The Health Care Blog – Page 972 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

Has Steve Poizner gone soft?

Sep 12, 2008

By Matthew Holt

California’s de facto health insurance commissioner Lisa Girion reports on California’s actual Insurance Commissioner Steve Poizner’s agreement with Healthnet. After all that fuss, the deal is that Healthnet pays $14m in canceled medical bills, reinstates around 1,000 canceled policy-holders and pays a $3.6m fine. Poizner agreed to this despite all his tough words of not too long ago.

How is it that the punishment fine is less than the cost of the offense? So let me see. Don’t pay $14m in medical bills you’d agreed to insure, and either get away with it, or run the slight risk of not getting away with it and pay $18m several years later. That’s a deal any self-respecting egregious booty capitalist would take. And let’s face it being one of those is a requirement of the job to run a health plan these days.

Of course, the separate $9m fine Healthnet has already seen in one case alone—handed down by an arbitrator whose decisions cannot be overturned later—gives a clue to what the real damages will be in the courts should these cases get there.

So no wonder Shernoff and the trail lawyers are pissed that this settlement may undercut their case. And why has Poizner rolled over?

UPDATE: Darrel Ng, Press Secretary at the CA Department of Insurance is working late on Friday and responded to this post "One of the highlights of the settlement is that by accepting the payments and health insurance, patients do not have to forgo future litigation. So while I know critics have made the assertion that their case may be undercut, I’m not sure why they would believe that’s the case." Darrel didn’t explain why the fine for one case in arbitration was three times the fine for 1,000 cases from the DOI.

Perils of Pay for Performance

Sep 12, 2008• 4

By Josh Siedman

Dr. Sandeep Jauhar wrote an essay this week in the New York Times about the perils of pay-for-performance (P4P). Specifically, Dr. Jauhar discusses how P4P may have unintended consequences and create perverse incentives due to poorly designed performance measures. The point is well taken, but it’s important not to confuse the merits of P4P with the measurement issues that exist.

With respect to the latter, back in my days as Director of Measure Development for the National Committee for Quality Assurance (NCQA), I co-authored a paper with Partners’ cardiologist Tom Lee, Jim Cleeman from NHLBI, and others working with us at NCQA on the development of new HEDIS cholesterol management performance measures. In the JAMA article, “Clinical Goals and Performance Measures for Cholesterol Management in Secondary Prevention of Coronary Heart Disease,” we tried (among other things) to communicate the difference between quality improvement measures and comparative performance measures.

Wonder if your doctor is laughing at you?

Sep 12, 2008• 3

By Sarah Arnquist

That CNN headline grabbed my attention and got me to read a column that basically chastises the 17 percent of internal medicine residents who reported they had laughed at patient in a survey published in JAMA.

The author then goes on to express great relief that 94 percent of those who find humor in their patients considered it unprofessional behavior.

Lighten up! Of course, no doctor — or any professional for that matter — should laugh in a patient or client’s face or use humor maliciously. That’s basic human decency.

But humor is a release, and in a work environment as stressful as a
hospital, people need a release. Maybe that release should occur
outside the hospital walls, but funny things occur in stressful
environments and people do strange things that often merit a chuckle or
two.

McGuire not in prison. Reyes is. Anyone understand?

Sep 12, 2008• 18

By Matthew Holt

So Bill McGuire has settled with CALPers in the scandal where he backdated the value of his United HealthGroup stock options. He’ll pay a $30m fine which sounds a lot but is a rounding error on his net worth. So it appears that his troubles are over.

Meanwhile Gregory Reyes the CEO of Brocade did exactly the same thing and he’s doing 21 months in the big house as well as paying a similarly big fine.

For that matter Steve Jobs apparently did the same thing too, and just today Apple settled with the SEC for a mere $14 million (or about 8 minutes of iPhone sales) and Jobs himself doesn’t seem to be paying anything.

Isn’t there something about equal treatment under the law in one of those fuddy-duddy 18^th century documents we Americans are so keen on? Can anyone explain the rationale behind these differences in treatment?

Remember pensions? The big differences between Obama & McCain’s health care plans

Sep 11, 2008• 8

By Robert Laszewski Politics

This election is different than any other on the issue of health care because both candidates are giving us serious blueprints to reorganize America’s health care system and those blueprints are very very different.

As voters, you have a huge and critically important choice on health care.

There are dozens of details upon which they differ and for those I would point you to my comprehensive posts on the McCain Health Care Plan and the Obama Health Care Plan.

But to understand their big idea differences, I would point you to our pension system to better understand where McCain and Obama are going on health care. Back in the 1960s and 1970s, it was common for workers to have what is called a defined benefit pension plan.The worker got a promise from the employer that when retirement came he’d get a certain monthly benefit — often about 60 percent of his final average earnings. That might be $2,000 a month — every month for the rest of his life. Therefore, a defined benefit.

No such thing as Free Lunch

Sep 11, 2008• 1

By Matthew Holt

I’m over at Spot-On today writing about a great new book I’ve read, "Free Lunch." Check
out and it, and, as always, come back here to comment. Here’s a taste of what you’ll find.

Few of the books I’ve read lately have been quite as staggering as Free Lunch, from former New York Times investigative reporter David Cay Johnston who, heroically, made his career writing about – brace yourselves – the U.S. tax code. Free Lunch is a fabulous book by a veteran investigative reporter giving you his life’s work–a look at how corporations and wealthy Americans have profited, again and again, at the expense of you and me.

Johnston’s best known for his exhaustive investigations at the Times into how corporations and very very rich individuals subvert U.S. tax law so that they pay less to the government, while the rest of us pay more. But in this book – written after he’s free of the "responsibility" of being a Times reporter – he gets almost biblical in calling out the cheats, crooks and murderers.

Conference to explore innovation in health care

Sep 11, 2008

Second Annual Innovation in Services Conference: "The Service of Health Care"
explores the innovations in technology, policy, operations and methods that address the deceptively simple question: How can we improve the service of health care?

Panels of academic, technology, government and policy experts will discuss the impact of information and digital service on patient care, considering such innovations as telemedicine, mobile services, serious gaming, personal health records, and Web 2.0.

Conference agenda and registration information are available here. A limited number of complimentary spaces are available for students and those with demonstrated need. For more information, please contact CITRIS at (510) 643-2217, or ci****@*******uc.org.

Using social networking to breakdown research silos

Sep 10, 2008• 8

By John Halamka

On September 4, a group of collaborators at Harvard launched a new website called Catalyst that is publicly available. I encourage you to visit it.

This site is remarkable in many ways. It brings together all the people, lifelong learning, and resources for the Life Sciences across Harvard and its affiliates.

In the People area, you’ll find social networking for the research community called Profiles. It not only shows traditional directory information, but also illustrates how each person is connected to others in the broad research community.

The never ending stent-bypass debate

Sep 10, 2008• 2

By Charlie Baker

A new study – a big one ($50 MM) – was recently released that compared the short and long term effects of drug eluding stents to bypass surgery for patients with serious heart disease. The headlines — “Heart Surgery Bests Stents” — pretty much told the story. In this particular case, 18% of those patients who had stents installed to treat their disease ended up either dying or needing another treatment over the next twelve months. Only 12% of bypass patients ended up with complications or passing on. The death rate in both instances was the same – 8%.

Stents — the tool of choice for interventional cardiologists — and bypass surgery — the technique of choice for cardiothoracic surgeons — have been playing this “which is better” game for almost ten years. Needless to say, both sides were represented in the stories that ran covering the results of this study. The bypass surgeons said, “More people should have bypass surgery instead of stents.” The stent docs said this study proved that stenting – which involves a much less aggressive and invasive procedure than bypass surgery — comes in a close second to bypass surgery, even in patients with complex conditions.

Health2.0: User-Generated Healthcare 2008

Sep 10, 2008

October 22 – 23 | The Marriott, San Francisco

Building on the excitement generated by the first two Health 2.0
conferences, Health 2.0 User-Generated Healthcare promises to take the
conversation to a new level across an even more dynamic and panoramic
landscape.You’ll see action-packed demos of new services and
tools. You’ll see how these new technologies are transforming – and in
some cases not transforming — the healthcare industry. You’ll network
with more than a thousand other health care & tech industry leaders.

Wednesday, October 22nd

8:00am	Introduction: The Future of Health 2.0 Indu Subaiya, MD / Matthew Holt
8:20am	Keynote: Health Comes Everybody? New media pioneer(ing) pundit Clay Shirky gives a new health-related talk
8:45am	Health 2.0 Across America: The Great American Health 2.0 Tour See the premier of the new documentary starring David Kibbe & a cast of thousands. Afterwards, David reflects on the new developments he discovered across the country regarding Health 2.0.
9:30am	Networking Break See the exhibitors and/or catch a sponsored “Deep Dive” Sponsored Deep Dive from
10:10am	Consumer Aggregators — One Year Later Jane Sarasohn-Kahn reviews a major year of product introductions and controversy. Conversations with, and demonstrations from: Wayne Gattinella, CEO, WebMD Peter Neupert, Corporate VP, Health Solutions Group, Microsoft Ronnie Zeiger, Product Manager, Google Health Mark Bertolini, President, Aetna Michael Yang, VP & GM, Yahoo! Health Plus some surprise guests and announcements of new partnerships. We’re also really excited that Federal Health IT Czar Robert Kolodner will be a special commentator on this panel.
11:30am	Lunchtime Unconference & Launch! The return of the popular Health 2.0 Unconference & the introduction of Health 2.0 Launch!
1:00pm	Search in the Long Tail & Intelligence in Communities Much of the promise of Health 2.0 is in searching for and finding exact, personalized health information content, especially for rare or hard to categorize conditions. Much of that information is in social networks. Matthew & Indu will introduce a new framework looking at the evolution of search into the long tail. Demonstrations & case studies from: Search: West Shell, CEO, Healthline Networks Tom Eng, President, Healia/Meredith Venky Harinarayan, Co-Founder, Kosmix/RightHealth Steven Krein, CEO, Organized Wisdom Social Networks: Daniel Palestrant, CEO, Sermo John DeSouza, CEO, MedHelp Bill Allman, GM, HealthCentral Ben Heywood, CEO, PatientsLikeMe Reaction and commentary from Gilles Frydman, founder of ACOR — the listserv engine that revolutionized the cancer community.
2:45pm	Breakout Demo Panels – Session A There’s so much happening in Health 2.0 that we’re taking a deeper look at specific technology and business segments in a series of demo-based break-out panels. Patient Social Networks (Part 1) Stead Burwell, CEO, Diabetic Connect; Brian Loew, CEO, Inspire; Glen House, CEO, Disaboom; Amir Leitersdorf, CEO, iMedix; Moderator, Amy Tenderich, DiabetesMine Content, Navigation & Advocacy Abir Sen, Co-Founder, RedBrick Health ; Andy Cohen, CEO, Caring.com; Michael Keriakos, CEO, WaterFront Media; Kevin Noland, CEO, ADAM; Moderator: Josh Seidman, Center for Ix Therapy; Commentary from Orly Avitzur, Medical Adviser, Consumers Union Managing Money in Health 2.0 Christopher Park, CEO, Change:Healthcare; Stefanie Fenton, Director of Healthcare, Intuit; Phil Micali, CEO, bWell International; Chini Krishnan, CEO, Vimo; Brandt Cannici, COO, Medicare Saver; Moderator: Scott Shreeve, Crossover Healthcare Clinician Social Networks Brijesh Mehta, Co-Founder, MedicalPlexus; Jason Bhan, Co-Founder, Ozmosis; Moderator: Enoch Choi, PAMF/MedHelp
3:30pm	Networking Break in the Exhibit Hall See the exhibitors and/or catch a sponsored “Deep Dive” Sponsored Deep Dive from
4:10pm	Breakout Demo Panels – Session B Patient Social Networks (Part 2): Jay Drayer, CEO, Careflash; Howard Steinberg, CEO, DLife; Manny Hernandez, CEO, TuDiabetes; Keith Schorsch, CEO, Trusera; Moderator, Amy Tenderich, DiabetesMine Health 2.0 platforms for patient-provider communication: Jay Parkinson, CMO, Myca; Daniel Sands, Senior Director, Cisco; Yael Glassman, SVP, Marketing, American Well; Michael Gorton, CEO, Teladoc; Moderator: David Kibbe Health Plans and Health 2.0: Joe Gifford, CMO, The Regence Group; Alexandra Drane, President, Eliza; Albert Prast, CIO, Connextions; Tony Miller, CEO, Carol; Moderator, Brian Klepper Provider search, directories & ratings MaryAnn Stump, CEO, Consumer Aware; Daniel Kogan, CEO HealthWorldWeb; Cyrus Massoumi, CEO, ZocDoc; Spencer Punter, CEO, Emphasis Search; Moderator, Michael Millenson
5:00pm	The Business Case for Health 2.0 How will today’s obvious social value and consumer enthusiasm be turned into revenue for sustainable businesses? Scott Shreeve will head a panel talking to payers, employers, pharma, media, and government. He’ll ask where the opportunities will be and who’ll be writing the checks, and for what? Panelists will include: Anna-Lisa Silvestre, VP Online Services, Kaiser Permanente Mitzi Reaugh, GM, NBC Digital Health Network Ken Shachmut, SVP, Health Initiatives, Safeway
5:50pm	Day 1 Wrap Up Indu Subaiya & Matthew Holt will keep you from cocktails for a minute or two.
6:00pm	Cocktail Reception Network with your new (or old) friends, talk to some of the exhibitors, hang out in the Lounge, play games, and have fun!
8:00pm	Self-Organizing Dinner Groups Unleash yourself on one of the best cities in the world for eating — with people who care about what you want to talk about. We’ll have a sign up system for groups and book some great places for you to go eat at. If you’re lucky, the investment banker or pharma company VP will pick up the check (no guarantees!)

Thursday, October 23rd

7:00am	Breakfast & catch a sponsored “Deep Dive”
8:00am	Introduction to Day 2 & Recap Indu Subaiya, MD / Matthew Holt
8:15am	3 Health 2.0 CEOs 3 CEOs from companies transforming, and being transformed by, Health 2.0, talk about the future of their businesses. Conversations with Jonathan Bush, (AthenaHealth), Kerry Hicks, (HealthGrades) & Daniel Palestrant (Sermo).
9:00am	Health 2.0 Around the World Outside of the US, Health 2.0 is taking off. James Matthews–global citizen and VP of Biz Dev at Sage Software–will take you on a tour of examples from Europe, Asia and the developing world where Health 2.0 tools and technologies are making a big difference. Panelists will include: Paul Meyer, CEO, Voxiva Thomas Liedtke, Head of Emerging Healthcare, ICW AG Marlene Winfield, SVP, Healthspace, NHS Connecting for Health David Webster, IDEO
10:00am	Networking Break in the Exhibit Hall See the exhibitors and/or catch a sponsored “Deep Dive”
10:45am	Tools for Consumers Along with search and community, tools are the “third leg” of the Health 2.0 stool. While they have historically been the least developed, they are now much more sophisticated and have great potential to fundamentally change care. Indu & Matthew will introduce a new model for understanding tools within the Health 2.0 context, and look at their ability to offer personalized information and enable decisions and transactions. We’ll be showing the best tools in clinical decision support, diagnostics and financial management. Panelists will include: Roy Schoenberg, CEO, American Well Michael Cho, CEO, DestinationRx Adam Bosworth, CEO, Keas Marlene Beggelman, CEO, Enhanced Medical Decisions Stefanie Fenton, Director of Healthcare, Intuit …and many special guests and surprises Panel Sponsored by
12:00pm	Lunch
1:30pm	Getting Past the Privacy Conundrum The Markle Foundation’s Josh Lemieux leads a discussion about how the issues of privacy, confidentiality and security will impact consumer confidence in Health 2.0. But more importantly, we’ll be demonstrating several solutions to get us past the privacy conundrum.
2:30pm	Breakout Demo Panels – Session C Wellness 2.0 Fred Goldstein, President & COO, US Preventive Medicine; Henry Albrecht, CEO, Limeade; Amir Kishon, CEO, Wellness layers; Moderator, Jeremy Nobel Sponsored by Genomics online Linda Avey, Co-CEO, 23andMe; Mari Baker, CEO, Navigenics; Moderator, Greg Simons, Faster Cures Pharmacy and medication management Peter Ax, CEO, Kwikmed; Eric Zimmerman, Chief Innovation Officer, Mirixa; Rick Noffsinger, CEO, SafeMed; Sean Teare, President, InnovationRx. Moderator, Jane Sarasohn-Kahn, THINK-Health Search (Part 1) Alain Rappaport, GM, Health Search, Microsoft Health Solutions; Venky, Harinaryan, Co-Founder, Kosmix/RightHealth; Rishi Sikka, CMO, Praxeon; Steven Krein, CEO, Organized Wisdom; Moderator, Craig Stoltz
3:15pm	Networking Break in the Exhibit Hall See the exhibitors and/or catch a sponsored “Deep Dive”
4:00pm	Breakout Demo Panels- Session D Pharma and Health 2.0 Andrew Levitt, CEO, HealthTalker; Kerry Hicks, CEO, HealthGrades; Jeff Shrager, CTO; CollabRx; Meredith Abreu, VP, Manhattan Research; Moderator, Jane Sarasohn-Kahn, THINK-Health Gaming in Health Care Richard Buday, CEO, ArchImage; Paul Puopolo, Humana; Richard Tate, Director, Communications & Marketing, HopeLab; Michael Cole, Fitbrains; Moderator, Doug Goldstein, Gaming4Health Disease Management 2.0 Stan Nowak, CEO, Silverlink; Ileana Welte, SVP, Health Hero Network; Neal Kaufman, CEO, Diabetes Prevention Source; Don Kemper, CEO, Healthwise; Moderator, Joseph Kvedar, Center for Connected Health Search (Part 2) Tom Eng, President & Founder, Healia/Meredith Corp.; West Shell, CEO, Healthline Networks; Laird Kelly, CEO, RSIFocalSearch; Riza Berkan, Co-Founder & CEO, Hakia; Moderator, Craig Stoltz
4:50pm	Looking ahead—The Business and Society of Health 2.0 As is now “traditional” the conference will close with speculation, commentary and forecasts from a stellar panel, while taking lots of time for participation from the audience and community. Noted analyst Brian Klepper will marshal proceedings amongst: Rob Kolodner, National Coordinator, ONCHIT David Kibbe, Senior Advisor, AAFP David Lansky, CEO, Pacific Business Group on Health Alan Greene, Founder of Drgreene.com & CMO, ADAM
5:45pm	Conference Wrap Up Indu Subaiya & Matthew Holt will keep you from cocktails for just more than a minute or two while we get reactions to two intense days of scanning the waterfront of Health 2.0
6:00pm	Cocktails Network among the exhibitors, hang out in the Lounge, play games, and have fun! You won’t get this chance again until the next Health 2.0 Conference!

Also at Health 2.0

You’ll also see and/or
take part in the following special features, with more to be announced:

The Health 2.0 Unconference (the audience favorite from the last two conferences)
Health 2.0 Launch! — special introduction of new companies and new products
IDEO will run another great design workshop
And you can relax in the Health 2.0 Experiential Lounge, with games and demonstrations.

(Agenda is subject to change)