The Health Care Blog – Page 924 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

A Broker’s Lament: We Brought This On Ourselves

Mar 7, 2009• 63

By JOHN SINIBALDI

A huge segment of the American population is simply far too strapped to ever afford the premiums and costs associated with health insurance/health care as it is structured today.

It isn't the employees of government (local, county, state or federal) who will demand immediate change. It isn't the employees of institutional companies (the Motorolas, GEs, Microsofts of the country) who will demand change. It isn't those on Medicare or Medicaid or the VA who will demand change. It isn't the wealthy. It isn't the poor. And, it isn't the vast majority of health insurance agents who work with large group clients (because, while that market is becoming ever more difficult and the work more taxing, they're still selling SOMETHING to these bigger businesses and government entities).

Why don't these people see what I'm seeing? Simply because, while they are feeling the effects of the rise in health care/health insurance costs and the downturn in the economy, most of these businesses and their employees and dependents (and the affluent) have yet to have a clue about how expensive things really are (or in the case of the rich, they can still afford their out-of-pocket expenses). The agents who market to large employers are still making lots of money (I know, I rub elbows with them at my local Health Underwriters meetings once a month).

Online care….from Hawaii to Wall Street (journal only so far!)

Mar 7, 2009• 2

By Matthew Holt

Chris Lawton has an article in Thursday’s Wall Street Journal called (wait for it) Cough, Cough. Is There a
Doctor in the Mouse?

It’s a good general run down of American Well, TelaDoc & SwiftMD, which are the leaders in synchronous web-based care. Of course there’s also lots of asynchronous care going on online. In particular Kaiser Permanente has shown a huge amount of online communication between its clinicians and members, and RelayHealth has a similar service in which several health plans are paying doctors to communicate online with patients.

And this is all starting to come together and have an impact. The Health 2.0 Hawaii chapter will be having a meeting about this very topic on March 26.

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Mar 6, 2009

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Calendar: Fourth National Pay For Performance Summit

Sponsored by the Integrated Healthcare Association. Co
sponsored by Bridges to Excellence, Leapfrog Group, the National
Business Coalition on Health, the National Committee of Quality
Assurance and the National Quality Forum. March 9 – 11, 2009 San
Francisco, CA. .www.PFPSummit.com

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Five Recommendations for an ONC Head Who Understands Health IT Innovation

Mar 6, 2009• 14

By David C. Kibbe, Brian Klepper and John Moore. Kibbe

Now that the legislative language of the HITECH Act — the $20 billion health IT allocation within the economic stimulus package — has been set, it’s time to identify a National Coordinator (NC) for Health IT who can capably lead that office. As many now realize, the language of the Bill can be ambiguous, requiring wise regulatory interpretation and execution to ensure that the money is spent well and that desired outcomes are achieved. Among other tasks, the NC will influence appointments to the new Health Information Technology (HIT) Policy and Standards Committees, refine the Electronic Health Record (EHR) technology certification process, and oversee how information exchange grants and provider incentive payments will be handled.

Why and How Secretary Sebelius Should Avoid a Network Monopoly

Mar 5, 2009• 13

By ADRIAN GROPPER MD

Obama is smart. His signing of the Health Information Technology for Economic and Clinical Health

(HITECH) Act (as part of the Stimulus package) recognizes the
importance of health IT as the foundation for health care reform and
cost savings. Good data and good consumer experience is a way to drive
a policy consensus when payment reform and health reform come to a vote
on Capitol Hill.

Technology certification and meaningful health
records exchange are the cornerstones of the HITECH Act. Health IT
should be engineered to promote transparency in health care
effectiveness and to reduce regional differences. To achieve this, the
secretary of HHS must ensure that scope of the Certification Commission for Health Information Technology (CCHIT) does not extend beyond hospital health records.

HHS
must stimulate reform through systems and services innovation. As with
previous federal actions, such as the the break-up of the AT&T
monopoly, HHS can enable future generations of innovation by excluding
health information exchange and patient-controlled health records from
the domain of CCHIT, big hospital and big vendor interests.

Value-Based Insurance Design and Medicare Part D – A Perfect Match?

Mar 5, 2009• 2

By TANISHA CARINO

Medicare could immediately modernize its benefit structure by incorporating value-based insurance
design (VBID) into the Part D program. This benefit design tool maps directly to the new Administration’s goals of improving quality and preventing complications of illness—and, as I’ll point out, it can be implemented without any new legislation.

VBID abandons the traditional approach of uniformly applying cost sharing to health services regardless of their effect on a patient’s health. Instead, VBID tailors cost sharing—so, the more clinically beneficial the service is to a patient, the lower that individual’s cost sharing for the service. In some cases, employers such as Marriott and Pitney Bowes have actually eliminated cost sharing associated with diabetes medications and achieved positive cost and quality outcomes.

With more than 26 million enrollees, Medicare Part D is a large target for this type of innovative, quality-focused benefit design. The 23% of Medicare beneficiaries who have five or more chronic conditions account for 68% of the program’s spending, and there is heavy reliance on medication to treat chronic illness.

Google Health sharing–simple but potentially important

Mar 4, 2009• 11

By Matthew Holt

Today late afternoon PST Google flipped the switch on an important change/add to Google Health.

Recently they’ve been adding more and more little features, such as printing & graphing, and in the last month getting CVS retail pharmacies on the network (to join Walgreens), and sucking up device data. But this new one may be the most interesting, as Google Health has added the ability for users to invite others to see their records.

Anyone who’s used Google Docs (and that includes all of us working at Health 2.0) immediately gets addicted to sharing those spreadsheets and text documents with a wider team. It’s so easy, you just invite them to it, and then one day you wake up and you’re sharing hundreds of documents with everyone you work with and cannot imagine how you did it before.

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Mar 4, 2009

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Classified: Leadership Summit on Member Retention for Health Plans

Mar 4, 2009

According to ConnextionsHealth, growing losses of
individual and group plan members are eroding acquisition costs,
profitability and competitive advantage at all major health plans,
making member retention a strategic priority for 2009. At some health
insurers, member turnover is running as high as 40%. Further, McKinsey
& Co. found that health plans capture less than 10% of members lost
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.