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Month: January 2008

QUALITY: Medicare Health Support–Done and more or less dusted

Recently the targets on Medicare Health Support were changed to make them more financially favorable to the DM companies running the projects. Everyone inside the DM industry has known that MHS has not been doing too well for some time now. But now according to Vince Kuratis’ blog, the preparations to pull the plug are well underway. Here’s Vince’s interpretation of CMS’ decidely low-key announcement of where MHS stands.

MHS is not meeting targets for financial savings.  While it is theoretically possible that the MHS program could climb out of the hole financially during the remaining months of the program, we are doubtful that this will happen — so much so that we are scheduling the patient’s (MHS’) funeral even though technically we are not allowed to pronounce the patient dead yet. In the event that hell freezes over and the program revives, we will then schedule Phase II, but don’t hold your breath.

In a new twist on an old saying by Mark Twain: The rumors of MHS’ death have NOT been greatly exaggerated.

POLICY: Plumpy’nut – Brian

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The NY Times ran an important op-ed yesterday by Susan Shepherd, a pediatrician and medical advisor to Doctors Without Borders.
The core of her message is that as the farm bill progresses through
Congress, we should focus not only on the quantity of food that is
produced and that we export for relief to underdeveloped nations, but
on its quality as well.

Dr. Shepherd describes the difficulties
in treating children who are victims of severe malnutrition,
particularly in areas like Africa and South Asia where milk and clean
water can be scarce.

Continue reading…

HEALTH 2.0/TECH: Collective intelligence in AthenaHealth

Scott Shreeve has spent much of his career promoting open source as a way to
harvest collective intelligence. But (irritated by a description from a knocker)
he’s done a great job at defining one shining example of a network that
becomes more intelligent as more data (and nodes) get plugged into it. And that
network is a private SaaS company, AthenaHealth.

This is a great example of two of O’Reillys constituents of Web 2.0, especially
the second one:

  1. Services, not packaged software, with cost-effective scalability that
    get richer as more people use them
  2. Control over unique, hard-to-recreate data sources that get richer as
    more people use them

Now of course that control over data is in a private network. And
it’s not an open source project. but the point is AthenaHealth is using that
business positioning to add features and gets more powerful as the company adds more
clients.

THCB Reader

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The Omnimedix Institute’s JD Kleinke wrote in to comment on the thread triggered by last week’s news on the dossia project, a story that came out when Wal-Mart CEO Lee Scott revealed new details of the retail giant’s plans to work with major employers to help them cut healthcare costs in his annual January address to the company’s managers and other employees in Kansas City. Scott’s plan provoked the usual skeptical response from critics in the blogosphere and the media, but JD had this to say:    

"Omnimedix is currently in the process of resolving a legal dispute with Wal-Mart and the other Dossia corporations regarding the development and operation of the Dossia PHR system. And while this dispute has been an annoyance for us and no doubt for Wal-Mart, I’d like to make it clear that we support Wal-Mart’s overall health care ambitions, which involve not only PHRs for their own employees, but an expansion of health benefits for those employees, and the creation of a modern, affordable, accessible health care delivery system.  Think whatever you want about this oft-vilified mega-retailer; Wal-Mart has the singular ability to bring a low-cost, low-friction, high-value, high-access alternative to health care delivery in the U.S., one we have desperately needed for decades." 

Continue reading…

HEALTH PLANS: WellCare…killing health care some more?

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After last Fall’s FBI raid the top management at Wellcare resigned on Friday. The board is hoping that the new CEO, former United executive Charles Berg, will right the ship. After all who could we trust more than the WellCare board to guarantee that the taxpayer and patients will have their affairs conducted in proper and decent order. Because there’s no chance that anyone on the WellCare board has ever taken advantage of their position in order to simply cash in, oh wait….

Well then surely there’s no chance that the three senior execs who resigned are the three who also sold millions in stock a few months before the FBI raids, is there? Oh it was them? That’s a surprise–and what about that other board member who also cashed in big time?

I guess I’ll check the comments section on this post to get Reggie’s  explanation…

PODCAST/HEALTH 2.0: Interview with Tony Miller, Carol

One of the most interesting new Health 2.0 companies is Carol–a Minnesota start-up that is aiming at the heart of the health care system. It’s trying to create "care packages" that will in the end (if it works) change how people buy care, and how providers organize to deliver it.

Ambitious and very interesting stuff. In one of the first interviews with Carol CEO Tony Miller since their launch last week, I asked him what the company was hoping to do and why he felt that they had a shot at changing the world! Here’s the interview part 1 & part 2

POLICY/INTERNATIONAL: The new health care system in the Netherlands

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It would be great if we could get the US to a system of health insurers competing over the right things. With a universal individual mandate that worked, risk adjustment between insurers, and social solidarity mixed with market incentives — the best of both worlds. The Dutch (pound for pound) have better football, beer and drug laws than anyone else.  And now a very sensible health care system too.

Here’s a video on the new health care system in the Netherlands.

POLICY/POLITICS: Health insurance without health care by Claudia Chaufan

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Claudia Chaufan teaches sociology of health and medicine and health policy at UC Santa Cruz,. and is Vice President of California Physicians Alliance, the California Chapter of Physicians for a National Health Program, which argues for a single payer system. What does she think of ArnieCare–which looks like it suffered a fatal blow in a California Senate committee yesterday? You can guess but read on….

Doesn’t everybody agree that the American health care system is broken, that too many are often an illness away from bankruptcy or go without medical care altogether – and up to 18, 000 die each year for that reason? If so, have some of us lost our senses when opposing the “Health Care Security and Cost Reduction Act”, or ABX1 1, according to the New York Times, a “bipartisan blueprint to bring near-universal coverage to the most populous state”? Are we driven by ideology, callously ignoring that this “ambitious” legislation has the potential to expand health coverage to 3.6 million Californians without raising any taxes or creating new ones?

Some would argue that we are. But be warned: when something is too good to be true, it is probably not true. For instance, some of us are concerned with the fantasy numbers of Governor Swcharzenegger and Assembly Speaker Fabian Nunez, proponents of the bill, who, if they at all bothered estimate the costs of the bill, conveniently stopped their estimates by the fourth year. As legislative analyst Elizabeth G. Hill pointed out, assuming that the $250 premium level proposed by the bill is realistic (Hill thinks it is not), revenues will cover the costs of the first year of operation of the program, but by the fifth year annual costs will exceed revenues by $300 million. So in the best case scenario, five years from now we will be facing the same, or worse, problems we do today.

Continue reading…

POLICY: Shannon Brownlee is da man!

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It’s been really great getting to know the new voice of the Dartmouth school, Shannon Brownlee. She’s interviewed in her local paper about the concept that the American health care system delivers More money, but less health. Hopefully we’ll have her writing more on THCB soon!

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