By BOB WACHTER

A study in this week’s Archives of Internal Medicine
by Vinny Arora and colleagues found that vanishingly 
few hospitalized
patients could name any of their hospital doctors. Should we care?

I think we should. Vinny
is one of the nation’s up-and-coming researchers in the field of
hospital medicine, and a good friend. In this clever study, she and
colleagues at the University of Chicago interviewed over 2800
hospitalized patients over 15 months. Three-fourths were unable to name
even a single doctor caring for them; of those who “could” name a
doctor, the majority of names were wrong. Sobering stuff.

There
are multiple issues at play here.

At a place like the University of
Chicago Hospital, hospitalized patients on the teaching service are
cared for by gaggles of residents, students, and others who are
increasingly working in shifts and running for the exits because of
duty hours limits.

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By Sarah Arnquist

The Obama Administration has yet to announce an appointment for the director of the Centers for Medicare and Medicaid Services (CMS). We're not about to start any rumors, but the announcement must be near.  The eventual appointee will confront an unenviable number of difficult problems, including state Medicaid programs feeling squeezed by the financial crisis, a Medicare trust fund facing insolvency in a decade, and competing interests in any reform proposal the Obama team may propose.

The folks at the industry newsletter RPM Report think Mayo Clinic CEO Denis Cortese may be at the top of the list. Analyst Ramsey Baghdadi notes:

"Cortese would be an intriguing pick to lead the agency
and seemingly has every qualification to lead the growing Medicare
programs: He's an outsider, he holds a medical degree, he manages a
large health institution and he's helped to implement a number of the
most talked about health reforms at Mayo and made them work. Cortese
also chairs the Institute of Medicine Roundtable on Evidence-based
Medicine."

A Mayo spokeswoman downplayed the idea,
telling the Minneapolis Star Tribune that the executive has not been offered
the job.

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Tracey Moorhead has been head of the DMAA–Care Continuum Alliance for a couple of years, coming from the pan-healthcare industry group the Healthcare Leadership Council.

DMAA is the trade group for the disease management & population health management crowd–a crowd that has had to take it's lumps of late–including from me, but more significantly from CBO and CMS. Tracey gives DM a very vigorous defense, and is very optimistic about the future of disease management despite the doubts harbored by some members of various house committees.

It's a fun interview, and Tracey gives probably better than she got….Here's the interview

Plus quick shout-out to DMAA's Integrated care Summit on March 29-31 in Austin, TX

By Matthew Holt

Daschle failed to pay $128,000 in taxes

Didn’t he complete that ridiculously long form about his past that the Obamanations wanted? Daschle may not have had a drunken picture of himself on Facebook but answering away not paying over $100K in tax is going to be tough. Did he think it wouldn’t come up? Now I know it was  only a free car & driver, but apparently Daschle took three years to notice that he wasn’t paying for it, and that it counted as income.

On the other hand, if Daschle doesn’t get past this, maybe we’ll get someone to run health care reform who has some slightly better ideas than Daschle’s somewhat sophomorific effort—even if not his political connections.

By Anne Tumlinson

Several contributors to THCB have commented that long-term care tends to get short shrift in healthcare discussions. New research might help to make a case for why we can no longer afford to demote this critical issue as we contemplate overarching healthcare financing strategies.

In the report, researchers looked at beneficiaries ages 65 and older who receive help with three or more activities of daily living (ADLs) — longhand for people who need long-term care — and found that, even though these individuals represent only 7% of the Medicare population, they account for nearly 25% of spending in Medicare Part A and B.

This is interesting because Medicare doesn't actually pay for extended nursing home stays, which is where long-term care is usually delivered, but it does pay for limited post-acute care. The implication here is that Medicare services that transition patients from acute to long-term settings might actually be filling a gap for long-term needs. And, given the size of the gap, it is equating to staggering levels of spending.

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By Jocelyn Guyer

The Senate passed its version of legislation to renew the State Children’s Health Insurance Program (SCHIP) Thursday, bringing the bill very close to its long overdue White House signing ceremony. The new bill is expected to cover an additional 4.1 million uninsured children by 2013.

Most importantly, the new bill – like the old ones vetoed by President Bush – gives states new funding to sustain and strengthen their SCHIP programs. This will occur just in time, as families hit by the economic downturn look for affordable coverage options. It also gives states new tools to reach already-eligible, uninsured children and provides them with performance-based incentives to enroll them.

I’m thrilled about this bill. Not because I think it will solve everything, but because it will offer concrete help to many kids who need it now and can’t wait until we figure out comprehensive health reform.

It is fair to say, however, that not everyone shares my joy.

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By Matthew Holt

The master interviewed. (including transcript) Don’t worry—he only talks this way to piss off John Goodman, Stuart Browning and Newt Gingrich.

Filed under possible sleepers we're-keeping-an-eye on:

Alex Gibney, the Academy-award winning film maker behind the widely acclaimed "Enron: The Smartest Guys in the Room" will show segments of his newest film, a feature length take on Maggie Mahar's "Money-Driven Medicine" at the Families USA Conference in Washington D.C. this week. Directed by Andrew Fredericks. Screening open to the public. Wed. 8PM. Renaissance Mayflower Hotel. 1127 Connecticut Avenue. NW. IMDB entry here.

By Sarah Arnquist

As an annual meeting of progressives should start, the Families USA conference of health advocates began in Washington D.C. this morning with applause and cheers of the announcement of President Obama's imminent signing of the Lilly Ledbetter Fair Pay Act and the anticipated adoption of a bill expanding the State Children's Health Insurance Program (SCHIP).

I missed the day's first talk by Sen. Charles Grassley (R-Iowa), who has been making headlines lately for his adopted role of Medicare kickback watchdog. (He's the only Republican I see on the agenda.)

House Majority Leader Steny Hoyer (D-MD) spoke next and promised successful passage of broad health reforms after the economic stimulus legislation is finalized. Vague on details, but full of enthusiasm gleaned from the opportunity seen in the current economic crisis, Hoyer said, "This is our moment."

"If we fail, if we have to revisit this issue in 10 or 15 years," he said, "I don't want even want to think about how bleak the picture will be then."

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