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What’s got lost in the public option kerfuffle

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By MATTHEW HOLT

Not so long ago, July this year in fact, PhRMA boss and former Dem Blue Dog & Republican Billy Tauzin told the Aspen Health Forum that a straw poll of Democrats at dinner with him in DC all said that they didn’t think there’d be a public option in the final bill arriving on Obama’s desk. By the way Tauzin, Dashle, and the rest all said that there would be a health care bill passed in 2009 even though the summer of “death panels’ was just getting under way.

Now Jonathan Cohn at TNR is reporting (along with others) that Harry Reid is going to include the public option with an opt-out for states that don’t want it (think Red states), rather than the trigger (public option to come later if health care costs go up) or the co-op (moving the rest of the US to Seattle) alternatives.

This is a turn around—no question. It’s apparent that the summer of death panels actually hurt the anti-reform crowd. It’s also clear that the recent barrage from AHIP actually hurt its stated case against the public option—although as I’ve said on THCB I think that AHIP will do better with one in place.

But the problem is that this all disguises the real questions about the minor insurance reform we’re about to pass.

Continue reading…

State of Health Care Quality: Some States Better Than Others

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Peggy O’Kane has been running the NCQA for longer than she might care to remember. NCQA is Peggy4an independent, non-profit organization whose mission is to improve the quality of health care everywhere, but it’s best known for creating the HEDIS measures that rate health insurer and provider performance. I’ve been a fan of Peggy since I met her in the mid-1990s. Today she shows she’s still fighting the good fight. This is her first contribution to THCB —Matthew Holt

By PEGGY O’KANE

Suppose you’re one of the 22 million Americans living with diabetes and you have to decide where you  want to live. Your choices: Providence, Rhode Island, or Houston, Texas.  Providence is pretty and you’d have easy access to lobster dinners and weekends at the Cape. But Houston is warmer in the winter and just a hop, skip and a jump from a weekend in Cancun.  A hard decision but you’re leaning toward Houston because, let’s face it, you hate shoveling snow!But then you take a look at the 13th annual State of Health Care Quality Report by the National Committee for Quality Assurance (plug alert: I run the place) and you find out the quality of care for diabetics is nearly 11 percentage points better in New England than it is in the South Central region of the U.S. and you begin to reconsider. In fact, you look at the newest data released October 22 and you find that the quality of care in the Texas region of the country is consistently the worst while care in New England is almost always the best.  Providence here I come!

Here’s the problem: Most people don’t have a choice of moving from Texas or Oklahoma or Alabama to Massachusetts, Connecticut or Rhode Island. They have to live with the health care system they have. For a diabetic, those 11 points can translate into more kidney problems, loss of vision, toe or foot amputations or, heaven forbid, a shorter lifespan.The thing is, it doesn’t have to be this way. True, care isn’t going to be identical in all parts of the country. And, true, the population of Dallas may have a lot more health problems than the people in Hartford. But 11 points is too big a gap to explain away with demographics.

Continue reading…

Health 2.0 Tools: The power of Twitter

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Picture 31

The power of Twitter is real kids, and not for what you think. Used properly Twitter is an information filter. Exhibit A is what happened to the Von Schwebers who run PHARMASurveyor. They were a huge part of the Tools Panel which featured interoperation among 8 members of the Health 2.0 Accelerator at Health 2.0 a couple of weeks back. Then last week they were at an AHRQ conference on Drug Interactions when this happened. Erick von Schweber’s email picks up the story ..

The Chief Medical Officer of Express Scripts is doing his talk, about halfway through, and then tells this rather academic audience of scientists and researchers that there’s something new they need to attend to. It’s called Health 2.0, he says, and he puts up a PowerPoint slide with screen captures from WebMD, HealthVault, Healthline, DoubleCheckMD, etc. Then he tells the audience that the prior week he saw tweets about something new in the space, so he checked it out. He says this is the next major leap ahead in drug safety. So up comes a series of four slides, all screen grabs of PharmaSURVEYOR. And he calls us the Accelerator and explains what we do, disclaiming that he had no knowledge that we’d be there at the conference (I had moderated that morning’s session on making DDI evidence more relevant to patients and physicians; Hansten and Horn were my speakers, the guys who introduced the term “drug interaction” in the mid-sixties). He tells the audience that they must go to PharmaSURVEYOR as well as begin thinking in terms of consumer generated healthcare.

Now it just so happens that the Chief Scientist of Express Scripts but not the Chief Medical Officer had been to Health 2.0 and (I assume) seen the Tools panel demonstrations. But, and this will amaze no one, busy executives at big corporations don’t always immediately communicate all of their learnings with each other. So how did the Chief Medical Officer find out? He probably saw a re-tweet of the #health2con hash tag. That, ladies’n’genelmen, is how our kids is learning these days.

And do you want to see the incredible tools panel from Health 2.0 which contained both the accelerator integration project (in two parts), the debut of Keas, and Eliza showing the first Health 2.0 marriage? Funny you should ask.

Health 2.0 – The Consumer Aggregators

The Consumer Aggregator Panel at Health 2.0 San Francisco

Featuring: Roni Zeiger MD, Product Manager, Google Health, Wayne Gattinella, CEO WebMD, David Cerino, Microsoft Health Solutions

Moderator: Jane Sarasohn-Kahn, Think-Health

Overview: With consumers turning to online sources in record numbers, competition is heating up between the giants in the field. In this segment recorded at Health 2.0 San Francisco, key players at Google, Microsoft and WebMD talk about important shifts in the industry landscape over the last year, their companies’ near term plans and the powerful trends likely to shape the way Americans – not to mention the rest of the planet – use the internet to look after their health and search for reliable health information.

Related video:

Gov 2.0: Obama administration CTO Aneesh Chopra talks about the administration’s call for innovation  in Silicon valley and broader adoption of information technology throughout the healthcare system. A must see in light of the national healthcare reform debate and growing investor interest in health IT.

The future of electronic medical records: Electronic medical records may be the most controversial technology around in an area with little shortage of controversey.  In the popular “Cats and Dogs” panel at Health 2.0, the key players in the debate over the future of this crucial technology take center stage in a culminating debate moderated by Health 2.0 co-founder Matthew Holt.  Dr. David Kibbe of the American Association of Family Physicians (AAFP), is an early proponent of electronic medical records who has since publicly reversed his position. Glen Tullman is the CEO of industry leader Allscripts and a commissioner on the board of trustees of CCHIT, the certification body responsible for overseeing much of the electronic medical records industry. Jonathan Bush is the CEO of athenahealth, a relative newcomer that has enjoyed a good deal of success challenging industry orthodoxies.

Hiding In Plain Sight: Using Medicare To Solve The ‘Public Option’ Conundrum

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Barack Obama_addresses_joint_session_of_congress_2-24-09As Senate and House Committee versions of health reform move toward unified legislation and floor votes, the most complex political challenge is how to resolve the “public option” controversy. While one would have thought weightier issues such as the shape of Medicare reform, the taxation required to support coverage subsidies, or the presence or absence of mandates would have been pivotal in this debate, the seemingly peripheral issue of a Medicare-like “public option” might be the hill on which health reform dies.

The reasons are almost completely political. The Democratic base wants to end private health insurance. Single payer advocates view the public option as a down payment on an entirely public health financing system. Public option advocates believe that the plan’s bargaining power will drive private insurers out of business. (I’ve argued in a previous blog posting that, without fully understanding what they are doing, these single payer advocates are probably right.)Continue reading…

Who Should Tell Your MD What to Do?

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By PAUL LEVY

In this Wall Street Journal op-ed, Norbert Gleicher suggests that expert panels won’t improve health care because the the quality of the research on which they would base their physician practice guidelines is not reliable. Instead, he suggests that our system can self-correct when experts lead us astray. He asserts that we have a “well working free market of ideas in health care, where effective therapies can rise to the surface and win out.”

I’m somewhat sympathetic to Dr. Gleicher’s point about a government-imposed clinical review process, but he overstates the case about a current free market of ideas. Individual insurance companies and Medicare currently make payment decisions with regard to therapeutic judgments every day. How are they informed, and what are their sets of vested interests? Much of that remains hidden from public view.

Meanwhile, too, doctors and hospital practice what Brent James calls “regional medical mythology,” patterns of care divorced from scientific evidence, based as much on the local supply of specialists and what they learned from their predecessors as any other factors.Continue reading…

European Union Anti smoking Campaign

Note: While the ” ” campaign is a public service announcement, THCB is receiving a relatively modest payment from the European Union to help cover the costs of operating the site. If you are a non-profit, government agency or international organization seeking to reach a monthly audience of 100,000 unique visitors we may be able to help . Please contact Editor In Chief John Irvine for more information. You can reach John at jo**@***************og.com.

Open Letter to Athena

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By SCOTT SHREEVEScottShreeve

Afterburner (af·tər′bər·nər) n.

  1. A device for augmenting the thrust of a jet engine by burning additional fuel in the uncombined oxygen in the gases from the turbine
  2. The augmentation of thrust obtained by afterburning may be well over 40% of the normal thrust and at can exceed 100% of normal thrust

Athenahealth is one of my favorite companies anywhere. I believe they have a great vision, a  highly capable team, an incredible business model, and an unprecedented business opportunity before them. However, for all the amor, I have been disappointed that even with all their blistering success (Bam, Bam, and Kabam!) they have captured less than 2% of the target market since the IPO. I am not just disappointed for them but for the entire ambulatory care space which doesn’t seem to readily get the value of the collective intelligence inherent in the network.Continue reading…

On Stage at Health 2.0: The Cats and Dogs of Health IT

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By Matthew Holt

Here's the first in a series of videos from the Health 2.0 Conference a couple of weeks back that we're going to feature on THCB. This was the last panel of the day and it featured three leading health IT figures who've never been on a panel together before.

Following the passing of the stimulus and the debate over meaningful use, there’s been lots of tension between the “cats” (the major IT vendors) & “dogs” (the web-based “clinical groupware” vendors). (Here's the article I wrote about it last January). The real question is how the new wave of EMRs is going to integrate with the consumer facing and population management tools. Can there be unity around the common themes of better health outcomes through physician and patient use of technology? Or will the worlds of Health 2.0 and the EMR move down separate paths?

On the panel were Glen Tullman from Allscripts, Jonathan Bush from AthenaHealth (in his Apple 1984 runner shorts) and David Kibbe, from the AAFP. A feisty discussion about how IT for doctors and patients should play out.

Link to video

assetto corsa mods