Author Archives

Matthew Holt

From the AHIP fields….

Jun 20, 2008• 3

Fun and games were had by all at the America’s Health Insurance Plans
(AHIP) conference yesterday. (BTW Now I have a real journalist working
with me on THCB and she says I have to spell out those acronyms!!)

Outside a couple of thousand single payer advocates noisily demanded a ban on greedy health plans. Now I know that the AMA has a running battle with the insurers (Read Michael Millenson’s hilarious piece about that on THCB yesterday). It’s also the case that certain Democratic Senators have it in for them, although as Bob Laszweski notes, that too is "not quite yet" an issue. But it wasn’t them outside!

Still it was rather fun going to an event that had
a real rather than a software demo going on!

Now the single payer crowd’s time has not yet come, and there is a chance that the private health insurance industry won’t screw itself into oblivion. (Although my guess is that they’ll be ascendant in 10-15 years)

MA plans won this round but future looks bleak

Jun 20, 2008• 1

By Robert Laszweski

Congressional Democrats tried to take a big bite out of private Medicare last week in an attempt to pay for an 18-month fix to the upcoming July 1 10.6 percent reduction in Medicare physician payments.

The effort, led by Senate Finance Chair Max Baucus (D-MT) got only 54 of the 60 votes he needed to end debate and move the issue to a floor vote. While getting that floor vote would almost have certainly meant passage of the bill in the full Congress, President Bush would have vetoed any attempt to cut the payments to private Medicare plans and the Dems would not have had the votes in either chamber to override.

Now, Baucus and Senate Finance Committee ranking member Chuck Grassley (R-IA) will have to find a more modest way of fixing the doc problem––likely for just six months. The docs are not going to suffer a Medicare payment cut this summer.

All of this was expected and is what I have been saying for months would happen.

Mckinsey smells opportunity in explaining health care

Jun 19, 2008• 5

By Scott Shreeve

McKinsey Quarterly released an interesting study this week under the moniker, “What Consumers Want in Health Care." The central theme of the publication was the large and growing opportunity for a new type of health care “infomediaries” (who traffic in the flow, enhancement, and interconnectivity of information) to have a large and sustained impact in the transformation of our current system to a next-generation system required to meet the health needs of the future.

A few relevant quotes:

Retail health consumers constitute a market worth hundreds of billions of dollars annually.
Currently 116 million consumers have a choice of health insurance (expected to be 151M by 2011).
Most consumers still do not “shop” for insurance — 74 percent will like purchase from current health insurer.
People who do “shop” do so during moments of considerable change — and a full 41 percent either considered or changed insurance.
Most people need additional guidance, education, and advice to make decisions.
Innovative, cross-industry products that assist with the complex decision making will be highly valued by an influx of consumers eager for options but unsure where to turn.

Around the Web in 60 Seconds (Or Less)

Jun 19, 2008

By THCB Staff

FORBES: Fed Chief Ben Bernanke fans the flames of
health reform. "It’s not just balancing the federal budget; it’s really
a much broader question of the stability and strength of our economy
over a longer period of time," Benanke said.CHICAGO TRIBUNE: AMA turns thumbs down to secret medical shoppers. "It is grossly unethical," said Dr. Howard Chodash, a professor at Southern Illinois University Medical School.

WASH POST: "Halting runaway medical inflation represents a potential victory for all generations," wrote Sandra Day O’Connor and James R. Jones.

BOSTON GLOBE: "No single reform would do as much to improve the wealth of our nation and the lives of Americans as a comprehensive overhaul of our healthcare system. But the best chance of swift and major reform may have died with the end of Hillary Clinton’s run for the White House," consultant Ellen Lutch Bender wrote in an Op-ed.

US NEWS: 6 Ways to Avoid Dying of a Surprise Heart Attack — inspired by the unfortunate and untimely death of Tim Russert.

NY TIMES: Massachusetts health reform working but challenges remain.

CNN: Baby Boomers seek "brain fitness" gurus.

AMA NEWS: Patients don’t use online ratings to pick docs but do rely on word of mouth online.

Does Bernanke understand health care?

Jun 18, 2008• 10

By Donald Johnson

Federal Reserve Board Chairman Ben Bernanke’s freshman-level term paper on health care economics shows how little he knows about it.

Here’s the evidence:

He talks about the health care system in America as if there is one. There are thousands of health care systems in this country. They include the military and Veterans Administration health care systems, the investor-owned and not-for-profit health care systems and systems owned and run by states, counties and municipalities. Typical systems include hospitals, specialty hospitals, long-term care facilities and services and primary care, diagnostic, emergency care and surgical clinics. Every state and municipality that has a hospital, doctor’s office, nursing home or other health care provider is a health care and health insurance market. In addition, we have dozens of medical devices, medical supplies and pharmaceutical markets. While they are interdependent, they are not in a “system.”

MARKETPLACE: U.S. Office of Disease Prevention and Health Promotion seeks eHealth fellow

Jun 18, 2008• 1

Odphp The Health Communication and ehealth Team in the U.S. Department of Health and Human Services’ Office of Disease Prevention
and Health Promotion (ODPHP) is seeking an ehealth Fellow.

This fellowship is offered in collaboration with the Association for
Prevention Teaching and Research (APTR) as part of the APTR-ODPHP
Health Policy Fellowship Program.

The fellow’s responsibilities would include:

Helping lead an ehealth research and development team transforming the National Health Information Center, currently a Web1.0 site, into a social networking site (Web 2.0) that supports health professionals and the public collaborate and learn online.
Helping develop and implement a strategic communication plan for Healthy People 2020, engaging stakeholders across the nation in participating in the development of a framework and objectives for measuring progress toward improved health and disparities reduction by 2020.
Opportunities for co-authoring peer-reviewed articles on ehealth research.

The deadline for applying is July 25, 2008, and fellows would start in mid-summer or early fall 2008. To apply go here and to learn more visit here.

The Talking Cure: moving patients to the center of care

Jun 17, 2008• 5

By Jane Sarasohn-Kahn

The relationship between patients and doctors is fundamentally changing. Transparency in medical records, patients’ accessibility to health information online, and online social media driving patient-to-patient conversations are some forces at the base of the future of health care.

This, according to a thought-provoking report that addresses the evolving nature of patients vis-à-vis physicians in the National Health Service (NHS) in the U.K. These factors are also driving change in health and health care in the U.S.

The Talking Cure: Why Conversation is the Future of Health Care is an essay published in mid-May 2008 by two smart guys at Demos. As the National Health Service in the U.K. approaches its 60th birthday, the Demos research organization launched The Healthy Conversations project (now known as The Talking Cure) to engage stakeholders in and outside of the NHS in a dialogue of how to move patients to the center of health in the U.K.

Grumpy doctors, but is it really worse now?

Jun 17, 2008• 13

By Matthew Holt

An essay in the NY times explains how terrible life is for doctors. Reimbursement is down, more time is spent arguing with managed care companies, there are more restrictions on the what they can prescribe, etc, etc.

Now I understand that primary care is in crisis, but overall physicians’ salaries in the last couple of years have gone up, and the first doc in the article is a cardiologist. Cardiologists, as this salary survey suggests, tend to make more than double what a primary care doc gets. And of course, fewer docs are primary care only now, and more are specialists (who make more money!). But whether or not physicians are getting paid less than they were, their perception surely is that that’s the case.

I am surprised that the burden of operating a practice and the demands of “managed care” are felt to have increased. Most observers would suggest that insurers have, since the days of Len Abramson & US Healthcare in the 1990s, backed off the extremes of medical micro-management. In fact, the most profitable health plan of recent years (Aetna) has bent over backwards to appear to be physician friendly. Whether or not it’s just window dressing is less certain.

If a doc living in the 1970s was forced into a 1990s world, I would understand the depression. And the surveys I was part of in the 90s indeed showed dismay at what was happening for them. But we’re now more than 10 years on from those times, and (as the politicians say) is it really worse now than it was four or five years ago?

Answers on a post-card (or at least in the comments), please!

Interest groups clash over doctor-owned specialty hospitals

Jun 17, 2008• 2

By Donald Johnson

Doctor-owned specialty hospitals deliver better quality of care, are more convenient for physicians and patients and take business away from not-for-profit and investor-owned general acute care hospitals, which have been trying to put them out of business for years.

The NY Times reports on the latest effort by liberal Democrats to take down the for-profit specialty hospitals. The Democrats behind this drive don’t believe in for-profit health care providers even though not-for-profit providers are as profit driven as the investor-owned providers. Most Republicans oppose the effort to restrict the growth of doctor-owned hospitals because they understand that many local hospital markets are dominated by a few institutions and that patients and insurance buyers need more competition among providers to keep costs under control.

This is a battle between the powerful American Medial Association, which supports doctor-owned hospitals, and the American Hospital Association, which represents mostly not-for-profit hospitals and wants to end competition from the doctor-owned specialty hospitals.

Trusera, out of beta & different enough to be interesting

Jun 17, 2008• 1

By Matthew Holt Trusera_copy

Keith Schorsch is a busy boy. Not only did he write a much commented piece about
Google Health and PHRs on this very station last week, but he also popped by last week to tell me about the new look for Trusera. Several of you saw Trusera launch at the Health 2.0 Conference last March. As of today they’ve removed the Beta tag, and have introduced a new look and new features.

The way Trusera is going about things is by collecting stories and journal entries, and then essentially parsing the keywords and text in those stories to connect people with others with similar situations. The distinction between this and most other social networking sites is that Trusera doesn’t have “forums
” or “channels” per se, but uses its search technology (somewhat inspired by Amazon where several of the founding team came from) to match lurkers and contributers with content and people relevant to them. There’s also some neat tools to help people build their stories with helpful suggestions appearing to the side as they’re being written — think of the Microsoft paper clip but done well! (At this stage it doesn’t take detailed self-reported patient clinical information a la PatientsLikeMe or PHRs).

So far there’s sizable activity on Trusera in autism, breast cancer and infertility, among other conditions. And of course Keith’s aim is to develop hundreds of thousands of members and millions of stories.

Trusera’s approach is different enough to be interesting as another option for community online. The technology is arguably better than others in the space, but as we know from other markets “better” technology doesn’t always mean most successful — as I tell many of my Mac using colleagues. But as was also pointed out to me this weekend, the vast majority of patients are not yet online in these communities. So it’ll be interesting as these numbers grow to see who will remain standing. Trusera clearly has a shot.