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Should Value Frameworks Take A ‘ Societal Perspective ’ ?
Editor’s note: One of the authors of this post, Peter Neumann, will be discussing issues related to the post at a Health Affairs September 13 event, “Understanding The Value of Innovations In Medicine.” In 1996, the U.S. Panel on Cost-Effectiveness in Health and Medicine recommended that analysts conducting cost-effectiveness analyses (CEAs) should perform a reference case analysis, following a set of standard methodological practices to improve comparability and quality. They further recommended that such analyses assume a societal perspective, reflecting the perspective of a decision maker allocating resourc...
Source: Health Affairs Blog - September 6, 2017 Category: Health Management Authors: Peter J. Neumann and Sachin Kamal-Bahl Tags: Costs and Spending Drugs and Medical Innovation Quality 2nd Panel on Cost-Effectiveness in Health and Medicine Source Type: blogs

DOJ Announces Another FCA Settlement - Sightpath Medical and TLC Vision Corporation
In late August 2017, the United States Department of Justice (DOJ) announced a $12 million settlement with Sightpath Medical and TLC Vision Corporation, as well as the former CEO of both entities, James Tiffany. The suit was brought by Kipp Fesenmaier, former vice president of the company, in 2013 for allegedly violating the False Claims Act and the Anti-Kickback Statute. Fesenmaier claimed that Sightpath knowingly took advantage of Medicare by using extravagant trips and social events to entice doctors to use its products and services, which were then billed to government healthcare programs. The complaint alleges ...
Source: Policy and Medicine - September 5, 2017 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

An Educational Conversation
I had an interesting conversation. I am doing some research on hospices and palliative care (for someone else, not me). I met with a social worker who used to work for a hospice. She was very helpful.I had no idea how hospice care worked, especially at home. Basically hospice care includes palliative care. If you have hospice care at home everything comes to you. Doctors, nurses, social workers, and more. It lasts for up to six months. If, at the end of the six months you are still alive, you can be recertified for more hospice time (I think) unless you are too healthy and stable and then its back to reality.Hospice c...
Source: Caroline's Breast Cancer Blog - September 1, 2017 Category: Cancer & Oncology Tags: dying hospice palliative Source Type: blogs

A Stealth Marketer Goes Through the Revolving Door to ... the President ' s Council of Economic Advisors?!
Stealthy, deceptive systematicmarketing,lobbying, andpolicy advocacy campaigns on behalf of big health care organizations, often pharmaceutical, biotechnology and medical device companies, have long been a subject of Health Care Renewal.  A relatively recently revealedexample was the stealth marketing campaign used by GlaxoSmithKline to sell its antidepressant Paxil.  This campaign includedmanipulating andsuppressing clinical research,bribing physicians to prescribe the drug, use ofkey opinion leaders as disguised marketers, and manipulation ofcontinuing medical education.  Other notable examples included Jo...
Source: Health Care Renewal - August 24, 2017 Category: Health Management Tags: conflicts of interest deception Donald Trump revolving doors stealth health policy advocacy stealth lobbying stealth marketing Source Type: blogs

To Combat ‘Information Blocking,’ Look To HIPAA
Back in 2009, when the Health Information Technology for Economic and Clinical Health (HITECH) Act became law, US taxpayers committed $300 million to seed nationwide health information exchange. Taxpayers also agreed to pay what turned out to be $35 billion in incentive payments for physicians and hospitals to adopt and “meaningfully use” electronic health records (EHRs). In implementing the meaningful-use program, the Centers for Medicare and Medicaid Services (CMS) required eligible providers and hospitals to attest to certain activities, including engaging in health information exchange and providing their patients ...
Source: Health Affairs Blog - August 24, 2017 Category: Health Management Authors: Lucia C. Savage Tags: Health IT 21st Century Cures electronic health records HIPAA information blocking medical data privacy Source Type: blogs

Did Medicaid Expansion Cause The Opioid Epidemic? There ’s Little Evidence That It Did.
Conclusion Some Medicaid recipients who gained coverage under the ACA may have become addicted to opioids, but we find little evidence that Medicaid expansion caused aggregate drug-related death rates to increase. Future research on the opioid epidemic should develop approaches that untangle the effects of Medicaid expansion from pre-existing economic trends and the spread of accessible illegal drugs. That said, by addressing the causes of addiction and promoting appropriate treatment, Medicaid could be an important tool for policy makers in the fight against opioid abuse. In January 2016, the Centers for Medicare and Medi...
Source: Health Affairs Blog - August 23, 2017 Category: Health Management Authors: Andrew Goodman-Bacon and Emma Sandoe Tags: Following the ACA Medicaid and CHIP Public Health Quality Medicaid expansion opioid epidemic Source Type: blogs

Confessions of a Healthcare Super User
BY JEFF GOLDSMITH On July 17 of this year, I journeyed from Charlottesville Virginia, where I live, to Seattle to have my cervical spine rebuilt at Virginia Mason Medical Center, whose Neuroscience Institute has a national reputation for telling patients they don’t need surgery. It was my fifth complex surgical episode in 29 months, after more than fifty years of great health.  My patient experience has been wrenching, and it made me question yet again the conventional wisdom about doctors and patients that dominates much of our current health policy debate. None of these interventions was remotely elective: head and ne...
Source: The Health Care Blog - August 22, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs

Policy Primers: Public Coverage And Prescription Drug Pricing
Health Affairs has released the next set in a series of peer-reviewed health policy briefs on key issues currently shaping the prescription drug market. Each brief offers a short, accessible overview of the issue and a close examination of how it affects pricing. This second set of briefs tell the story of different prescription drug coverage mechanisms (who pays whom and how much), how they interact with other pricing measures, and what future reforms might look like. They are: MEDICARE PART B The Medicare Part B “buy and bill” payment structure for physician-administered drugs also influences private-sector prices. M...
Source: Health Affairs Blog - August 10, 2017 Category: Health Management Authors: Health Affairs Tags: Elsewhere@ Health Affairs Featured Health Policy Briefs Source Type: blogs

The Skinny On The Senate ACA Debate, Day Three
Editor’s note: This post is part of ongoing Health Affairs Blog coverage by Tim Jost of the Senate debate over repealing and replacing—or maybe just repealing, or maybe just minimally repealing, or maybe retaining—the Affordable Care Act. See Tim’s earlier post and updates for more coverage. Update: Medicare-for-All And Abortion At about 2:30, the Senate voted on an amendment put forward by Senator Daines (R MT) incorporating the House Medicare-for-All bill. His intent was to embarrass and perhaps divide the Democrats by forcing them to vote on a proposal that some of them embrace, but some do not. In fact,...
Source: Health Affairs Blog - July 27, 2017 Category: Health Management Authors: Timothy Jost Tags: Costs and Spending Following the ACA Insurance and Coverage 1332 waivers Congressional Budget Office employer mandate individual mandate medical device tax skinny ACA repeal Source Type: blogs

Health + Design, Refactored
By ANDY ORAM Health care providers love to vaunt the unique and subtle needs of patients. How many ads have you heard from cancer centers or health clinics touting their flexibility and showing grateful, tear-flecked patients? But key aspects of our health care systems turn out to be rigid and heartless in practice. Despite the compassion of individual staff, our organizations tell patients in dozens of ways that they are widgets on an assembly line: We force patients to come early for every appointment and fill out the same paperwork each time with information they have given before. Patients traverse long, crowded corri...
Source: The Health Care Blog - July 25, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs

Unsustainable Costs of Library Resources
Sometimes I feel like medical librarians have been talking to brick walls.  Either that, or we are talking to bobble heads who don’t really listen to us but nod their heads in agreement. I get a weekly email summarizing the healthcare industry.  It is broken into local and national information and it is often an interesting quick read.  Today I read the article “US medical expenditures on the rise, except for primary and home health.” The largest expenditures were attributed to prescribed medications, specialty physicians, visits to the emergency department and inpatient hospitalizations.  While that ...
Source: The Krafty Librarian - July 18, 2017 Category: Databases & Libraries Authors: KraftyLibrarian Tags: Uncategorized Source Type: blogs

The Messenger Also Matters: Value-Based Payment Can Support Outreach To Vulnerable Populations
With the proliferation of value-based payment initiatives and implementation of the Affordable Care Act’s (ACA’s) coverage expansions, states have had many opportunities in recent years to improve the health of vulnerable populations through health promotion, prevention, and care coordination. We believe value-based payment models can and must support accountable health care delivery systems in partnering with community-based “messengers” to engage vulnerable individuals in health education and promotion. We explore one such messenger program, ACCESS, a Brooklyn-based project of the Arthur Ashe Institute for Urban ...
Source: Health Affairs Blog - July 10, 2017 Category: Health Management Authors: Ruth C. Browne, Marilyn Fraser, Judith Killen and Laura Tollen Tags: Health Equity Medicaid and CHIP Population Health Arthur Ashe Institute for Urban Health New York New York State Social Determinants of Health value-based payment vulnerable populations Source Type: blogs

Have Employer Coverage? GOP Proposals Will Affect You Too (Part 2)
As Senate Republican leaders continue to craft their bill to repeal and replace the Affordable Care Act (ACA), most attention has been focused on the number of individuals who would lose coverage if the legislation is enacted. To be sure, the ACA coverage expansions—through Medicaid and subsidized Marketplace plans—have been a lifeline for millions of people, particularly those who are low income, and have reduced the number of individuals without coverage to record lows. But the legislation that passed the House and the bill now under consideration in the Senate could also affect the more than 150 million peop...
Source: Health Affairs Blog - July 6, 2017 Category: Health Management Authors: JoAnn Volk and Sabrina Corlette Tags: Following the ACA Insurance and Coverage ACA repeal and replace employer-sponsored coverage Employer-Sponsored Insurance Essential Health Benefits Source Type: blogs

Health Affairs – Advanced Illness & End-of-Life Care
The July 2017 issue of Health Affairs is a special issue on Advanced Illness & End-of-Life Care. Advanced Illness And End-Of-Life CareAlan R. Weil Advance Care Planning With Alzheimer’s: A Tortuous PathRebecca Gale Epidemiology And Patterns Of Care At The End Of Life: Rising Complexity, Shifts In Care Patterns And Sites Of DeathMelissa D. Aldridge and Elizabeth H. Bradley A National Profile Of End-Of-Life Caregiving In The United StatesKatherine A. Ornstein, Amy S. Kelley, Evan Bollens-Lund, and Jennifer L. Wolff Medicare Beneficiaries With Advanced Lung Cancer Experience Diverse Patterns Of Care F...
Source: blog.bioethics.net - July 6, 2017 Category: Medical Ethics Authors: Thaddeus Mason Pope, JD, PhD Tags: Health Care syndicated Source Type: blogs

Patient Access to Medical Services Varies by Individual Physician ’ s Will to Fight Insurance Companies
American healthcare reform debates are focused on strategies to provide “access” to medical services for all. Lack of insurance (or under-insurance) seems to be the primary focus, as it is falsely assumed that coverage provides access. Unfortunately, the situation is far more complicated. Once a person has health insurance, there is no guarantee that they will receive the medical services that they need. Not because their plan is insufficiently robust, but because the roadblocks for approval of services (provided in the plans) are so onerous that those providing the service often give up before they receive i...
Source: Better Health - July 3, 2017 Category: American Health Authors: Dr. Val Jones Tags: Health Policy Opinion Administrative Burden Coverage Is Not Care Health Insurance Roadblocks Pre-Authorization Underinsured Source Type: blogs