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Tag: Quality

Interview with Kerry Hicks, HealthGrades CEO

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By Matthew Holt

HealthGrades has been busy. The publicly traded, pure-play provider ratings company is changing the way it offers ratings, it’s publishing a book, and it’s starting to rate drugs. It’s not alone. Last week, Consumer Reports announced it also is getting into the business of rating hospitals and using a model developed in conjunction with the Dartmouth crowd. Plus, there’s the CMS effort.

Given the way that ratings are evolving and HealthGrades’ partnership with Google, (more to come on Google from me separately soon) last week was a great time to talk with HealthGrades Chairman & CEO Kerry Hicks. (Sadly it was before the Consumer Reports announcement but fascinating nonetheless).

Listen to the Kerry Hicks interview.

Real transparency in a socialist nirvana? UK releases hospital death rates

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By Michael Millenson

Nhs_2
In yet more evidence that the transparency revolution is worldwide and not merely a product of American capitalism, comes news that in the UK death rates for specific types of surgery at NHS hospitals are to be revealed. Can this be happening in the single-payer government morass that we’ve been warned off for years? Michael Millenson, one of America’s leading experts in patient safety and quality, gives us his reaction.

This is mind-boggling, if, alas, short on some crucial detail: Is this based on claims data (high-school-graduate-coded administrative information) or clinical claims? If the former, it is impressive, if the latter, extraordinary. For those who believe in the superiority of American medicine, here are a few observations.

First, he who pays the piper calls the tune. If NHS decides to
collect this data, it’s done. One also presumes they don’t need an act
of Parliament to do so, thereby avoiding at least some degree of
political interference.Second, a leading physician, who
actually pioneered releasing clinical data to the public, went on to
serve in the Cabinet and continue leading this effort on behalf of the
broader public interest. By comparison, our equivalent of a cardiac
database, the Society of Thoracic Surgeons database, has strict
confidentiality requirements that don’t even allow city-city or
state-state comparisons. The exception: a physician can release his own
information for marketing purposes.Third, and most interesting, are these seemingly innocuous sentences. “There were initially fears
raised that releasing the information would lead to surgeons avoiding
difficult cases which could impact their rates. But agreement was
reached on a method to take into account the difficulty of cases and
mortality rates are released against the number of deaths expected. Sir
Bruce has been working with hospital specialists on a way of rolling out
a similar scheme across all areas of surgery and medicine to help
patients choose where to be treated.”

Continue reading…

A Hat Tip to Pediatrician Dr. Benjamin Spock

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By Brian Klepper

Here’s one of today’s entries in The Writers’ Almanac, the wonderful daily newsletter sent out by Garrison Keillor on NPR. Parents of boomers like me were big fans of Dr. Spock, treating him with an almost cult-like reverence for his sensible wisdom about child care. He later parted ways with some of his more conservative followers, when he became an iconic protester against America’s war in Viet Nam. I wonder whether regular THCB readers will read this and, like me, note that this is the same message Jane Sarasohn-Kahn relates in The Wisdom of Patients. We stand on the shoulders of giants.

It’s the birthday of Dr. Benjamin Spock, (books by this author) born in New Haven, Connecticut (1903). His Common Sense Book of Baby and Child Care (1946) was a best seller during the period after World War II, when parents across America were raising the Baby Boom generation. Spock opened his first pediatric practice in 1933. After 10 years of observing children and their health, Spock decided to write a book about taking care of them. Instead of writing it out himself, he dictated the book to his wife, to give it a conversational tone. Previous parenting guidebooks had encouraged parents to be stern with their children, and they were written as a list of commands. Dr. John B. Watson had written in his guidebook, "Never, never kiss your child. Never hold it in your lap. Never rock its carriage." Dr. Spock encouraged parents to be affectionate, and he also encouraged them to follow their own instincts. The first sentence of his book was, "You know more than you think you do."

An Open Response To HHS Secretary Mike Leavitt – Brian Klepper and Michael Millenson

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By Brian Klepper and Michael Millenson

A few months ago, the two of us – both long-time advocates for
transparency and accountability – posted separate comments on Secretary
Mike Leavitt’s blog.  Brian asked Secretary Leavitt to square his
support of "Chartered Value Exchanges” with the attempt to block
release of physician-specific Medicare claims data to Consumers’
Checkbook, which wants to rate doctors. After a court ruled that the
data should be provided to the group, HHS appealed. Michael urged the
secretary to go beyond supporting Consumers’ Checkbook and use his
“bully pulpit” to promote sophisticated data analysis that could be
used to create national quality comparisons.
Secretary Leavitt graciously asked us to consider and comment on the
department’s proposed "Medicare trigger legislation" calling for the
release of physician performance measures. We are delighted to continue
the conversation.

First, let’s give credit where credit is due. We agree that the proposed legislation is a major step in the right direction.

Continue reading…

Which way to go for health reform? From Birkenstocks to pom-poms

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By Sarah Arnquist

The methods proposed to clean up the health care mess in the United States that leading voices pitched to hundreds of journalists Friday unsurprisingly were as varied as their Birkenstocks and patriotic tie.

David Himmelstein, co-founder of Physicians for a National Health Program and Birkenstock-wearing Harvard Medical School professor of medicine, unrelentingly pushed a single-payer system. "We need a reform that helps the insured as well as the uninsured," he said, adding that the system should "get rid of the insurance companies that provide no added value."

At the other end of the spectrum, Tom Miller, resident fellow at the American Enterprise Institute conservative think tank, wants more tax credits to put consumers in the driver’s seat and deregulation of the individual market.

Between those two ideologies, were Karen Davis, president of The Commonwealth Fund, and Julie Barnes, deputy director of the New America Foundation‘s health policy program.

Continue reading…

Dennis Quaid takes on hospital errors

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By Sarah Arnquist

Oie_800px_dennis_quaid_dn_sc_04_1_2Hospital patient safety has a new celebrity advocate in Dennis Quaid, whose twin newborns received a massive overdose of a blood thinner last year at Cedars-Sinai Medical Center while being treated for infections.

While his twins bled profusely, Quaid and his wife, Kimberly, were met by a hospital risk management team, who instead of offering an apology and explanation, provided half-truths and excuses, Quaid told hundreds of journalists Thursday at the annual Association of Healthcare Journalists Conference in Washington D.C.

The Quaids’ experience has been widely covered in the press, and he and his wife recently started The Quaid Foundation to shine a spotlight on the 100,000 people who the Institute of Medicine estimates die annually from preventable hospital errors.

"Unfortunately this tragic secret in the medical industry will continue until the medical community overwhelms a conspiracy of silence and demands public accountability,” Quaid said. "I do realize that because I’m a known person, we have an opportunity to get the word out."

Continue reading…

QUALITY: Medicare Health Support–Done and more or less dusted

Recently the targets on Medicare Health Support were changed to make them more financially favorable to the DM companies running the projects. Everyone inside the DM industry has known that MHS has not been doing too well for some time now. But now according to Vince Kuratis’ blog, the preparations to pull the plug are well underway. Here’s Vince’s interpretation of CMS’ decidely low-key announcement of where MHS stands.

MHS is not meeting targets for financial savings.  While it is theoretically possible that the MHS program could climb out of the hole financially during the remaining months of the program, we are doubtful that this will happen — so much so that we are scheduling the patient’s (MHS’) funeral even though technically we are not allowed to pronounce the patient dead yet. In the event that hell freezes over and the program revives, we will then schedule Phase II, but don’t hold your breath.

In a new twist on an old saying by Mark Twain: The rumors of MHS’ death have NOT been greatly exaggerated.

POLICY: Plumpy’nut – Brian

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The NY Times ran an important op-ed yesterday by Susan Shepherd, a pediatrician and medical advisor to Doctors Without Borders.
The core of her message is that as the farm bill progresses through
Congress, we should focus not only on the quantity of food that is
produced and that we export for relief to underdeveloped nations, but
on its quality as well.

Dr. Shepherd describes the difficulties
in treating children who are victims of severe malnutrition,
particularly in areas like Africa and South Asia where milk and clean
water can be scarce.

Continue reading…

POLICY: Shannon Brownlee is da man!

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It’s been really great getting to know the new voice of the Dartmouth school, Shannon Brownlee. She’s interviewed in her local paper about the concept that the American health care system delivers More money, but less health. Hopefully we’ll have her writing more on THCB soon!