President have come to agreement on a deal to increase the [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5096147 Tue, 02 Aug 2011 15:02:45 +0100 5096147 http://www.medworm.com/index.php?rid=5086163&cid=t_99568_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F08%2Fhealth-plans-must-provide-birth-control-for-free.html Starting next year, all new health plans must cover 100 percent of the cost of contraception and a list of other women’s preventive services, with no deductibles or copays, according to the U.S. Department of Health and Human Services. With one exception (see below), HHS adopted all the recommendations made by an expert committee of the Institute of Medicine, which we wrote about when it came out a couple of weeks ago. To recap, here are the covered services: • All FDA-approved contraceptives. • Annual HIV test for all sexually active women. • Screening pregnant women for gestational diabetes. • A DNA test for human papillomavirus (HPV) in women over 30 who have a normal Pap smear (also covered), in order to identify women at higher risk of developing cervical cancer in th... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=5086163 Mon, 01 Aug 2011 17:35:00 +0100 5086163 http://www.medworm.com/index.php?rid=5077672&cid=t_99568_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F07%2Fwill-medicare-pay-for-dental-implants-needed-as-a-result-of-my-autoimmune-disease.html Q: I have Sjogren’s Syndrome, an autoimmune condition that has attacked my salivary glands. As a result, my teeth have been destroyed by the lack of saliva. Dentists say a bridge of false teeth will not stay in place because there is no saliva to form a suction lock. I must have implants instead. Can I get any help from Medicare with this expense, as it is a medical condition that caused the loss of my teeth? A: Probably not, but you should try anyway. In fact there is a class-action lawsuit currently pending that aims to get Medicare to change its no-dental-coverage policy for people in your situation. We contacted Sally Hart, an attorney for the Center for Medicare Advocacy, who filed the suit in a federal district court in Phoenix, Ariz., to learn more. She explained that by law... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=5077672 Fri, 29 Jul 2011 12:00:00 +0100 5077672 http://www.medworm.com/index.php?rid=5077619&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2F1kMEVwhvadI%2Fmedical-education-cost-health-policy-imperative.html Whenever I talk about the cost of medical education, I like to bring up this chart. It starkly illustrates just how expensive it is to train a doctor in the United States, compared to Canada and France.New York Times contributor Pauline Chen wrote a column on the issue recently.  Most doctors graduate with a debt exceeding $150,000, and end up paying for it well into their 40′s and 50′s.  This is giving pause to some who are considering medicine:Paying so much up front has transformed an education that was once a path to public service into a significant financial investment that needs to yield returns. “Because of all the debt, people stop thinking of medicine as an incredible opportunity to do good,” Dr. Greysen said. For some young people, looming debts mean eschewing ... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5077619 Thu, 28 Jul 2011 20:00:31 +0100 5077619 http://www.medworm.com/index.php?rid=5077642&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F07%2F28%2Fu-s-health-spending-projected-to-grow-5-8-percent-annually%2F All health care spending in the United States is projected to grow at an annual average rate of 5.8 percent for the period 2010 through 2020, 1.1 percentage points faster than expected growth in Gross Domestic Product (GDP). By 2020, health care spending is projected to be 19.8 percent of GDP, nearly one-fifth of economic [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5077642 Thu, 28 Jul 2011 13:48:45 +0100 5077642 http://www.medworm.com/index.php?rid=5069460&cid=t_99568_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F07%2Fwill-my-familys-pre-existing-conditions-be-covered-if-i-change-jobs.html Q. I am considering changing jobs but am concerned about insurance coverage for pre-existing conditions. My son had a transplant, I had a pituitary tumor, and my husband had open-heart surgery. If I change jobs and insurance, is the new insurance required to cover us? A. It most certainly is, thanks to a federal law called the Health Insurance Portability and Accountability Act of 1996, commonly known as HIPAA. This law makes it illegal for group health plans to deny coverage to employees (and their dependents, if the group health plan offers dependent coverage) on the basis of pre-existing conditions. And they cannot charge you more for your premium contribution than any other employee. A couple of things to keep in mind: You must start your new health plan within 63 days of leaving ... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=5069460 Wed, 27 Jul 2011 16:30:00 +0100 5069460 http://www.medworm.com/index.php?rid=5069597&cid=t_99568_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=5062213&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F07%2F25%2Fha-blog-posts-on-exchange-regs-highlighted-in-health-wonk-review%2F Check out Julie Ferguson’s “Heatwave” edition of the Health Wonk Review at Workers’ Comp Insider. Julie presents a great selection of health policy blogging, including Tim Jost’s Health Affairs Blog series on proposed new regulations on state health insurance exchanges. Copyright © 2011 Health Affairs Blog. This Feed is for personal non-commercial use only. All [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5062213 Mon, 25 Jul 2011 18:11:25 +0100 5062213 http://www.medworm.com/index.php?rid=5062185&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FDJfnN4UOGHQ%2Fhealth-coaches-fix-healthcare-system.html Simply put, habits are hard to break and bad habits like smoking, drinking, sedentary lifestyle and overeating are making our population sick. Who in the healthcare system can tackle these issues before they manifest into chronic disease?Doctors are trained to diagnose and treat, but they aren’t trained to help people change their behavior, nor should they be since most physicians, particularly general practitioners, are already severely overloaded. Nurses provide support and information but their assistance is limited to office visits or hospitalizations. Until recently, there has been an unmet need in the healthcare system for a provider who works with patients in the days and weeks between appointments. But now there is a new breed of healthcare professionals, called health and wellne... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5062185 Mon, 25 Jul 2011 18:00:57 +0100 5062185 http://www.medworm.com/index.php?rid=5062186&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FuaurS68J9Ao%2Fexecutive-compensation-rising-cost-health-care.html The revelations about the huge golden parachute given the outgoing CEO of ostensibly non-profit Massachusetts Blue Cross Blue Shield induced some public discussion about the disconnect between executive compensation and the mission of health care organizations.First, new proxy statements revealed the compensation of executives of two large for-profit health care insurers/managed care companies.CignaAs reported by the AP, via ABC News, the CEO got a big raise:Cigna Corp. CEO David M. Cordani’s total compensation more than doubled in 2010, his first year as leader of the nation’s fourth-largest health insurer, and a period in which the company’s earnings, revenue and enrollment all climb.Cordani, 45, received compensation valued at $15.1 million last year from the Philadelp... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5062186 Mon, 25 Jul 2011 17:00:13 +0100 5062186 http://www.medworm.com/index.php?rid=5062347&cid=t_99568_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=5062188&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FBI-l56LQe-8%2Fpolicy-makers-doctors-problem.html Sometimes you just don’t want to be right.  Over the past 5 years, I have seen an alarming pattern arise in my profession.  Many of my patients have heard me talk about Soylent Green, an old Charleton Heston movie.  The premise of the movie seems absurd.  Can you imagine the government of the United States providing for all the needs of its people including healthcare, food, clothing, and even death?David Brooks’ recent opinion piece in the New York Times makes my fear of a “Soylent Green” society frightenly real.  While I recommend you read the entire piece, for the purpose of this blog, I want to highlight the following.Read the rest of Policy makers aren’t doctors, and why that’s a problem on KevinMD.com.Category: Policy | Tags: Health reform | 1... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5062188 Mon, 25 Jul 2011 15:00:56 +0100 5062188 http://www.medworm.com/index.php?rid=5057695&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FoPt7bdG8d_Y%2Faccountable-care-organizations-acos.html Washington has been touting Accountable Care Organizations (ACOs) as the end-all solution to health care’s woes. Designed to reduce Medicare spending and increase care coordination across a large number of patients, members of an ACO – hospitals, primary care physicians, specialists – would be paid if and when their patient population received outstanding quality of care. However, as the Centers for Medicare and Medicaid Services (CMS) finalize their ACO regulations, many both inside and outside the Beltway are beginning to wonder: Where’s the value?Read the rest of The value of Accountable Care Organizations (ACOs) on KevinMD.com.Category: Policy | Tags: Health reform | 1 comment (Source: Kevin, M.D. - Medical Weblog) Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5057695 Sat, 23 Jul 2011 11:15:00 +0100 5057695 http://www.medworm.com/index.php?rid=5057708&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F07%2F22%2Fletting-go-of-employer-based-health-insurance%2F Other than the egg-laying exercise surrounding the ACO regulations, 2011 was a quiet year among Washington health policy experts until June 6 when McKinsey released the results of a survey of employer plans under the Affordable Care Act. The McKinsey study found that roughly 30 percent of employers were considering dropping their employee insurance coverage [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5057708 Fri, 22 Jul 2011 18:16:37 +0100 5057708 http://www.medworm.com/index.php?rid=5057699&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2Fagdm4dKxkS4%2Facos-putting-form-function.html At UC Berkeley in the 70s, the secretary in the Department of Psychology pasted a bumper sticker on her desk positing the question: “… yes, but are we asking the right questions?”For some reason, this subtle invitation remains with me today, echoing amidst the ACO fervor of “… better care at lower costs.”… the good news is we’re making great time, the bad news is we don’t know where we are going. — Eastern Airlines PilotAs is often the case, and perhaps so today, when you need to “do something” (since movement in the absence of same, seems like progress), but are not quite clear what that “something” looks like, there’s a tendency to default to the familiar, i.e., this is how we roll. The more conservative among us will hedg... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5057699 Fri, 22 Jul 2011 17:00:46 +0100 5057699 http://www.medworm.com/index.php?rid=5057700&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FvZu6Wxljni0%2Frole-nonphysician-clinicians-primary-care.html With sixteen million more Americans expected to gain health care coverage in the coming years as a result of the Affordable Care Act, access to actual health care providers may become more difficult. This may be especially true for patients with marginal coverage such as Medicaid.The Kaiser Family Foundation recently explored the role of non-physician clinicians -  specifically nurse practitioners (NPs) and physician assistants (PAs) – in delivering primary care.  Both NPs and PAs are trained (often at the master’s level) to diagnose and treat patients and to prescribe medications under physician supervision. In fifteen states (including the District of Columbia), NPs are able to conduct these three core functions without any physician supervision. On the contrary, all PAs work in so... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5057700 Fri, 22 Jul 2011 16:00:53 +0100 5057700 http://www.medworm.com/index.php?rid=5050438&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FSpC-_vQn_ag%2Fmedical-care-doctors-obliged-provide.html I couldn’t pass up the opportunity to comment on Dr. Karen Sibert’s recent op-ed piece in the New York Times.  She argues that, especially given the current shortage of primary care doctors in this country, being part of the medical profession confers one with the moral obligation to serve and, as such, conflicting interests, such as raising a family, should take lower priority.  I worked with a radiology attending once who expressed a similar view of his relationship to his profession this way, “It would be irresponsible of me to have kids because I spend so much time working.  I wouldn’t be able to spend enough time with them.”Read the rest of How much medical care are doctors obliged to provide? on KevinMD.com.Category: Physician | Tags: Health reform, Primary care | No... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5050438 Fri, 22 Jul 2011 13:00:01 +0100 5050438 http://www.medworm.com/index.php?rid=5050499&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F07%2F21%2Flarsen-praises-state-progress-on-exchanges-at-ha-newsmaker-breakfast%2F States are making progress in varied ways toward creating the health insurance exchanges provided for in the Affordable Care Act, a senior official at the Centers for Medicare and Medicaid Services said at a Health Affairs Newsmaker breakfast this morning. The state exchanges, which must be up and running by January 1, 2014, will provide [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5050499 Thu, 21 Jul 2011 21:40:00 +0100 5050499 http://www.medworm.com/index.php?rid=5050500&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F07%2F21%2Fthe-womens-preventive-services-report-and-the-role-of-evidence%2F Section 1001 of the Affordable Care Act establishes women’s preventive health benefits as a new mandatory coverage class for all insurance products sold in the individual and group markets, self insured employer-sponsored health plans, and benchmark plans enrolling newly eligible Medicaid beneficiaries.  In implementing the Act in accordance with the tight deadlines established under the [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5050500 Thu, 21 Jul 2011 18:59:57 +0100 5050500 http://www.medworm.com/index.php?rid=5050443&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FJysS8lH5lkc%2Fama-health-insurers-denial-rates-error-rates.html A guest column by the American Medical Association, exclusive to KevinMD.com.Billions of dollars in administrative waste would be eliminated each year if health insurers sent a timely, accurate and specific response to each physician claim, and while this year’s AMA National Health Insurer Report Card shows promising improvements in denial rates, more work needs to be done.The AMA’s fourth annual check-up of the nation’s health insurers shows that claims denial rates in 2011 are dramatically lower than in previous years. Major national insurers Aetna, Anthem Blue Cross Blue Shield, Health Care Service Corporation and UnitedHealthcare have significantly reduced their denial rates, and CIGNA continues to hold the top spot for its industry-leading low denial rate of .68 percent.Read t... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5050443 Thu, 21 Jul 2011 18:00:08 +0100 5050443 http://www.medworm.com/index.php?rid=5050811&cid=t_99568_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FtS3SgTYmYeY%2F by Vince Kuraitis JD, MBA and Jaan Sidorov MD, MHSA, FACP In our introductory posting of this series, we noted that economic incentives previously aligning doctor-hospital interests were changing. This creates the potential for The 100 Year Shift – physicians awakening to possibilities for stronger partnerships with payers than with hospitals. In this post, we will zero in on the changing economic position of hospitals and the effect this is having on physician-hospital relationships. We will examine the trend of hospital employment of physicians and point out challenges and tensions for the future. [This is a long post...so now might be the time to refill your coffee cup.] (more…) Article Series - The 100 Year Shift? Strategic Realignment among Physicians, Hospitals and Payer... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=5050811 Tue, 19 Jul 2011 19:28:14 +0100 5050811 http://www.medworm.com/index.php?rid=5050505&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F07%2F19%2Fimplementing-health-reform-insurance-cooperatives%2F The exchange and the reinsurance, risk adjustment, and risk corridor (3R) proposed regulations released by HHS on July 11 were only the first two in a series of exchange-related notices of proposed rulemakings (NPRMs) that will be rolled out in the coming weeks and months.  A third NPRM dealing with the Consumer Operated and Oriented [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5050505 Tue, 19 Jul 2011 15:03:42 +0100 5050505 http://www.medworm.com/index.php?rid=5036205&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FibRXjmi0-zo%2Fobesity-concern-conservatives.html by David Gratzer, MD Does it really matter how many ribs Michelle Obama ate on her vacation? For too many conservatives, the answer seems to be yes, with pundits poking fun at the anti-obesity guru’s dinner choice. But conservatives need to give it a rest: many seem to prefer scoring easy points against the First Lady to arguing about the best way to attack the obesity epidemic — and some even claim that obesity isn’t really a problem.Conservatives, though, should be concerned about obesity for five reasons.(...)Read the rest of Why obesity should concern conservativesCategory: Policy | Tags: Health reform, Patients | No comment (Source: Kevin, M.D. - Medical Weblog) Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5036205 Sun, 17 Jul 2011 19:00:33 +0100 5036205 http://www.medworm.com/index.php?rid=5036215&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F07%2F15%2Fthe-insurance-exchanges-open-enrollment-and-switching-plans%2F The Department of Health and Human Services released proposed regulations this week on the new health insurance exchanges that the Affordable Care Act will set up.  While they don’t address all of the important policy issues related to how these new entities will work, they do lay out when people can sign up for exchange [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5036215 Fri, 15 Jul 2011 16:03:50 +0100 5036215 http://www.medworm.com/index.php?rid=5028116&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F07%2F14%2Flow-income-patients-in-california-experiences-and-expectations%2F Editor’s Note: Another Health Affairs Blog post published today also discusses the California health care system and how the Affordable Care Act will affect the way the state meets the needs of low-income patients. Many low-income patients have had little or no choice about where they obtain health care. But this will change when the [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5028116 Thu, 14 Jul 2011 18:24:00 +0100 5028116 http://www.medworm.com/index.php?rid=5028117&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F07%2F14%2Fmedicaid-expansion-and-reform-hopes-and-lessons-from-california%2F Editor’s note: In addition to Autumn Kieber-Emmons (photo and bio above), this post is coauthored by Tom Bodenheimer and Kevin Grumbach. Bodenheimer is Professor of Family and Community Medicine at University of California, San Francisco. Grumbach is Professor and Chair of the Department of Family and Community Medicine at UCSF and Chief of Family and [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5028117 Thu, 14 Jul 2011 18:21:45 +0100 5028117 http://www.medworm.com/index.php?rid=5028040&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FwUnqhb2y1n0%2Fmedicaid-represents-nations-moral-commitment-poor.html by Ricky Y. Choi, MD, MPHWhat if I were to tell you that Washington is trying to balance the budget by making cuts to a program that covers 70% of the nation’s nursing home costs and 43% of all births in California? Well they are.The rancorous debate over how to balance the federal budget includes drastic cuts to Medicaid. And while this program may seem distant to people in power and the general public, the reality is that cuts will effect far more people than you expect and may even impact you or someone you know.(...)Read the rest of Medicaid represents our nation’s moral commitment to help the poorCategory: Policy | Tags: Health reform, Medicare | 16 comments (Source: Kevin, M.D. - Medical Weblog) Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5028040 Thu, 14 Jul 2011 13:00:58 +0100 5028040 http://www.medworm.com/index.php?rid=5028118&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F07%2F13%2Fimplementing-health-reform-health-insurance-exchanges-part-3%2F Editor’s Note: Below, Timothy Jost continues his Health Affairs Blog series analyzing regulations implementing the Affordable Care Act. Health Affairs Blog will also offer additional perspectives on the newly released regulations governing the state health insurance exchanges established under the Affordable Care Act. Although the proposed exchange rule released by HHS on July 12 was [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5028118 Wed, 13 Jul 2011 15:03:23 +0100 5028118 http://www.medworm.com/index.php?rid=5028200&cid=t_99568_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2F6Yvhta4ECuk%2F By Hope Ditto. Most of the country is sweltering its way through this week’s heat wave, but there is one thing here in DC rising faster than the mercury in our thermometers – tensions on the Hill as the debt ceiling stalemate continues. Whispers [well, tweeted whispers] of default “what ifs” abound here in the nation’s capital as lawmakers continue to play a high-stakes game of chicken through day after day of floor debates, committee hearings and negotiating sessions. With interest rates, Social Security payments and America’s credit score dangling in the balance, and the clock ticking towards the Aug. 2 deadline, the air is even thicker with panic than it is with humidity (though my frizzy hair would say otherwise). As with April’s narrowly-avoided government shutdown, pun... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=5028200 Wed, 13 Jul 2011 13:00:17 +0100 5028200 http://www.medworm.com/index.php?rid=5028119&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F07%2F12%2Fimplementing-health-reform-health-insurance-exchanges-part-2%2F Editor’s Note: Below, Timothy Jost continues his Health Affairs Blog series analyzing regulations implementing the Affordable Care Act. Health Affairs Blog will also offer additional perspectives on the newly released regulations governing the state health insurance exchanges established under the Affordable Care Act. This is the second part of a three part analysis of the [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5028119 Tue, 12 Jul 2011 21:18:05 +0100 5028119 http://www.medworm.com/index.php?rid=5028120&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F07%2F12%2Fimplementing-health-reform-health-insurance-exchanges%2F Editor’s Note: Below, Timothy Jost continues his Health Affairs Blog series analyzing regulations implementing the Affordable Care Act. Health Affairs Blog will also offer additional perspectives on the newly released regulations governing the state health insurance exchanges established under the Affordable Care Act. Yesterday, on July 11, 2011, the Department of Health and Human Services [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5028120 Tue, 12 Jul 2011 15:29:45 +0100 5028120 http://www.medworm.com/index.php?rid=5028631&cid=t_99568_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=5028046&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2F32Xolzzg7o8%2Fprivate-sector-solution-wider-affordable-health-coverage.html by J.E.B. Johnson, MDLet me preface this comment by stating I am not an actuarial. I hated statistics and am no fan of insurance companies. That said I would like to know why patients and the US government think that health insurance companies should accept unlimited risk? My car insurance has limits, my homeowners insurance has limits, my malpractice insurance has limits.  Why should my health insurance not have limits?How can a company successfully do business with unlimited risk? They must build a substantially larger cushion into their premiums when they are forced to accept unlimited risk . How can we lower the cost of insurance? We must accept more of the risk.(...)Read the rest of A private sector solution for wider, more affordable health coverageCategory: Policy | Tags: Health re... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5028046 Tue, 12 Jul 2011 13:00:33 +0100 5028046 http://www.medworm.com/index.php?rid=5028191&cid=t_99568_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F07%2Fhealth-insurance-rate-hikes-to-get-government-review.html Increases in your health-insurance premiums will soon be reviewed by state or federal government agencies, the Obama administration announced late last week. Starting in September, increases of 10 percent or more in either individual or small business plans will trigger an automatic review to gauge the “reasonableness” of the increase. Premium rate review, as it’s known, is a major piece of health-care reform and the Affordable Care Act. In many states, premium increases for individuals and small businesses have risen by double digits every year. As a result, health insurance has become increasingly unaffordable even as the recession has taken a toll on people’s ability to pay the tab. DeAnn Friedholm, the director of Consumers Union's health reform campaign, sa... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=5028191 Tue, 12 Jul 2011 12:00:00 +0100 5028191 http://www.medworm.com/index.php?rid=5028194&cid=t_99568_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F07%2Fshould-we-sign-up-for.html Q. My husband and I are self-employed, with a two-year old son. We are considering joining the Samaritan Ministries health-care sharing ministry, which is a faith-based non-profit in which members help each other pay medical bills. Is that a good idea? A. Samaritan Ministries is one of three major health-care sharing ministries in the U.S. (the others are Christian Care Ministry’s Medi-Share and Christian Healthcare Ministries). The first thing you need to understand is that they do not provide the same degree of legal and financial protection as real insurance. “Health insurance is an actuarial contract,” says James Lansberry, Samaritan’s executive vice president and also president of the Alliance of Health Care Sharing Ministries, a trade organization. “Pe... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=5028194 Mon, 11 Jul 2011 19:41:00 +0100 5028194 http://www.medworm.com/index.php?rid=5028121&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F07%2F11%2Fnew-health-policy-brief-legal-challenges-to-the-affordable-care-act%2F A new Health Policy Brief from Health Affairs and the Robert Wood Johnson Foundation examines the issues inherent in the lawsuits filed by state governments, organizations, and private citizens challenging the Affordable Care Act. To date, about 30 legal challenges have been filed. Federal District Court decisions have been split, with four judges ruling that the [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5028121 Mon, 11 Jul 2011 15:51:20 +0100 5028121 http://www.medworm.com/index.php?rid=5028632&cid=t_99568_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=5008057&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2F_F6-R51ictA%2Fstaff-resist-quality-improvement-efforts.html by Donald Tex BryantPerhaps you are just beginning a quality improvement program or project.  Perhaps you have several project improvement projects successfully completed at your healthcare site.No matter what your level of experience, you have encountered staff who are roadblocks to your efforts.  What are you to do?  Ignoring them or doing nothing will imperil your quality efforts eventually.  Let me share some ideas on what to do based upon my own experience and on advice from experts.(...)Read the rest of Staff who resist quality improvement effortsCategory: Policy | Tags: Health reform | No comment (Source: Kevin, M.D. - Medical Weblog) Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5008057 Fri, 08 Jul 2011 15:00:20 +0100 5008057 http://www.medworm.com/index.php?rid=5008181&cid=t_99568_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2FCRDbof3Lrxk%2F By Jane Sarasohn-Kahn. Can a patient’s experience with health care providers be as engaging, entertaining and satisfying as time spent at amusement parks? The Disney Institute thinks so, and has established a program to help health providers delight health consumers called Building a Culture of Healthcare Excellence. With the tagline, “D-Think Your Way to Success,” The Disney Institute offers programs that help organizations apply Disney’s lessons in customer service, creativity and leadership to their own situations. In the case of the Healthcare Excellence program, Disney is looking to re-focus health care delivery beyond clinical outcomes toward the overall patient experience. The Institute’s press release notes that the HCAHPS survey on patients’ experiences with provider... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=5008181 Fri, 08 Jul 2011 13:58:49 +0100 5008181 http://www.medworm.com/index.php?rid=5008372&cid=t_99568_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FXIWnixTJ1Vs%2F by Jaan Sidorov MD, MHSA, FACP and Vince Kuraitis JD, MBA In our introductory posting, we suggested that a huge shift is underway in the health care industry.  Decades of hospital-physician cooperation are not only eroding, we suggest this trend could accelerate.  Instead of a natural clinical and economic affinity with hospitals, we foresee the potential for physicians forming a new dyad with insurer-buyers. In this post, we will examine what we and many other commentators view as inevitable: the demise of volume-based payment systems and how the drive for greater value will cause physicians and insurers re-examine their normally antagonistic relationship. (more…) Article Series - The 100 Year Shift? Strategic Realignment among Physicians, Hospitals and PayersThe 100 Year Shift?... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=5008372 Thu, 07 Jul 2011 20:42:41 +0100 5008372 http://www.medworm.com/index.php?rid=5008062&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FBsTE0Rtf_nA%2Fradiation-delivered-ct-scanners-largely-unregulated.html by Bob Wachter, MDAlthough the medical profession has been harming unlucky patients for centuries, the patient safety movement didn’t take flight until 1999, when the Institute of Medicine published its seminal report, To Err is Human. And that report would have ended up as just another doorstop if not for its estimate that 44,000-98,000 Americans each year die from medical mistakes, the equivalent of a jumbo jet crashing each day.Come to think of it, the quality movement also gelled after the publication of Beth McGlynn’s 2003 NEJM study, which produced its own statistical blockbuster: American medical care comports with evidence-based practice 54% of the time, a number close enough to a coin flip to be unforgettably disturbing.(...)Read the rest of The radiation delivered by CT scann... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5008062 Thu, 07 Jul 2011 19:00:34 +0100 5008062 http://www.medworm.com/index.php?rid=5008063&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2F1ww7I9bD5zk%2Fhealth-system-defaults-treatment-compassion.html by Sara Billings, RNI believe knowledge is power. There is no more complex topic in the healthcare debate than end-of-life care. I have been a Registered Nurse for thirty years. I deal with this every day. All of us will confront this issue eventually. When it’s your turn, I hope the medical profession will guide you to the best options for you and your family.Often I see patients who have prepared living wills and think a document will protect them. This is frequently not the case. Often these documents are not specific enough to guide family members. Occasionally they are completely ignored.(...)Read the rest of Our health system defaults toward treatment rather than compassionCategory: Patient | Tags: Health reform, Hospital, Patients, Primary care | 12 comments (Source: Kevin, M.D. -... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5008063 Thu, 07 Jul 2011 18:00:59 +0100 5008063 http://www.medworm.com/index.php?rid=5008414&cid=t_99568_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_99568_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=5008200&cid=t_99568_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-massachusetts-experiment-analyzed-provider-payments-based-on-their-negotiating-strength-not-quality-of-care%2F2011.07.06 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 Blu... Better Health blogs http://www.medworm.com/rss/comments.php?id=5008200 Wed, 06 Jul 2011 23:00:08 +0100 5008200 http://www.medworm.com/index.php?rid=5008114&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F07%2F06%2Fhypercostitis-political-theater-in-massachusetts%2F The Play’s the Thing. America boasts the highest health care costs on God’s green earth, and Massachusetts spends more per capita than any other state. Some might say we have a problem. On June 30th, Massachusetts completed four days of hearings on run-away medical costs — what drives them and how to rein them in. [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5008114 Wed, 06 Jul 2011 16:35:34 +0100 5008114 http://www.medworm.com/index.php?rid=5008115&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F07%2F05%2Fjosts-look-at-court-fight-over-reform-tops-ha-blogs-june-most-read-list%2F Tim Jost’s analysis of crucial appellate arguments over the constitutionality of the Affordable Care Act leads June’s list of most-read Health Affairs Blog posts. Jost examines the arguments before the federal Eleventh Circuit Court of Appeals in a challenge to the legislation brought by more than half the states and the National Federation of Independent [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5008115 Tue, 05 Jul 2011 16:31:47 +0100 5008115 http://www.medworm.com/index.php?rid=4992681&cid=t_99568_87_f&fid=38368&url=http%3A%2F%2Fwww.changehealthcare.com%2Fdownloads%2Fhcti%2FHCTI_Q42010.pdf My mama told me you’d better shop around, as Smokey Robinson also told us. We now know it pays to shop the prices for digital imaging. The price of an MRI of the brain ranges from a low of $825 to a high of $3,600 within the Southeast region of the U.S. In the Northeast, the low is $1,540 and the high, $3,500. There are similar price “spreads” in other regions of the country for the same imaging study, and across other imaging modalities such as PET and CT. The greatest regional variances by service type are for MRI scans of the brain, varying 747% between a low price of $425 in the Southwest to a high of $3,600 in the Southeast, based on an analysis from change: healthcare‘s Q2 2011 Healthcare Transparency Index. USA Today reported on this study on June 30, 2011. Christopher Park... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=4992681 Fri, 01 Jul 2011 15:47:47 +0100 4992681 http://www.medworm.com/index.php?rid=4984408&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F06%2F30%2Fin-first-appellate-case-a-significant-victory-for-the-affordable-care-act%2F On June 29, 2011, the Sixth Circuit federal court of appeals held that Congress has the power under the Constitution to adopt the minimum coverage requirement of the Affordable Care Act. The decision in Thomas More Law Center v. Obama is very significant for several reasons.  First, it is the first ruling by a federal [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4984408 Thu, 30 Jun 2011 11:22:04 +0100 4984408 http://www.medworm.com/index.php?rid=4984442&cid=t_99568_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2Fff8Oq-VAK_A%2F Health is where we live, play, work and pray — and also where we moisturize. Eucerin is working to create a Skin Savvy Nation. Welcome, health consumers, to the Eucerin Skin Health Cost Calculator, a tool that quantifies the financial impacts of skincare habits by estimating the life-cycle costs and benefits those skin health habits would have. The Calculator takes the consumer through a battery of questions together which yield a “skin score.” These include personal health habits such as not smoking, using skin-protecting moisturizer on a daily basis, and staying out of the sun. Eucerin gauges the cost of poor skincare at $400 billion a year in the U.S., about $400 per capita for each American. This is part of Eucerin’s PR campaign called the “Skin First Movement,” in wh... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=4984442 Wed, 29 Jun 2011 13:09:26 +0100 4984442 http://www.medworm.com/index.php?rid=4976011&cid=t_99568_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=4975784&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2Fa_A97FEe_u8%2Fchallenge-preauthorization-elective-procedure.html by Grayson Wheatley, MDIt was supposed to be a routine office visit for my patient.Unexpectedly, it turned into a real-world health economics lesson for me, the treating physician. The old adage “listen to your patients; they will always give you the answer” became exceedingly true in this case, even when it dealt with an issue beyond a medical diagnosis, such as lack of transparency regarding insurance coverage for medical procedures.(...)Read the rest of The challenge of pre-authorization for an elective procedureCategory: Policy | Tags: Health reform, Patients, Specialist | 4 comments (Source: Kevin, M.D. - Medical Weblog) Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=4975784 Mon, 27 Jun 2011 20:00:34 +0100 4975784 http://www.medworm.com/index.php?rid=4975841&cid=t_99568_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2Fm_tMpvIn4JY%2F By Daniel J. MitchellThis new video, based in large part on the good work of Michael Cannon, explains why Medicaid should be shifted to the states. As I note in the title of this post, it’s good federalism policy and good fiscal policy. But the video also explains that Medicaid reform is good health policy since it creates an opportunity to deal with the third-party payer problem. One of the key observations of the video is that Medicaid block grants would replicate the success of welfare reform. Getting rid of the federal welfare entitlement in the 1990s and shifting the program to the states was a very successful policy, saving billions of dollars for taxpayers and significantly reducing poverty. There is every reason to think ending the Medicaid entitlement will have similar positive... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4975841 Mon, 27 Jun 2011 14:55:48 +0100 4975841 http://www.medworm.com/index.php?rid=4975813&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F06%2F27%2Fhealth-affairs-briefing-new-directions-in-systems-innovation%2F On July 7, 2011, Health Affairs will unveil its July 2011 issue, “New Directions In Systems Innovations.” The issue explores ongoing innovations in health care organization, delivery and financing across a broad front – from Vermont’s recent passage of single payer legislation, to new responsibilities for hospital boards of trustees as a consequence of the [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4975813 Mon, 27 Jun 2011 14:36:16 +0100 4975813 http://www.medworm.com/index.php?rid=4968415&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2F-R7RBnjHNI4%2Fteam-based-care-health-reform-patient-involvement.html The following op-ed was published on June 7, 2011 in USA Today.by Kevin Pho, MDMore than ever, I find myself fielding questions from patients about the health care reform law. The most common one is, “How will reform affect me?” It’s a complicated question, with a different answer for each patient. But as the law’s full effects unfold, one of the more significant changes will be in how patients interact with their doctors. This sea change became clearer in March, when the Department of Health and Human Services proposed rules encouraging health providers to operate in teams.(...)Read the rest of Team based care in health reform needs patient involvementCategory: Pho | Tags: Health reform, Patients, Primary care | 10 comments (Source: Kevin, M.D. - Medical Weblog) Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=4968415 Sat, 25 Jun 2011 17:00:17 +0100 4968415 http://www.medworm.com/index.php?rid=4968661&cid=t_99568_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=4968445&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F06%2F23%2Fimplementing-health-reform-the-appeals-process-amended-rule%2F Editor’s Note: This is the latest in a series of posts by Timothy Jost on the implementation of the Affordable Care Act.  Earlier posts have analyzed some important guidances, as well as provisions governing state waiver requests, student health plans, premium review (proposed rule and final rule), medical loss ratios, insurance exchanges, coverage for pre-existing conditions, appeals [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4968445 Thu, 23 Jun 2011 14:32:42 +0100 4968445 http://www.medworm.com/index.php?rid=4968482&cid=t_99568_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2FGFJvnH55rv4%2F Discussion “Health Care Reform Implementation” Speaker: Mayra Alvarez, MPH* Director, Public Health Policy, Office of Health Care Reform U.S. Department of Health and Human Services Thursday, June 30th, 2011 6:00 pm – 9:00 pm Clyde’s of Gallery Place 707 7th St. NW Washington, DC R.S.V.P. to RSVP1@nhmamd.org by June 27th In partnership with the DC Medical Society, Latino Medical Student Association, and NHMA Council of Residents and sponsored by AMGEN Founded in Washington, DC in 1994, The National Hispanic Medical Association (NHMA) is a nonprofit association representing Hispanic physicians in the U.S. NHMA’s mission to empower Hispanic physicians to improve the health of Hispanic populations with Hispanic medical societies, resident and medical student organizations and our p... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=4968482 Thu, 23 Jun 2011 13:30:38 +0100 4968482 http://www.medworm.com/index.php?rid=4968662&cid=t_99568_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=4960013&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F06%2F22%2Fa-physician-fallow-program-to-improve-quality-safety-and-costs%2F In a recent New York Times op-ed, Rita Redberg MD, a cardiologist and Chief Editor of Archives of Internal Medicine, described the American health system’s penchant for delivering high volumes of “procedures and devices [to] patients who get no benefit and incur risks from them.” The culprit, of course, is fee-for-service reimbursement, used by Medicare, Medicaid and commercial [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4960013 Wed, 22 Jun 2011 19:12:02 +0100 4960013 http://www.medworm.com/index.php?rid=4959987&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FCbjzfIA8CRA%2Forganization-primary-care.html by Paul Fischer, MDRecently, the Board of the American Academy of Family Physicians (AAFP) announced that, for now, it would continue participating in the Relative Value Scale Update Committee (RUC), the secretive American Medical Association committee that, through a longstanding relationship with the Centers for Medicare and Medicaid Services (CMS), has heavily influenced physician reimbursement.At nearly the same time, Medicare announced that it will go broke in 2024, a decade sooner than expected and only 13 years away.(...)Read the rest of A new organization for primary careCategory: Policy | Tags: Health reform, Primary care | 9 comments (Source: Kevin, M.D. - Medical Weblog) Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=4959987 Wed, 22 Jun 2011 18:00:22 +0100 4959987 http://www.medworm.com/index.php?rid=4959989&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FbeJCTIcT8QM%2F5-strategic-tools-solve-healthcare-woes.html by Joe FlowerIt’s getting scary.We are facing, before the end of this decade, a bifurcated future. The way things are going now—with the economy wheezing, doctors bailing, chronic disease rising fast, boomers sliding out of the Viagra years into the Depends years, reimbursements getting squeezed ever tighter, Medicaid sputtering on fumes, and 30 million or more new people soon swarming our doors with insurance cards—if we don’t pull a rabbit out of a hat real soon now, we’re in serious trouble.(...)Read the rest of 5 strategic tools to solve our healthcare woesCategory: Policy | Tags: Health reform | 3 comments (Source: Kevin, M.D. - Medical Weblog) Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=4959989 Wed, 22 Jun 2011 15:00:11 +0100 4959989 http://www.medworm.com/index.php?rid=4953082&cid=t_99568_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=4952725&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2F_VMgd5oF2MQ%2Fmedical-practice-career-choices-commonly-medical-business-failures.html by Curt Graham, MDNever in the history of medicine have doctors faced such a ruthless gauntlet of threats, financial debts, and practice restrictions than they do today.  These factors, among others just as crucial, don’t begin to tell the story about why 40% of medical doctors readily admit to intense frustration in their practices, in addition to the percentage of doctors quitting medical practice completely.They’re not retiring.  They’re adapting.  Extended hours to see more patients to make enough income to stay financially solvent is just one highly stressful necessity causing eventual burnout.  Coupled with the recognition that private medical office practice for most doctors is not lucrative enough to reach their original goals and dreams for their careers, reasonable sati... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=4952725 Tue, 21 Jun 2011 14:00:00 +0100 4952725 http://www.medworm.com/index.php?rid=4952729&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FTY8FZ-VPCD4%2Fama-decline-doctors-care.html by Kevin Pho, MDThe American Medical Association recently released its membership numbers, and they’re declining.According to MedPage Today, the AMA “saw another steep drop in its membership in 2010 — this time losing about 12,000 members or 5% of its total membership.”It’s been well publicized that the AMA only represents a minority percentage of physicians, depending on what you read, it’s between 20 and 30%.  But it seems many physicians have little positive to say about the organization.In a provocative opinion piece, former JAMA editor George Lundberg asks, “Why do so many physicians hate the AMA?”(...)Read the rest of Why the AMA is in decline, and should doctors care?Category: Pho | Tags: Health reform, Primary care, Specialist | 27 c... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=4952729 Mon, 20 Jun 2011 20:07:43 +0100 4952729 http://www.medworm.com/index.php?rid=4952832&cid=t_99568_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F06%2Fis-menopause-a-pre-existing-condition.html Q. I may have to change insurance companies soon, and I will also likely enter menopause. Will my new insurer consider that a pre-existing condition? A. Any middle-aged person contemplating a switch in health insurance plans has every reason to be concerned about pre-existing conditions. But menopause itself isn’t one of them because it’s not a disease, it’s a normal stage of life for women. “Just being a 50-year-old woman with no symptoms obviously would not be a problem,” says Mark Brown, a certified financial planner and longtime insurance agent in Naperville, Ill. But menopause can produce symptoms for which women do seek medical treatment—hot flashes, say, or trouble sleeping. In most states, Brown said, those might well trigger a rate hike or ... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=4952832 Fri, 17 Jun 2011 16:40:00 +0100 4952832 http://www.medworm.com/index.php?rid=4952777&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F06%2F17%2Fthe-mixed-demerits-of-bending-the-cost-curve%2F Political scientists emphasize the importance of “framing” in policy debates.  The health care cost control debate in the United States has been reframed by the promotion of a metaphor, “bending the curve.”  This metaphor has merits but they are decidedly mixed. The sudden popularity of the idea of “bending the cost curve” is significant because [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4952777 Fri, 17 Jun 2011 13:41:22 +0100 4952777 http://www.medworm.com/index.php?rid=4934071&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F06%2F16%2Fhealth-policy-brief-medicare-advantage%2F A new Health Policy Brief from Health Affairs and the Robert Wood Johnson Foundation describes the provision in the Affordable Care Act of 2010 that will gradually reduce federal payments to the Medicare Advantage program. Roughly one in four of the nation’s 47 million Medicare beneficiaries currently participate in Medicare Advantage. These are private health [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4934071 Thu, 16 Jun 2011 16:00:56 +0100 4934071 http://www.medworm.com/index.php?rid=4934004&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2Fl0QVN0PJOoU%2Fnarrative-medicine-means-effective-healthcare.html by Jennifer Adaeze Anyaegbunam and Jennifer SotskyAs undergraduate premedical students, we learned about narrative medicine by chance in a New York Times article titled “Learning to Listen.”After exploring the research of Dr. Rita Charon, we were both drawn to the new field and what it had to offer us as future medical professionals. The Times article explains, “Through literature, [Dr. Charon] learned how stories are built and told, and translated that to listening to, and better understanding, patients.” As humanities majors, our course work seemed unrelated to our professional pursuits in medicine. Columbia University’s Master of Science in Narrative Medicine program offered us an exciting opportunity to bridge our backgrounds in Film Studies and English Litera... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=4934004 Thu, 16 Jun 2011 13:00:26 +0100 4934004 http://www.medworm.com/index.php?rid=4934073&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F06%2F14%2Fstates-and-health-it-upcoming-conference%2F As mentioned before on this blog, Health Affairs is the official media sponsor for the upcoming 2011 State Healthcare IT Connect Summit, June 21-23 in Dulles, Virginia. If you are interested in the conference but can’t attend in person, you can participate via live Webcast. This option, which is complimentary for government participants and costs [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4934073 Tue, 14 Jun 2011 20:55:31 +0100 4934073 http://www.medworm.com/index.php?rid=4921412&cid=t_99568_87_f&fid=38368&url=http%3A%2F%2Fwww.hlc.org%2Fwebsite_demo2011%2Fblog%2Fwp-content%2Fuploads%2F2010%2F07%2FHLC-Value-Compendium-EMAIL.pdf By Mary Grealy. It’s easy to get so caught up in the battle over whatever healthcare legislation is before Congress, or the newest set of regulations to come out of the departments and agencies, that one can make the mistake of thinking that all healthcare reform has its genesis within the confines of Washington, D.C. The truth, though, as spelled out in forceful detail by McKesson Corporation CEO John Hammergren (a Healthcare Leadership Council member) in a Forbes blog post this week, is that genuine, system-changing reform is taking place up and down the healthcare spectrum outside of the Washington Beltway. His sound advice to his counterparts in the healthcare industry is simple and compelling:  Don’t wait for Washington to enact change.  Make it happen yourselves. Mr. Hammergren... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=4921412 Fri, 10 Jun 2011 14:03:02 +0100 4921412 http://www.medworm.com/index.php?rid=4921370&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F06%2F09%2Fanalyzing-a-crucial-battle-in-the-legal-war-over-health-reform%2F For a lawyer, the argument of Florida v. the Department of Health and Human Services before a three judge panel of the Eleventh Circuit Federal Court of Appeals on Wednesday, June 8, was a beauty to behold.  (For a non-lawyer it was probably tedious, repetitive, and much too long).  Three active and very well-prepared judges [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4921370 Thu, 09 Jun 2011 13:44:03 +0100 4921370 http://www.medworm.com/index.php?rid=4921413&cid=t_99568_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2FQeyJQ0P52KI%2F Anna Gawlinski The following is a guest post by: Anna Gawlinski, RN, DNSc, FAAN, Director, Research and Evidence-Based Practice and Adjunct Professor at Ronald Reagan UCLA Medical Center and UCLA School of Nursing and Elizabeth Henneman, PhD, RN, Assistant Professor at The School of Nursing at the University of Massachusetts-Amherst. It’s easy to criticize the current state of our health care system. All over the place, even outside of Washington DC, people are talking left and right (politically, that is) when they should be talking right and wrong (care, that is). But, one important talking point that’s almost always left out of the equation is our role, the role of the nurse. Or more specifically, the critical care nurse whose job it is to save you or your family members’ lives... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=4921413 Thu, 09 Jun 2011 13:02:44 +0100 4921413 http://www.medworm.com/index.php?rid=4902412&cid=t_99568_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F06%2Fshould-i-buy-a-low-priced-limited-benefit-health-insurance-plan-just-in-case-something-happens.html Q. My former employer went into receivership so my COBRA plan is terminating and I need to buy health insurance on my own. Money is tight, and I’ve found plans from Assurant and Lands Health that cost much less than the plans from big-name companies like Blue Cross and Aetna. Are these cheaper plans legit? I know they’re not major medical but it seems like there’s enough coverage to get in the door in case something happens. I’m thinking of buying the Lands Health Silver plan. A. I think you’d be making a potentially catastrophic mistake to rely on one of these plans for your sole health coverage. They are limited-benefit indemnity plans and both clearly state on their websites that they are “not major medical insurance plans.” Suppose the &#82... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=4902412 Mon, 06 Jun 2011 20:05:00 +0100 4902412 http://www.medworm.com/index.php?rid=4893328&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2Fb_tQ-3naVjU%2Fniaspan-comparative-effectiveness-research.html by Harlan M. Krumholz, MDComparative effectiveness research — investigations that determine which treatments are best — has attracted attention in the health care debate. Critics charge that these studies are designed to restrict choice. The Center for Medicine in the Public Interest released a report that suggested that they would stifle innovation. Often they are framed as studies to support efforts to keep useful but expensive therapies from patients.But what if these studies, done well, revealed that some medications were better than others? What if they overturned conventional wisdom about understudied drugs, demonstrating that many patients were receiving ineffective treatments? What if they showed that some patient were actually being harmed? What if more knowledge about the ben... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=4893328 Fri, 03 Jun 2011 18:00:00 +0100 4893328 http://www.medworm.com/index.php?rid=4893368&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F06%2F03%2Fpost-on-health-reform-and-medicare-tops-mays-ha-blog-most-read-list%2F Thomas Saving’s and John Goodman’s post on the implications of the Affordable Care Act for Medicare leads the list of most-read Health Affairs Blog posts for May. On the list as well are posts on the hazards of ignoring the lessons of the Clinton years; the opportunities offered by clinical registries; and the implications of [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4893368 Fri, 03 Jun 2011 15:40:41 +0100 4893368 http://www.medworm.com/index.php?rid=4893331&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FkUBjllr8JqY%2Fhealth-reforms-prejudice-specialist-physicians.html by Gary Levin, MDHave you noticed the recent trend against specialty physicians? Policy experts have determined that primary care needs incentives to attract medical students away from those “highly lucrative” specialties such as plastic surgery, orthopedic surgery, interventional cardiology, and neurosurgery.Our federal government believes in equal opportunity — if you wish to become a family doctor. There are incentives sponsored by cities, states, Indian reservations, public health service, and more if one wants to become a family doctor in turn for serving in a community. There aren’t many of those for specialists, except perhaps for psychiatrists.(...)Read the rest of Health reform’s prejudice against specialist physiciansCategory: Policy | Tags: Health refor... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=4893331 Fri, 03 Jun 2011 14:00:14 +0100 4893331 http://www.medworm.com/index.php?rid=4893643&cid=t_99568_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=4893370&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F06%2F03%2Fsuccess-factors-for-creating-accountable-care-organizations%2F Healthcare organizations across the country are learning how to adapt to the concept of an Accountable Care Organization (ACO). Having been closely involved in Intermountain Healthcare’s evolution as a prototype ACO, we offer our experience in making that transition. Intermountain Healthcare is a not-for-profit, integrated, healthcare system serving Utah and southern Idaho. With 23 hospitals, [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4893370 Fri, 03 Jun 2011 12:15:06 +0100 4893370 http://www.medworm.com/index.php?rid=4893435&cid=t_99568_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F06%2Fwhat-can-i-do-if-my-doctor-has-opted-out-of-medicare.html Q. My doctor has opted out of Medicare and has asked me to sign a form that says I won’t submit a claim to Medicare for his services. Do I simply submit that signed form to Medicare along with my bill? Can I assume Medicare will then forward that bill to my Medigap insurance company? A. The answer to both of your questions is no. While most doctors do participate in Medicare, they don’t have to. Medicare has set up a formal opt-out procedure that your doctor seems to have followed. This includes having you sign a contract acknowledging Medicare won’t pay for his services, and that you won’t submit a claim on your own to either Medicare or Medigap. If you do so, your claim will be denied. If you are not willing and able to pay this doctor’s bills in full fro... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=4893435 Thu, 02 Jun 2011 21:10:00 +0100 4893435 http://www.medworm.com/index.php?rid=4893372&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F06%2F01%2Fsen-menendez-no-way-to-make-medicare-premium-support-acceptable%2F Here’s a brief Q&A between Democratic Senator Robert Menendez of New Jersey and Health Affairs Blog. It took place earlier this afternoon during a press call by Senator Menendez, which was coordinated by the office of Senate Majority Leader Harry Reid (D-NV). In the exchange, Senator Menendez rules out any reform that turns Medicare into [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4893372 Wed, 01 Jun 2011 20:31:21 +0100 4893372 http://www.medworm.com/index.php?rid=4893644&cid=t_99568_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=4883567&cid=t_99568_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F05%2Fcan-i-find-affordable-insurance-if-i-have-a-pre-existing-condition.html Q. Is there a health insurance plan that will take me if I have an existing health problem—at a reasonable price? A. The answer to your question got a little more encouraging today with the announcement by the federal government that it’s cutting premiums for its Pre-Existing Condition Insurance Plan (PCIP) program for the second time since it started last summer. Whether you, personally, can now afford such coverage is a question I can’t answer without looking at your bank balance. But in some states premiums for these policies will go down as much as 40 percent beginning July 1. The PCIP was set up as part of the Affordable Care Act, with the idea of offering stopgap help for people with pre-existing conditions until 2014, when the reform law will be fully implemented... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=4883567 Tue, 31 May 2011 20:50:00 +0100 4883567 http://www.medworm.com/index.php?rid=4883515&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FWPJggz8hqWI%2Fmedical-professionalism-federal-debt.html by Rosemary GibsonIn recent weeks, headline news has been reporting on the battle to curb the federal debt.  What does this have to do with medical professionalism?The federal government must borrow forty cents of every dollar it spends.  In health care, it needs to borrow from China and other lenders to reimburse doctors, hospitals and other providers who bill federal programs.(...)Read the rest of What medical professionalism has to do with the federal debtCategory: Physician | Tags: Health reform | 1 comment (Source: Kevin, M.D. - Medical Weblog) Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=4883515 Tue, 31 May 2011 18:00:53 +0100 4883515 http://www.medworm.com/index.php?rid=4883549&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F31%2Fsaving-the-shared-savings-program-part-2-financial-issues%2F Editor’s Note: This is the second installment of a series of blog posts by Ron Klar offering suggestions on how to make the Medicare Shared Savings Program a more viable vehicle for the creation of accountable care organizations. You can read the first installment here. In this posting I will address the three financial issues [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4883549 Tue, 31 May 2011 16:25:27 +0100 4883549 http://www.medworm.com/index.php?rid=4883724&cid=t_99568_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=4883520&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2F8Z0vj1HvVPI%2Ffree-medical-school-save-primary-care.html by Kevin Pho, MDMedical school should be free.That’s an argument made by physicians Peter B. Bach and Robert Kocher in the New York Times.This isn’t a new concept.  I’ve discussed whether medical school should be free for students who choose primary care.  And, for some in the country, it’s already happening.  Like at Case Western Reserve University, for instance.  The Cleveland Clinic subsidizes tuition there, although their intent is to drive more students to choose academic careers, not necessarily primary care.(...)Read the rest of Would free medical school be enough to save primary care?Category: Pho | Tags: Health reform, Medical school, Primary care | 8 comments (Source: Kevin, M.D. - Medical Weblog) Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=4883520 Tue, 31 May 2011 13:07:28 +0100 4883520 http://www.medworm.com/index.php?rid=4872025&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FGyPVSTz61_k%2Facos-reinvent-american-health-care-system.html by George Lundberg, MDThe cost curve of American medicine continues to bend up. That is unsustainable. It must begin to bend downward.Two recent headlines focus the problem: New York Times, May 14, 2011: Health Insurers Making Record Profits as Many Postpone CareAnd, CNN Money, May 11, 2011 reports “Your family’s healthcare costs $19,393.” That is for a family of four, which has a median income of $75,700  – before taxes.Opportunity knocks, loudly. We can change our medical world now.(...)Read the rest of Can ACOs reinvent the American health care system?Category: Policy | Tags: Health reform, Primary care | 3 comments (Source: Kevin, M.D. - Medical Weblog) Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=4872025 Thu, 26 May 2011 18:00:47 +0100 4872025 http://www.medworm.com/index.php?rid=4872081&cid=t_99568_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F05%2Fvermont-establishes-road-map-for-single-payer-health-care.html Vermont made history today when Governor Peter Shumlin, a Democrat, signed into law a plan to create the nation’s first state-run “single-payer” health system. If fully implemented, every Vermont resident, including those on Medicare and Medicaid, would be entitled to enroll in the state’s own insurance plan, Green Mountain Care. Private insurers would still be allowed to operate in the state. The goal is to establish a system in which “health care is a right and not a privilege,” Governor Shumlin told National Public Radio. But the new law doesn’t establish the system right away. Instead, it creates a five-member board that is charged with coming up with options to pay for the system, which are to be presented to the legislature for approval by ... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=4872081 Thu, 26 May 2011 16:00:00 +0100 4872081 http://www.medworm.com/index.php?rid=4872049&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F26%2Fhealth-wonk-review-memorial-day-edition%2F If you’re traveling over the long weekend, you’ll want to take along some reading material. While some might reach for a good novel by John Grisham or Dan Brown, the health policy blogs in this edition of the Health Wonk Review tackle equally compelling mysteries. Was the Medicare Trustees report really that gloomy? If Workers [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4872049 Thu, 26 May 2011 13:29:21 +0100 4872049 http://www.medworm.com/index.php?rid=4872084&cid=t_99568_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2F-PNnvtaDT_A%2F By Mary Grealy. It wasn’t a head-to-head battle, as such, but Congresswoman Allyson Schwartz (D-PA) squared off against the USA Today editorial board yesterday on the subject of the Independent Payment Advisory Board (IPAB), and I believe the lawmaker clearly made the better arguments. USA Today’s editorial made the point that the IPAB, created as part of the Affordable Care Act to curb Medicare costs, is essential to do the job that Congress won’t in cutting program spending.  The newspaper compared the new board to the base closing commission that successfully shuttered unneeded military installations. That’s a dubious argument, though, at best.  The base closing commission carefully studied the value and usefulness of military bases before choosing which ones could be closed w... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=4872084 Thu, 26 May 2011 13:00:30 +0100 4872084 http://www.medworm.com/index.php?rid=4862451&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FNBdWMV2D8U0%2Feprescribe-risk-medicare-penalty.html by Rosemarie Nelson, MSDoctors who do not successfully e-prescribe 10 times for Medicare patients in the first six months of 2011 using claims-based reporting may be hit with a 1% penalty on their Medicare Part B payments for covered professional services in 2012.The penalty will increase to 1.5% in 2013 for those who don’t e-prescribe for 25 Medicare patients during 2011.Not yet e-prescribing?Maybe your EMR will be implemented soon, but maybe not soon enough!(...)Read the rest of E-prescribe now, or risk a Medicare penaltyCategory: Policy | Tags: Health reform, Medicare, Primary care, Specialist | No comment (Source: Kevin, M.D. - Medical Weblog) Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=4862451 Wed, 25 May 2011 18:00:26 +0100 4862451 http://www.medworm.com/index.php?rid=4862487&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F25%2Fpioneer-acos-the-right-direction-but-whats-the-goal%2F Editor’s Note: The post below discusses the recent announcement regarding accountable care organizations by the Center For Medicare and Medicaid Innovation. This is also the topic of another post, by Douglas Hastings, published today on Health Affairs Blog. For large entities that already successfully participate in managed care, the recently announced Center for Medicare and [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4862487 Wed, 25 May 2011 15:31:01 +0100 4862487 http://www.medworm.com/index.php?rid=4862488&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F25%2Fpioneer-acos-surging-to-a-new-level-of-integration%2F Editor’s Note: The post below discusses the recent announcement regarding accountable care organizations by the Center For Medicare and Medicaid Innovation. This is also the topic of another post, by Steve Lieberman, published today on Health Affairs Blog. In a speech on February 1, among other comments, Dr. Don Berwick, the Administrator for the Centers [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4862488 Wed, 25 May 2011 15:28:44 +0100 4862488 http://www.medworm.com/index.php?rid=4862454&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2F-woE4MC8JjA%2Facp-accountable-care-team-sport.html A guest column by the American College of Physicians, exclusive to KevinMD.com.by John Tooker, MD, MBA, MACPOn March 31, 2011, CMS issued a proposed rule to implement a section of the Patient Protection and Affordable Care Act (ACA) that requires the HHS Secretary to establish a Medicare Shared Savings Program. Under the proposed rule, eligible providers and hospitals that create or join accountable care organizations (ACOs) can continue to receive traditional Medicare fee-for-service payments under Medicare parts A and B and be eligible for additional payments based upon satisfying quality and cost savings requirements.(...)Read the rest of ACP: How accountable care is a team sportCategory: Policy | Tags: Health reform, Primary care | 2 comments (Source: Kevin, M.D. - Medical Weblog) Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=4862454 Wed, 25 May 2011 14:04:09 +0100 4862454 http://www.medworm.com/index.php?rid=4862458&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FHcpYnHjym24%2Fbasing-physician-pay-popularity-marginalizes-patients.html Part one of the three-part series, Let’s Pay Popular People More!by Jan Gurley, MDMy patient only had 20 minutes to wait for the van headed to detox. The people who had worked to get him into a detox program already numbered in the double digits. Sam (not his real name) was the classic public inebriate — he woke on sidewalks with the shakes, vomited blood on a regular basis, had lost most of his teeth, and was such a frequent victim of head trauma that depressions and scars ridged his balding skull.Over the last week, our substance abuse counselor had daisy-chained together an impressive series of phone calls, blood tests, and clearance forms to line him up for one of our rarely-available detox beds.Only 20 minutes to go.(...)Read the rest of How basing physician pay on popularity ... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=4862458 Tue, 24 May 2011 20:00:44 +0100 4862458 http://www.medworm.com/index.php?rid=4862539&cid=t_99568_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2FxqlsdGvGlEM%2F “What Does Health Reform Do for People on Medicare?”  The new health reform law benefits people on Medicare in a number of ways. This video explains some of the ways, such as ending out-of-pocket expenses for recommended screenings, checkups and other preventive services, and reducing prescription drug prices in the “doughnut hole.” Featuring John Rother, executive vice president of policy and strategy for AARP. “Will Health Reform Reduce the Federal Deficit?”   The Congressional Budget Office estimates that the health reform law will reduce the federal deficit by $124 billion by 2020. Respected analysts disagree, however. In this video, economist Joe Antos of the American Enterprise Institute explains why he believes health reform will cost much more than expected, primaril... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=4862539 Tue, 24 May 2011 13:06:41 +0100 4862539 http://www.medworm.com/index.php?rid=4847948&cid=t_99568_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F05%2Fif-health-reform-was-supposed-to-bring-prices-down-why-has-my-premium-gone-up.html Q. If health reform was supposed to bring prices down, why has my health-insurance premium gone up…a lot? A. This question has come my way repeatedly, with only minor variations, ever since the Affordable Care Act became law in 2010. The short answer: insurers won’t be able to get away with this much longer. The several pieces of health reform that will bring premiums down haven’t been fully implemented yet and until they are, insurers are raising premiums as much as they dare-and earning record profits as a result. That’s about to change, and consumers will begin to notice it as early as this fall’s open enrollment season. Two things are going on simultaneously. Insurers will have to start spending more of their income on health care. Insurers have trad... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=4847948 Fri, 20 May 2011 17:40:00 +0100 4847948 http://www.medworm.com/index.php?rid=4847932&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F20%2Fimplementing-health-reform-the-preview-review-final-rule%2F Editor’s Note: This is the latest in a series of posts by Timothy Jost on the implementation of the Affordable Care Act.  Earlier posts have analyzed some important guidances, as well as provisions governing state waiver requests, student health plans, premium review, medical loss ratios, insurance exchanges, coverage for pre-existing conditions, appeals of coverage denials, coverage for [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4847932 Fri, 20 May 2011 14:34:47 +0100 4847932 http://www.medworm.com/index.php?rid=4841412&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F19%2Fthe-beacon-communities-at-one-year-the-colorado-experience%2F Editor’s Note: The federal government’s Beacon Program provides funding to 17 communities that have already made inroads in the development of secure, private, and accurate systems of electronic health record (EHR) adoption and health information exchange. This is the second in a series of Health Affairs Blog posts in which leaders of several Beacon communities [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4841412 Thu, 19 May 2011 18:56:51 +0100 4841412 http://www.medworm.com/index.php?rid=4841381&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FqigJcoPmQKM%2Fdirect-primary-care-marcus-welby-vision-primary-care.html by Dave ChaseThe insurance middleman has taken a toll on the family doctor. New practice models plan to change that. Physicians in Seattle, Silicon Valley and Boston are proving what the rest of the world already knows. When you have a high function primary care system, there’s less money spent and better health outcomes.Before House, M.D., there was Marcus Welby, M.D. who epitomized the glory days of healthcare. Dr. Welby knew every one of his patients. If you got sick, he took care of you right away, always spending whatever time necessary.(...)Read the rest of Direct primary care and the Marcus Welby vision of primary careCategory: Policy | Tags: Health reform, Primary care | 5 comments (Source: Kevin, M.D. - Medical Weblog) Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=4841381 Wed, 18 May 2011 18:00:12 +0100 4841381 http://www.medworm.com/index.php?rid=4841413&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F18%2Fhealth-policy-brief-the-class-act%2F The latest Health Policy Brief from Health Affairs and the Robert Wood Johnson Foundation examines the Community Living Assistance Services and Supports (CLASS) Plan, a voluntary, publicly administered insurance program enacted as part of the Affordable Care Act in 2010. It is designed to help people should they become disabled and need long-term services and [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4841413 Wed, 18 May 2011 15:45:27 +0100 4841413 http://www.medworm.com/index.php?rid=4841689&cid=t_99568_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_99568_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=4828797&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FegO8PPUzhTY%2Fpredictions-future-medicine-health-care-reform.html by Wes Fisher, MDRecently, an editorial from a plastic surgeon Lloyd Kreiger, MD, appeared in the Wall Street Journal entitled “ObamaCare Is Already Damaging Health Care.”While I’m not sure I’m ready to concede that Obamacare has already damaged health care in America, I will agree the law is certainly is changing health care, aligning health care corporate interests with political interests, with doctors feeling the squeeze between the two.(...)Read the rest of Predictions on the future of medicine after health care reformCategory: Policy | Tags: Health reform, Patients, Primary care, Specialist | 4 comments (Source: Kevin, M.D. - Medical Weblog) Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=4828797 Mon, 16 May 2011 19:00:36 +0100 4828797 http://www.medworm.com/index.php?rid=4828800&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2Fuw8fnvf_bCA%2Faco-affect-relationship-doctor-patient.html by Randall S. Bock, MDAt the heart of medicine is the relationship between a doctor and a patient.The more a doctor knows about his patients, the better. While visual changes and numbness might represent migraine symptoms for one patient, for another they could forebode a stroke. Having followed patients through the stages of life, participating in their medical experiences firsthand rather than solely reviewing those as written case-files — I can vouch that knowing their lifestyle and personality helps doctors not only in diagnosis but also in tailoring treatment.(...)Read the rest of How an ACO will affect the relationship between a doctor and a patientCategory: Policy | Tags: Health reform, Patients | 5 comments (Source: Kevin, M.D. - Medical Weblog) Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=4828800 Mon, 16 May 2011 16:17:09 +0100 4828800 http://www.medworm.com/index.php?rid=4828841&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F16%2Fthe-beacon-communities-at-one-year-the-central-indiana-experience%2F Editor’s note: The federal government’s Beacon Program provides funding to 17 communities that have already made inroads in the development of secure, private, and accurate systems of electronic health record (EHR) adoption and health information exchange. This is the first in a series of Health Affairs Blog posts in which leaders of several Beacon communities [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4828841 Mon, 16 May 2011 16:14:39 +0100 4828841 http://www.medworm.com/index.php?rid=4820773&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FsIXIjdM28ec%2Facos-creatively-destroy-fee-service-medicine.html by David Cundiff, MDThe U.S. Department of Health and Human Services (HHS) advocates the “creative destruction” of the traditional system of U.S.physicians practicing solo or in small groups operating as small businesses.Republicans and Democrats approve of ACOs in concept. The Affordable Care Act of 2010 calls for shifting from fragmented care provided by uncoordinated health care professionals to integrated treatment by “accountable care organizations” (ACOs). While still evolving in terms of definition and regulations, the HHS’ model of ACOs would consist of primary care providers, specialists, and possibly hospitals with professional healthcare management personnel.(...)Read the rest of How ACOs creatively destroy fee for service medicineCategory: Policy | Tag... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=4820773 Fri, 13 May 2011 11:00:12 +0100 4820773 http://www.medworm.com/index.php?rid=4820950&cid=t_99568_113_f&fid=34625&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FNeilVerselsHealthcareItBlog%2F%7E3%2F-gmzgCD_78g%2F I’ve just finished my latest post for EMR and HIPAA, based on a session I moderated this week at the the Institute for Health Technology Transformation health IT summit in Fort Lauderdale, Fla. Here’s a taste: The panelists did great job of articulating some of these conundrums and strategies to overcome them, but none better than Kevin Maher, director of clinical innovations for Horizon Healthcare Innovations, a new affiliate of Horizon Blue Cross Blue Shield of New Jersey tasked with testing new care models, and Victor Freeman, M.D., quality director in the Health Resources and Services Administration‘s Office of Health IT and Quality. The patient-centered medical home is a great idea for managing care, promoting prevention and, ultimately reducing costs. “We view the ba... Neil Versel's Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=4820950 Thu, 12 May 2011 21:59:53 +0100 4820950 http://www.medworm.com/index.php?rid=4820798&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F12%2Fwonk-review-includes-ha-blog-post-on-aca-legal-fight%2F Hank Stern has posted a “Spring Cleaning” edition of the Health Wonk Review on InsureBlog. Among the posts Hank highlights is Tim Jost’s Health Affairs Blog post on the first appellate arguments over the constitutionality of the Affordable Care Act. Health Affairs Blog will host the next Health Wonk Review two weeks from today, on [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4820798 Thu, 12 May 2011 20:48:16 +0100 4820798 http://www.medworm.com/index.php?rid=4820776&cid=t_99568_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FsH9mgOg6i_I%2Fama-individual-responsibility-health-insurance-helps-americas-patients-pocketbooks.html A guest column by the American Medical Association, exclusive to KevinMD.com.by Cecil B. Wilson, MDA wise physician once said, “Health is not valued til sickness comes.” The same can certainly be said about health insurance.This concept is at the heart of our current debate about individual responsibility for health insurance coverage. While we hope never to need surgery or chemotherapy or to have an unexpected accident or illness, it’s certain that many of us will. Health insurance helps individuals get the care they need, while spreading out the financial risk for everyone.(...)Read the rest of AMA: Individual responsibility for health insurance helps America’s patients, pocketbooksCategory: Policy | Tags: Health reform, Patients | 4 comments (Source: Kevin, M.D. - M... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=4820776 Thu, 12 May 2011 18:00:27 +0100 4820776 http://www.medworm.com/index.php?rid=4820800&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F12%2Fwhat-health-reform-means-for-medicare%2F While President Barack Obama and congressional leaders continue to tussle over what to do about the nation’s unsustainable entitlement spending programs, the effects of the Patient Protection and Affordable Care Act (PPACA) seem to have gone largely unnoticed. This oversight is hard to explain. In recent decades, real Medicare spending has been growing at a [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4820800 Thu, 12 May 2011 12:26:08 +0100 4820800 http://www.medworm.com/index.php?rid=4813277&cid=t_99568_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F05%2Fwhat-happens-when-cobra-coverage-ends.html Q. Our daughter’s COBRA coverage just expired and she’s been turned down for individual insurance policies in Ohio—probably because she smokes and is overweight. Does she have any other options? A. Yes, but tell her to act quickly. The Health Insurance Portability and Accountability Act (HIPAA) guarantees that anyone whose COBRA coverage runs out is entitled to purchase a specially-designated individual plan, without being subject to a waiting period or exclusions for pre-existing conditions. But to take advantage of this right, you must begin new coverage within 63 days after COBRA ends. States handle this guarantee in different ways. In Ohio, the program is called Open Enrollment, and it offers two plans, Basic and Standard. The Basic plan has lower premiums but less... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=4813277 Wed, 11 May 2011 17:15:00 +0100 4813277 http://www.medworm.com/index.php?rid=4813229&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F11%2Fclinical-registries-the-opportunity-for-the-nation%2F In the early 1970s, the Cystic Fibrosis Foundation began tracking the health of patients with cystic fibrosis.  What began as a modest data collection effort is today a comprehensive clinical registry of 26,000 patients.  Caregivers and researchers use the registry to identify new trends in outcomes; recognize the most effective treatments; and design clinical trials [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4813229 Wed, 11 May 2011 16:22:36 +0100 4813229 http://www.medworm.com/index.php?rid=4813280&cid=t_99568_87_f&fid=38368&url=http%3A%2F%2Fwww.allhealth.org%2Fhealth-issues-sourcebook2011%2Fcovering-health-issues-2011.pdf The completely updated 200-page Alliance sourcebook, “Covering Health Issues, 6th Edition,” is now available. Written with reporters in mind, “Covering Health Issues” is useful for anyone looking for concise information on health policy issues, and experts from across the political spectrum. Chapters contain fast facts, background, tips for reporters, story ideas and experts with contact information. The book also includes an extensive glossary, ideas and examples for TV and radio reporters, and links to polls on health issues. Supported by a grant from the Robert Wood Johnson Foundation. To see a video demonstration of the book by Julie Rovner of NPR, click here. To see individual chapters, click on any of the chapter titles below. To download the entire sourcebo... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=4813280 Wed, 11 May 2011 13:00:06 +0100 4813280 http://www.medworm.com/index.php?rid=4813230&cid=t_99568_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F10%2Fhealth-reform-the-legal-fight-moves-to-the-next-level%2F Today, May 10, the Fourth Circuit federal court of appeals heard oral arguments in two Affordable Care Act cases (ACA), Liberty University v. Geithner and Virginia v. Sebelius. In the Liberty University case, Judge Norman Moon of the Western District of Virginia had upheld the constitutionality of the Affordable Care Act against a challenge brought [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4813230 Tue, 10 May 2011 23:57:38 +0100 4813230