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Above the Fold
Classified: Leadership Summit on Member Retention for Health Plans
According to ConnextionsHealth, growing losses of
individual and group plan members are eroding acquisition costs,
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making member retention a strategic priority for 2009. At some health
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through job termination, early retirement and elimination of
employer-funded coverage. This “employee transition” market segment
alone is estimated at $40 billion annually.To address this
emerging market need, ConnextionsHealth and World Health Care Congress
are hosting a first-of-its-kind Leadership Summit on Member Retention
for Health Plans scheduled for March 18-19, 2009 in Orlando, FL.
Designed for health plan senior executives, the Summit will provide an
insider’s look into the underlying issues and successful strategies for
retaining individual and small group plan members and building brand
loyalty. More information is available at www.worldcongress.com/retention.
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Gupta said to be out of running in Surgeon General race
Rumor has it that Sanjay Gupta
is no longer in the running for the office of Surgeon General. Many
peopl
e had voiced their concerns about his potential nomination
(including Paul Krugman, Maggie Mahar, Gary Schwitzer, Dr. David Gorski, and myself)
and it looks as if his lack of experience or training in matters of
public health, along with a history of industry ties has put the kabosh
on his nomination.
So who will be our next Surgeon General? It’s hard to say, but a petition is circulating on behalf of Dr. George Lundberg – a fine nominee for the position in my opinion. Let me explain why.
A review of Dr. Lundberg’s curriculum vitae easily
establishes his professional qualifications for the position. Not only
has he been one of the longest standing Editors-In-Chief of all the
American Medical Association journals (including JAMA), and the founder of the world’s first open-access, peer reviewed online medical journal (Medscape Journal of Medicine)
but has served in an advisory capacity to everyone from the World
Health Organization, to AHRQ, the Joint Commission, Harvard’s School of
Public Health, the Department of Health and Human Services, Food and
Drug Administration and the Surgeon General of the US Navy. He is also
a prolific and influential writer, having authored 149 peer-reviewed
articles, 204 editorials, and 39 books or book chapters. Dr. Lundberg
has a large and devoted national and international audience and is
highly esteemed by all who know him.
Frances Dare explains HITECH, really well
Frances Dare from Cisco is a buddy of mine who has more and more been their student of what's going on in Washington. Given that we just saw the biggest piece of health care IT legislation ever pass, I thought I'd check in with her. Frances, has really done her homework about exactly what's in that $19.2 billion pot and more (yes there's more than that) and how it's going to be spent.
This is a long(ish) and detailed interview, but if you care about IT in health care, I highly suggest you listen!
Comparing the Effectiveness of Comparative Effectiveness Research
An increased investment in comparative effectiveness research to gather additional evidence on what medical therapies and technologies work best is often cited as a fix for the nation’s rising health costs.
Unfortunately, lessons from its use abroad and in the U.S. show that this dramatically overstates its benefits as a cost-containment tool.
Comparative effectiveness research entities, such as England’s National Institute for Health and Clinical Excellence (NICE) and Germany’s Institute for Quality and Efficiency in Health care (IQWiG), have not led to decreased national health spending on new technologies. NICE recommendations are thought to account for 10 percent of the increase in England’s health costs.
And as Tara Parker Pope reminded us this week in her NY Times Well column, the uptake and adoption of the evidence, which is just as important as the research, varies widely among physicians.
While it hasn’t always been called comparative effectiveness research, the U.S. has plenty of evidenced-based guidelines for physicians and has a long, sordid history with technology assessment (another name for CER).
Reform? Marginal, I fear…
Today’s news is that there is now a double header running health care with the addition of the
(notably all-female) team of Sebelius & DeParle joining Orzsag, Zeke Emmanuel and a host of others with influence on the health care policy tiller. We await a CMS leader, and probably multiple other appointments quickly down through the ranks.
However, I remain convinced that not much is going to happen, and that even if Obama’s “plan” gets enacted, it’s a limited reform that is not the big bang we need to do the job.
Thankfully rather than me having to explain why, Bob Laszewski (who makes me feel like an inadequate noobie every time I read his stuff) details the problems over at Health Affairs blog. The Bob L summary?
- Obama’s team has not aggressively gone after the hard cost problems as part of Medicare & Medicaid, preferring to trifle around the edges with modest cuts
- For the (these days relatively modest!) $120 billion a year the reforms are going to cost it’s only looking to the health care system to pony up around half of it—the rest (c. $65bn a year) will come from the taxpayer.
- The details of the plan are being left to the Congress which means that it’ll be watered down.
As I said in the looooong comment thread on Maggie Mahar’s piece on THCB yesterday—BTW Maggie’s comment on her own piece may be the longest comment I have ever seen on any blog!—there’s no reason that the rest of the economy should contribute more to the health care system. As John McCain might say (albeit with disapproval), we need to redistribute the wealth within the system.
Grand Rounds, up, pithy
How to Win Docs and Influence Patients
Pretty much everyone agrees that we need to improve the quality of healthcare delivered to patients. We’ve all heard the frightening statistics
from the Institute of Medicine about medical error rates – that as many
as 98,000 patients die each year as a result of them – and we also know
that the US spends about 33% more than most industrialized country on healthcare, without substantial improvements in outcomes.
However, a large number of quality improvement initiatives rely on
additional rules, regulations, and penalties to inspire change (for
example, decreasing Medicare payments to hospitals with higher
readmission rates, and decreasing provider compensation based on quality indicators).
Not only am I skeptical about this stick vs. carrot strategy, but I
think it will further demoralize providers, pit key stakeholders
against one another, and cause people to spend their energy figuring
out how to game the system than do the right thing for patients.
There is a carrot approach that could theoretically result in a $757
billion savings/year that has not been fully explored – and I suggest
that we take a look at it before we “release the hounds” on hospitals
and providers in an attempt to improve healthcare quality.
