Category: Health Tech

Online behavioral health on American Well’s platform, and a hint at Cisco/UHG

Aug 3, 2009• 6

By MATTHEW HOLT

As usual I am way behind on tech and Health 2.0 news but here’s one that was “thrown out with the trash” late last week because the service went live on Saturday. American Well has has added TriWest Healthcare Alliance as a client on its online service. Most significantly this is for behavioral health care (psychological counseling et al) for military families covered under Tri-Care—the program for the families of service personnel.

Given what the military has been through in the last decade you can imagine how badly this is needed. And it’s an extension of the current primary and urgent care services already being delivered online.

In fact beyond American Well there are a number of even smaller companies starting to aim at the behavioral health online market—which has a strong tradition of success in telemedicine and is ripe for expansion into the online arena.

However, where I’m really late is that a couple of weeks back Cisco—which does higher-end telemedicine—announced a program with United Healthgroup to provide its HealthPresence technology in mobile trucks for underserved populations. United’s Optum unit also recently announced that it too would be using American Well. So we’re seeing an extension of the use of both higher tech and web-based online care, and that for the first time health insurers are taking this very seriously.

Continue to watch this space as it looks like finally the technology is ready and the payers are finally coming on board. And (ahem) you’ll hear much more about this at the Health 2.0 Conference in San Francisco on October 6–7.

Sunday mumbles

Aug 2, 2009• 19

By Matthew Holt

If you can’t quite remember why we’re doing this health reform stuff, here’s a very amusing defense of the current health care system by Jonathan Adler at Newsweek (hat-tip to Jon Cohn).

Meanwhile by any measure July was the most read month on THCB with sitemeter telling us that there were some 129,000 visits. Thanks to everyone for coming, but to be fair while we could expect health reform month to ramp up the visits a little, this shows the power of Google. If you search “Obama health care”, this excellent article by Bob Laszewski comes up near the top of the front page… Hopefully some of the new readers will see that it’s 18 months old and stick around to catch the new developments. But kudos to Bob L for doing such a great job here and of course on his own blog Health Care Policy & Marketplace Review.

Two rules by which to judge a health reform bill

Jul 31, 2009• 49

By Matthew Holt

Right now we have sausage-making going on in DC and lots of uninformed opinions and outright lies being strewn across the front pages and on cable from newly declared experts. I sat in an airport last night and heard 5 Wall Street pundits spewing rubbish about health reform on one cable show. It even included an aging upper-class British twit declaring that government health care was more expensive than private systems. Clearly he’d managed to miss comparing the 8% of GDP his (and my) original homeland spends on health care versus the 17% we spend here. Later on CNN had 4 random people including Christine Hefner—yes one of those Hefners—talking about it. I suspect that if you know something about health care and your name’s not Michael Cannon you’re just not allowed on cable TV.

But all the hot air aside, even those of us in the punditocracy who know something about the subject matter (i.e. anyone reading THCB) seem to be so deep in the weeds that we have lost the basics about what we should be looking for from a health care bill. So it’s time to make that very clear, and here in my not so humble opinion are the rules by which to judge reform.

Rule 1 A health care reform bill needs to guarantee that no
one should find themselves unable to get care simply because they
cannot afford it. Neither should anyone find themselves financially
compromised (or worse) because they have received care.

Rule 2 A health care reform bill needs to limit the amount of
GDP that is going to health care to its current level, with an overall
aim of reducing the share of health care going to GDP.

Live from Aspen: the moderates’ view on Obama health reform

Jul 27, 2009• 14

By Matthew Holt

Paul Krugman’s article today excoriates the Blue Dogs and a former dog Billy Tauzin in particular. He also (as I did a week or so back) wonders where the Dogs were when the Bush tax cuts were bumping the deficit more than the proposed health reform bill will and redistributing wealth from future poorer taxpayers to the very rich in the process.

Funnily enough I’ve been at the Aspen Health Forum where the self-same Billy Tauzin used his not inconsiderable Cajun charm and a dollop of PhRMA’s money to buy me (and a bunch of others) a whisky and a s’more on Saturday night, and took part in a couple of panels I watched on Sunday. We had a couple of brief chats, one about his cancer treatment and another about getting big Pharma to behave better. He claims some progress there (voluntary restrictions on DTC, better posting of clinical trial data, reductions in marketing excess to docs). I suggested that there was more progress required both in pricing policy and PR. He said it was hard, I told him that was why they paid him the big bucks.

Interview with Jonathan Bush, AthenaHealth CEO

Jul 26, 2009• 3

By MATTHEW HOLT

In this interview Jonathan Bush explains the nation’s major problem: a severe shortage of MUMPS programmers. Well not exactly, but as always the AthenaHealth CEO is well worth watching. And of course he’ll be at Health 2.0 on the same panel as Allscripts CEO Glen Tullman. That will really be worth watching, and of course you can sign up to come to Health 2.0 in October here.

Carleen Hawn debuts HealthSpottr and a list

Jul 24, 2009• 29

By Matthew Holt

Carleen Hawn’s new site HealthSpottr is up and she’s starting with a list of the Top 100 random people in health care. Well it’s supposed to be innovators, but it mashes up a bunch of Health 2.0 folks with some biotech people, some health policy types (Berwick & Wennberg are close to the top), some health system types, and some academics. And yes, a certain Harvard Business School prof who’s one step ahead of the SEC is ahead of Uwe Reinhardt, with Enthoven not on the list. Perhaps most amusing is that Microsoft’s Peter Neupert is #1 while no-one from Google is on the list (Although Adam Bosworth is in there).

As you know I think lists and awards are tosh. But they are the US Weekly of the online world—trashy, you can’t admit to reading, but very good fun. Special prize for the THCB regular who can find the wrong photo attached to a name swiped from these very pages (hint, a mix up between two people who write together a lot),

So dive in and enjoy, and I think Carleen will be back with something a little more substantial soon.

Meanwhile, perhaps THCB should do one–I’m thinking “worst people in the healthcare world”. Votes for who I’d put on top please…

Costs v Coverage: Krugman gets it–Brooks is almost quite close

Jul 24, 2009• 11

By Matthew Holt

So Paul Krugman, the NY Times Nobel Prize winning lefty columnist, says this (and echoes what I’ve been saying for a while)

So where in America is there serious consideration of moving away from fee-for-service to a more comprehensive, integrated approach to health care? The answer is: Massachusetts — which introduced a health-care plan three years ago that was, in some respects, a dress rehearsal for national health reform, and is now looking for ways to help control costs.

Why does meaningful action on medical costs go along with compassion? One answer is that compassion means not closing your eyes to the human consequences of rising costs. When health insurance premiums doubled during the Bush years, our health care system “controlled costs” by dropping coverage for many workers — but as far as the Bush administration was concerned, that wasn’t a problem. If you believe in universal coverage, on the other hand, it is a problem, and demands a solution.

So universal coverage systems find that they can’t just let the health care system increase costs because there is no safety valve of the uninsured to dump out of the system. We’re all in it.

Rantology: Sympathy for the blue devils?

Jul 22, 2009• 21

By Matthew Holt

I do have some vague sympathy for the Blue Dogs, the group of mostly red-state Democrats who have to pretend that they care about fiscal responsibility. They, like me, think that we shouldn’t be increasing taxes on the non-health sector to pay for universal coverage. Unlike me they think that we should be reducing any commitment to universal coverage by reducing the level at which subsidies for people mandated to buy health care coverage cut off—which will leave us in a situation with lots of people who forgo coverage because they can’t afford it. I of course think that we should be finding the money to cover the uninsured from within the 16% of GDP we already spend on health care and then ratchet that overall number down, but then again I don’t have to get elected to Congress.

But I do have one modest question. Where were the dogs/devils’ concerns about the deficit when George Bush was borrowing for the future to pay for income and dividend tax rebates for the very wealthy, by invading Iraq and hiding the accounting, and by creating the boondoggle that was the Medicare Modernization Act. Now it’s late at night and I’m not going to go chasing voting records from 2001–3. But I sure have my guess….

More on the politics of health care reform:

Health “reform”: Lest we forget…

Jul 21, 2009• 17

By Matthew Holt

There’s been a lot of hand-wringing and b.s. discussed about the comparatively minor health reform that’s snaking its way through Congress. And when I say comparatively minor I mean it. Mostly because there’s lots this legislation doesn’t do.

1) There’s no significant reform of how we pay for health care—even though Orszag, Obama et al want it, and maybe Rockerfeller will inject the “MedPAC as Federal Health Board” into the end result….but I doubt it.

2) There’s no significant change in how we raise money for health care. Employment-based insurance stays as it is. Medicare and Medicaid basically stay as they are. Even if there are NO revenue sources for extending care to the uninsured, it’s still only a roughly a 5% increase in the cost of health care. If you hadn’t noticed we get that increase every year anyway! (By the way CBO actually scores the economics as being significantly better than that).

3) There’s no significant tax increase. Well the apologists say so, but the proposed tax increase on very high earners is trivial compared to how well they’ve done in the last twenty years. The chart below shows the share of overall earnings since the 1980s.

Eliza gets a nice write up in BusinessWeek

Jul 13, 2009• 2

BY MATTHEW HOLT

Indeed, it’s so nice that methinks Lucas & Alex were quite seductive! Speaking as a friend and one who’s been indoctrinated into the cult of Alexandra Drane, its interesting to see the mainstream press picking up the “phone as a tool” theme. The BusinessWeek article shows that a) these calls work to change behavior if targeted correctly and done well and b) that Eliza is humming along very nicely financially. What it doesn’t hint at, but is well worth considering, is the vast potential for these calls to collect data from patients as well, as to relay information to them. As you may guess you’ll see more from Eliza at Health 2.0 this fall, and you can be sure that we’ll be hounding them on that latter point.