Category: Matthew Holt

Matthew Holt is the founder and publisher of The Health Care Blog and still writes regularly for the site and hosts the #THCBGang and #HealthInTwoPoint00 video shows/podcasts. He was co-founder of the Health 2.0 Conference and now also does advisory work mostly for health tech startups at his consulting firm

Sam’s Club as a locus for (The) Prevention (Plan)?

Picture 10 There’s lots going on in the world of online tools for health improvement and prevention. Yesterday I saw a new demo of the latest version of Keas (can’t tell you much but think Zynga!). Just this Fall we had a whole host of wellness tools including Limeade which is working with REI and other employers. Another of our buds in the world of Health 2.0 is Fred Goldstein, who runs The Prevention Plan. Like the others, Fred’s mostly been going after employers as his main client base. But is there room for a consumer-direct online wellness plan?

Fred obviously thinks so and today is announcing that a major retailer, Sam’s Club (the warehouse store owned by the beast of Bentonville) will be selling The Prevention Plan at $99 to its members. Sam’s Club has had a couple of false starts in health care before (remember them trying to sell eClinicalWorks to doctors?) but it’s likely that they think that their members (many of whom are small businesses) might be interested in buying wellness as a consumer product. By the way, Whole Foods CEO John Mackey also said at a conference in October that they’re getting into that business too.

So we’ll see. But maybe this is the way that (at least some of) middle America gets into the world of wellness.

And if you want to get a freebie intro, tomorrow (Saturday) Sam’s Club will be offering free health screenings.

2011 beckons; Matthew’s personal end of year letter

This is my personal end of year letter. I used to send it to my personal email list but in the Facebook/Twitter era, it doesn't make much sense. I hope THCB readers will indulge me by taking a look and maybe even thinking about some of the charities and causes I support–feel free to add your own in the comments. I'll be back with a more health care featured forecast next week–Matthew

I'm determined to make this the end of 2010 letter, not "well into 2011" letter. But as I've also got tons to do of an unfortunate work nature on NYE even though it's a holiday, so I am going to be quick–or at least a little quicker than in years past.

I do these letters about charity and politics every year and moved them onto a blog a while ago (here's 2010 2009s, 2008s and you can search back), and now it's all I use my personal blog for, given that my Twitter account @boltyboy & Facebook page contain most of my very limited rantings. Of course I started these partly because I didn't have the wife & kids that most people send out their end of year missives about. Then in 2007 I added the wife part, and this year's big news is that next year Amanda and I are expecting a daughter. Little Colette should be here around the end of April, and I'm sure she'll have her own Facebook page and 529 account very soon if I know Amanda! The other family news this year is that my sister Dordy had a baby boy called Alex in February. Sister-in-law Lyn has a baby girl called Talia in 2009 but as it was Dec 26 you can count her in the most recent crop!

But enough about babies (for now!). I'm still running the Health 2.0 Conference with my partner Indu Subaiya and now (gulp) four other full time staff (Hillary, Lizzie, Bianca & new recruit Emily). It's still growing (4 conferences last year including one in Europe) and much more besides. Somehow none of this has translated into more time off for me and Indu! I still own The Health Care Blog but basically now that's a group blog I contribute to very occasionally! Other than getting a little plumper around the middle, Amanda is still being a big time star running HR at her company PRN.

This letter is, though, about stuff I care about on a slightly more altruistic level. This annual missive usually breaks down into my views and suggestions for donations about health care, poverty in developing world, poverty at home, torture, and drug prohibition. Feel free to comment, ignore, delete or whatever. But hopefully at least some of you may pay attention to some of it or even write a check.

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Send in the Clowns!

David is a long time friend and occassional contributor to THCB. And he politely asked if the THCB audience would be interested in helping contribute to the charity he works with–please read and give what you can–Matthew Holt

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The Hearts & Noses Hospital Clown Troupe provides professionally trained volunteer clowns to hospitalized children in Greater Boston and training for other clown troupes worldwide. I’m chairman of the board of directors and hope you will join me in supporting the work of the clowns by making a donation.

Hospitalized children often experience stress, fear, and anxiety, which can become a barrier to healing. Hearts & Noses clowns are specially trained to provide relief for ill children and respite for their families. Our clowns strive to uncover the hidden spirit of joy and the creative energy that lives in the heart and soul of children− a spirit that is often dampened by the sterile and sometimes frightening clinical environment. Our clowns’ central goal is to engage, empower and give choices to hospitalized children.

After a life-changing trip to Russia with famous clown and physician Patch Adams, troupe founder Jeannie Lindheim began offering a series of seminars on hospital clowning in the 1990s. Lindheim, an actor, began training clowns to visit ill and disabled children at Boston area hospitals. She formed the Clown Troupe and worked diligently to build a strong, professionally-trained group of volunteers. More than a decade later, our clowns are still all volunteers and we have helped build clown troupes throughout the world.

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Engage with Grace at Thanksgiving

Since 2008 THCB has featured Engage with Grace at Thanksgving. We invite everyone to post this to their blog or Facebook page, and to link here with their status update. You can download a “blog ready” html version of this piece in .txt format to drop into your blog software by right-clicking and choosing”save link as” here. This post was written by Alexandra Drane and the Engage With Grace team.

For three years running now bloggers have participated in what we’ve called a “blog rally” to promote Engage With Grace – a movement aimed at making sure all of us understand, communicate, and have honored our end-of-life wishes.

The rally is timed to coincide with a weekend when most of us are with the very people with whom we should be having these unbelievably important conversations – our closest friends and family.

At the heart of Engage with Grace are five questions designed to get the conversation about end-of-life started. We’ve included them at the end of this post. They’re not easy questions, but they are important.

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Suzanne Delbanco on the new Catalyst for Payment Reform

Catalyst for Payment Reform is a new organization set up by several large employers. The organization’s goal is to pay for health care differently, and make sure that those employers run ahead of any Medicare payment reform coming down the track. Suzanne Delbanco, formerly of Leapfrrog, is now the first Executive Director and Founder of the new organization. Last week I interviewed her about what the organization is going to do, what employers care about, and (despite decades of employers being simple price takers in health care) why this time it’s going to be different.

Keep watching to the very end to see the great view from Suzanne’s office!

Eric Dishman talks about Intel in health

Eric Dishman has been working with a big team at Intel on the use of technology to help seniors and patients age in place. It’s been a long-ish road for Eric but in the last few years his extensive work on the anthropology of aging is starting to bear fruit in terms of products from the chip giant, including a new-ish joint-venture with GE. I talked with Eric and got some brief overviews of some of the products at last week’s TEDMED conference.

Vic Fuchs Speaks!

I was absolutely delighted that after several polite “maybe later” responses I was able to  recently interview Victor Fuchs, the Henry J. Kaiser Professor Emeritus at Stanford University. Vic is best known as the “Father of Health Economics” and perhaps less well known (but more importantly to me!) the professor who taught the first health economics class that I ever took.

Matthew Holt: Victor, thanks so much for agreeing to come on THCB. I must admit Vic when I joined your class I had no idea about your background and reputation in health economics. So, I was just delighted to figure out that I blundered in right at the top. It’s a real pleasure to have you on the line

Victor Fuchs: I think you’re doing a great job and therefore I’m glad to spend some time with you.

Matthew Holt: Fantastic! You’ve, obviously, been observing and commenting on– and more recently sort of promoting ideas around –health reform for quite a while now, so let’s jump into a couple of things that you’ve published very recently, in fact just these past few weeks.

The first is a paper in The New England Journal of Medicine about a conceptual future for new biomedical innovation and I’d be grateful if you could just explain just a little bit what your general concepts are here. You’ve been working on this for quite a while. In fact, back when I was in your class, you were publishing some stuff with Alan Garber about technology assessment and this is sort of a continuation to that in some ways. So, I’d love to hear your thoughts.

Victor Fuchs: Well, I think there were two key elements here, one of them better understood by a larger audience and one of them I think rather new. Let me do the new one first. The new one is that we are going through what I call the second demographic transition.

The first transition was when every country had high mortality and high fertility and then the mortality especially of young people started to drop, but fertility did not drop right away, so you had a divergence there and in some cases it lasted for a couple of decades and during that time the population soared because there was this discrepancy between mortality and fertility.

You see the high fertility made sense when mortality was high because you wanted to have at least a couple of children survive to adulthood, but when mortality dropped it didn’t sink into people’s consciousness right away, so it took quite a bit of period which the historians and the demographers referred to as the demographic transition, okay. I don’t know if you’re familiar with it or not, but —

Matthew Holt: Yeah, I get the concept and there’s been some stuff written about that in terms of the impact on social security and healthcare.

Victor Fuchs: And some of the third world countries are going through it now, but now the second demographic transition is the one that I talk about in the NEJM piece a little bit. It has the following elements.

First is that a very large and increasingly large percentage of the population cohort lives until age 65, whereas at the beginning of the 20th century only a small percentage lived until 65. Now we’re going to 80% and we’ll eventually approach close to a 100% living till 65.

The second element is that life expectancy at 65 is increasing and it’s increasing at a quite brisk pace in recent decades. You put those two things together and you find out a very large and growing percentage of all the additional years that are lived if you have increasing life expectancy will be lived after 65.

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The trifecta: Reform idiocy, Hospital CEOs and the Obesity Problem

It’s rare that you get such a delicious health care story combining human frailty, blindness and multiple stereotypes, but Julie Rovner of NPR found it. In fact I literally thought she’d been set up but she confirmed to me that it was true and put me in touch with the CMS spokesman who confirmed it. So remember, this really happened.—Matthew

An interim hospital CEO in Ohio Valley Medical Center, in West Virginia “found out” “advanced intelligence” from “word of mouth” sources in Washington DC that the “High Commissioners of the Healthcare Reform Bill” were going deny Medicare payments  to any hospital of which than 5% of employees were 25% overweight.

This rumor prompted the said CEO to panic. Now before I tell you what he did, let me tell you a little of his story. To quote the CEO as he tells it:

I am five feet, 10 inches tall. The guidelines (he’s referring to standard BMI guidelines) suggest that I should weigh between 151 and 163 for my medium frame. If you add 25 percent to the upper limit, I would need to be no heavier than 204 pounds. I currently weigh 272 pounds, down from 335. I would have three years to lose 68 pounds

That is indeed some challenge. Not to mention that the hospital is in West Virginia (albeit the northern sliver between Ohio & Pennsylvania) where the obesity rate is among the nations highest—there’s a reason that Jamie Oliver took his childhood obesity crusade there. In fact Ohio County, WV’s obesity rate is 32% according to the rather fun County Sin Rankings site. And as obesity tends to mean a BMI of roughly 25% more than the outer band of the guidelines, it’s a fair bet that somewhere close to 32% of the workforce is obese. So getting that number down to 5% would be a major struggle.

The interim CEO also wanted to promote not only his own weight loss story but the laudable activities of his hospital’s dietitians and its weight-loss programs. Here’s his counsel to hospital employees.

I strongly urge you to take advantage of the programs OVMC and EORH are currently offering employees who are battling with excess weight. Mary Velez is doing a fabulous job with Weight Watchers programs, and in addition, I have also been offering a program known as “Diet and Fitness for Love.”

And who could be against that advice?

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