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By ROBERT LASZEWSKI
I’ve never seen a week in health care policy like last week. The media reports have to be in the thousands, all trying to make sense of the furious debate between Obama and Romney over Medicare.
As someone who has studied this issue for more than 20 years, it has also been more than exasperating for me to watch each side trade claims and for the press to try to make sense of it. Allow me to list a few of the questions people are asking and give you my take on it. Read more.
On 1932, the Committee on the Cost of Medical Care identified rising medical costs as a threat to the financial security of millions of Americans. In a series of studies that created the field of health services research, the Committee recommended several strategies for cost containment that reads like a blueprint for today’s cost containment efforts: prevention, price controls, capitation, elimination of unnecessary care, and integration. If it sounds like a précis of my previous two blogs – cut prices and cut quantities – it should. We have known for a long time that those are the only ways to cut spending. And yet here we are, 80 years later, facing a spending crisis that threatens to take down the entire economy. Read More.
Here’s a Question to Ask Romney or Ryan
By AARON CARROLL, MD
Last week, I noted the significant differences between Paul Ryan’s proposals, from his 2012 budget to Ryan-Wyden to his 2013 budget. I also noted that while it would be tempting to campaign against the 2012 budget, which massively shifted costs onto seniors, his later proposals did that to a far lesser extent. Or did they?
Governor Romney has endorsed Paul Ryan’s latest plan, which is specific in that it will reduce future Medicare spending by unleashing the power of the free market through competitive bidding. But what if that doesn’t happen? Read more.
Profits, Quality, and U.S. Hospitals
By ASHISH JHA, MD
The recent articles in the New York Times about the Hospital Corporation of America (HCA) have once again raised important questions about the role of for-profit hospitals in the U.S. healthcare system. For-profits make up about 20% of all hospitals and many of them are part of large chains (such as HCA). Critics of for-profit hospitals have argued that these institutions sacrifice good patient care in their search for better financial returns. Supporters argue that there is little evidence that their behavior differs substantially from non-profit institutions or that their care is meaningfully worse. Read more.
To Gauge Hospital Quality, Patients Deserve More Outcome Measures
By PETER PRONOVOST, MD
Patients, providers and the public have much to celebrate. Recently, the Centers for Medicare and Medicaid Services’ Hospital Compare website added central line-associated bloodstream infections in intensive care units to its list of publicly reported quality of care measures for individual hospitals.
Why is this so important? There is universal support for the idea that the U.S. health care system should pay for value rather than volume, for the results we achieve rather than efforts we make. Read more.
Closing the Translational Gap: A Challenge Facing Innovators in Medical Science — and in Digital Health
By DAVID SHAYWITZ, MD
The gap between model or potential solutions and solutions that work in the real world – the translational gap — is arguably the greatest challenge we have in healthcare, and is something seen in both medical science and in digital health.
The single most important lesson I learned from my many years as a bench scientist was how fragile most data are, whether presented by a colleague at lab meeting or (especially) if published by a leading academic in a high-profile journal. It was not uncommon to watch colleagues spend months or even years trying to build upon an exciting reported finding, only to eventually discover the underlying result was not reproducible. Read more.
Let's Do the Numbers
By PAUL LEVY
Julie Creswell and Reed Abelson offer a story in the New York Times about the HCA for-profit hospital system, noting "A giant hospital chain is blazing a profit trail." The HCA story and similar ones about other hospital chains financed by private equity force us to consider how a such firms can achieve a return on equity that satisfies investors. The answer is that they cannot, if we think about running the business on a long-term basis. What makes it work is extracting cash and the exit strategy, the heart and soul of private equity. Read more.
Using Predictive Modeling to Make Better Decisions
By RUSS RICHMOND, MD
In an article posted earlier this year on this blog I argued that hospitals have traditionally done a sub-par job of leveraging what has now been dubbed “big data.” Effectively mining and managing the ever rising oceans of data presents both a major challenge – and a significant opportunity – for hospitals.
By doing a better of job connecting the dots of their big data assets, hospital management teams can start to develop the crucial insights that enable them to make the right and timely decisions that are vital to success today. And, better, timelier decisions lead to improved results and a higher level of quality patient care. Read more.
A Big Fat Stupid Law??
By MARION NESTLE
The Affordable Care Act instituted national menu labeling—the posting of calories on the menu boards of fast food chains. The FDA still has not issued final rules, leaving vast amounts of time for lobbying and pushback. Now John Carter (Rep-TX) has introduced HR 6174, the anything but “Common Sense Nutrition Disclosure Act of 2012.” This bill was introduced under lobbying pressure from the pizza and supermarket industries. Its purpose is to exempt supermarkets and convenience stores from having to post calorie information on prepared foods. Read more.
The Coming Battle for Medicare
By ROBERT LASZEWSKI
Republican Vice Presidential pick Paul Ryan isn’t the only one Democrats are piling on this week. The knives have come out for Senator Ron Wyden, the Oregon Democrat.
I guess that isn’t a surprise. If Ron Wyden is right on Medicare then so are Paul Ryan and Mitt Romney. The fundamental problem here is that the Democrats have decided that their best path to victory in the November elections is to say that the Republicans want to destroy Medicare as we know it and that the Democrats can preserve it.
The truth is that no one can preserve Medicare as we know it. There isn’t a prayer that your father’s Medicare will be around in 10 years. Read more.
THCB Marketplace NEW RELEASES The Health Care Handbook The American health care system is vast, complex and confusing. Books about it shouldn’t be. The Health Care Handbook is your one-stop guide to the people, organizations and industries that make up the U.S. health care system, and the major issues the system faces today. How to Live Forever *Results May Vary. Nominee Palm Springs International Film Festival. Nominee Hamptons International Film Festival. How to Live Forever Director Mark Wexler embarks on a worldwide trek to investigate just what it means to grow old and what it could mean to really live forever. But whose advice should he take? Does 94-year-old exercise guru Jack LaLanne have all the answers, or does Buster, a 101-year-old chain-smoking, beer-drinking marathoner? 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. CONFERENCES
Health 2.0 San Francisco
October 7-10, Hilton San Francisco
The groundbreaking conference series returns to San Francisco. Keynotes by Joe Flower and Aetna CEO Mark Bertolini. Speakers from Qualcomm, AT&T, Mayo Clinic, National Cancer Institute, ZocDoc, OptumHealth and RedBrick Health, along with presentations from top health care startups changing the field and many more.
The First Annual Open Source EHR Summit and Workshop
October 17-18, Gaylord National, National Harbor, MD
It is projected that more than 200 hospitals and 1000 clinics, within the federal sector alone, will be managing and maintaining their EHRs using open source codes within the next few years. An increasing number of state agencies are deploying open source solutions as well. In recent months, many private sector health care communities facing the unsustainable high costs of health IT have started calling for alternate approaches to maintain and manage traditional proprietary electronic health records. These open source activities create a huge market opportunity for both private and public sectors.
REAL ESTATE 61,000 Square-Foot Building Available For Lease Near Boston
Ideal for Medical Offices, Back Office Uses A 61,000 SF building that can be easily converted to medical use is available for lease just 17 miles from downtown Boston. Located in Hingham Technology Park 3 on a 9-acre parcel in Hingham, Mass., and there is close proximity to numerous hotels and conference centers, and easy access to Rtes. 3, 93, 128 and 95. The site is a quick drive to Plymouth and Cape Cod. For more information, contact Richard McKinnon at 617-472-2000, or email richmck@grossmanco.com. To learn more about the additional development potential of this site, visit www.HT3park.com.
COURSES UPenn Online Course: Health Policy Health Care and the Affordable Care Act, Ezekiel Emanuel, MD PhD "This course will explore the history and structure of the current American health care system, including the history of and problems with employment-based health insurance, the challenges surrounding access, cost and quality, and the medical malpractice conundrum. The course will then explore the history of health care reform and the challenges that were overcome to achieve health reform in America. Finally, we will delineate the specific ways that the Affordable Care Act improves access and quality, and will control costs. Throughout lessons regarding health economics, health policy, and medical practice will be elucidated." For more information, click here.
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