Month: April 2008

Is Non-Profit Business An Oxymoron?

Apr 9, 2008• 13

By Paul Levy

An April 4 article in the Wall Street Journal, entitled "Nonprofit Hospitals, Once For the Poor, Strike It Rich" has prompted a slew of comments
on wsj.com. I think they are worth reading and do not intend to
summarize them here. Some accused the Journal and the quoted
politicians of grandstanding. Others said the story was right on target.

The
issue of the type and degree of benefits provided by non-profit
hospitals is a legitimate and important one. Our institutions are given
certain privileges by the government, and the government has a right to
supervise our performance in carrying out our public service functions.
Recently, the Massachusetts Attorney General announced a review
of certain of these activities, those relating to community benefits.
This is a healthy step, in that as times change, the standards of
behavior and reporting should likely change, too.

The WSJ’s
story contained examples of non-profit behavior that many will find
excessive. I think some examples chosen are unusual and not reflective
of most hospitals. But I imagine that a detailed review of
Massachusetts hospitals would find some items of a more modest level
that at least some people would find troubling.

Fourth Annual Games for Health Conference 2008

Apr 9, 2008• 2

May 8-9, 2008 :: Baltimore Convention Center

The Games for Health Conference offers a rich platform for learning, promotion, networking and business development for organizations interested in the intersection between games and health. Topics to be covered include exergaming, medical simulation, interactive messaging, health behavior change, medical informatics, physical therapy and game development.

More than 300 individuals from 100 organizations – academic institutions, government agencies and foundations – are expected to attend.

Also, a pre-conference event on May 7 will offer two workshops: Games Accessibility and Virtual Worlds & Health. All conference participants will have the chance to interact and play with these games that are improving society.

Web site for registration: www.gamesforhealth.org

Registration is $395 for Thursday, May 8 & Friday, May 9 and the pre-conference workshops on Wednesday, May 7 are $99-$129.

Weightism: The newest discrimination in America?

Apr 9, 2008• 10

By Sarah Arnquist

Few would dispute that curbing rising rates of obesity is one of the greatest public health challenges of the 21st Century, yet as a nation, we grapple with how to talk about being fat. The Centers for Disease Control and Prevention even dances around the subject by labeling overweight kids "at risk for overweight" and obese kids "overweight."

One might argue that labeling any kids or adults is wrong, but you can’t solve the problem unless you name it and quantify it. Well, we’ve quantified it. Roughly one-third of adults are obese and two-thirds are overweight.

So now, we have to do something about this grossly expensive epidemic. Some employers facing ballooning health costs have taken punitive approaches to push their workers to lose weight. But arms flew up aghast when Chicago’s police chief dared to say that all officers must pass a physical fitness test. The police department already has a voluntary program that provides a $250 bonus to the cops that pass. Voluntary, clearly didn’t work

Some obesity experts say these punitive approaches to reduce obesity won’t work, and in fact, they are discriminating. Some have coined this "weightism."

Researchers at Yale University published a paper last month in the International Journal of Obesity saying discrimination based on weight is as much of a problem in American society as discrimination based on race or gender, especially for women and individuals with a Body Mass Index of 35 or higher (a 200 pound 5’4" person has a BMI of 35).

Many contributing factors to obesity are beyond individual control and simply suggesting that people exercise more and eat less probably won’t work, especially if you live in a neighborhood without safe streets and parks and no healthy food. But some behaviors are within our control, and progress cannot be made if political correctness overtakes frank discussions.

I asked one of the Yale study’s lead authors, Rebecca Puhl, about the study, discrimination and possible solutions to the obesity epidemic. Here are her answers:

An Invitation to DNANYC

Apr 8, 2008

The Board of Directors and Advisors of Navigencs invite you to join us for a series of seminars, panel discussions and other events dedicated to helping you thrive in this new world of truly individualized health and wellness.

DNANYC Presented by Navigenics
April 8th – 17th
76 Greene Street
New York, NY 10012
9am – 9pm
Bringing the power of genetics from the laboratory into your life.

RS**@********cs.com

Calendar of Events

Tuesday, April 8 :: The World of Personalized Genomics
David Agus, MD; Brook Byers; John Doerr; Gred Simon, MD, MPH; Dietrich Stephan, PhD
6:00pm – 7:00pm Cocktail Reception
7:00pm – 8:00pm Panel and Open Discussion

Wednesday, April 9 :: Industry Leadership Discussion on Personalized Medicine and Genomics
David Agus, MD; Raju Kucherlapati, PhD; Dietrich Stephan, PhD
Private Event

Wednesday, April 9 :: The Future of Personalized Medicine: How Genomic Advances are Driving a New Industry
David Agus, MD; Brook Byers; Raju Kucherlapati, PhD; Mark Kvamme; Andrew Schiff, MD; Dietrich Stephan, PhD
6:00pm – 7:00pm Cocktail Reception
7:00pm – 8:00pm Panel and Open Discussion

Thursday, April 10 :: Personalized Genomic Health: New Paradigms, New Industry
David Agus, MD; John Doerr; Steven Krein; Dean Ornish, MD
6:00pm – 7:00pm Cocktail Reception
7:00pm – 8:00pm Panel and Open Discussion

Friday, April 11 :: The New Age of Prevention: How Personalized Health and Wellness Can Improve Your Life
David Agus, MD; Stephanie Middleberg, RD; Dean Ornish, MD
10:00am – 12:00pm

Friday, April 11 :: Wine Tasting Reception
Heather Bauer, RD, CON
Private Event

Monday, April 14 :: The Practice of Medicine Meets the Promise of Genomics
Geoffery Ginsburg, MD, PhD; Elissa Levin, MS, CGC; Michael Nierenberg, MD; George H. Sack Jr., MD, PhD; Benjamin Safirstein, MD
6:00pm – 7:00pm Cocktail Reception
7:00pm – 8:00pm Panel and Open Discussion

Tuesday, April 15 :: Genomic Testing and Your Practice
Robin Bennett, MS, CGC; Elissa Levin, MS, CGC; Kelly Ormond, MS, CGC; Dietrich Stephan, PhD
Private Event

Tuesday, April 15 :: Genetics Symposium
Bob Green, MD; Pardis Sabeti, PhD; Dietrich Stephan, PhD; Jeffrey Trent, PhD
7:00pm – 8:00pm Cocktail Reception
8:00pm – 9:00pm Panel and Open Discussion

Wednesday, April 16 :: Personalized Medicine Ethics and Policy Luncheon
Private Event

Wednesday, April 16 :: Bringing Personalized Medicine to the Consumer in the Information Age
Minalkumar Patel, MD, MPH; Ryan Phelan; Jay Silverstein; Indu Subaiya, MD
6:30pm – 7:30pm Cocktail Reception
7:30pm – 9:00pm Panel and Open Discussion

Thursday, April 17 :: Exploring the Meaning of a “Genetically Healthy Lifestyle”
Fred DeVito; Howard Fillit, MD; James Heywood; Jennifer Kaye; Michael Nierenberg, MD
6:00pm – 7:00pm Cocktail Reception
7:00pm – 8:00pm Panel and Open Discussion

Calendar is subject to change.

Lack of health insurance forces man to become rich, famous pimp

Apr 8, 2008• 13

By Michael Millenson

OK, that wasn’t the title on an article in the metro section of the April 7 New York Times. But there, buried
in the fine print of a story about Emperor’s Club VIP — the high-priced international prostitution service that serviced ex-NY Governor Elliot Spitzer — was this explanation of the financial distress that first motivated its founder.

"Its boss was Mark Brener, 62. He dealt with a stack of medical bills
for his late wife by starting the escort service, an idea that dawned
on him several years ago as he surveyed sex-related advertisements in
the weekly newspaper The Village Voice, an associate of Mr. Brener’s
said. The venture reinvigorated Mr. Brener. He dyed his hair black, donned a leather jacket and recruited three women to help him."

Brener, the article continued, "a 5-foot-5 tax man with thinning gray hair and crooked teeth, had never fit anyone’s image of a pimp." But after his wife contracted cancer, and eventually died, Brener found himself "broke and facing court judgments for unpaid medical bills." That’s when the ads for the escort services caught his eye.

Who says that private sector entrepreneurs can’t help the uninsured?

The Security of Patient Data

Apr 8, 2008• 3

By Brian Klepper

EXCLUSIVE TO THCB: HIMSS Analytics, the research arm of the powerful, thoughtful and highly regarded Health Information Management Systems Society, has published a sobering study, Security of Patient Data – see here – that highlights the gap between hospital patient data security practices and the reality of impacts if a breach occurs. The report, commissioned by Kroll Fraud Solutions, should be a splash of cold water to health care executives in all settings with responsibility for patient data. A link to the Executive Summary has been placed at the bottom of this post.

In the wake of several recent incidents involving breaches of celebrity records, what’s fascinating about the study is that the executives interviewed claimed a very high familiarity with HIPAA rules; they averaged 6.53 (on a 7 point scale) and 75 percent of those interviewed gave themselves a 7. The report attributes the high sense of HIPAA knowledge with the current rounds of HIPAA compliance audits and the penalties for non-compliance that have resulted in some cases.

You’ve Gotta Spend Money to Save Money …

Apr 7, 2008• 5

By Eric Novack

Or so the thought is by many in the health care world.

Thus, the motivation for chronic care management programs was born.

CMS, the august government body charged with overseeing Medicare (and Medicaid), instituted a 3 year, $360 million, test program to see if these programs would have the effect of saving the system money.

The conclusion after the 3 years:

Using regular phone contact to check on the health of chronically ill U.S. Medicare patients appears to cost more than it saves the system.

More from the article: "[t]he problem is that the fees paid to the companies make the program uneconomic." (Note that a longer version is available at the NY Times website here.)

My favorite part of the UPI brief: "Sens. John Kerry, D-Mass., and Lamar Alexander, R-Tenn., are pressing for its continuation. Companies involved in the program are based in both of their states."

Knowledge Like Clear, Clean Water: Muir Gray on Health Care’s Progress

Apr 7, 2008• 4

By Brian Klepper

Over the last year or so, I’ve written a lot about how health care
information will become increasingly available to consumers and health care
business, and how this access will drive new decision-support
capabilities that will profoundly change how health care works,
eliminating many of the problems that have placed health care in
crisis. So imagine my delight when a colleague forwarded this quote.

Sir Muir Gray is Chief Knowledge Office of Britain’s National Health Service. His wonderfully clear explanation of how health care knowledge will become guidance – that is, decision-support – makes a compelling case for the transformative power of Health 2.0.Check it out.

The future is something we make, not something we discover. And the
future is easy to make because as William Gibson has said, the future
is here, it’s just not evenly distributed.

The second revolution took place in the latter part of the 20th
Century. It was driven by science, making plastics, airplanes,
televisions and innovation in chemical and mechanical technology in
health care.

We’re in the middle of the third Healthcare revolution. The first was
based on common sense, an empirical revolution; the health of nations
was transformed by making observations and deductions from data and
improving conditions based on those deductions. So now, for example, we
take clean clear water for granted.

The (Non)-Profit Motive

Apr 4, 2008• 17

By Eric Novack

From today’s Wall Street Journal: "Nonprofit Hospitals, Once For the Poor, Strike it Rich."

It has long, and often, been argued here on THCB and so many other places, that if we simply ‘take the profit motive out’ of health care, the system will get better, people will be healthier, costs will go down, and cats and dogs will no longer fight.

Others have called for a “Hill-Burton Act” for health care technology, in reference to the federal law which gave favorable treatment to hospitals.

Here is my favorite quote, from the end of the article:

"Nonprofit is a misnomer — it’s nontaxable," says Sacred Heart Hospital’s Mr. Novak. (No relation to me, BTW) "When you’re making hundreds of millions of dollars a year, how can you call yourself a not-for-profit?"

Patient Ping-Pong: Cholesterol

Apr 4, 2008• 2

By George Van Antwerp

As if it’s not already difficult for patients to navigate their benefits, DTC advertising, and all the healthcare information on the web, it seems we are structurally trying to make it more difficult. With the recent news around Vytorin and Zetia, the drugs used to treat high cholesterol have gone through some dramatic changes over the past few years. (Here is the formal study.)

In an editorial by the New England Journal of Medicine:

“Until such data are available, it seems prudent to encourage patients whose LDL cholesterol levels remain elevated despite treatment with an optimal dose of a statin to redouble their efforts at dietary control and regular exercise. Niacin, fibrates, and resins should be considered when diet, exercise, and a statin have failed to achieve the target, with ezetimibe [Vytorin] reserved for patients who cannot tolerate these agents.”

For several years, Lipitor was clearly the market leader with Zocor as a close second. Even with one drug (Mevacor) available generically, most plans (other than Kaiser) had single digit utilization. Kaiser was able to drive significant use of generic Mevacor as a first-line agent. When Zocor was going to lose it’s patent protection in 2006, most plans began moving Lipitor to the 3rd tier and introducing programs to move Lipitor patients to Zocor (generic name simvastatin). These included step therapy programs along with simple copay incentives by having a large copay differential between the 1st or 2nd tier and the 3rd tier.