The Insider's Guide - Tech - The Business of Health Care - Physicians - Subscribe Fools' Gold Rush: Obamacare And The Medicaid "Opportunity" By J.D. KLEINKE You know we’ve gone through the looking glass when the hottest health care money on Wall Street is chasing Medicaid. No, I didn’t mean Medicare, the $560 billion per year federal program for insuring the elderly that has launched a thousand IPOs. The current darling of health care investors is Medicaid, the hybrid federal-state program for insuring the poor that now dominates, and often overwhelms, state government budgets.
Last month, Wellpoint agreed to pay $4.5 billion for Amerigroup, a Medicaid managed care company, representing a nearly 50% premium over Amerigroup’s market price. Not to be outdone, Aetna this past week purchased Coventry for $5.7 billion, which also services Medicaid populations. Read more.
What Am I Worth?
By DR. WES
Recently I was asked to serve as a consultant on a medical matter. Interestingly, they requested my hourly price for my services. I thought about this and wondered, "What am I worth in per hour in the open market?" It is an interesting question to ponder.
I have decided to ask the blog-o-sphere. Call it a bit of "free market economics." For the record, 100% of my hourly wage for my services will be sent to our cardiovascular research fund at our hospital to avoid any conflict of interest. I will not see ANY of the money the blog-o-sphere decides personally, but I really want to know what people think. So where to begin? Read more.
By DAVID ALLEN
My summer job before I left for college in 1965 was the night admitting clerk in the emergency room in the Huntsville, Alabama county hospital – a facility built to support a few thousand in a small rural community but now taxed with serving hundreds of thousands, brought to town by the new Apollo missile program. Saturday nights in the small emergency room were often pure chaos, with auto wreck victims lined up on gurneys in the hallway. Those shifts passed the quickest for me, and I slept the best, afterwards.Crisis promotes a kind of serenity. Why do people commonly tend get into their “zone” then? Read more.
The Direct Project Has Teeth, but It Needs Pseudonymity
By FRED TROTTER
Yesterday, Meaningful Use Stage 2 was released. As we read and parse the 900 or so pages of government-issued goodness, you can expect lots of commentary and discussion. Geek Doctor already has a summary and Motorcycle Guy can be expected to help us all parse the various health IT standards that have been newly blessed. Expect Brian Ahier to also be worth reading over the next couple of days.
I just wanted to highlight one thing about the newly released rules. As suspected, the actual use of the Direct Project will be a requirement. That means certified electronic health record (EHR) systems will have to implement it, and doctors and hospitals will have to exchange data with it. Awesome. Read more.
Health Care: An Alternate Economic Universe
By JEFF GOLDSMITH
In July, 2012, the US economy produced roughly the same volume of goods and services as it did five years earlier with five million fewer workers. Yet, during the first four years of the recession (May 2007 to May 2011), the US health system, despite slowing or declining utilization, added 1.149 million workers. Key sectors, specifically hospitals and physician offices, grew their workforces despite declining admissions and office visit volume.
Compared to the rest of the economy, health care seems to exist in an alternate economic universe. This would be good news, rather than a problem, if we were not borrowing roughly half of every dollar of general revenue the federal government is spending on health care and if employers were not robbing their workers of wage increases to fund their health benefits. Read more.
The Drug Formulary Death Cage Match of Awesomeness
By ROB LAMBERTS, MD
I got an unusual request last week. I had written a prescription of a generic medication (which has been generic for a couple of years) and the prescription was denied by the insurance carrier. The reason for denial: I had to try a brand-name medication first.
Stop. Read that again. They wouldn’t allow me to give a prescription for the (cheaper) generic drug because I had to try the brand-name medication first. This is opposite of the usual reason for denial, the availability of a cheaper alternative than the prescribed drug, and, to my knowledge, is the first time I have ever seen it upside-down like this, and I have been in the ring for the duration of the drug formulary death cage match of awesomeness. Read more.
Medical Apps: The Next Generation
By KENNY LIN, MD
Doctors of my generation have experienced dramatic changes in the way we access the information we need to care for patients. As a medical student 15 years ago, my "peripheral brain" consisted of fat textbooks sitting on office bookshelves or smaller, spiral-bound references stuffed into the bulging pockets of my lab coat. As a doctor-in-training, I replaced those bulky references with programs loaded onto PDAs. Today, smartphone apps allow health professionals at all levels to access the most up-to-date medical resources such as drug references, disease-risk calculators, and clinical guidelines—anytime, anywhere. Read more.
Why We Avoid Telling Patients the Truth
By STANLEY WINOKUR, MD
When I started practicing oncology, I was frequently asked by my patients, “What’s my prognosis, what can I expect?” At first, I was reluctant to tell the patient very much, especially when I knew the prognosis wasn’t good. I wanted to spare the patient the details of the inevitable outcome of his cancer, so I downplayed the truth. Some may call it sugarcoating the information. I just wanted to do anything I could to protect my patient from learning that not only didn’t we have a cure for his cancer, we didn’t even have a treatment to extend his life. The best we could do was to maybe improve the quality of his life for as long as possible. Read more.
All Hell Hath Broken Loose 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. THCB Marketplace: Reach a focused audience of thousands of health care professionals. Post a classified in the THCB marketplace. Email ad_sales@thehealthcareblog.com 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. The Great Experiment is about much more than a single state experiment, or the immediate questions the presidential primary may raise regarding Mr. Romney’s term as governor of Massachusetts. Rather, Pioneer assembled some of the best thinkers to outline the options before state and federal officials. The Great Experiment aims to lay out a market-oriented blueprint for the next decade. Download free chapters, including an introduction by Dr. Jeffrey Flier, Dean of Harvard Medical School, or purchase a copy at greatexperiment.org. CONFERENCES
Fifth Annual IEM Symposium: Nanotechnology and Nanomedicine
Aug. 28, 2012, Mayo Auditorium, U of MN, Minneapolis, MN
The 5th Annual Institute for Engineering in Medicine Symposium will be taking place August 28, 2012. This year's program, Nanotechnology and Nanomedicine, covers one of the most revolutionary fields in modern science. During this all day event, seventeen top researchers at the University will be presenting on topics covering /tools and materials, basic nanomedical research, clinical applications, and the ethics and future of nanomedicine.
Opening remarks this year are being provided by Dr. Eric Kaler, President of the University of Minnesota, highlighting why this topic is so important to the University as well as the industrial and local communities. Previous IEM symposiums have been rather popular, so Register NOW!
This event is open to the public. Contact Adam Klein, klei0115@umn.edu for additional information or see the Agenda (pdf).
AARP Health Innovation@50+ LivePitch
Sept. 21, New Orleans Convention Center
Please join us for AARP Health Innovation@50+ LivePitch, Friday, September 21 at the New Orleans Convention Center. Health Innovation@50+ is the premier showcase featuring the most exciting companies in the “50 and over” health technology and innovation sector. The pitch event offers the venture capital and angel investor community as well as the media, the opportunity to connect with outstanding startups in the field of health technology and innovation.
Health Innovation@50+ takes place at the annual Life@50+ AARP National Event & Expo, which is attended by 20,000+ members and guests from across the U.S. and the globe. This is the best opportunity of the year for entrepreneurs and investors to capitalize on the world’s largest and fastest-growing consumer market. Register now at http://Health50.org
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.
THE FINE PRINT Reach a focused audience of thousands of health care professionals. Post a classified in the THCB marketplace. Email ad_sales@thehealthcareblog.com 
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