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Athena announces payer rankings

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By Matthew Holt

AthenaHealth has announced its rankings on the best and worst payers in health care. Athena CEO Jon Bush discussed the PayerView rankings on the CNBC Squawkbox with Ron Williams, CEO of Aetna, the No. 1 ranked fastest payer. Williams pontificated about how great it will be when all the stuff Aetna is putting in motion is up and running.

Johnbush
Then, he got a tough question about the pressure that high-deductible health plans have put on physicians by making them figure out payments from consumers and insurers. This is a real problem for doctors and getting worse. The amusing thing is that the question came not from the journalists but from Bush.

After Williams’ somewhat waffly answer, Bush said that he’s looking forward to announcing real-time claim adjudication with Aetna any time now. I’m not sure if Bush intended that as a slam or a promise (maybe both), but it seems AthenaHealth has had it with Humana and United Healthcare for a while.

Here’s the video and here’s the press release. New York’s Medicaid program is the worst payer, as if you were surprised.

 

 

Caring.com & Trusera — two Health 2.0 newbies talk

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By Matthew Holt

Two of the more interesting newcomers in the Health 2.0 scene gathered around the electronic watercooler, which is THCB’s podcast series, to talk about what they’re up to and why they are worth looking at.

Andy Cohen is CEO of Caring.com and Keith Schorsch is CEO of Trusera. Some of you may have seen Keith at the March 2008 Health 2.0 Conference. Andy is providing content checklists and much more for those who have sick or frail parents, which will be most of us. Keith is providing a sophisticated place for story telling and information exchange for those facing serious health conditions. Both have serious ambitions.

Interesting stuff — listen to the podcast

Around the Web in 60 Seconds (Or Less)

By THCB Staff

The WSJ Health blog: Police shoot a man with a Taser gun and inadvertently correct his heart beat.

California proposed legislation would allow pharmacies to sell patient info to marketers.

NYT Well: Childhood obesity rates level off.

John McCain releases more than 1,000 pages of his medical records.

Health industry gives more to Democrats than Republicans.

Financial Times: Indian drugmakers threaten to stop production en masse.

Massachusetts docs sue state agency claiming it publishes faulty physician ratings.

Business Week asks if FDA regulations are preventing U.S. cancer patients from accessing advanced cancer drugs.

NYT: SEC allows shareholders to vote on proposals for universal health coverage.

CJR: Democrats waver on prospects of health reform.

Boston Globe: Former Harvard Med School dean discusses new doctors’ march away from primary care to lucrative sub-specialties.

AP: Half of all insured Americans take at least one daily prescription for a chronic ailment.

FDA proposes new drug labels for pregnant and breastfeeding women

Self diagnosis in military health care

By Matthew Holt

Given how much cool stuff comes out of the military and eventually has an impact in real life (not to mention the $800 billion a year we’re spending on it), the MC4 (Medical Communications for Combat Casualty Care) is worth a look. Unfortunately the sound on the video dies after a minute, but you’ll get the idea.

It appears that for those of you elitists with an iPhone ADAM is doing something similar (but of course I can’t tell, not having got one, n’all).

Microsoft Health Vault gearing up

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By Matthew Holt

Just a week after certain blogs (including this one) seem to have gone Google Health crazy, Microsoft gears up for its HealthVault Partners meeting next week in Seattle with both a $1.4- million  increase in its BeWell funding for HealthvVault partner applications (an idea originally thought up by Grad Conn in the shower, so he says), and by MSFT Health Solutions Group’s head honcho Peter Neupert’s blog, Neupert On Health.

Peter will discover that the blog is a cruel mistress, but it’s great to see them getting more and more serious about Health (even in a week when some less successful non-health care projects have been trimmed).

FD. Peter will be back at Health 2.0 this fall, but sadly I won’t be in Seattle because I’ll be jetting to Ix Therapy in Washington DC instead.

Google Health — A view from the Inside

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By Robert Wachter

Google Health launched last Monday, which sent the world’s Google-watchers into a tizzy. I serve on Google Health’s Advisory Council – which met all day Tuesday – and so here’s a bit of inside dish, along with my impressions of the site and the company.Google Health pageFYI,
my work on the Council is covered by a Non-Disclosure Agreement, so I
won’t reveal anything that isn’t publicly known regarding Google’s
products or intentions. Also, in the interest of full disclosure, you
should know that I am compensated for my Google service. (No stock options, darn it.) With that as background, here’s the scoop. Google
began working on its version of the personal health record a couple of
years ago, after the company realized that a remarkably high percentage
of searches were for health information (I know, if that’s going to be
how priorities are set, you’re wondering if Google Sex is next). Google
put together an impressive team to develop the concept. One of the
leads is a former UCSF medicine resident, Dr. Roni Zeiger. Many of our
residents come to me for career advice, and I seem to recall Roni
asking me about pursuing his interests in informatics after residency
about a decade ago. Sage that I am, I probably told him that this
computer thing didn’t have legs. Luckily he didn’t listen, and now he’s
the top doc at Google. Go figure.

Continue reading…

Let’s talk about tax exemptions

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By Paul Levy

An excellent article by Stephanie Strom in Monday’s New York Times covers what appears to be a growing controversy about the degree to which nonprofit organizations should or should not be permitted to be tax exempt under federal and state rules. This is a legitimate area for public debate, and the article sets out a number of examples and points of view.

I do not know much of the history of tax-exempt status, but I am guessing it was given by Congress and state legislatures to certain categories of non-profits in light of their public service obligations and activities. I am personally involved on the boards of several tax-exempt nonprofits, including BIDMC, an academic medical center devoted to clinical care, research, education, and community service, MIT, a university, and others currently and previously.

Now, if we think about it, any one of these lines of service could be
provided by for-profit corporations. What does society
get out of granting tax-exempt status to these institutions? The most
obvious thing is that none of the gains (i.e., "profits") of
non-profits are distributed to private investors. They are all recycled
into the mission and services of the organization.

Continue reading…

The Innovation xChange

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THCB is proud to welcome our latest sponsor: Humana and ChangeNow4Health.com. This site would not be possible without the generous backing of corporate sponsors like Humana. So we’d like to thank them – as well as all of our other wonderful sponsors – for their very kind support.

When you have a moment pop over to Change Now 4 Health and have a look at the very clever innovation contest they’ve organized. You can send in your brilliant ideas in one of the following four areas: (1). Helping Consumers Make Smarter Health Care Decisions, (2) Simplifying the Business of Health Care, (3.) Preventing Sickness and Maintaining Health, (4.) General Innovations in Health Care. 

You’ll also be able to read other people’s entries and comment on them. User-Generated Content at its finest! Top finalists will be eligible for three $10,000 prizes and possible additional support from the Humana Innovation Center. The official contest lingo:

Do you want to improve the U.S. health care system? Or at least be part of the much-needed dialogue? If you have ideas or solutions to improve the system, submit your ideas through ChangeNow4Health  Innovation xChange and you can win up to $10,000 or have your ideas published in the e-book,
Tomorrow’s Health Care. 

The Innovation xChange is looking for practical ideas and suggestions for improving the health care system. All participants in the system, from providers and health plans to consumers and government, are encouraged to join in the discussion.

All entries submitted on ChangeNow4Health will be open to comments and voting by the coalition’s communities. The top 20 entries will be published in ChangeNow4Health’s e-book, Tomorrow’s Health Care, and up to three finalists will be awarded  $10,000 each.

In addition, Humana Inc., a founding member of the coalition, will consider the top
        award-winners for a joint venture with the company’s Innovation Center, to incubate the winning idea and bring it to reality.  Winners will be announced by August 31, 2008.

For more info: ChangeNow4Health.com

       

Health Plans mark it up and pass it on

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By Matthew Holt

Buried in a quick notice in BusinessWeek was this paragraph:

Health insurance companies have plenty of critics. Now they have one more: Leemore Dafny, an assistant professor at Northwestern University’s Kellogg School of Management. Insurers argue that because they compete against one another, they keep prices down, saving everyone money. Not necessarily, says Dafny in a March paper, "Are Health Insurance Markets Competitive?" Dafny looked at data from 1998 to 2005, provided to her by a benefits consulting firm, that tracked the behavior of 200 major companies to see whether they shopped around to find the cheapest insurers. Dafny found that when these big companies made more money, their insurance providers raised their premiums. But instead of dropping the carrier to get a better deal, Dafny writes, companies generally stuck with their health insurers and paid more. "Carriers can and do take advantage of a firm’s increased profits and extract higher prices from them," she says.

Here’s how this works:

Continue reading…

Cerner immune to economic troubles, apparently …

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By Matthew Holt

Gathered at at hobnobbing summit in Tokyo, executives from high technology companies planned recently for economic troubles. And, apparently, troubles are mounting because consumers are running out of money, having to spend it on rising gas and food costs.

Virgin Mobile USA Inc (VM.N), the prepaid mobile phone service company, expects economic problems to last into the first half of next year for its mostly young customers.

Meanwhile apparently government spending isn’t guaranteed either.

Fujitsu Ltd (6702.T) Senior Executive Vice President Chiaki Ito said he was concerned that the costs of absorbing the crisis in subprime mortgages — the risky home loans that have gone bust for many U.S. and U.K. lenders — could divert government funds usually spent on technology." I am extremely worried about the indirect effects of the subprime problem," he said. Meanwhile, manufacturing faces risks from rising food and fuel costs. "If costs go up, this could trigger a recession," he added.

And even the ones that are doing well, such as IBM, are basing their success on infrastructure projects in the developing world.

"If I were in a business model where I needed double-digit growth out of the G7 to drive my performance, I would be in a cold sweat," said IBM Chief Financial Officer Mark Loughridge, referring to the Group of Seven nations.

But that’s apparently not the case in Kansas City, home of Cerner, the largest independent health care information technology company Indeed at their recent shareholders meeting Cerner’s two longtime leaders, Trace Devanny and Neal Patterson, said that things couldn’t be brighter.

Why such confidence? Either health care costs are going up very fast (from $2 trillion to $4 Trillion in the next ten years) in which case Cerner will get its share.

"The delivery of care and the spending around care delivery is relatively recession proof …," Cerner President Trace Devanny said. "There’s no way to slow down this train."

Or government will squeeze the health care industry, in which case Cerner will get more than its share.

Former U.S. Sen. John Danforth, a Cerner board member, agreed, saying the only way federal politicians attempt to rein in health care costs is by "putting the squeeze on providers." That will prompt doctors and hospitals to look for greater efficiency, which will make Cerner more valuable to them, Danforth said.

And not only is the U.S. market guaranteed, but foreign markets may also offer growth opportunities.

International business continues to account for a greater percentage of Cerner’s annual revenue, which hit $1.52 billion in 2007. Devanny said the company’s global revenue had grown tenfold to $290 million in 2007 from $29 million in 2002. "We hope to scare the daylights out of $400 million" in global revenue in 2008, Devanny said.

And even better, there is an open field in the relatively underserved ambulatory EMR market and other places

Cerner officials outlined several other areas of growth. They include expansion of Cerner’s core U.S. hospital market, where adoption of physician order entry software is still only 17.5 percent; the physicians office market; retail pharmacies; sales of aggregate patient data to big pharma companies and other clients; integration of care devices into hospital electronic medical record systems; and employer services, such as on-site clinics and regional health information exchanges that use Cerner software.

So what could possibly go wrong?

Continue reading…

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