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Sunday, July 29, 2012

Health Care's New Rule: If You Don't Buy Health Insurance, Will You Really Pay the Tax?

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The Insider's Guide Tech - The Business of Health Care

 

Health Care's New Rules: If You Don't Buy Health Insurance, Will You Really Pay the Tax?
By JOSEPH ANTOS and MICHAEL R. STRAIN

Now that the Supreme Court has decided that ObamaCare’s mandate to buy health insurance is a tax, will the IRS be able to collect it?

Generally speaking, if you owe the IRS, it will get the money from you—with the possible exception of the ObamaCare tax. Though ObamaCare’s individual mandate imposes a tax on people who do not purchase government-approved health insurance, the law explicitly neuters the IRS’s ability to collect the tax. Read more.


How The iPhone Might Disrupt The Medical Industry
By DR. WES

Doctors wanting to determine a patient’s atrial fibrillation burden have a myriad of technologies at their disposal: 24-hour Holter monitors, 30-day event monitors that are triggered by an abnormal heart rhythm or by the patient themselves, a 7-14 day patch monitor that records every heart beat and is later processed offlineto quanitate the arrhythmia, or perhaps an surgically-implanted event recorder that automatically stores extremes of heart rate or the surface ECG when symptoms are felt by the patient. The cost of these devices ranges from the hundreds to thousands of dollars to use. Read more

From Nursify to Visit Minder: Seven iPhone Apps We'd Like To See
By DAVID SACK, MD

I read a few months ago that the number of available iPhone apps had exceeded a million, with new apps now appearing that are intended to help sort through the mountain of other apps. We have reached the age of meta-apps.

In spite of this seeming  plethora of handy apps, there are still a few I have yet to encounter and would like to see created, although I will probably receive some comments on this post alerting me to the fact that some of what I am looking for has already been produced. Read more.

 

Physicians Aren't (Feeling Very) Social
By JIM GOLDEN

There were two interesting developments in the field of social networks for healthcare practitioners last week.  The first was the publication of a paper in JAMA “Variation in Patient-Sharing Networks of Physicians Across the United States”.  The second was the sale of Sermo Physician Network to WorldOne for an undisclosed price.  Sermo had raised $40+m in venture capital prior to sale, making a bet that social networking for physicians could drive value to pharmaceutical and financial firms based on disclosing interactions between members of the network.

If physician behavior and prescribing activity are key to your healthcare business, I think it is important to understand the relationship and differences between these two events. Read more.
 

HealthCamp Boston: Brainstorming the Future of Health Care
By DAVID HARLOW

HealthCamp Boston is a forum for people with interest in all areas of health and wellness to gather, to generate ideas, and to take practical steps towards building the future of health care. HealthCamps are different from traditional conferences where speakers talk at you. At HealthCamp Boston, an “unconference,” attendees set the agenda, and all contribute to the event according to their interests. Read more.
 

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Tuesday, July 24, 2012

THCB Reader: Health Insurers & the Affordable Care Act: Extinction or Reinvention?

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The Op-Ed Page - Tech  - Hospitals - Health Plans - Physicians

 

Health Insurers & the Affordable Care Act: Extinction or Reinvention?
By KENT BOTTLES, MD

Now that the Supreme Court has upheld the constitutionality of the Patient Protection and Affordable Care Act (PPACA), health insurers are scrambling to reinvent themselves for a new era.  In an earlier post, I quoted Aetna CEO Mark Bertolini as saying he wants to create a business model that makes sense under the new rules and regulations.  In a recent speech Bertolini explained, “We need to move the system from underwriting risk to managing populations.  We want to have a different relationship with the providers, physicians and hospitals we do business with.” Read more.

In God We Trust. All Others Must Bring Data.
By BOB WACHTER, MD 

I knew it would happen sooner or later, and earlier this week it finally did.

In 2003 US News & World Report pronounced my hospital, UCSF Medical Center, the 7th best in the nation. That same year, Medicare launched its Hospital Compare website. For the first time, quality measures for patients with pneumonia, heart failure, and heart attack were now instantly available on the Internet. While we performed well on many of the Medicare measures, we were mediocre on some. And on one of them – the percent of hospitalized pneumonia patients who received pneumococcal vaccination prior to discharge – we were abysmal, getting it right only 10% of the time. Read More. 
 

See One. Do One. Harm One? 
By PETER PRONOVOST, MD

I recently cared for Ms. K, an elderly black woman who had been sitting in the intensive care unit for more than a month. She was, frail, weak and intermittently delirious, with a hopeful smile. She had a big problem: She had undergone an esophagectomy at an outside hospital and suffered a horrible complication, leading her to be transferred to The Johns Hopkins Hospital. Ms. K had a large hole in her posterior trachea, far too large to directly fix, extending from her vocal cords to where her trachea splits into right and left bronchus. She had a trachea tube so she can breathe, and her esophagus was tied off high in her throat so oral secretions containing bacteria did not fall through the hole and infect her heart and lungs. It is unclear if she will survive, and the costs of her medical care will be in the millions.  Read More.

Who Owns a Patient’s Health Information?
By FRED TROTTER

·The patient to whom it refers?
·The health provider that created it?
·The IT specialist who has the greatest control over it?

The notion of ownership is inadequate for health information. For instance, no one has an absolute right to destroy health information. But we all understand what it means to own an automobile: You can drive the car you own into a tree or into the ocean if you want to. No one has the legal right to do things like that to a “master copy” of health information.

All of the groups above have a complex series of rights and responsibilities relating to health information that should never be trivialized into ownership. Read more.


The Destructiveness of Measures

By DR. WES

A little box pops up before him asking if he asked the patient about the exercise.  He mumbles something under his breath, clicks a little box beneath the question, then moves on.
This is what medicine has become:  a series of computer queries and measures of clicks.  It must be measurable, quantifiable, and justifiable or it didn’t happen.

Do they ask if I asked them about if they used cocaine?  Of course not: too politically incorrect.
Do they ask if I really listened to their heart?  Of course not – this activity is not a paid activity.
Do they ask about the myriad of phone calls and e-mails to arrange for a procedure?  Nope.
Read More.

 

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Why Nobody Believes the Numbers Ever wonder if those wellness, disease management, medical home and other programs imposed on your medical practices really work? Answer that question for yourself by reading Why Nobody Believes the Numbers, the first population health outcomes measurement book not infused with THC.

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Wednesday, July 18, 2012

Health Insurance Blog - Women's Health Insurance Prices To Drop

 

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Women’s Health Insurance Prices To Drop

Women’s health insurance has always struggled to find balance between affordability and quality coverage.  Over 90% of individual health insurance plans charge women higher premiums than men for equal coverage according to Michelle Andrews’ article on NPR.org.  This practice is known as gender rating and has been considered acceptable for years, but this is to change with the implementation of health care reform, set to start in 2014.

A recent report from the National Women’s Law Center calculated that women spend over $1 billion more a year on their health insurance premiums when compared to men.  This shocking statistic lends the question of whether or not this is fair.  Health insurance companies argue that women’s health care costs are typically higher, due in part to maternity health related costs.  Gender rating will be banned starting in 2014 under health care reform and many women are happy to hear this.  Surprisingly, about 65% of people are unaware of this provision in the Affordable Care Act based on a poll conducted by the Kaiser Family Foundation’s April health tracking poll.  There needs to be more education available to Americans to truly understand how health care reform will affect their lives.

Health care reform will still allow health insurance rates to be based on four main factors.  These factors are family vs individual enrollment options, age of applicant, location of applicant and whether or not the applicant smokes.  The new formula could dramatically change the way health insurance rates are charged and some people may see rates decrease, including women.  What will this mean for men?  Some men may end up paying more to balance out the change.  The poll shows about 60% of people favor the new provision, feeling that it levels the playing field for paying premiums.

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Tuesday, July 17, 2012

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Health Insurance Blog - Pennsylvania Health Insurance: Plan Rankings 2012

 

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Pennsylvania Health Insurance: Plan Rankings 2012

J.D. Power and Associates released their health plan rankings for 2012, and the award recipient for the state of Pennsylvania was Geisinger Health Plan of Pennsylvania.  Geisinger’s Overall Experience received a score of 5 out of 5.  Other categories that received 5 out of 5 included Coverage and Benefits, Information and Communication, Claims Processing, Statements, and Customer Service.

Highmark Blue Shield also received a five in Overall Experience with a five in Provider Choice, Claims Processing, and Approval Processes.  Capital Blue Cross received a 4 out of 5 while HealthAmericaHealthAssurant, HighMark Blue Cross Blue Shield, Independence Blue Cross, and UPMC Health Plan received a score of 3 out of 5 which is considered about average.

Four health plans received rankings that were less than desirable including UnitedHealth of Pennsylvania, Cigna of Pennsylvania, Blue Cross of Northeastern Pennsylvania, and Aetna with 2 out of 5.  You can learn more about how plan rankings are calculating by visiting J.D. Power and Associates’ Power Circle Ratings.

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