Episode 5 of “The THCB Gang” was live-streamed Thursday, April 16 at 1pm PT- 4pm ET! 4-6 semi-regular guests drawn from THCB authors and other assorted old friends of mine will shoot the sh*t about health care business, politics, practice, and tech. It tries to be fun but serious and informative! If you miss it, it will also be preserved as a weekly podcast available on our iTunes & Spotify channels.
(Foxnoxious News) WASHINGTON, April 1 – President Trump today urged all insured Americans infected by the coronavirus to seek care only at for-profit facilities.
“American capitalism is the world’s greatest job-creating engine,” said the president in a prepared statement. “That’s why I urge all Americans who have both good health insurance and COVID-19 to get their care at for-profit hospitals and other wonderful, for-profit health care facilities.
The president expressed his compassion “for all the great companies whose share prices are suffering.” Americans who fall sick “can help make your life savings great again,” he said, by using investor-owned firms. In addition to hospitals, these include for-profit nursing homes, rehab facilities, home care and hospice, as well as funeral homes.
“If one million Americans get infected by COVID-19, that’s a terrific business opportunity,” the president declared.
Super Bowl Week ended with the San Francisco 49ers and 161 U.S. hospitals having something in common.
Both were publicly penalized, both lost money as a result and both passionately believed the process was unfair. Unfortunately, it’s not easy to decide whether their objections were sensible or sour grapes and, in the case of hospitals, the real-life consequences are not a game.
The penalty that pained the 49ers occurred shortly before halftime of Super Bowl LIV, when offensive pass interference was called on tight end George Kittle. The call negated a big gain that might have enabled the 49ers to take the lead.
Replays showed that the referees – nicknamed “zebras” for their black-and-white striped shirts – were technically correct in their decision. Nonetheless, controversy erupted over whether given other possible penalties called or overlooked, this one deserved a yellow flag.
Hospitals call that kind of context “risk adjustment.” A few days before the Super Bowl, the Medicare program blew the whistle on a group of hospitals having high rates of infection and other patient injuries. The hospitals who are outliers in what are blandly labeled “hospital-acquired conditions” (HACs) suffer a cut of one percent in their Medicare payments over next fiscal year.
At kitchen tables everywhere, ordinary Americans have been grappling with the arcane language of deductibles and co-pays as they’ve struggled to select a health insurance plan during “open enrollment” season.
Unfortunately, critical information that could literally spell the difference between life and death is conspicuously absent from the glossy brochures and eye-catching websites.
Which plan will arrange a consultation with top-tier oncologists if I’m diagnosed with a complex cancer? Which might alert my doctor that I urgently need heart bypass surgery? And which plan will tell me important information such as doctor-specific breast cancer screening rates?
According to Matt Eyles, president and chief executive officer of America’s Health Insurance Plans (AHIP), insurers over the last decade have made a “dramatic shift” to focus more on consumers. That shift, however, has yet to include giving members the kind of detailed information available to corporate human resources managers and benefits consultants (one of my past jobs).
What’s at stake could be seen at a recent AHIP-sponsored meeting in Chicago on consumerism. Rajeev Ronaki, chief digital officer for Anthem, Inc., explained how the giant insurer is using artificial intelligence to predict a long list of medical conditions, including the need for heart bypass surgery. Information on individual patients is passed on to clinicians.
That history should provide a sobering perspective on the distinction between inevitable and imminent (a difference at least as important to investors as intellectuals), even on hot-button topics such as new data uses involving the electronic health record (EHR).
I’ve been one of the optimists. Earlier this year, my colleague Adrian Gropper and I wrote about pending federal regulations requiring providers to give patients access to their medical record in a format usable by mobile apps. This, we said, could “decisively disrupt medicine’s clinical and economic power structure.”
Sharing a hotel room, however, does not a marriage make. In order to get better digital health interventions to market faster, we need what I’m calling a Partnership for Innovators, Policymakers and Evidence-generators (PIPE). As someone who functions variously in the policy, tech and academic worlds, I believe PIPE needn’t be a dream.
I could’ve been Kamala Harris, Joe Biden and Marianne Williamson all rolled into one. That’s how I might have handled my first, only, and not-so-great presidential debate.
No, I wasn’t actually running for president. But I was involved in the campaign of someone who was: Barack Obama. In September, 2008, the campaign asked me to serve as a surrogate in a debate with John McCain’s health care adviser when one of Obama’s close advisers – as opposed to me, who’d met the candidate once at a campaign event – couldn’t make it.
As a policy wonk and politics junkie, I was ecstatic. Entering the debate, I was confident. Afterwards, metaphorically dusting the dirt off my clothing and checking for cuts and bruises, I was chastened.
Getting off the couch and onto the stage, even a small one, is tougher than it looks. Watching the cluster of Democratic presidential candidates go at it on health care, I scoffed and sneered along with other experts at their obfuscations and oversimplifications. (More on that in a moment.) But I also sympathized.
Say you want to know which baseball players provide the most value for the big dollars they’re being paid. A Google search quickly yields analytics. But suppose your primary care physician just diagnosed you with cancer. What will a search for a “high value” cancer doctor tell you?
Public concern over bloated and unintelligible medical bills has prompted pushback ranging from an exposé by a satirical TV show to a government edict that hospitals list their prices online. But despite widespread agreement about the importance of high-value care, information about the clinical outcomes of individual physicians, which can put cost into perspective, is scarce. Even when information about quality of care is available, it’s often unreliable, outdated, or limited in scope.
For those who are sick and scared, posting health care price tags isn’t good enough. The glaring information gap about the quality of care must be eliminated.
“When people are comparison shopping, knowing the price of something is not enough,” notes Eric Schneider, a primary care physician and senior vice president of policy and research at the Commonwealth Fund. “People want to know the quality of the goods and services they’re buying.”