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Stressed Out System

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By ROB LAMBERTS

I saw a patient today and looked back at a previous note, which said the following: “stressed out due to insurance.” It didn’t surprise me, and I didn’t find it funny; I see a lot of this. Too much. This kind of thing could be written on a lot of patients’ charts. I suspect the percentage of patients who are “stressed out due to insurance” is fairly high.

My very next patient started was a gentleman who has fairly good insurance who I had not seen for a long time. He was not taking his medications as directed, and when asked why he had not come in recently he replied, “I can’t afford to see you, doc. You’re expensive.”

Expensive? A $20 copay is expensive? Yes, to people who are on multiple medications, seeing multiple doctors, struggling with work, and perhaps not managing their money well, $20 can be a barrier to care. I may complain that the patients have cable TV, smoke, or eat at Taco Bell, but adding a regular $20 charge to an already large medical bill of $100, $200/month, or more is more than some people can stomach. I see a lot of this too.Continue reading…

A Shout-out to our sponsors

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THCB would not exist without the  support of our generous sponsors. So we’d like to give a shout to our friends at Eliza, our latest corporate sponsors.

“Who says nerds can’t talk to people? We use technology to engage people in conversations about their health. We crunch the data. We apply what we learn. You enjoy the benefits. “Eliza: Data-driven healthcare communications solutions. Visit www.elizacorp.com to learn more.

Thanks guys!!! Interested in reaching a national monthly audience of 90,000 healthcare-obsessed readers? Find out about our corporate sponsorship program and opportunities for advertisers. Drop us a ****@***************og.com“>line. We’ll get back to you with rates and options.

Hospital Quality Group Obscures Hospital Quality Reports, Journalists Charge

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By MICHAEL MILLENSON

The Joint Commission, which accredits four-fifths of the nation’s hospitals, is being accused of misleading consumers about the quality of care at those hospitals and then ignoring suggestions on how to correct the problem.

“The organization that accredits hospitals around the country, and voices support for transparency about hospital quality, has a Web site that obscures the reality of many hospitals’ performance,” said Charles Ornstein, president of the Association for Health Care Journalists (AHCJ) and a reporter for the public-interest journalism group ProPublica . In a March 1 letter sent to Dr. Mark R. Chassin, the Joint Commission’s president and CEO, Ornstein noted that not only has the group not addressed the “navigational issues” raised by AHCJ more than two years ago, but problems that make the commission’s QualityCheck site even less useful have cropped up.

For instance, that “Gold Seal of Approval” for your local hospital? Perhaps it should be called a Gold Seal of Possible Approval. Says the AHCJ: “[It] is misleading because hospitals with conditional accreditation or preliminary denial of accreditation still receive the same gold seal as fully accredited facilities.”Continue reading…

What Happens Next in MA?

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By PAUL LEVY

Paul levyWhat happens next in Massachusetts with insurance reimbursement rates now that many of the facts and figures have been made public?

Here’s what I see. The dominant parties in the state on whose watch the disparities in the marketplace have taken place — Blue Cross Blue Shield and Partners Healthcare System — face financial and political problems, respectively. The PHS rates that are so much higher than others’ cause a major financial drain for BCBS. They do so in the short run just by the degree of current utilization. The effect is compounded over the long run, though, as PHS has a competitive advantage vis-à-vis other systems in recruiting community-based doctors and thereby brings more and more referrals into its hospitals. That these differentials have now been made public by the state creates a political embarrassment for PHS, which has often asserted that its creation brought about substantial economies of scale through integration of care.

I suspect that these factors will lead to a negotiated agreement between BCBS and PHS, where PHS takes a bit of a haircut in its current reimbursement contracts. Not so much that it dramatically affects the PHS bottom line, but enough so that both parties can say that they have cooperatively acted to slow down the rate of health care spending in the state. Will the new rates be anywhere near the statewide average? No way. Will they do anything to offset the competitive advantage that PHS has had or will continue to have? No.

Continue reading…

Policy for Equal Access Care: You Make It Possible

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At New York-Presbyterian Hospital, we’re building technology and influencing policy that will shape the future of health care delivery.  Visionary executive leaders are driving momentum in the movement toward a connected health information technology environment—the next frontier in modern medicine. Empowered patients, equal-access care— you can help Make It Possible.

Director – Technology Policy Development
The Director of Technology Policy Development provides executive leadership for technology-related policy initiatives. Reporting to the Vice President of Government Relations and Strategic Initiatives, you will lead and strengthen advocacy for our world-class university hospital.

The job will interface between the policy world and hospital operations. You will scope out the legislative and policy environment for HIT, advise on proposals to receive governmental and other third party funding, help initiate new funded projects and support the VP in advocacy.
Qualified candidates must have a bachelor’s degree along with a minimum five years’ related experience. A master’s degree is preferred. Your experience must include knowledge of advocacy programs as well as health care-related project management. Experience with policy and government is also required.

__________________

#1 in New York. #6 in the Nation. – U.S.News & World Report, “America’s Best Hospitals 2009”

Discover why we’re #1 in New York – an unparalleled pursuit of excellence and the widest array of choices for your career. We’re inviting the best professionals to work side-by-side to lead the way.

Learn more about what we can offer you at: www.ecentralmetrics.com/url/?u=3501278206-62

We are an equal opportunity employer.

The 2010 DiabetesMine Challenge

By Amy Tenderich

2010 DBMine Challenge - Vertical logo

We have just opened the 2010 DiabetesMine Design Challenge. This year, we’ll be selecting THREE Grand Prize winners to EACH receive $7,000 in cash and a support package to help winners realize and commercialize their design ideas.

There’s also $1,000 each for the Most Creative Idea and Kids’ Categories.

And… Community Voting! The community will select the contest finalists in open voting taking place in mid-May.

So… Do you have an idea for an innovative new diabetes device or web application? The contest is open to ANYONE with a good idea: patients, parents, startup companies, design & medical students, developers, engineers, etc.

Please have a look at www.diabetesmine.com/designcontest

Octopus and other Fishes

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By Matthew Holt

One of the most fun times at HIMSS last week was the MEDecision party at the Georgia aquarium. I took a few videos of the Fish and the humans—so something a little different for you all

Continue reading…

Health 2.0 Europe–Webinar on Wednesday

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This Wednesday, March 10th at 4:30 CET / 7:30AM PST our FREE hour long webinar series will be highlighting the upcoming Health 2.0 Europe conference with our Parisian partner, Denise Silber of Basil Strategies. Joining in the discussion and presenting will be Roberto Ascione, PagineMediche.it and David Doherty, 3G Doctor. REGISTER HERE NOW!

To find our more about the Health 2.0 Europe conference in Paris on April 6-7 at the Cité Internationale Universitaire, please see our website. The FINAL agenda has been announced so don’t wait to register – conference rates increase Tuesday March 16th @ midnight!

Also the Sponsorship deadline is this Friday, March 12th to get your organization to gain unparalleled exposure in front of the the most influential leaders in healthcare. Get in front of this prestigious crowd and join our other distinguished sponsors (Bupa, Akamai, Orange, Publicis, UCB and LEEM). To apply and find out more CLICK HERE.

And for a little treat, here’s Denise and Matthew discusing Health 2.0 Europe from Denise’s apartment in Paris XVIeme arrondisement.

Why Rush Vendor Certification of EHR Technologies?

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By DAVID C. KIBBE, MD and BRIAN KLEPPER

A surprise move by ONC/HHS indicates the wheels may be falling off health IT reform at about the same rate they’ve fallen off Democrats’ broader health reforms.

David Blumenthal and his staff have unveiled two separate plans to test and certify EHR technology products and services. We don’t think this is a good idea. We’ve supported the purpose and spirit of the ARRA/HITECH incentive programs, and believe ONC’s/HHS’ re-definition of EHR technology puts it on a trajectory to improve the quality and efficiency of health care in the U.S. But this recently-announced two-stage EHR technology certification plan bears all the marks of a hastily drawn up blueprint that, if rushed into production, could easily collapse of its own bureaucratic weight.

The new Proposed Rule puts vendors through the wringer, twice. As defined by ONC, vendors with “complete EHRs” and those with “EHR modules” will have to find an “ONC-approved testing and certification body” (ONC-ATCB) that will take them through a “temporary certification program” from now until end of 2011. Then in 2012, under a “permanent certification program,” they’ll have to switch over to a National Voluntary Laboratory Accreditation Program (NVLAP)-accredited testing body for testing, after which they must seek an “ONC-approved certification body” (ONC-ACB, not to be confused with ONC-ATCB) that can provide certification. The ONC-ATCB will be accredited by ONC, but the ONC-ACBs will be accredited by an “ONC-approved accreditor” (ONC-AA).Continue reading…

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