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#WWBR Week of August 28, 2015

by John Moore lll | August 28, 2015

“You Get Reminded You’re a Sick Person”: Personal Data Tracking and Patients With Multiple Chronic Conditions
Jessica Ancker, et al in Journal of Medical Internet Research
“Stop me if you’ve heard this before, but there’s a disconnect between what health IT entrepreneurs think and what patients think. A study in the Journal of Medical Internet Research found that patients with multiple chronic conditions — the ideal demographic for tech solutions that improve care and lower costs — see data tracking as at best a chore and at worst a reminder that they are sick and always will be. Two takeaways for app developers: Let users set personal goals, instead of imposing external goals, and give users tools for coping with the negative feelings that so often accompany life with chronic disease.” – Brian E.

Hot Tech Start-Ups May Face a Long and Bumpy Fall
Katie Benner in The New York Times
“This commentary of the state of tech startups is worth a glance. In 2010, there were less than a dozen startups valued at $1B, and the VC industry invested roughly $23B. Today, those billion dollar “unicorns” number over 130, and the amount of investment has more than doubled to $50B in 2014. These numbers should not be surprising, but they do raise the question of how quickly the environment has changed, for investors as well as startups, in just the last few years. What are the implications for healthcare?” – Naveen

Bigger Hospital Rooms for Bigger Patients
Maxine Levy in The New York Times
“In a sign of the times, Parkland Hospital in Dallas employs up-to-date design thinking in order to accommodate bigger patients, caregivers, and visitors. This article surveys the sundry mechanisms and design choices the hospital employed in its new 862 bed tower and they go far beyond lifts. What sets Parkland apart from other hospitals is that this was not a retrofit — every aspect of the physical plant and furnishing reflects the needs of this patient population.” – Brian M.

JAMA Forum: Insurers Are Once Again At Odds With Hospitals and Physicians
David Cutler in News@JAMA
“Prof Cutler, who was instrumental in forming Obama’s healthcare policies, takes a look at the big consolidation trends in healthcare and posits that maybe what will really disrupt the status quo is not these mega-mergers, but technology itself, that is increasingly finding its way into the hands of the consumer.” – John

Breaking The Fee-For-Service Addiction: Let’s Move To A Comprehensive Primary Care Payment Model
Rushika Fernandopulle in The Health Affairs Blog
“This manifesto on the evils of FFS reviews all of the reasons it is so counter-productive. This is a great read based on the experiences of Iora Health. The problem with the proposed solution, besides being a little vague in the specifics, is its wild impracticality. Converting the wider healthcare system to VBR “cold turkey”, as the author suggests, would upset a number of entrenched players seeking to protect revenue streams regardless of the payment system.” – Brian M.

How Many Employers Could be Affected by the Cadillac Plan Tax?
Gary Claxton and Lerry Levitt in The Kasier Family Foundation
“Significant percentage of employers face exposure to the ACA “Cadillac tax” that kicks in in 2018. This article looks at the implications to future employee health benefit plan structures. Likely outcome, the eventual disappearance of Flexible Spending Accts (FSA) and migration to narrower network plans.” – John

Quality Improvement: ‘Become Good At Cheating And You Never Need To Become Good At Anything Else
Gary Claxton and Lerry Levitt in The Kasier Family Foundation
“The good news about hospital readmissions, much like the home run totals of sluggers from the steroid era, might have to come with an asterisk. A Health Affairs blog post points out that the much-touted drop in readmissions among Medicare beneficiaries has coincided with a rapid rise in “observing” these patients. Observation counts as an outpatient service an not an inpatient admission, so in addition to not counting against the readmission penalty it leaves patients responsible for the bill. This, Health Affairs said, essentially eradicates whatever quality gain hospitals claimed by reducing readmissions.” – Brian Eastwood

How to understand the new ACO results
Ben Umansky for The Advisory Board
“Nice summary and light analysis here of Medicare’s recently released updates on the their Pioneer ACO and Shared Savings Programs. The programs who have shown an ability to earn bonus payments last year are steadily earning bigger payments this time around. But the majority (about 75%) of HCOs participating did not earn any rewards, and half of all programs wound up costing more than expected. The high level takeaway here is that while Medicare remains as committed as ever to these programs, those waiting for these organizations to “mature” to the point of making steady investments in IT might have to hang on a little bit longer. ” – Naveen

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