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Above the Fold

Reputation versus quality: U.S. News Hospital Ranking

Apr 21, 2010• 9

By PAUL LEVY

Each year, US News and World Report publishes its list of the top 50 hospitals in various specialties (example here). Now, an article has been published suggesting that one aspect of the methodology used by the magazine is flawed.

“The Role of Reputation in U.S. News & World Report’s Rankings of the Top 50 American Hospitals,” by Ashwini R. Sehgal, MD is in the current edition of theAnnals of Internal Medicine. (You can find an abstract here, and you can obtain a single copy for review from Dr. Sehgal by sending an email to axs81 [at] cwru [dot] edu.)

Dr. Sehgal finds that the portion of the U.S. News ranking based on reputation is problematic because reputation does not correlate with established indicators of quality:

The relative standings of the top 50 hospitals largely reflect the subjective reputations of those hospitals. Moreover, little relationship exists between subjective reputation and objective measures of hospital quality among the top 50 hospitals.Continue reading…

Another physician tool: mPay Gateway interview

Apr 21, 2010• 3

By Matthew Holt

While I clear out interviews that I have had in the can that were interrupted by first health reform and then Health 2.0 Europe, here's an interesting one on a very niche application mPay Gateway that helps physicians get paid by allowing them to collect co-pays and co-insurance from consumers.

The interview is with CEO Brian Beutner. Note that since this interview was taken a little over a month ago, mPay Gateway has been getting quite some plaudits from one of their major partners, Allscripts.

Catching up with Anvita Health

Apr 21, 2010• 1

By Matthew Holt

Another one of my HIMSS interviews that's taken a while to make it onto THCB. But that shouldn't fool you–Anvita Health is one of the more interesting companies out there, doing complex analytics to personalize and identify individuals who need various types of help and intervention (think medication safety, gaps in care). It essentially connects reference clinical information with huge databases with individual patient data.

Here’s CEO Rich Noffsinger to tell you more and catch you up. (But he’s still very quiet about identifying who their big clients are!)

Health 2.0 in the Doctor’s Office

Apr 20, 2010• 7

By Matthew Holt

The Health 2.0 meetings are coming thick and fast at the moment. No sooner have we finished Health 2.0 Europe in Paris (a very successful first venture abroad—and fortuitously held before the Icelandic eruptions suspended air travel in the EU), than it’s time for another new territory. And this territory is the world of physicians. We’re going to be in Ponte Vedra Beach near Jacksonville, FL for the Health 2.0 in the Doctor’s Office conference.

The audience will be a little unusual for a Health 2.0 Conference, as this is specifically about the emerging Health 2.0 tools aimed at improving the practices of physicians. That includes both EMRs, practice management tools, and many other lightweight applications for various physician and patient-provider communication and analysis.

Here’s the agenda in Florida, and there’s still room for both physicians and others interested in the physician practice to come join us.

What kind of tools will be there? Well to give you some idea, Allviant (a subsidiary of Medicity) will be demoing their CarePass solution which helps manage patient flow in physicians’ offices, and helps increase the number of patients who come to their appointments while reducing work for the clinic staff—and it makes patients happier too!

Carepass is just the first of Allviant’s big ideas. Here’s a video interiew I did with Lilian Myers (CEO) and Tom McHale (VP, Business Development) at HIMSS a few weeks back to tell you more. You can meet Tom in Florida.

Myths and Facts About Health Reform Part II

Apr 16, 2010• 77

By MAGGIE MAHAR

Lobbyists representing the many who profit from our $2.6 trillion health care industry spent millions in the war over healthcare reform. Yet National Journal Contributing Editor Eliza Newlin Carney suggests that “it’s unclear whether all that lobbying, advertising and check-writing yielded much.”

No question, the reform legislation that finally passed falls short of many reformers’ hopes. The public option is gone. Private sector insurers will scoop up all of the new business. Meanwhile, by agreeing to support reform—and make some financial concessions—Pharma bought protection from generic competition, plus a promise that it can continue to set prices, without worrying about Medicare trying to bargain for discounts.

Nevertheless, as I argued in part one of this post, Carney has a point. Lobbyists lost on many issues. Under the legislation, insurers who offer Medicare Advantage are going to lose their windfall payments. Some relied on that corporate welfare to stay in the black. In addition, insurers who cover large groups will have to pay out 85% of premiums to physicians, hospitals and patients, keeping only 15%. This rule kicks in next year, and makes raising premiums far less attractive. If an insurer lifts premiums by 10%, it will have to increase pay-outs by 8 ½%. Meanwhile a 10% hike means that it the company likely to lose market share, particularly in the more transparent new exchanges that open up in 2014.

Insurers will gain millions of new customers, but the majority will be expensive. Some patients suffering from pre-existing condition will need extensive care, and many others will come from low-income families who, as a rule, are not as healthy as more affluent Americans. Moreover, between now and 2014, it’s likely that Congress will bring back the public option.

A Microsoft EMR: It’s Not Just a Matter of When, It’s a Matter of Who

Apr 16, 2010• 19

By AUSTIN MERRITT

Microsoft Dynamics is largely present in just about every software market but medical. And they’re missing out big time. The United States healthcare IT market is growing at about 13% per year and is expected to reach $35 billion in 2011¹. The biggest opportunity for growth in the industry is among ambulatory care physician practices, partly due to the Stimulus Bill requiring the use of electronic health records (EHR) systems by 2015.

You would think Microsoft would be in such a promising industry, but you won’t find a Microsoft EHR available. The primary reason why is that EHRs are highly specialized, and Microsoft’s main products (Dynamics, CRM, and SharePoint) don’t come anywhere near the needs of physician practices. It would be very difficult for Microsoft to build an EHR from scratch and introduce it to the market.

So what should Microsoft do to enter the industry? Acquire a current player.

Engage with Grace on Decisions Day

Apr 16, 2010

By Leigh Calabrese-Eck & Alexandra Drane

Friday April 16 is National Health Care Decisions Day — a national campaign that aims to encourage people to complete advance directives or living wills to document end-of-life-wishes.

In the sprit of the day, we are asking folks to share The One Slide with at least five friends, family members, or colleagues — and then ask them to do the same. Or spread the word even further, faster by bumping it to the top your Facebook page, blog, or Twitter feed.

Let's keep the momentum going!

Vist here for more information on National Health Care Decisions Day, and please don't forget to visit the Engage with Grace website.

Health 2.0 Europe – Opening Presentation Available!

Apr 15, 2010

Once again, we’d like to thank everyone for making Health 2.0 Europe a smashing success!

In case you missed the event (we’re sure you had a good excuse!) or if you wanted to see our research again, here’s a look at the opening PowerPoint presentation by Matthew Holt, Indu Subaiya and Denise Silber (Health 2.0’s European partner at Basil Strategies).

Health 2 0 Europe Presentation

View more presentations from Health 2.0.

Important: Input on consumer ‘Meaningful Use’ requested and required, Apr 20

Apr 15, 2010• 6

By MATTHEW HOLT

Josh Seidman, now running the meaningful use program at ONC, but formerly of the Center for Ix Therapy writes with an important request:

The Meaningful Use Workgroup of the Health IT Policy/federal advisory committee that advises ONC) is holding a hearing on Tuesday, April 20 in Washington (open to the public in person and virtually) on patient/family engagement. This testimony and other public input will be critically important in laying out the foundational steps for the evolution of Stages 2 & 3 definitions of MU for patient/family engagement.

In addition to the hearing itself, we are now inviting public input in advance of the hearing and follow-up to it on the FACA Blog, and we’d love to get as much thoughtful input as possible.

It goes without saying, but I’m going to say it again anyway, that Josh’s shepherding of the meaningful use criteria plus his earlier lobbying of the process from the outside HHS was very instrumental in making the consumer such a big part of phase 1 of the meaningful use criteria. However, you can be assured that there are lots of people wanting to put the brakes on any expansion of the consumer-facing meaningful use criteria.

We’ve just come back form Europe where the Danes showed us that all their citizens already have access to everything we’re talking about in stages 2–3 of meaningful use. So I believe that we should be shooting for the stars here.

BUT unless the Health 2.0 crowd, the ePatients, and the consumer gets into the commenting mix, there are no guarantees. So please take the opportunity to get involved virtually and in reality if you’re in DC next week.

VAT On the Horizon

Apr 14, 2010• 32

By PAUL LEVY

Several months ago, a friend met with a high government official and expressed concern that the new health care bill would be more expensive than people were saying.

“Oh yes,” said the official, “In several years, the United States will pass a value-added tax.”

After the bill passed, Charles Krauthammer wrote this column in the National Review saying the same thing:

American liberals have long complained that ours is the only advanced industrial country without universal health care. Well, now we shall have it. And as we approach European levels of entitlements, we will need European levels of taxation.Continue reading…