The Health Care Blog – Page 292 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

What Baseball Can Teach Doctors

Nov 16, 2017• 5

By MICHAEL MILLENSON

Baseball, like medicine, is deeply imbued with a sense of tradition, and no team more so than the New York Yankees, disdainful of innovations like placing players’ names on the backs of their jerseys and resistant to eroding strict standards related to haircuts and beards.

It’s why doctors and patients alike should pay special attention to why the Yankees parted ways with their old manager and what they now seek instead. In a word: “collaboration.”

That’s the takeaway from a recent New York Times article examining why the Yankees declined to re-sign manager Joe Girardi despite his stellar “outcomes” (to use a medical term); i.e., the best record in baseball during his 10 years at the Yankees’ helm. But Yankees executives believe the game has changed. The model for future success is the Los Angeles Dodgers, the tradition- and cash-rich franchise on the opposite coast that went to this year’s World Series while the Yankees sat home.

The new way to win? According to Dodgers executives, it requires a combination of statistical analysis, shared decisions and communication between and among all stakeholders based on collaborative relationships.

The New Health Care Experience For Consumers

Nov 16, 2017• 1

By HEALTH 2.o SPONSORED CONTENT

We are human and we need health care. These are universal truths. Here’s another one – we are consumers. Consumers who happen to be in a constant state of adapting to new health care protocols. The advent of value-based care over fee-for-service has also seen an emergence of empowered consumers who are not only informed but savvy in their health care decision making. Where do I purchase? From who? How much does it cost? How much can I afford? When do I purchase? What if I need a specialist? The list goes on. Luckily there is an ever-growing group of people and organizations who continue to make the consumer experience streamlined, affordable, and personal. Even in the gravest of scenarios.

Remembering Uwe

Nov 15, 2017• 3

By JEFF GOLDSMITH

The healthcare world learned with great sadness this week of the passing of our friend, Uwe Reinhardt. I met Uwe in 1982 at the Federation of American Hospitals meeting in Las Vegas. Uwe opened the meeting by apologizing, in his disarming German accent, for not being his usual sharp self. He had, he said, skipped breakfast because his wife May had instructed him not to pay for anything in Las Vegas that he could get for free at home. This was vintage Reinhardt, innocent and knowing at the same time. That meeting was the beginning of a long and warm friendship.

Uwe would have been acutely uncomfortable with his colleagues referring to him as a “giant” in our field, because he was genuinely humble, and had not forgotten what it felt like growing up poor in devastated post-War Germany after WWII. And there was no sterner test of humility that occupying the James Madison Professorship of Political Economy at Princeton, just about as flossy an academic title as you will find.

For many years, Uwe taught a standing-room-only undergraduate course in Accounting at Princeton. The way he taught it was as a cleverly disguised course in moral philosophy. A main trope: “how would a ‘seasoned adult’ look at this problem?” A ‘seasoned adult’ was someone who had lost his or her moral compass and sense of shame. So, where would a ‘seasoned adult’ book a bribe paid to a foreign official to obtain a contract, etc.? He was cleverly goading them not to lose their sense of outrage and their own moral compass, a tricky task without patronizing them.

Trump’s New Man at HHS

Nov 15, 2017• 3

By STEVE FINDLAY

President Trump’s nominee to be the next HHS Secretary—Alex Azar—has a sparkling resume and by most accounts is a practical, accomplished and solid choice to lead the agency and the federal government’s health programs for at least the next 3 years.

He served as HHS Deputy Secretary under George W. Bush.

But the choice is yet another by the Trump administration that puts industry leaders in charge of public policy and programs. And in this case that could matter as much as the appointment of Scott Pruitt to head the EPA—although I do not equate the two personally since Pruitt is a severe partisan with a disdain for the federal government while Azar apparently acquitted himself well while serving at HHS under Bush.

The problem is Azar spent most of the last 10 years at pharmaceutical giant Eli Lilly and was president of Lilly’s U.S. affiliate before leaving that post in January. He also served on the board of the biopharmaceutical industry trade group BIO.

A Brief History of Price Controls by Annoyed Republican Administrations

Nov 15, 2017• 17

By UWE REINHARDT

Although, unlike most other nations, the U.S. has only two parties worth the name, their professed doctrines compared with their actions strikes me as more confusing than the well-known Slutsky Decomposition which, as everyone knows, can be derived simply from a straightforward application of Kramer’s rule to a matrix of second partial derivatives of a multivariable demand function.

The leaders of the drug industry, for example, probably are now breaking out the champagne in the soothing belief that their aggressive pricing policies for even old drugs are safe for at least the next eight years from the allegedly fearsome, regulation-prone, price-controlling Democrats. My advice to them is: Cool it! Follow me through a brief history of Republican health policy, to learn what Republicans will do to the health-care sector when it ticks them off.

Republicans like to tar Democrats over allegedly socialist policy instruments such as price controls, global budgets and deficit-financed government spending. Democrats usually roll over to take that abuse, almost like hanging onto their posteriors signs that says “Kick me.” I say “abuse,” because Republicans have never shied away from using the Democrats’ allegedly left-wing tactics when health care chews up their budgets or turns voters against them.

Uwe Reinhardt 1937-2017

Nov 14, 2017

Uwe Reinhardt, Princeton economist and one of the best known and best loved personalities in the health policy world died today. I join the rest of the health policy community in mourning the passing of the master explainer and wit that Uwe was.

But I also remember a small act of his kindness. The first time I met him I was a little late joining a crowd trying to get his attention after a keynote. He had talked to many, and had to go. But as he was being hustled off by his handlers, he realized he hadn’t talked to me, and he walked back to do an introduction and share a few words. He was already the biggest celebrity in our little world, and he was clearly running late for his next appointment. He didn’t know me, yet was prepared to spend the extra moment to make me feel included. And in all our future interactions over the next 2 decades, he was the same way.

It’s clear that it was the same for everyone he knew and it’s why the grief and shock in our community is so heartfelt.

John & I are very proud that in recent years Uwe offered to write some original pieces for our little blog, and we will be running a few of them in the next few days.

RIP and thank you Uwe, and we send our condolences to his wife Mae and their daughter and son–Matthew Holt

What Would a Disrupted Health Care Field Look Like?

Nov 14, 2017• 4

By ANDY ORAM

Clayton Christensen, the famous economist who popularized ideas of innovation and disruption, showed up at the recent Connected Health conference in Boston. Although billed as a panelist, he turned up without warning as a guest in a keynote and posed the same question I asked in an article back in July: “The overarching question: whither technology?”

Like my article, Christensen distinguished between incremental improvements that don’t challenge current power structures or sources of revenue, and disruptive change that offers new solutions to old, intractable problems. Disruptive change, as summarized by Christensen, changes processes as well as products.

A similar question came up in a panel, where the moderator asked his guests whether device and app manufacturers were thinking just about the health care field as it is now, or the field as it will be in four or five years. It’s telling that his question went unanswered. I believe that most health care developers are seeking a niche in the current ecology, although hoping to be able to make the evolutionary leap when that ecology changes.

The Next Tech Wave To Impact Personalized Health

Nov 14, 2017• 1

By HEALTH 2.0 SPONSORED POST

The Technology For Precision Health Summit is just around the corner, and it’s the place to discover new digital platforms that will improve the patient experience, and access a deeper insight into the data behind key decisions for treatment and for maintaining health.

Join more than 300 healthcare providers and payers, advocates, developers, investors, entrepreneurs, policymakers, and advocates for the 1-day action-packed summit which includes:

Keynote presentation on quality of patient experience; and initiatives to improve care providers to securely review, analyze and share medical information across the healthcare system by Claudia Williams, CEO of Manifest MedEx; and a presentation by Carlos Bustamante, Professor of Biomedical Data Science, of Genetics at Stanford Medicine on Stanford Medicine’s precision health initiative, and an insight into its Precision Health and Integrated Diagnostics Center.
Presentations and demos from Syapse and Cota focusing on genomics and other omics technologies that are rapidly making their way to clinicians and into Electronic Health Care Records (EHRs) during the Precision Medicine – Decision Support for Clinicians session.
New Diagnostic and Screening Tools session featuring live demos from Helix, DotLab, Ivary, and ColorGenomics.
An in-depth look at funding sources for precision medicine and health as well as insight on how value based medicine and population health incentives and policy are shaping investment with Illumina Accelerator, GE Ventures, Cricket Health, and the California Governor’s Office of Planning and Research during the Business Models and Investing in Precision Health session.

What are you waiting for? Register for the Technology for Precision Health Summit to see healthcare technology demos from some of the most innovative personalized medicine companies, and hear penetrating discussions on precision medicine delivery, innovation in clinical trials, and advances in oncology.

Why Hospitals Are Losing Serious Money And What That Means For Your Future

Nov 12, 2017• 12

By ROBERT PEARL, MD

A strange thing happened last year in some the nation’s most established hospitals and health systems. Hundreds of millions of dollars in income suddenly disappeared.

This article examines the economic struggles of inpatient facilities, the even harsher realities in front of them, and why hospitals are likely to aggravate, not address, healthcare’s rising cost issues.

According to the Harvard Business Review, several big-name hospitals reported significant declines and, in some cases, net losses to their FY 2016 operating margins. Among them, Partners HealthCare, New England’s largest hospital network, lost $108 million; the Cleveland Clinic witnessed a 71% decline in operating income; and MD Anderson, the nation’s largest cancer center, dropped $266 million.

How did some of the biggest brands in care delivery lose this much money? The problem isn’t declining revenue. Since 2009, hospitals have accounted for half of the $240 billion spending increase among private U.S. insurers. It’s not that increased competition is driving price wars, either. On the contrary, 1,412 hospitals have merged since 1998, primarily to increase their clout with insurers and raise prices. Nor is it a consequence of people needing less medical care. The prevalence chronic illness continues to escalate, accounting for 75% of U.S. healthcare costs, according to the CDC.

Practicing Medicine While Black

Nov 9, 2017• 10

By KIP SULLIVAN, JD

The managed care movement thrives on misleading words and phrases. Perhaps the worst example is the incessant use of the word “quality” to characterize a problem that has multiple causes, only one of which might be inferior physician or hospital quality. [1] To illustrate with a non-medical analogy, no one would blame auto repair mechanics if 50 percent of their customers failed to bring their cars in for regular oil changes. We would attribute the underuse of mechanics’ services to forces far beyond the mechanic’s control and would not, therefore, refer to the problem as a “quality” problem.

But over the last three decades it has become acceptable among American health policy experts and policy-makers to characterize any measurement of under- or over-use of medical care, or any measurement of a medical outcome, no matter how poorly adjusted to reflect factors outside provider control, as an indication of “quality.” The widespread, inappropriate use of “quality” long ago set off a vicious cycle. It helped spread the folklore that the quality of America’s doctors and hospitals is awful, and that in turn was used to justify taking even more crude measurements of quality, and so on. [2]Continue reading…