The Health Care Blog – Page 433 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

Value-Based Reform

Mar 2, 2015• 31

By JACK COCHRAN, MD and CHARLES KENNEY

The U.S. Department of Health and Human Services’ recent announcement to move the Medicare program toward value-based payments is among the most promising recent developments in health care.

While changing the way we pay for care will not be easy, we believe that shifting away from fee-for-service to value-based payments could be a catalyst to a better, more affordable health care system in our country.

Three Benefits of Paying for Quality
There are numerous potential benefits to paying for quality rather than quantity, including the three we want to focus on today.

We believe this payment shift has the potential to accelerate progress toward achieving the Triple Aim – defined as better individual care, better population care, and lower cost.
We believe the payment shift by Medicare will accelerate the transition to value-based payments among commercial insurers – a major benefit to employers in terms of improved health for employees and greater affordability.
We believe value-based payments have the potential to help slow – and possibly reverse – the epidemic of physician burnout in the United States, particularly among primary care doctors.Continue reading…

THCB E-mail Notifications Are Back!

Mar 2, 2015

THCB Tech Desk

Never miss an important post again. Sign up here.

King v Burwell: Three Scenarios

Mar 2, 2015• 15

By ROGER COLLIER

By now, every reader of THCB must be aware the Supreme Court is hearing arguments this week in a case that could undermine much of Obamacare. Simplifying somewhat, the plaintiffs in King versus Burwell argue that the phrase “exchange established by the state” in the Affordable Care Act’s section 1311 dealing with tax subsidies precludes making such subsidies available to those who enroll through the federal exchange(s). The government argues (a) that other sections of the law make it apparent that all exchange enrollees are potentially eligible for subsidies, and (b) that language in section 1321 providing that HHS shall “establish and operate such exchange within the state,” where a state is unable or unwilling to create their own exchange, essentially establishes a state exchange.

As many media articles have commented, the implications of a SCOTUS ruling for the plaintiffs are huge. Some five to eight million enrollees in the 34 federal exchange states would lose their subsidies, making insurance unaffordable for many of them, and premiums in these states would skyrocket—all while leaving the existing tax fines for being uninsured in place.

Using a Mobile App for Monitoring Post-Operative Quality of Recovery

Mar 2, 2015• 5

By JAAN SIDOROV, MD

While your correspondent is tantalized by the prospect of healthcare consumers using mHealth apps to lower costs, increase quality and improve care, he wanted to better understand their real-world value propositions.

Are app-empowered patients less likely to use the emergency room?

Do they have a higher survival rate?

Do they have higher levels of satisfaction?

In other words, where’s the beef?

That’s when this paper caught my search engine eye. It’s a report on using an app to monitor post-operative patients at home.Continue reading…

Shared Responsibility in the Affordable Care Act

Mar 1, 2015• 3

By DRANOVE AND GARTHWAITE

Recently we wrote that it was well past time to end the employer mandate in the Affordable Care Act. In light of some commentary, we thought it best to revisit this issue in more detail. It seems that most of the support for the employer mandate comes from a misguided understanding of why employers are currently the primary source of private health insurance. It is explicitly not because of a sense of “responsibility” to the employee, at least not any more responsibility than they feel when they pay employee wages for their work.

Here is a basic summary of how labor markets work, based on decades of very widely accepted academic research and practical experience. Employees receive compensation from their employers in return for their work product. In other words, employers aren’t running charities for their workers, but neither are workers volunteering their time at firms. Each expects something from the other. Some employee compensation comes in the form of cash wages and some in the form of fringe benefits such as health insurance, pensions, free coffee, parking, etc.Continue reading…

Feedback Loop

Feb 27, 2015• 14

By PHILIP ALLEN GREEN

Right now there are two patients in every room. One is made with flesh, bones, and blood. One is made with a monitor, a mouse, and a keyboard.

Both demand my time.

Both demand my concentration.

A little over two weeks ago I wrote the short story Please Choose One. I posted it online. The response it generated exceeded anything I could have ever imagined. It struck a nerve. People contacted me from all over the world, from all walks of life, about the story. Everyone, it seems, can relate to the challenge of having to choose between a person and a screen.

People sent me all kinds of suggestions and ideas. A few sent words of encouragement. Yet, what struck me the most about the people who contacted me was what they did not say. Not a single IT person argued the computer was more important than the patient. Not a single healthcare provider stated they wanted more time with the screen and less time with the patient. And finally, most importantly, not a single patient wrote me and said they wished their doctor or nurse spent more time typing and less time listening.

Medicine is the art of the subtle- the resentful glance from the mother of the newborn presenting with the suspicious bruise, the solitary bead of sweat running down the temple of the fifty three year old truck driver complaining of reflux, the slight flush on the face of the teenage girl when asked if she is having thoughts of hurting herself. These things matter. And these same things are missed when our eyes are on the screen instead of the patient.

Health 2.0 Asia: Japan Conference Partnership

Feb 27, 2015

By SOPHIE PARK

Tokyo, Japan – Health 2.0 announces the Health 2.0 Asia partnership with MedPeer, Inc. to showcase the Health 2.0 Asia conference Japan on November 4-5, 2015. The conference will be the first of a series of events expanding the global presence for Health 2.0 in Asia. This conference will feature ground-breaking insights and leadership within the global health care technology industry while showcasing cutting-edge technologies for user-generated health care. The conference will become a forum for attendees to build networks for exchanging innovative ideas and developing new business parternships, which will promote active inbound and outbound investment within the health-tech industry. MedPeer, Inc. will expand Health 2.0 activities across Japan in collaboration with local chapters by holding a series of health-tech hackathons.

About Health 2.0

Health 2.0 is the premiere showcase and catalyst for the advancement of new health technologies. Through a global series of conferences, thought leadership roundtables, developer competitions, pilot programs, and leading market intelligence, Health 2.0 drives the innovation and collaboration necessary to transform health and health care.

Media Contact
Sophie Park
so****@********on.com

The Facebook Model for Socialized Health Care

Feb 26, 2015• 5

By EDGAR T. WILSON

As government involvement in U.S. health care deepens—through the Affordable Care Act, Meaningful Use, and the continued revisions and expansions of Medicaid and Medicare—the politically electric watchword is “socialism.”

Online, of course, social media is not a latent communist threat, but rather the most popular destination for internet users around the world.

People, whether out of fear for being left behind, or simply tickled by the ease with which they can publicize their lives, have been sharing every element of their public (and very often, their private) lives with ever-increasing zeal. Pictures, videos, by-the-minute commentary and updates, idle musings, blogs—the means by which people broadcast themselves are as numerous and diverse as sites on the web itself.

Even as the public decries government spying programs and panics at the news of the latest massive data-breach, the daily traffic to sites like Facebook and Twitter—especially through mobile devices—not only stays high, but continues to grow. These sites are designed around users volunteering personal information, from work and education information, to preferences in music, movies, politics, and even romantic partners.

So why not health data?

The Digital Doctor: Automation, Aviation and Medicine

Feb 26, 2015• 13

By ROBERT WACHTER, MD

The story of Chesley “Sully” Sullenberger – the “Miracle on the Hudson” pilot – is a modern American legend. I’ve gotten to know Captain Sullenberger over the past several years, and he is a warm, caring, and thoughtful person who saw, in the aftermath of his feat, an opportunity to promote safety in many industries, including healthcare.

In my continuing series of interviews I conducted for my upcoming book, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age, here are excerpts of my interview with Sully, conducted at his house in San Francisco’s East Bay, on May 12, 2014.

Bob Wachter: How did people think about automation in the early days of aviation?

Sully Sullenberger: When automation became possible in aviation, people thought, “We can eliminate human error by automating everything.” We’ve learned that automation does not eliminate errors. Rather, it changes the nature of the errors that are made, and it makes possible new kinds of errors. The paradox of cockpit automation is that it can lower the pilot’s workload in phases of flight when the workload is already low, and it can increase the workload when the workload is already high.Continue reading…

A Master Class In Health Policy with Kavita Patel

Feb 26, 2015• 3

By MATTHEW HOLT

The HxRefactored Conference kicks off April 1st in Boston and we are excited to have Kavita Patel giving a Master Class in U.S. Health Policy.” Kavita is a Managing Director at The Brookings Institution in Washington, DC and has a long history working in health reform for both Ted Kennedy and at the Obama White House. I interviewed Kavita to talk health care reform impact, insight, technology and and timing.

Matthew Holt: What are the most important changes that you are currently seeing due to Health Care Reform as well as in the health care system as a whole?

Kavita Patel:I would say the most important change is everybody is now intensely focused on transforming every aspect of health care, not only the consumer experience or people who are not already inside the health care system, but also for patients and then for their family members–whether it’s an insurance company that had massive numbers of enrollees, as a result of the Affordable Care Act and the last wave of 11 million people who signed up, or if it’s the one person’s primary care physician who is now looking at whether or not he or she should be part of the patient centered medical home, because he or she is kind of thinking through what the future of medicine will look like, as well as patients and consumers.Continue reading…