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Will Anyone Listen When Former CMS Chiefs Call For More Objective Physician Payment?

Jul 13, 2012• 9

By Brian Klepper

On May 10^th, the US Senate Finance Committee, co-chaired by Senators Max Baucus (D-Mont) and Orrin Hatch (R-Utah), convened a remarkable panel of four former Administrators of the Health Care Finance Administration (HCFA) and the Centers for Medicare and Medicaid Services (CMS): Gail Wilensky, Bruce Vladeck, Thomas Scully and Mark McClellen. (See the video here.) Against a backdrop of intensifying budgetary pressures, the roundtable was to provide perspectives on Medicare physician payment, including several controversial issues: the Sustainable Growth Rate (SGR) formula, the Resource-Based Relative Value Scale (RBRVS), and the RVS Update Committee (RUC).

Ironically, the day before, a Maryland Federal District judge dismissed a suit brought against HHS and CMS by six Augusta, GA primary care doctors over CMS’ longstanding relationship with the RUC, based on a procedural technicality and without weighing the substance of the complaint.

Your Doctor’s Brain

Jul 12, 2012• 4

By Rob Lamberts, MD

I have a split medical personality. On one hand, I am a pediatrician; I light up around babies and love to mess around with little kids. On the other hand, I am an Internist; I love complex problems and love talking to the elderly. But the one part of internal medicine which gives me perhaps the most joy is the opportunity to solve medical puzzles. Yes, pediatrics has puzzles in it too, but they are far more common in adults.

The term used for a medical puzzle-solver is diagnostician. It is always a great compliment to a physician to be called a great diagnostician. It means you are a good thinker, have a good store of facts, know how to organize your thoughts properly, and can see patterns in things you otherwise would never have found. It is the Sherlock Holmes, Lord Peter Whimsey, or Harry Dresden side of medicine. The diagnostician searches for clues, but especially searches where they are most often missed: right out in the open.

I am not sure anyone has called me a good diagnostician, but there are few things that give as much satisfaction in my job. It calls on my creativity, my memory, my mental organization, my ability to ask questions, my power of observation, and my ability to put all the disparate pieces together to form a cohesive whole. It’s not just coming up with an answer; it’s coming up with a plan.Continue reading…

Call For Innovators: Just Two Weeks Left to Enter the EHR Accessibility Module Challenge!

Jul 11, 2012

By Hemali Thakkar

The deadline for the EHR Accessibility Module Challenge is slowly approaching, with less than two weeks to go!

Sponsored by the Office of the National Coordinator for Health IT (ONC), this challenge emphasizes accessibility and usability in health IT, which are high priority issues for the disabled community. A consumer-oriented system providing easy-to-use access to health information would be a valuable tool and significantly improve the health of disabled individuals. First place winners are awarded $60,000 and opportunity to demo at one of Health 2.0 premier conferences or at another national conference. The second place winner will receive $20,000 and third place, $5,000.

Where’s the Controversy in Saving Lives?

Jul 11, 2012• 1

By Melinda Gates

As we get closer to the London Summit on Family Planning, people often ask me, “Why is family planning so important to you?” The simple answer is that it can mean everything to so many of the women and families I meet. It means the difference between being empowered and feeling powerless. It means the difference between celebrating a daughter’s graduation and watching her drop out of school. It even means the difference between life and death.

Providing family planning information and services to millions of women and girls in the poorest countries in the world gives them the opportunity to determine their own futures, and the best future for their children.

As a woman and a mother, I can’t imagine anything more important.

The women and girls I speak with, whether in India or Kenya, tell me they want to be able to plan for their families. They tell me they want what’s best for themselves and their children. They want the right to participate freely and equally in society.

You Want to Sue Me?

Jul 11, 2012• 27

By Mandy Huggins, MD

“I’d be lookin’ to sue you.”

I’m sorry, what?? That is what I heard from the mother of one of my patients. I was evaluating a high school athlete who had recurrent stingers (nerve injury that affects an upper limb, usually resolves with time) and a possible episode of transient quadriparesis (affecting all limbs this time). I wasn’t on the sidelines for these injuries, so I had to go on the reports given to me by the athlete and the school’s athletic trainer. However, with that information, I did not want to clear this player to return to football until I could be certain he didn’t have any cervical stenosis or any other abnormality that might put him at risk for permanent damage if he suffered another neck injury.

I told the athlete and his mother that I needed to get an MRI of his cervical spine (neck) in order to determine this. The athlete was understandably upset with my decision, but his mother supported my decision to proceed with caution. She explained to me that if her son played again, sustained another injury, and something “bad” happened, she would be more than happy to take legal action against me. Fantastic.

First of all, I can’t say that I would blame her for being angry (at the very least) if I screwed up. But to tell me in my office, to my face, that she’s already thinking about suing me? I found that ridiculous. I must be in the minority, however. If you Google “how to sue a doctor,” an abundance of information follows. There’s an “ehow” on the subject, and even CNN offers an opinion.

Are Fewer People in MA Paying the Individual Mandate Penalty?

Jul 11, 2012• 3

By Josh Archambault

Since the Supreme Court upheld the ACA/Obamacare, there has been a renewed interest in the Massachusetts healthcare law. I have blogged many times before to caution readers and the media not to assume the two laws will lead to the same results, because they won’t, mostly as Massachusetts is not the same patient with the same ailments as New Mexico, or Michigan, or even Florida.

I know I am fighting against the conventional wisdom, but this issue warrants discussion as Congress passed a national program and modeled the behavior and cost estimates (incorrectly in my opinion) partially on our experience here in the Bay State.

As a result of the national interest, I assume we will see more local reports on Romneycare. On cue, WBUR’s CommonHealth Blog put up:

5 Quick Facts About Mass. Health Reform You Now Need To Know

One of the facts cited is the decrease in the number of Massachusetts residents paying the individual mandate penalty.

How the United States Supreme Court Saved My Life

Jul 11, 2012• 12

By Spike Dolomite Ward

Not to be overly dramatic, but for me the Supreme Court decision on the Affordable Care Act was a matter of life and death. Because the law was largely upheld, I will be able to continue receiving treatment for breast cancer.

I was one of the early beneficiaries of the law. When I was diagnosed with an aggressive form of breast cancer late last year, I had no health insurance, which meant my options were extremely limited. No insurer would pick up someone in my circumstances. But luckily, the Pre-existing Condition Insurance Plan had already kicked in, and it made it possible for me to purchase insurance under a government program.

I was uninsured not because I’m a lazy, freeloading deadbeat but because my husband and I are self-employed. We had been purchasing health insurance on the individual market along with 6% of the rest of the population. But after exhausting all of our resources trying to keep up with premiums of $1,500 a month, we had no choice but to cancel it.

Alex B. Fair talks Medstartr

Jul 11, 2012

By Matthew Holt

After a lot of pre-publicity, Medstartr is here. Modeled after Kickstatr and other crowdfunding sites, Medstartr is the brainchild of Alex Fair who is not only the founder of FairCareMD but also the generalissimo of the Health 2.0 NYC chapter. Lots has already been written about crowdfunding and even crowdfunding in health care (see this Health 2.0 News article on LumoBack last week), so I thought we’d let Alex describe it in his own words.

Matthew: If I have a company looking to raise money how does Medstartr work? What share of the money do you take?

Alex: Crowdfunding is a little like talking to your in-laws about your healthcare startup. Give a great explanation that works for everyone who has a stake in your project’s success: Patients, doctors, institutions, Big Pharma, HHS, and any partner you want to work with. Then list the rewards they get for supporting your project. Everything from a heartfelt thank you note, to a tax-deductible contribution (through our Partner Cancer101), to a production ready version of your product or service when it is ready to licensing rights for distribution. Next, spread the word through the groups of people who will love your products. Not just the Health 2.0 crowd, but everyone whom your innovation helps. MedStartr helps people fund the innovations in care that people care about and gives them a say in what comes next.

23andme buys Curetogether

Jul 10, 2012

Big news over in the world of online patient data as DTC genomics company 23andme (partially funded by Google in the early days) buys crowdsourced cure community site Curetogether. My interview with Curetogether’s Alex Carmichael is at Health 2.0 News—Matthew Holt

Would I Let My Son Play Football?

Jul 10, 2012• 2

By Andrew Blecher, MD

“Would I let my son play football?”

It’s a question that more and more parents are asking themselves these days. There are some people out there who say, “No way!”

Football is way too violent and should be abolished as a sport. Even some NFL players admit that they would not let their own sons play football. Then there are others, fierce advocates who think football is a wonderful game with tremendous benefits to its participants and think all of the media hype about injuries are just overrated scare tactics and headline grabbers.

But the majority of us are probably somewhere in the middle and aren’t quite sure what to think. So why don’t we spend a little time sifting through all the facts and emotions and see if we can make some logical decisions about the subject. I have an interesting perspective in that I am a sports medicine physician who is a true fan of the game, has played the game, has sustained injuries and has a son of my own.

Thus I can see the argument from all sides. Let’s start with the physician side. My job is taking care of injured athletes. I see patients with fractures, sprains, strains, overuse injuries, head injuries, concussions, trauma, you name it. During the months of August, September, October and November, I probably see more patients than I do for the entire remainder of the year. Why? Football season.