The Health Care Blog – Page 218 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

Financial Toxicity is Hurting my Cancer Patients

Apr 12, 2019• 7

By LEILA ALI-AKBARIAN MD, MPH

As news of Tom Brokaw’s cancer diagnosis spreads, so does his revelation that his cancer treatments cost nearly $10,000 per day. In spite of this devastating diagnosis, Mr. Brokaw is not taking his financial privilege for granted. He is using his voice to bring attention to the millions of Americans who are unable to afford their cancer treatments.

My patient Phil is among them. At a recent appointment, Phil mentioned that his wife has asked for divorce. When I inquired, he revealed a situation so common in oncology, we have a name for it: Financial Toxicity. This occurs when the burden of medical costs becomes so high, it worsens health and increases distress.

Phil, at the age of 53, suffers with the same type of bone cancer as Mr. Brokaw. Phil had to stop working because of treatments and increasing pain. His wife’s full time job was barely enough to support them. Even with health insurance, the medical bills were mounting. Many plans require co-pays of 20 percent or more of total costs, leading to insurmountable patient debt. Phil’s wife began to panic about their future and her debt inheritance. In spite of loving her husband, divorce has felt like the only solution to avoiding financial devastation.

Six Health-Focused Fixes for SNAP

Apr 11, 2019• 1

By CHRISTINA BADARACCO

The $867 billion Farm Bill squeaked through our polarized Congress at the end of last year, though it was nearly derailed by arguments over work requirements for SNAP recipients. That debate was tabled after the USDA crafted a compromise, but it is sure to continue at the state level and in the next round of debates. While Republicans tend to favor work requirements and Democrats tend to oppose them, here’s something both sides can agree on: SNAP should help Americans eat healthy food.

The Supplemental Nutrition Assistance Program (SNAP)—formerly known as food stamps—provides financial resources to buy food and nutrition education to some 40 million low-income Americans. Costing taxpayers almost $80 billion per year, the program serves Americans across the spectrum of ages, ethnicities, and zip codes. Simultaneously, we reached a deficit of almost $800 billion in 2018. So how can we ensure this at-risk population of Americans can access nutritious food and better health outcomes within the confines of our current resources?

Studies have proven time and again how participation in SNAP reduces rates of poverty and food insecurity. And the program has improved substantially in recent years, with recipients now using debit-style cards to buy groceries and receiving increased benefits at thousands of farmers markets across the country.

Despite these clear benefits, SNAP dollars often don’t support healthy diets. In fact, a 2015 study determined that SNAP participants had poorer diets, with more empty calories and less fresh produce, than income-eligible non-participants. In 2017, another study found that participants have an increased risk of death due to diet-related disease than non-participants. The authors reported that the discrepancy might be partly caused by individuals who think they have high risk of poor health and/or struggle to pay medical bills are more likely to put in the effort to enroll in and redeem SNAP benefits. A recent survey of Americans across the country showed that foods purchased using SNAP benefits were higher in calories and unhealthy components, like processed meat and sweeteners, than those purchased by non-participants of the same income level.

The Next Frontier: Clinically Driven, Employer-Customized Care

Apr 10, 2019• 1

Health systems and employers are bypassing insurers to deliver higher-quality, more affordable care

By MICHAEL J. ALKIRE

Employee health plan premiums are rising along with the total healthcare spending tab, spurring employers to rethink their benefits design strategy. Footing the tab, employers are becoming a more active and forceful driver in managing wellness, seeking healthcare partners that can keep their workforce healthy through affordable, convenient care.

Likewise, as health systems assume accountability for the health of their communities, a market has been born that is ripe for new partnerships between local health systems and national employers in their community to resourcefully and effectively manage wellness and overall healthcare costs. Together, they are bypassing traditional third-party payers to pursue a new type of healthcare financing and delivery model.

While just 3 percent of self-insured employers are contracting directly with health systems today, dodging third parties to redesign employee benefit and care plans is becoming increasingly popular. AdventHealth in Florida announced a partnership with Disney in 2018 to provide health benefits to Disney employees at a lower cost in exchange for taking on some risk, and Henry Ford Health System has a multi-year, risk-based contract with General Motors.

The notion of bypassing payers is attractive for employers, especially on the back of consecutive cost increases they and their employees have swallowed over the last several years. Payers have traditionally offered employers rigid, fee-for-service plans that not only provide little room for customization, but often exacerbate issues with care coordination and lead to suboptimal health outcomes for both employees and their families. Adding to this frustration for employers is the need to manage complex benefits packages and their corresponding administrative burdens.

Patients Win When Payers and Providers Speak the Same Language

Apr 9, 2019• 1

By CECI CONNOLLY

Discouraging headlines remind us daily of the ugly battles between payers and providers. Fighting for their slice of the $3.5 trillion health care pie, these companies often seem to leave the consumer out of the equation. But it is not the case across the board. Our latest research documents that when doctors and health plans drop their guards, align incentives and focus on the mutual goal of delivering the best possible care, patients win.

For example, when SelectHealth in Utah partnered with obstetricians and refused to pay for medically unnecessary — often dangerous — early inductions of labor, procedure rates dropped from 28% to zero, leading to shorter labors, fewer C-sections and $2.5 million in annual savings for all. When Kaiser Foundation Health Plan execs collaborated with Permanente doctors around opioid safety, prescriptions for the often-deadly drugs dropped 40%. And, when Security Health Plan in Wisconsin enlisted physicians and surgeons to develop a new outpatient surgery and rehab center, health outcomes improved; patient satisfaction jumped to 98%; and they saved $4.7 million in the first two years.

These productive partnerships occur in multiple communities across the nation as illustrated in in “Accelerating Adoption of Evidence-Based Care: Payer-Provider Partnerships,” a new report by the Alliance of Community Health Plans. With funding from the Patient-Centered Outcomes Research Institute (PCORI), the 18-month project uncovered five best practices in effective collaboration for health plans:

Build consensus and commitment to change;
Create a team that includes the necessary skill sets, perspectives and staff roles;
Customize education, tools and access to specialized knowledge that the audience needs;
Share timely and accurate data and feedback in a culture of transparency, accountability and healthy competition; and
Align financial investments with clinical and patient experience goals.

THCB Spotlights: Lightbeam Health Solutions

Apr 9, 2019

By ZOYA KHAN

Today, THCB is spotlighting Lightbeam Health Solutions. Lightbeam is an end-to-end population health management solution, which means they build everything from the ground up (i.e. no acquisitions or 3^rd party interfaces are used). “Interface to innovation” as Jorge Miranda, CRO of Lightbeam, states, allows Lightbeam to build a health system’s value-based contracts relatively quickly. Their main focus is to generate data insights for ACOs and other provider systems, to engage care teams in the coordination of patient care. This is Lightbeam’s 6^th year in the health care field, and with 100 customers and over 20 million patients in their enterprise data warehouse (EDW), they have no signs of slowing down.

Lightbeam has 4 main focuses: data ingestion, data insights, the engagement of the team with the data gathered, and the patient outcomes that result from that data. Lightbeam seeks to use their insights to empower care teams by giving the information back to the caregivers, physicians, and patients. According to them, this creates more transparency in the entire process as well as allows the patient and caregivers to play an active role in their health care process.

The ultimate value that clients (health systems or providers) receive from Lightbeam’s system is cutting costs and improving quality. Lightbeam does this by monitoring engagement numbers and patient outcomes based on the data and insights they gathered, ensuring costs savings for clients as well as an effective approach to cutting the high cost of care today. Lightbeam’s ultimate goal is to replace a manual process that is currently being done by multiple people and using multiple resources, to refocus the target on improving care for everyone involved in the health care system.

Zoya Khan is the Editor-in-Chief of THCB as well as an Associate at SMACK.health, a health-tech advisory service for early-stage startups.

Death by 1000 Clicks Redux

Apr 8, 2019• 5

By MARK BRAUNSTEIN, MD

Back in the ‘stone ages’ when I (an MIT grad) was an intern, I was called at 4 AM to see someone else’s gravely ill patient because her IV had infiltrated. I started a new one and drew some blood work to check on her status. When the results came back (on paper) I (manually) calculated her anion gap. This is simple arithmetic but I had been up all night and didn’t do it right.

She died.

On morning rounds the attending assured me that there was nothing I could have done anyway but, of course, in other circumstances it could have made a difference and an EHR could have easily done this calculation and brought the problematic result to my attention. My passion for EHRs and FHIR apps to improve them really traces back to this patient episode I will never forget.

My criticism of the recent Kaiser Health News and Fortune article Death by 1000 Clicks is generally not about what it says but what it doesn’t say and its tone.

The article emphasizes the undeniable fact that EHRs cause new sources of medical error that can damage patients. It devotes a lot of ink to documenting some of these in dramatic terms. Yes, with hundreds of vendors out there, the quality of EHR software is highly variable. Among the major weaknesses of some EHRs are awkward user interfaces that can lead to errors. In fact, one of the highlights of my health informatics course is a demonstration of this by a physician whose patient died at least in part as a result of a poor EHR presentation of lab test results.

However, the article fails to pay equal attention to the ways EHRs can, if properly used, help prevent errors. It briefly mentions that around a 60% majority of physicians using EHRs feel that they improve quality. The reasons quality is improved deserved more attention. The article also fails to discuss some of the new, exciting technologies to improve EHR usability through innovative third party apps and he real progress being made in data sharing including patient access to their digital records.

Changing the Way You Care: The Coming 5G Revolution

Apr 8, 2019

XX Marks the Spot: Why Did Women Tech Experts Rule at DC Health Data Confab?

Apr 5, 2019• 1

By MICHAEL L. MILLENSON

Three government experts on a health tech conference panel discuss the urgency of releasing actionable data; all are women. A more senior official, another woman, gives a TED-style talk making the same case. And a four-person, private-sector panel debates privacy and ethics; three of the four are female.

Health Datapalooza, a conference begun with government sponsorship a decade ago, proclaims its goal as “data liberación” – freeing health data from deep within federal agencies and giving it to patients and entrepreneurs. But in 2019, women’s “liberación” seems to have become an unspoken sub-theme.

Interestingly, while women’s status in tech was the focus of a plenary panel on diversity and inclusion, the panelists seemed oblivious to the robust participation of women in their own meeting.

To put some data behind my subjective impressions, I went back and examined the list of speakers, who came from a wide range of organizations and included individual patient activists. I counted 89 men and 99 women. Liberación, indeed.

WTF are Digital Therapeutics? | Digital Therapeutics Alliance Executive Director, Megan Coder

Apr 4, 2019

Digital therapeutics has exploded as the new hot buzzword in digital health. But how are digital therapeutics different from digital health applications, applied health signals, or m-health technologies? The Digital Therapeutics Alliance was formed to answer that exact question. DTA Executive Director Megan Coder sets the record straight, hint: it involves software algorithms.

Filmed at JP Morgan Healthcare in San Francisco, CA, January 2019.

Jessica DaMassa is the host of the WTF Health show & stars in Health in 2 Point 00 with Matthew Holt.

Get a glimpse of the future of healthcare by meeting the people who are going to change it. Find more WTF Health interviews here or check out www.wtf.health.

Ridesharing Startup Cuts Medical Costs with Innovative Service | Mark Switaj CEO of RoundTrip

Apr 4, 2019

By JESSICA DAMASSA, WTF HEALTH

The future of healthcare includes ridesharing, according to startup CEO Mark Swita of RoundTrip. 1 in 5 patients misses or delays care due to transportation issues, which creates costly problems that are much more expensive to treat later. RoundTrip is disrupting the medical transportation industry by providing on-demand medical transportation for hospitals, healthcare organizations, transportation organizations, and health plans.

Filmed at the JP Morgan Healthcare Conference in San Francisco, CA, January 2019.

Jessica DaMassa is the host of the WTF Health show & stars in Health in 2 Point 00 with Matthew Holt.

Get a glimpse of the future of healthcare by meeting the people who are going to change it. Find more WTF Health interviews here or check out www.wtf.health.