Health and Medical News and Resources

General interest items edited by Janice Flahiff

[Press release] Care of patients prior to making a diagnosis rarely assessed by quality measures

Care of patients prior to making a diagnosis rarely assessed by quality measures

From the 3 February 2015 press release

An examination of process measures endorsed by the National Quality Forum finds that these measures focus predominantly on management of patients with established diagnoses, and that quality measures for patient presenting symptoms often do not reflect the most common reasons patients seek care, according to a study in the February 3 issue of JAMA.

 

Health care reform efforts, such as accountable care organizations, focus on improving value partly through controlling use of services, including diagnostic tests. Publicly reported quality measures that evaluate care provided prior to arriving at a diagnosis could prevent financial incentives from producing harm. The National Quality Forum (NQF) currently serves as the consensus-based quality-measure-endorsement entity called for in the Affordable Care Act. Endorsed measures are often adopted by the Centers for Medicare & Medicaid Services in payment and public reporting programs, according to background information in the article.

 

Hemal K. Kanzaria, M.D., M.S.H.P.M., of the University of California, Los Angeles, and colleagues examined NQF-endorsed process measures that evaluate the prediagnostic (prior to making a diagnosis) care of patients presenting with signs or symptoms. There were 372 process quality measures listed on the NQF website as of June 4, 2014; from these, 385 codings were determined, by categorizing the process quality measures by a system developed by the Institute of Medicine. Approximately two-thirds (n = 267) targeted disease management and 12 percent (n = 46) targeted evaluation/diagnosis. The remaining were evenly distributed among prevention, screening, and follow-up.

 

Of 313 measures pertaining to evaluation/diagnosis or management, 211 (67 percent) began with an established diagnosis, whereas 14 (4.5 percent) started with a sign/symptom. The sign/symptom-based measures focused on geriatric care (e.g., memory loss, falls, urine leakage) or emergency department care (e.g., chest pain). In contrast, many common reasons for which patients seek care, including fever, cough, headache, shortness of breath, earache, rash, and throat symptoms, were not reflected by the quality measures. The performance of a lab test or medical imaging study was the action required by 59 of 313 (19 percent) endorsed quality measures; many others required actions related to medication prescribing.

February 5, 2015 Posted by | health care | , , , , | Leave a comment

[Reblog] A sampling of perspectives on Brill’s take on health reform

From the 23 January 2015 post at Covering Health-Monitoring the Pulse of Health Care Journalism

I’m sure a lot of you have Steven Brill’s “America’s Bitter Pill” on your bedside table by now – I’m not going to try to recap it here.

But I did want to share a few links to some of the more thoughtful (or provocative) articles and reviews, representing critics on both the left and right. I also wanted to draw your attention to another recent book providing a conservative perspective on health reform.

The second book (and I should say that while I have a copy, I loaned it to a colleague before I read it myself…) is by the Washington Examiner‘s commentary editor,  Philip Klein, who looks at the options and thoughts on the right in “Overcoming Obamacare: Three Approaches to Reversing The Government Takeover of Health Care.” It hasn’t been as widely reviewed as Brill’s book but Aaron Carroll gives it an interesting write-up in the Incidental Economist blog.

January 27, 2015 Posted by | health care | , , , , , , , | Leave a comment

[News article] Health Insurance, Death Rates and the Affordable Care Act

Health Insurance, Death Rates and the Affordable Care Act.

From the 12 May 2014 article at Pew State and Consumer Initiatives

The mortality rate in Massachusetts declined substantially in the four years after the state enacted a law in 2006 mandating universal health care coverage, providing the model for the Affordable Care Act. 

In a study released last week, Harvard School of Public Health professors Benjamin Sommers, Sharon Long and Katherine Baicker conclude that “health reform in Massachusetts was associated with a significant decrease in all-cause mortality.” 

 

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                                        A portion of the chart

The authors caution that their conclusions, published in Annals of Internal Medicine, may not apply to all states, and other studies have shown little correlation between having insurance and living longer. Nevertheless, the Harvard study adds to a growing body of evidence that having health insurance increases a person’s life expectancy.

…..

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May 13, 2014 Posted by | Health Statistics | , , , | Leave a comment

[Reblog] Fatal Error (in Health Care)

 

The VA Palo Alto Health Care System in Palo Al...

The VA Palo Alto Health Care System in Palo Alto, California. (Photo credit: Wikipedia)

From the 4 April 2014 post by Rob Lamberts, MD at The Health Care Blog

The janitor approached my office manager with a very worried expression.  ”Uh, Brenda…” he said, hesitantly.

“Yes?” she replied, wondering what janitorial emergency was looming in her near future.

“Uh…well…I was cleaning Dr. Lamberts’ office yesterday and I noticed on his computer….”  He cleared his throat nervously, “Uh…his computer had something on it.”

“Something on his computer? You mean on top of the computer, or on the screen?” she asked, growing more curious.

“On the screen.  It said something about an ‘illegal operation.’  I was worried that he had done something illegal and thought you should know,” he finished rapidly, seeming grateful that this huge weight lifted.

Relieved, Brenda laughed out loud, reassuring him that this “illegal operation” was not the kind of thing that would warrant police intervention.

Unfortunately for me, these “illegal operation” errors weren’t without consequence.  It turned out that our system had something wrong at its core, eventually causing our entire computer network to crash, giving us no access to patient records for several days.

The reality of computer errors is that the deeper the error is — the closer it is to the core of the operating system — the wider the consequences when it causes trouble.  That’s when the “blue screen of death” or (on a mac) the “beach ball of death” show up on our screens.  That’s when the “illegal operation” progresses to a “fatal error.”

The Fatal Error in Health Care 

Yeah, this makes me nervous too.

We have such an error in our health care system.  It’s absolutely central to nearly all care that is given, at the very heart of the operating system.  It’s a problem that increased access to care won’t fix, that repealing the SGR, or forestalling ICD-10 won’t help.

It’s a problem with something that is starts at the very beginning of health care itself.

The health care system is not about health.

……

For any solution to have a real effect, this core problem must be addressed.  The basic incentive has to change from sickness to health.  Doctors need to be rewarded for preventing disease and treating it early. Rewards for unnecessary tests, procedures, and medications need to be minimized or eliminated.  This can only happen if it is financially beneficial to doctors for their patients to be healthy.

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May 3, 2014 Posted by | health care | , , | Leave a comment

[Reblog] Measuring Quality of Care for Older Adults With Serious Illness

From he 22 January 2014 post at HealthAffairsBlog

by Laura Hanson, Anna Schenck, and Helen Burstin

Editor’s Note: This post is the third in a periodic Health Affairs Blog series on palliative care, health policy, and health reform. The series features essays adapted from and drawing on an upcoming volume, Meeting the Needs of Older Adults with Serious Illness: Challenges and Opportunities in the Age of Health Care Reform, in which clinicians, researchers and policy leaders address 16 key areas where real-world policy options to improve access to quality palliative care could have a substantial role in improving value. 

In the United States, value is the new health care imperative – improving quality while controlling costs.  We spend nearly twice the rate of comparable nations, yet have poorer health outcomes.  In 2010, President Obama signed the Patient Protection and Affordable Care Act (ACA), mandating a new emphasis on paying for value, not volume.

Our greatest opportunity to enhance value in US health care is to improve quality of care for older adults with serious illness – the group who uses the most health care services. Serious illness, in which patients are unlikely to recover, stabilize, or be cured, is life-altering for patients and family caregivers.  It includes advanced, symptomatic stages of diseases such as congestive heart failure, chronic lung disease, cancer, kidney failure, and dementia. Serious illness may also refer to the cumulative consequences of multiple conditions progressing over time, causing functional decline or frailty.

We’ve made important progress in understanding high quality care for this population of patients.  Researchers have asked patients with serious illness and their families how they define high quality care.  Especially in serious illness, patients want control over treatment through shared decision-making.   Even when there is no cure, most patients still want health care that helps them live longer – but only if they can also get help with function, physical comfort, and attention to family, emotional and spiritual needs.

We know what types of health care help patients and families cope with serious illness.  A 2012 report to the Agency for Healthcare Research and Quality finds evidence for three types of care to improve health outcomes:

  1. Expert pain and symptom treatment
  2. Communication to engage patient preferences for treatment decisions
  3. Interdisciplinary palliative care

We’ve developed quality measures to understand how often real-world care lives up to these ideals.

……

 

Read the entire article here

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January 26, 2014 Posted by | health care | , , , , , | Leave a comment

STATISTICAL BRIEF #424: The Long-Term Uninsured in America, 2008-2011 (Selected Intervals): Estimates for the U.S. Civilian Noninstitutionalized Population under Age 65

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STATISTICAL BRIEF #424: The Long-Term Uninsured in America, 2008-2011 (Selected Intervals): Estimates for the U.S. Civilian Noninstitutionalized Population under Age 65.

    From the Web page of the Medical Expenditure Panel Survey

November 2013
Jeffrey A. Rhoades, PhD and Steven B. Cohen, PhD

Highlights

  • Approximately 20.4 million people, 7.6 percent of the population under age 65, were uninsured for the four-year period from 2008 through 2011. The percentage of long-term uninsured exceeded 10 percent for some younger adult age groups.
  • Adults ages 18 to 24 and 25 to 29 were the most likely to be uninsured for at least one month (48.0 and 46.9 percent, respectively) during 2010-2011. Children under age 18 were the least likely to be uninsured for the full four-year period from 2008-2011 (2.3 percent).
  • Individuals reported to be in excellent or very good health status were the least likely to be uninsured for at least one month during 2010 to 2011 (26.6 and 31.1 percent, respectively).
  • Hispanics were most likely to be uninsured for at least one month during 2010 to 2011 (47.8 percent) and for 2008-2011 (17.4 percent).
  • Hispanics were disproportionately represented among the long-term uninsured. While they represented 18.2 percent of the population under age 65, they comprised 41.5 percent of the long-term uninsured for 2008-2011.
  • Individuals who were poor, near poor, and low income were represented disproportionately among the long-term uninsured. While poor individuals represented 16.8 percent of the population under age 65, they represented 29.9 percent of those uninsured for 2008-2011.

 

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January 12, 2014 Posted by | health care | , , , | Leave a comment

Incentivizing Healthy Behaviors in Low-Income Patient Populations

Incentivizing Healthy Behaviors in Low-Income Patient Populations.

From the 24 October 2013 blog item at Leavitt Partners

What works and 8 lessons other health care organizations learn

Data suggests costs can be better contained if all people are practicing healthy life behaviors.[i] State and Federal leaders, charged with holding down costs without sacrificing access to or quality of care, agree with this principal—and as a health insurance payer with one of the longest histories of serving low-income individuals, state Medicaid programs have explored many approaches to incentivizing positive health-related behaviors in its patient populations.

On January 1 2014, about half of the states will expand their Medicaid programs to newly eligible individuals with income below 133% FPL. Insurance subsidies will also be provided to individuals with income between 100% and 400% FPL, increasing access to commercial insurance to those with low- to moderate-incomes. As health care organizations begin managing the health and wellbeing of these newly insured groups, many will be looking for ways to control long-term costs by incentivizing healthy changes in behaviors.

In order to better understand which approaches are the most effective, Leavitt Partners analyzed case studies and program outcomes to answer the following questions:

What are the most effective approaches to motivate low-income adults to make positive changes in their behavior (for themselves and children)?

What are the most effective approaches to motivate low-i

– See more at: http://leavittpartners.com/2013/10/incentivizing-healthy-behaviors-low-income-patient-populations/#sthash.DyBTYRJG.dpuf

 

 

October 26, 2013 Posted by | health care | , , , , , | Leave a comment

Health Law Helper – Affordable Care Act Interactive Tool

Health Law Helper – Affordable Care Act Interactive Tool.

From the Consumer Reports Web site

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Related Affordable Care Act (Obamacare) Resources 

Information about the Act (Obamacare)

Other pages at HHS.gov/healthcare (US Dept of Health and Human Services)

  • Live Chat courtesy of  the US Department of Health and Human Services (HHS)
  • Prevention and Wellness with information on how many insurers are required to cover certain preventive services at no cost to you.

October 1, 2013 Posted by | health care | , , , , | 1 Comment

Useful Video For Understanding 2014 Health Care Changes and “Obama Care”

Great 7 minute overview, published by KaiserHealthCare. Really liked how the graphics (including Playschool like cartoon figures) outlined the major points without making me feel like a dummy!

From the 26 August 2013 post at Sara Zia Ebrahimi

Do you have a good sense of what the new health care options are starting 2014? The HR folks at work just shared this cute 7minute video that does a good job of clarifying what the options are and the advantages and disadvantages of each. I found it really useful and thought I’d pass it along.

Excerpts

  ” Individual exchanges in 34 states will be created via the federal government – but on July 5, it quietly granted another concession. The Department of Health and Human Services relaxed a requirement for the 16 other states and the District of Columbia to verify the income and health coverage status of applicants to those individual exchanges. These 17 exchanges will only check the income eligibility of applicants at random next year, and they will wait until 2015 to check if applicants are getting employer-sponsored health benefits.5″

Where do things stand state-by-state with the Medicaid expansion? Just 23 states and the District of Columbia have signed up for it. (You’ll recall that the Supreme Court allowed states to opt out of it when it ruled that the ACA was constitutional in 2012.) In these states and in Washington D.C., those with earnings of up to 138% of the federal poverty level may qualify for Medicaid (that works out to earnings of $15,856 for an individual and $32,499 for a family of four). The expansion of Medicaid in these states doesn’t require the federal government to recreate the wheel, but delays could happen in other ways. In Michigan, for example, state legislators have passed their own version of a Medicaid expansion requiring a 90-day federal review process, which will put Michigan weeks behind in enrolling participants in expanded Medicaid coverage.6,”

August 28, 2013 Posted by | health care | , , , , , , , , , | Leave a comment

Rational Rationing vs. Irrational Rationing

 

English: This image depicts the total health c...

English: This image depicts the total health care services expenditure per capita, in U.S. dollars PPP-adjusted, for the nations of Australia, Canada, France, Germany, Japan, Switzerland, the United Kingdom, and the United States with the years 1995, 2000, 2005, and 2007 compared. An ‘OECD Health Data 2010’ report is used for the information, which is available here. Note that there is additional information in this list. (Photo credit: Wikipedia)

 

Rational Rationing vs. Irrational Rationing By DAVID KATZ, MD in the 13 September 2012 article at The Health Care Blog

Excerpts

n a system of universal, or nearly universal health insurance such as in Massachusetts, decisions about what benefits to include for whom are decisions about the equitable distribution of a limited resource. If that is rationing, then we need to overcome our fear of the word so we can do it rationally. By design or happenstance, every limited resource is rationed. Design is better.

In the U.S. health care system, some can afford to get any procedure at any hospital, others need to take what they can get. Some doctors provide concierge service, and charge a premium for it. Any “you can have it if you can afford it” system imposes rationing, with socioeconomic status the filter. It is the inevitable, default filter in a capitalist society where you tend to get what you pay for.

That works pretty well for most commodities, but not so well for health care. As noted, failure to spend money you don’t have on early and preventive care may mean later expenditures that are both much larger, and no longer optional — and someone else winds up paying. If you can’t afford a car, you don’t get one; if you can’t afford care for a bullet wound — if you can’t afford CPR — you get it anyway, and worries about who pays the bill come later.

But those costs, and worries, do come later — and somewhere in the system, we pay for them.

By favoring acute care — which can’t be denied — our current system of rationing dries up the resources that might otherwise be used for both clinical preventive services and true health promotion. Fully 80 percent of all chronic disease could be eliminated if our society really rallied around effective strategies for tobacco avoidance, healthful eating, and routine physical activity for all. But when health care spending on the diseases that have already happened is running up the national debt, where are those investments to come from? The answer is, they tend not to come at all. And that’s rationing: not spending on one thing, because you have spent on another.

Nor is this limited to health care. The higher the national expenditure on health-related costs, the fewer dollars there are for other priorities, from defense, to education, to the maintenance of infrastructure. If cutting back on defense calls the patriotism of Congress into question, then classrooms get crowded and kids are left to crumble. Apparently, it is no threat to patriotism to threaten the educational status of America’s future. …

 

 

 

 

September 14, 2012 Posted by | health care | , , , , , , , | 1 Comment

[reblog]Journal editorials this week: the magic asterisk and transparency in clinical trials

From the 30 August 2012 blog posting at HealthNewsReview

Two journal editorials touching on different health care reform issues caught our eye.

Harold DeMonaco, MS, one of our story reviewers on HealthNewsReview.org, thought that an editorial in the New England Journal of Medicine by editor Jeffrey Drazen, MD, deserves some news attention.  DeMonaco wrote me:

“Over the past five years or so, there has been a gradual increase in the registration of clinical trials into a single database.  Although it would be nice to believe that the pharmaceutical industry has embraced the concept of transparency, it is more likely that the FDA Amendments Act of 2007 forced their hand.  Without registration of the clinical trial and reporting of the results, the FDA would not consider the data for submission for a New Drug Application.

As Dr. Drazen notes, there are some holes in the existing legislation.  Not all studies need be registered.  A newly introduced bill into the US House of Representatives would close the loopholes and provide ‘real transparency.’  There are always two sides to every story and the pharmaceutical industry has legitimate proprietary concerns that no doubt will be voiced loudly to members of the House and to the media.  It seems to me that this issue represents a wonderful opportunity for the media to inform and educate the public on this important piece of legislation for both sides on the issue.”

 

And in the JAMA Forum, David Cutler, PhD, of Harvard and the Institute of Medicine suggests that journalists and the public pay more attention to “the magic asterisk” in health policy discussions.

 

September 6, 2012 Posted by | health care | , | Leave a comment

[on the Affordable Care Act] HealthNewsReviews.org Guest post: Bewitched, bothered and bewildered

 

Reblog from 7 August 2012 article at HealthNewsReview.org

The following is a guest post submitted by Harold DeMonaco, MS, one of our expert story reviewers for HealthNewsReview.org.  The opinions stated are his.

——————————————————————————————

I, like many, read the internet version of my local newspaper.  And in doing so, I am provided with an opportunity to view the comments of my fellow residents on topics of importance.  My local newspaper is a bit right leaning and as a result, the vox populi is as well.

Many of those who post thoughts on current events do so with great fervor and some with great frequency.  The tone and tenor of the “discussions” can vary but were at their most vitriolic when writers could use pseudonyms.  Many of the most vocal appear to have departed when a requirement was made to self identify posts to the site.  Several continue to provide the rest of us with the fruits of their years and breadth of experience as well as their keen intellect.

Given the right leanings of the newspaper and the most vocal of the vox populi, it is not surprising that the Affordable Care Act (presumably a four letter word for many) is viewed in a somewhat negative fashion.  This is somewhat surprising since presumably the writers are either the beneficiaries of then Governor Romney’s surprising insight into healthcare or to the workings of President Johnson’s Great Society and Medicare.  Massachusetts has managed to insure just about every citizen in the state and has now enacted legislation to better control health care costs.  While there is work to be done to develop an ideal healthcare delivery system in Massachusetts and control costs, near universal access has been accomplished.

Why then do people object so strenuously to Obamacare?  Is it their fear of government control?  If so, the objectors should rightfully refuse Medicare, a pay as you go, government run insurance program managed by the Centers for Medicare and Medicaid.  I suspect that the underlying reason is really rooted in economics.  In essence, it is a zero sum game. If you win something, I must lose something.

The Blue Cross Foundation of Massachusetts periodically publishes updates on the Massachusetts experiment.  Here are the latest findings:

  • 439,000 more Massachusetts residents have health insurance coverage than did before reform.
  • Massachusetts has the highest rate of insurance in the country with 98.1 percent of residents insured.
  • There has been no evidence of subsidized coverage “crowding out” employer-sponsored insurance, and employer offer rates have grown from 70 percent to 77 percent since implementation of reform.
  • Public support for Massachusetts health reform has remained strong with two out of three adults supporting reform.
  • Most employers believe health reform has been good for Massachusetts and 88 percent of Massachusetts physicians believe reform improved, or did not affect, care or quality of care.
  • The cost of health care and the annual rate of increase in health care spending remains a challenge.  With no intervention, per capita health care spending in Massachusetts is projected to nearly double by 2020.

Given the intensity of the debate around Obamacare, I would have assumed that more news stories would provide readers with more information about the Massachusetts experience.  More often than not however, readers are provided with partisan arguments for and against the Affordable Care Act.  While there is a good deal of noise, there often is little in the way of real information.

 

 

The following is a guest post submitted by Harold DeMonaco, MS, one of our expert story reviewers for HealthNewsReview.org.  The opinions stated are his.

——————————————————————————————

I, like many, read the internet version of my local newspaper.  And in doing so, I am provided with an opportunity to view the comments of my fellow residents on topics of importance.  My local newspaper is a bit right leaning and as a result, the vox populi is as well.

Many of those who post thoughts on current events do so with great fervor and some with great frequency.  The tone and tenor of the “discussions” can vary but were at their most vitriolic when writers could use pseudonyms.  Many of the most vocal appear to have departed when a requirement was made to self identify posts to the site.  Several continue to provide the rest of us with the fruits of their years and breadth of experience as well as their keen intellect.

Given the right leanings of the newspaper and the most vocal of the vox populi, it is not surprising that the Affordable Care Act (presumably a four letter word for many) is viewed in a somewhat negative fashion.  This is somewhat surprising since presumably the writers are either the beneficiaries of then Governor Romney’s surprising insight into healthcare or to the workings of President Johnson’s Great Society and Medicare.  Massachusetts has managed to insure just about every citizen in the state and has now enacted legislation to better control health care costs.  While there is work to be done to develop an ideal healthcare delivery system in Massachusetts and control costs, near universal access has been accomplished.

Why then do people object so strenuously to Obamacare?  Is it their fear of government control?  If so, the objectors should rightfully refuse Medicare, a pay as you go, government run insurance program managed by the Centers for Medicare and Medicaid.  I suspect that the underlying reason is really rooted in economics.  In essence, it is a zero sum game. If you win something, I must lose something.

The Blue Cross Foundation of Massachusetts periodically publishes updates on the Massachusetts experiment.  Here are the latest findings:

  • 439,000 more Massachusetts residents have health insurance coverage than did before reform.
  • Massachusetts has the highest rate of insurance in the country with 98.1 percent of residents insured.
  • There has been no evidence of subsidized coverage “crowding out” employer-sponsored insurance, and employer offer rates have grown from 70 percent to 77 percent since implementation of reform.
  • Public support for Massachusetts health reform has remained strong with two out of three adults supporting reform.
  • Most employers believe health reform has been good for Massachusetts and 88 percent of Massachusetts physicians believe reform improved, or did not affect, care or quality of care.
  • The cost of health care and the annual rate of increase in health care spending remains a challenge.  With no intervention, per capita health care spending in Massachusetts is projected to nearly double by 2020.

Given the intensity of the debate around Obamacare, I would have assumed that more news stories would provide readers with more information about the Massachusetts experience.  More often than not however, readers are provided with partisan arguments for and against the Affordable Care Act.  While there is a good deal of noise, there often is little in the way of real information.

 

 

 

 

August 15, 2012 Posted by | health care | , , , , , | Leave a comment

Where do our wasted health dollars go to?

From the 29 April 2012 article at Kevin MD.com

The biggest problem with health care delivery in the US is cost, which seems to have taken a back seat to other issues meant to be addressed by health care reform. We spend about $2.5 trillion dollarsa year on health care—that’s over eight thousand dollars a year for every man, woman, and child. What’s that getting you?

According to the government, about 30% goes to hospitals; 20% goes to doctors and other clinicians, 10% goes for prescriptions, and the other 40% or so goes for “other spending,” mostly administrative costs and haircuts for insurance executives. But it’s probably even worse than that: according to arecent JAMA study, about 20% of total healthcare expenditures are wasted dollars.

20% of 2.5 trillion dollars, by the way, is 500 billion dollars. Each year. The JAMA article breaks down the waste into several categories:..

Read the article here for the category breakdown

 

 

Related Resources

Related articles

A group of nine medical specialty societies recently announced the “Choose Wisely” campaign, targeting 45 commonly performed medical procedures and tests that offer little or no value in improving health. These interventions waste precious health care resources, lead to erroneous conclusions and/or false security, spur unwarranted additional interventions, and cause patient harm. Among the appropriately indicted procedures was cardiac stress testing of asymptomatic, low-risk patients. There is an old adage among savvy clinicians: “It is difficult to make an asymptomatic person feel better.” Attempting to do so can cause more harm than good.

 

May 3, 2012 Posted by | health care | , , | Leave a comment

Nimble Medicine | The Health Care Blog

Nimble Medicine | The Health Care Blog

This is an interesting blog posting on business models (old) and technologies (new) in health care delivery.
The author writes on why this is not working.

Specifically the author is advocating decentralization of health care delivery to reduce costs and reduce time in treating people at the onset of health problems (before and during treatment).

The author does provide a disclaimer, he is employed by a health care technology company.

Still, an interesting view of what health care industry trends.

 

February 13, 2012 Posted by | health care | , , | Leave a comment

What’s Wrong With a Welfare Nation?

Posted on January 31, 2012 by

At The Atlantic, a post by Alex Tabarrok, “The Innovation Nation vs. the Warfare-Welfare State“, has been making its way around the bloggysphere, in part due to the big shout out to science, as embodied by this figure:

innovation welfarewarfare

Tabarrok:

We like to think of ourselves as an innovation nation, but our government is a warfare/welfare state. To build an economy for the 21st century we need to increase the rate of innovation and to do that we need to put innovation at the center of our national vision.

Innovation, however, is not a priority of our massive federal government. Nearly two-thirds of the U.S. federal budget, $2.2 trillion annually, is spent on the four biggest warfare and welfare programs, Medicaid, Medicare, Defense and Social Security. In contrast, the National Institutes of Health, which funds medical research, spends $31 billion annually, and the National Science Foundation spends just $7 billion.

I’m all for cutting back on the warfare state–that senitment is as old as the biblical prophets. And spending more money on non-military research is a good thing (and while we’re on the subject, go sign this petition). Regular readers will know I agree with that. But I’m not sure what’s wrong with the so-called welfare programs.

I’m all for controlling healthcare costs and figuring out ways of delivering care more effectively (who could possibly be against these things?).

February 1, 2012 Posted by | health care | , , , | Leave a comment

Short Animated Video on Current Health Care System Changes – Kaiser Health Reform

Health Reform Hits Main Street – Kaiser Health Reform

From the Kaiser Health Reform Source Web page

Confused about how the new health reform law really works? This short, animated movie — featuring the “YouToons” — explains the problems with the current health care system, the changes that are happening now, and the big changes coming in 2014. Learn more about how the health reform law will affect the health insurance coverage options for individuals, families and businesses with the interactive feature “Illustrating Health Reform: How Health Insurance Coverage Will Work.”

January 31, 2012 Posted by | health care | , , , , | Leave a comment

An annual checkup on the Affordable Care Act

An annual checkup on the Affordable Care Act

An excerpt from the article by by  at  the December 2011 issue of KevinMD.com

As we approach the end of what has been another roller-coaster year for our country, it seems an appropriate time for an “annual checkup” on healthcare reform in the U.S.

Like many of my colleagues, I have followed the implementation of the monumental Patient Protection and Affordable Care Act (ACA) with great interest, mild trepidation, and a small measure of optimism.

It’s hard to believe that almost two years have flown by since the passage of this historic, game-changing legislation that will influence how healthcare is delivered and reimbursed in the U.S. for decades to come.

Although debates will continue to rage about the law and its sweeping array of mandates, the ACA and the overwhelming majority of its provisions are likely here to stay.

The popular media tends to focus on the “chief complaints” — a few hot-button issues such as “death panels” and the significant number of state-sponsored challenges to the legality and “constitutionality” of some of the law’s provisions.

However, in the course of a comprehensive “annual physical” exam, it is clear that a surprisingly large number of the law’s provisions have already gone into effect — smoothly and as planned across the entire industry.

Here are just a few …..

Read the entire article

December 13, 2011 Posted by | health care | , , | Leave a comment

How Human Services Programs and Their Clients Can Benefit from National Health Reform Legislation

urban institute nonprofit social and economic policy research

From the Report Summary (Urban Institute)

Human services programs-the Supplemental Nutrition Assistance Program, Temporary Assistance to Needy Families, subsidized child care, etc.-and their clients can benefit from national health reform. Millions of low-income health coverage applicants can be connected with human services programs, as the latter programs: (a) help health programs efficiently reach eligible consumers; (b) access unprecedented, time-limited federal funding for modernizing eligibility computer systems while limiting risks to current funding; (c) keep social services offices available as an avenue for seeking health coverage; and (d) use a forthcoming Medicaid expansion to accomplish core human services goals related to employment and child development.

 

 

November 17, 2011 Posted by | Public Health | , , , , , , | Leave a comment

   

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