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Healthcare Economics: Employers Incentivize Healthy Lifestyles With Penalties And Rewards

How do companies curb health care costs?

Do healthier employees lead to increased productivity?  Several progressive companies believe so and have committed to providing employees with programs to help engage them in a healthier lifestyle.

As part of the incentives to lead a healthier lifestyle some employers have instituted a penalty and reward system tied to the companies’ benefits.  For example, smokers may incur a significant surcharge to the cost of their health insurance plan while nonsmokers could see a reduction in cost.

According to an article in The New York Times, a growing numbers of companies including Home Depot, PepsiCo, Safeway, Lowe’s and General Mills are seeking higher premiums from some workers who smoke, similar to Wal-Mart’s addition of a $2,000-a-year surcharge for some smokers.

Escalating health care costs Read more »

*This blog post was originally published at Health in 30*

Can The Healthcare “Consumers” Drive The Waste Out Of The System

Patients are first. Patients are the reason for the existence of the healthcare system. Physicians are second. They are trained to understand the pathophysiology of illness and to treat patients for their disease. Everyone else is a secondary stakeholder (provider).

All the stakeholders create waste in the healthcare system. If an accurate analysis were performed, most of the waste and the resulting profits would be attributed to the secondary stakeholders. Patient and physicians drive this waste and profits into the hands of the secondary stakeholders. Neither patients nor physicians are aware of driving the waste and profit into these stakeholders’ coffers.

The patient-physician relationship should be a one on one transaction. Patients and physicians are frustrated and many have accepted the disappearance of this human-to-human interaction.

Healthcare insurance companies and hospital systems think they own the patients and the physicians. This will turnout to be a fatal misperception.

To many observers of the healthcare system Read more »

*This blog post was originally published at Repairing the Healthcare System*

Intensity-Modulated Radiation Therapy (IMRT) For Cancer: How Lucrative Is It For Doctors?

I’ve been traveling in Europe, including giving a talk at the Salzburg Global Seminar on involving and informing patients in healthcare decisions. In that presentation, I talked about promotion of a newer form of cancer radiation therapy called intensity-modulated radiation therapy (IMRT).

So I want to point out that while I’ve been away the Wall Street Journal published an important piece on this very topic under the headline “A Device to Kill Cancer, Lift Revenue.” An excerpt:

Roughly one in three Medicare beneficiaries diagnosed with prostate cancer today gets a sophisticated form of radiation therapy called IMRT. Eight years ago, virtually no patients received the treatment.

The story behind the sharp rise in the use of IMRT—which stands for intensity-modulated radiation therapy—is about more than just the rapid adoption of a new medical technology. It’s also about financial incentives.

Taking advantage of an exemption in a federal law governing patient referrals, groups of urologists across the country have teamed up with radiation oncologists to capture the lucrative reimbursements IMRT commands from Medicare.

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

Pay Patients To Take Their Medicine?

The New York Times reported recently on efforts by providers and payers to increase patient medication adherence through the use financial incentives paid to patients. The article cited the use of small financial payments (<$100), awarded via lotteries, to patients that take Warfarin –- an anti-blood clotting medication.

There is certainly nothing wrong with financial incentives. Incentives have been proven successful in changing selected provider (quality and safety improvement) and patient behavior (stop smoking, weight loss and taking health risk surveys). But paying patients to take their medication is different. Actually, the evidence suggests that it is a just plain stupid idea for a whole lot of reasons. Read more »

*This blog post was originally published at Mind The Gap*

Another Reason Why Doctors Don’t Discuss End Of Life Care

A recent study suggests that doctors may put off holding end of life care discussions that involve subjects like advance directives, hospice or site of death.

Recommendations suggest that physicians hold these conversations when patients have about a year to live, but the data show  those guidelines aren’t being followed.

Why? Read more »

*This blog post was originally published at*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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