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Bundled Payment Web Site Appeals to Self-Pay and HDHP Consumers
Many employers are now providing high deductible heath plans (HDHP) to their employees with lower monthly cost to the companies but with a catch -- the employees need to pay more of the healthcare costs themselves (i.e., the deductible) before the insurance company covers anything. HDHPs have begun to stimulate consumers to shop for lower priced healthcare services. The Dark Daily recently discussed bundled pricing which provides the opportunity for consumers to save money on healthcare (see: More Providers and Payers Use Bundled Pricing to Serve Patients with Hig...
Source: Lab Soft News - July 8, 2016 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Health Insurance Healthcare Delivery Medical Consumerism Source Type: blogs

Time To Fix The Black Hole In Medicare Data
Every year, the Medicare program pays for nearly 500,000 hip and knee replacement surgeries for America’s seniors. At the same time, approximately 25,000 patients undergo procedures to remove and replace a previous artificial joint, sometimes because it failed before the end of its expected useful life. Remarkably, and largely due to inadequacies in the systems that collect data through routine billing, the Medicare program is unable to identify product failures and patient safety problems, or to measure and promote high-value care with medical devices. This problem is serious, but can, and should, be fixed. A number...
Source: Health Affairs Blog - June 29, 2016 Category: Health Management Authors: Ben Moscovitch, Josh Rising, Gregory Daniel and Joseph Drozda Tags: Costs and Spending Health IT Health Policy Lab Health Professionals Medicare Public Health Quality Alternative Payment Models Congress medical device safety medical devices unique device identifier Source Type: blogs

Reflecting on Father’s Day and Fertility
My dad taught me a lot. Because of him, I’m a passionate sports fan. I was wrapped in a Cubs blanket when I was born – remnants of his hometown of Chicago traveled with him to my birthplace in Austin. Baseball, football, basketball, golf, soccer… he introduced me to all of those and more. But above all, he taught me to be competitive. I owe a lot to my dad. Yes, he may have instilled a deep love for heartbreaking teams like the Chicago Cubs and Bears, but also the legacies of coaches like Vince Lombardi and Jimmy V. He positively reinforced my athletic endeavors. It was never “don’t strike out” but always ...
Source: LIVESTRONG Blog - June 16, 2016 Category: Cancer & Oncology Authors: LIVESTRONG Staff Source Type: blogs

The World’s Greatest Health Care Plan
Wherever we look around the world today, we almost always find that normal market processes have been systematically suppressed in health care. As a rule, no one ever sees a real price for any medical service. No patient. No doctor. No employer. No employee. Further, we have not replaced the price system with an alternative that would allow people to make rational health care choices. As a consequence, in virtually every health care system in the world, people face perverse incentives. When they act on those incentives, they do things that make costs higher, quality lower, and access to care more difficult than otherwise w...
Source: Health Affairs Blog - June 16, 2016 Category: Health Management Authors: John Goodman Tags: Costs and Spending Featured Insurance and Coverage Organization and Delivery Payment Policy ACA replacement Bill Cassidy Pete Sessions Politics Source Type: blogs

A Pot Luck Health Wonk Review
The posts for this week’s Health Wonk Review are an interesting and varied lot. Accordingly, despite the absence of a post on medical marijuana, we’ll call this a “Pot Luck” edition of the Health Wonk Review. We start with Peggy Salvatore’s post at Health System Ed. Peggy describes a Google Hangout featuring Peter Diamandis, cofounder of the Human Longevity Institute, which seeks to extend and expand the “healthy, high-performance lifespan.” Diamandis described “Human Nucleus,” a project that could allow you, for a $25,000 payment, to have your genome completely sequenced and analyzed. “The ide...
Source: Health Affairs Blog - June 16, 2016 Category: Health Management Authors: Chris Fleming Tags: Drugs and Medical Technology Elsewhere@ Health Affairs Featured Insurance and Coverage ACA Marketplaces Cancer Colorado drug shortages Health Wonk Review Hillary Clinton personalized medicine Workers' Comp Source Type: blogs

Confusion over HIPAA Causes Grief in Orlando
By ARTHUR CAPLAN, MD & CRAIG J. KONNOTH After the horrific shootings in the gay dance nightclub that killed 49 individuals, 53 survivors were rushed to surrounding hospitals.  In the hours that followed family members anxiously sought updates about their loved ones.  Yet, confusion over the privacy rules that govern health information prevented them from getting immediate access to what they surely needed to know. Confusion was not restricted to hospital staff.  Reporters and political officials alike were confused about what the law permitted. This is not the first time that HIPAA related confusion affected a gay...
Source: The Health Care Blog - June 15, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized HIPAA HIPAA Waiver Source Type: blogs

Partnering to Help Survivors Address Financial Hardships
Cancer care has come a long way in recent years, with breakthroughs and advancements in areas such surgery, radiology, symptom management, chemotherapy and immunotherapy. However, in many cases, these advancements have also increased the cost and complexity of care. For example, patients are now paying higher insurance premiums, deductibles, coinsurance and co-payments. The rise in care costs has created a new side effect for cancer patients– financial toxicity(1). This term refers to the negative impact the cost of cancer care can have on the patient’s financial circumstances such as their ability to pay for medical b...
Source: LIVESTRONG Blog - June 9, 2016 Category: Cancer & Oncology Authors: Guest Source Type: blogs

Obama Administration Acts To Stabilize Marketplaces, Implement Expatriate Coverage Legislation
On June 8, the federal departments tasked with implementing the Affordable Care Act (ACA) released a barrage of regulatory issuances, including fact sheets, guidances, a blog post, and a notice of proposed rulemaking (NPRM). These issuances serve two major purposes. First, several of them, as summarized in a press release and fact sheet released by the Centers for Medicare and Medicaid Services (CMS), are intended to stabilize the marketplace risk pool. They are, that is, intended to draw healthy as well as unhealthy enrollees into the market and to discourage potential gaming on the part of insurers or enrollees that migh...
Source: Health Affairs Blog - June 9, 2016 Category: Health Management Authors: Timothy Jost Tags: Following the ACA Insurance and Coverage Medicaid and CHIP Medicare ACA Marketplaces Essential Health Benefits expatriate coverage minimum essential coverage risk pools special enrollment periods Source Type: blogs

LGBT Protections In Affordable Care Act Section 1557
On May 13, 2016, the U.S. Department of Health and Human Services Office for Civil Rights (HHS OCR) issued a historic new rule that codifies nationwide nondiscrimination protections for lesbian, gay, bisexual, and transgender (LGBT) people in health facilities, programs, and activities receiving federal funding. This rule confirms that Affordable Care Act Section 1557 prohibits discrimination against LGBT people in health insurance coverage and health care. Key provisions of the final rule that relate specifically to LGBT people include: Interpreting Section 1557’s sex nondiscrimination protections to include explicit p...
Source: Health Affairs Blog - June 6, 2016 Category: Health Management Authors: Kellan Baker Tags: Costs and Spending Equity and Disparities Following the ACA Insurance and Coverage Medicaid and CHIP Public Health Quality HHS OCR LGBT issues section 1557 transgender rights Source Type: blogs

Is High Prescription Drug Spending Becoming Our New Normal?
This report concluded there was value in these therapies but also raised concerns about whether their effects will translate into lower rates of heart attack and stroke. Further, ICER concluded that a discount of 67 percent off the drugs’ list price would better represent their overall benefit. ICER’s assessment is still in draft form and it remains unclear whether the report will have any effect. Nevertheless, such work is a step in the right direction. Other entities are developing alternative methods to evaluate prescription drugs. The American Society for Clinical Oncology has sought comment on its proposed val...
Source: Health Affairs Blog - May 17, 2016 Category: Health Management Authors: Leigh Purvis and Crystal Kuntz Tags: Costs and Spending Drugs and Medical Technology Featured Payment Policy Quality Big Pharma Biosimiliar Comparative Effectiveness FDA PCSK9 inhibitors Sovaldi specialty drugs Source Type: blogs

HHS Issues Health Equity Final Rule
On May 13, the Office of Civil Rights (OCR) of the Department of Health and Human Services (HHS) issued a final rule implementing section 1557 of the Affordable Care Act. The rule finalizes a proposed version issued in September of 2015, analyzed in this blog at that time. The final rule was accompanied by a press release, summary, and series of fact sheets. Section 1557 of the ACA provides that an individual shall not, on the basis of race, color, national origin, sex, age, or disability, be excluded from participation in, denied the benefits of, or subjected to discrimination under any health program or activity of whi...
Source: Health Affairs Blog - May 14, 2016 Category: Health Management Authors: Timothy Jost Tags: Equity and Disparities Featured Following the ACA Insurance and Coverage Medicaid and CHIP Medicare age discrimination disability discrimination health equity national origin discrimination racial discrimination sex discrimination Source Type: blogs

Datapalooza: MACRA, EHR Reform and Working with Doctors – Not Against Them
BY ANDY SLAVITT There’s a bit of a checklist for speaking at Datapalooza. Thank Niall. Mention Todd Park. Remark at how big the event has gotten compared to last year. Recap how much progress has been made. Refer to yourself as a “data geek” . Also, have in my notes “Good not to follow Farzad or Aneesh” . Perhaps even make some news with an announcement or grant or contest. Several of my colleagues did this and I share their excitement. But I’m not going to make news. Instead, I’m going to relay a bit of my personal experience with health care innovation and technology as my goal is to leave this job with not...
Source: The Health Care Blog - May 12, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs

Looking Back From 2019: Why the Republicans Nationalized Healthcare
By JOE FLOWER It was the Mother of unintended consequences. By the time of the 2016 elections, health plans, hospitals and health systems had squeezed and consolidated and trimmed and cut costs under the gun of lower Medicare reimbursements and the new rules of Obamacare — but mostly they had adapted. Most of them had survived. On November 9, the country woke to find itself with a Republican President-elect, a Republican majority in the House, and a Republican majority of 55 in the Senate. The Grand Old Party was dedicated to repealing #EveryWord of the Affordable Care Act, the hated Obamacare which was, after all, “...
Source: The Health Care Blog - May 8, 2016 Category: Consumer Health News Authors: John Irvine Tags: THCB Uncategorized Donald Trump Futurists Joe Flower Nationalized Healthcare Source Type: blogs

Watch Out for Those Deductibles!
Lots of folks in the U.S. are finding themselves with health insurance coverage that requires them to pay lots of money, in their deductible, before insurance kicks in. Here is a nice piece in Cancer Today Magazine on the topic: … Continue reading → The post Watch Out for Those Deductibles! appeared first on PeterUbel.com.
Source: blog.bioethics.net - April 25, 2016 Category: Medical Ethics Authors: Peter Ubel Tags: Health Care Peter Ubel syndicated Uncategorized Source Type: blogs

John Stossel Discovers Health Care Dysfunction, Blames it on "Socialists" - Like Maurice Greenberg (AIG), John Thain (Merrill Lynch), Sanford Weill (Citigroup), and David H Koch?
In conclusion, I am glad that some of the problems in the dysfunctional US health care system are getting more public attention.  However, now we need to calmly and rationally consider what is causing them and what to do about them without the blinders of ideology or vested interests.  IMHO, true US health care reform would put the operation of US health care organizations more in the hands of people who have knowledge and experience in health care, and are willing to be accountable to support health care professionals' values.  Furthermore, oversight and stewardship of these organizations should represent t...
Source: Health Care Renewal - April 24, 2016 Category: Health Management Tags: boards of trustees bureaucracy finance generic managers managerialism New York - Presbyterian Hospital Source Type: blogs