Home  >  ACOconsumer healthPolicyUncategorizedWhat we've been reading   >   #WWBR Week of January 19, 2015

#WWBR Week of January 19, 2015

by John Moore lll | January 23, 2015

Start-Ups Are Helping Consumers Make Better Health Care Purchases
Sachin Jain for Harvard Business Review
“Sachin Jain’s analysis of the trend of consumer-directed health is spot on. While giving more control to consumers is an undeniably important issue, the specifics of how provision of information can unlock value for the long term are not simple. A couple of the wrinkles touched on here include the unnecessary complexity of how benefits actually work (and the implications for consumer behavior), and communicating the value of preventative care for long term health outcomes. The work being done by some of the leading startups such as Castlight is important – but begs the question of how much can really be done without more buy in (and action) from health plans, employers, and the delivery system itself.” – Naveen

A Prescription to Move: Giving Exercise Its Due
Carl J. Lavie, Jr and Steven N. Blair for Medscape (free account required for access)
“The benefits of exercise and the obvious implication that it should be prescribable is the topic. This interview illustrates the relationships between fitness levels and health outcomes. In this case, they discuss running, not everyone’s cup of tea, and how even minimal amounts lead to significantly less mortality. I think the upshot here is that cardiovascular benefits notwithstanding, many people cannot tolerate running and alternatives should be incented or catalyzed.” – Brian

Could This Pricing Tool For Consumers Disrupt Healthcare?
Dan Munroe for Forbes
“BCBS of North Carolina introduced a new pricing tool for the general public on its website. It features comparisons of 80 of elective procedures, organized by total cost of care. Dan’s analysis of the potential of this model – in terms of “depth” (e.g. adding quality metrics or comparing against more than just two plans), as well as “breadth” (Blues Plans cover some 105M Americans nationwide) is optimistic. We agree with his bullish sentiment, but offer a note of caution about how HCOs need to ensure consumers, and providers, are made aware of and trained on effective use of such tools.” – Naveen

Beyond Belief — How People Feel about Taking Medications for Heart Disease
Lisa Rosenbaum for NEJM
“One of the most vexing issues in healthcare is medication adherence. Pharma companies have spent well over $1billion trying to address this issue with little success. Providers, increasingly on the hook for patient outcomes will be next to spend enormous amounts of resources to address this issue, likely with little success. As this article clearly points out, the reason for non-compliance is as varied as patient attitudes. Patient-centric care will not tackle this one – will personalized medicine have a chance?” – John

Academic Medical Centers Should Lead The Charge On Price Transparency
Giffin Daughtridge and Richard Shannon for Health Affairs Blog
“This Health Affairs Blog Post makes a good case that Academic Medical Centers should take charge on piloting various price transparency practices with patients. Early evidence has shown that people will pick lower priced options if given information beforehand. And it’s badly needed – the example of a $275k variation for a CABG in a PA market is just stunning. Yet somehow, this piece seems incomplete with nary a mention of health insurance’s role in setting consumer expectations when it comes to paying for medical procedures. If co-pays are the same, patients are less likely to care about the end price. If such pilots do roll out, there is a role to be played by the statewide transparency mandates (such as Massachusetts’) that the authors have left out.” – Naveen

Cost Comparison Between Home Telemonitoring and Usual Care of Older Adults: A Randomized Trial (Tele-ERA)
Benjavan Upatising, et al. in Telemedicine and e-Health
“A study published in this month’s Telemedicine and e-Health journal found the use of remote patient monitoring helped reduce the cost of care for patients, but results weren’t statistically significant. Researchers from the Mayo Clinic in Minnesota randomized more than 200 patients to receive either additional home tele-monitoring or the usual medical care. Those receiving the telemedicine had lower spending for inpatient, outpatient and emergency department services as well as their total cost of care, although it wasn’t clear over what time span the savings were realized. It is likely that more random-controlled studies on telemedicine/tele-monitoring are going to be published in medical literature this year and that they will also present mixed messages on cost savings with the biggest challenge being how to calculate cost-savings and ROI for these solutions. ” – Matt

A Response to Steven Brill
Robert Pearl for The Health Care Blog
“This blog post from the CEO of the Permanente Medical Group is a response to the sidebar back and forth generated by Malcolm Gladwell’s review of the new Steven Brill book. At issue was a perceived unfavorable comparison between the blogger’s delivery system and some “name” brands in other geographies. I think that the blogger, Gladwell, and Brill are confusing status and efficacy. A delivery system’s brand should be based on its efficacy, not on whether other providers find its academic chops impressive. The transition to FFV will be accompanied by a more direct focus on outcomes and efficiency and less focus on perceptions of fanciness.” – Brian

Designing Smarter Pay-for-Performance Programs
Aaron McKethan and Ashish K. Jha in JAMA
“There is an excellent article in the December 24/31, 2014 issue of JAMA by Dr. Aaron McKethan (of UNC) and Ashish K Jha, MD (of Harvard) entitled, “Designing Smarter Pay-for Performance Programs.” The article describes how current P4P programs between payers and providers are very wasteful because they are not TARGETED. The authors make a very compelling point that giving ‘bonus’ payments to providers for meeting certain outcomes measurements for patients across the board does not take into account that those patients have very different levels of complexity and many of these patients will have good outcomes without any change in practice or extra attention by the provider. If P4P programs are going to evolve and actually shift the cost curve for managing chronic disease patients, they do need to be radically redesigned instead of the standard practice today of paying a set amount for achieving a measure threshold level for all patients. This is not a new issue either and articles about how to properly design P4P programs have been appearing for over a decade yet progress on designing impactful and effective P4P programs remains quite elusive.” – Matt

Measles Cases Linked to Disneyland Rise, and Debate Over Vaccinations Intensifies
Adam Nagourney and Abby Goodnough for The New York Times
“A small measles outbreak that may have started in Disneyland in Southern California is causing a stir. Researchers are examining the potential link between “under-vaccination” and the spread of this contagious disease among school-age children. Not much by way of health IT here – and that’s the point. As we move towards “population health” – the systems and tools that we are all clamoring for will need to be flexible, responsive, versatile – it’s not just about collecting bonuses for avoiding rehospitalizations. The opportunities for comprehensive IT systems abound for a scenario like this one: better digital education for new parents, real-time disease monitoring through mobile phones, tying vaccination status checks to medical counseling, and many more.” – Naveen

Georgia is Losing its Rural Hospitals
Misty Williams for The Seattle Times
“An article in the Atlanta Journal-Constitution chronicles how hospital services in Georgia are deteriorating due to the rural healthcare financial crisis. The article highlights two-thirds of the state’s 61 hospitals lost money in the past year and roughly a third have experienced serious budget shortfalls for five years running. 21 suffered budget shortfalls for at least five years in a row with another 17 ended four of the five years in the red. 8 hospitals since 2001 have shut down with Charlton Memorial Hospital in Folkston which closed in August 2013 being the most recent. The article goes on to highlight how demographics and economics simply don’t support hospitals anymore in certain rural areas and many counties under 40,000 people. With Georgia being staunchly opposed to expanding Medicaid, it is willing to see what continues to happen with hospitals and to see the effects in other stats that also are not willing to expand Medicaid and have a number of small hospitals in rural areas.” – Matt

Leave a Reply

Your email address will not be published. Required fields are marked *

Leave a Reply

Your email address will not be published. Required fields are marked *

Stay up to the minute.