Health and Medical News and Resources

General interest items edited by Janice Flahiff

[Reblog] Four insurers reveal what they pay for 70 health care services

Four insurers reveal what they pay for 70 health care services | Association of Health Care Journalists.

From the 26 February 2015 article at Covering Health

Health insurers are taking incremental steps to release information on what they pay to health care providers. Each month, they reveal just a bit more.

This week, Aetna, Assurant Health, Humana and UnitedHealthcare released state and local cost information through the nonprofit Health Care Cost Institute (HCCI) on a consumer site called Guroo.com. The data show the costs for about 70 common health conditions and services and are based on claims from more than 40 million insured individuals, HCCI announced.

No other organization has made these data available, HCCI said. In that way, this release is significant. Or, as the Guroo site says of the data: “The biggest collection of cost information is now at your fingertips, so you know what care really costs.”

Well, not exactly. The data show what insurers paid. Or, as Jason Millman pointed out in The Washington Post, “The site doesn’t break down what a consumer pays for services versus what the insurer pays.”

The release of cost-transparency data seems to be gaining some momentum. Last month, the North Carolina Department of Health and Human Services published what it said was “the most current price information” from hospitals and ambulatory surgery centers. In so doing, North Carolina joined Maine and Massachusetts as the only states that publish price data on the web, according to last year’s Report Card on State Transparency Laws  from the Catalyst for Payment Reform and the Health Care Incentives Improvement Institute.

Within days of the publication of the state data, Blue Cross Blue Shield of North Carolina published data on what it pays hospitals and physicians. In an earlier blog post we covered those events in North Carolina.

March 3, 2015 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

Enhanced by Zemanta

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

Improving Health Care through Mobile Medical Devices and Sensors

From the 22 October 2013 Brookings Report

Health care access, affordability, and quality are problems all around the world and large numbers of individuals do not receive the quality care that they need. Mobile technology offers ways to help with these challenges. Through mobile health applications, sensors, medical devices, and remote patient monitoring products, there are avenues through which health care delivery can be improved. These technologies can help lower costs by facilitating the delivery of care, and connecting people to their health care providers. Applications allow both patients and providers to have access to reference materials, lab tests, and medical records using mobile devices.

Complex mobile health applications help in areas such as training for health care workers, the management of chronic disease, and monitoring of critical health indicators. They enable easy to use access to tools like calorie counters, prescription reminders, appointment notices, medical references, and physician or hospital locators. These applications empower patients and health providers proactively to address medical conditions, through near real-time monitoring and treatment, no matter the location of the patient or health provider.

In this paper, part of the Mobile Economy Project, Darrell West looks at specific applications and inventions, and discuss how mobile is transforming health care in the United States and around the world. He argues that mobile health helps frontline health workers and health care providers extend their reach and interactions – enabling them to be more efficient and effective in their provision of medical assistance. And in the conclusion, West recommends several steps that will speed the adoption of mobile technology in health care.

  • Policymakers should encourage the use of mobile devices for health care. Moving to electronic systems for service delivery will save money, improve access, and provide higher levels of quality in both developed and developing nations.
  • Nearly three-quarters of medical expenditures takes place on a small number of chronic illnesses including cardiovascular disease, cancer, diabetes, and asthma. We should encourage the use of mobile systems that monitor patient symptoms and provide real-time advice on treatment and medication because they have the potential to control costs, reduce errors, and improve patients’ experiences.
  • We should work to remove barriers to adoption of mobile applications that aid in chronic disease management and make these tools much more widely available.
  • With growing knowledge about diseases, genetics, and pharmaceutical products, the practice of medicine has become far more complicated. Health providers need access to as much accurate data as they can get on how to treat various ailments.
  • One of the barriers to cost containment and quality service delivery has been the continued reliance in many locales on paper-based medical systems. In a digital world, one cannot imagine a costlier way to run a health care system.
  • On the issue of government regulation, the FDA has finalized its guidance on how mobile applications and regulated mobile medical devices are to be treated in an effort to clarify some of the ambiguities and help further innovation. Having clear rules that encourage desirable behavior is the best way to move forward in mobile health.

Editor’s Note: This paper is released in tandem with the panel discussion: The Modernization of Health Care through Mobile Technology and Medical Monitoring Devices on October 22, 2013.

 

October 23, 2013 Posted by | health care | , , , , , , , , , , , , | Leave a comment

Why the despicable deserve the best care possible

The comment about this piece I left on Facebook.

Wonderful piece. Yes it is up to God. Whom I believe is pure love, pure mercy. All we can do is do our best to be instruments of his peace. And that includes doctors of compassion as Dr. Greg Smith.

 

From the 2 October article at KevinMD.com by Greg Smith, MD

I received a very intriguing question the other day.

“What happens when someone despicable, someone who has committed some horrible act or made some terrible decision, comes in for evaluation or treatment and you have to see them?”

I have been asked to see child molesters of the worst kind, men (usually) who have done things so vile to children that it would make your stomach turn to hear about them. Having raised three daughters of my own and now having two grandchildren and another on the way, these things brought forth such a visceral reaction from me that it was all I could do sometime to continue the interview and not just scream, “Enough!”

I have sat three feet away, close enough for the toe of our shoes to touch, from a murderer in little interview rooms in a county jail. The feeling is almost surreal when a murderer tells you about his family, spending holidays with his wife, his love for his Chevy truck, and the day he got his first job. You listen and you piece the story together and you do your job, but somewhere in the deep recesses of your brain that little protective, self-preserving blinking red light warns you. This man shot another person at point blank range with a twelve gauge shotgun. He could kill you too.

I have interviewed husbands who beat their wives so badly that they sent them to the hospital, jaws broken, ribs cracked, bleeding, faces blue and puffy and swollen. I have heard them blame their wives for the beatings, explaining to me in plaintive, sincere, pleading tones about how she asked for it, she provoked it, she wanted it, she needed it. Again, stomach-turning stuff, my friends.

The question made me think about these people I’ve interviewed over the years in hospitals and emergency rooms and county jails and clinics and courthouses. What is the common denominator here?

Read the entire article here

October 8, 2013 Posted by | health care | , , , | Leave a comment

AHRQ’s Health Care Innovations Exchange Focuses on Clinical-Community Linkages to Improve Chronic Disease Car

Clinical-Community Linkages to Improve Chronic Disease Care

AHRQ’s Health Care Innovations Exchange Focuses on Clinical-Community Linkages to Improve Chronic Disease Care

From a recent email update rec’d from AHRQ (US Agency for Healthcare Research and Quality)

The July 3 issue of AHRQ’s Health Care Innovations Exchange features two profiles of partnerships between clinical practices and community organizations that leverage health provider teams and lay health advisors to improve the management of chronic diseases. One profile describes a public-private initiative that worked with community health teams to improve the delivery of preventive, health maintenance, and chronic care services in Vermont. The pilot program included incentive payments to providers who met National Committee for Quality Assurance-determined care standards, access to an insurer-funded team of community-based health providers, health information incorporated into a Web-based clinical tracking system, and interfaces with other State care coordination initiatives. Over a 4-year period, the pilot program experienced a 6 percent decrease in inpatient admissions and a 10 percent decrease in emergency department visits among participating practices. Select to read more profiles related to clinical-community linkages, including innovations and tools, on the Health Care Innovations Exchange Web site, which contains more than 700 searchable innovations and 1,500 QualityTools.

July 9, 2012 Posted by | health care, Public Health | , , , , , , , | Leave a comment

   

%d bloggers like this: