January 5th, 2012 by DavidHarlow in Health Policy, Opinion
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There are at least two conversations going on in the health care marketplace today, each focused on one of two key questions. One is: How can we achieve the Triple Aim? The other is: Why do they get to do that? (It’s not fair! I want more!)
Until we stop asking the second question, we can’t answer the first question. Why? Because all too often the answer to the second question is the equivalent of: It’s OK, Timmy, I’ll buy you TWO lollipops; pick whichever ones you want.
It’s the tragedy of the commons, transposed to the health care marketplace.
Recent cases in point:
- Avastin
- Tufts Medical Center – Blue Cross Blue Shield of Massachusetts grudge match
- Mammography and PSA guidelines
1. Avastin. Late last year, Read more »
*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*
December 15th, 2011 by DavidHarlow in News, Opinion
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Microsoft and GE Healthcare announced a joint venture last week (as-yet unnamed), trumpeted as bringing together the best of both companies’ offerings in the health care provider market. (More from the NY Times.) Late in the day, I spoke with Brandon Savage, Chief Medical Officer at GE Healthcare, and Nate McLemore, General Manager of Microsoft Health Solutions Group. They had a great deal to say about the companies’ shared vision of the use of platform technology to enable care teams to deliver the right decision at the right time, noting that their core products complement each other rather than overlap.
The centerpiece of the collaboration will be an amalgamation (so to speak) of the two companies’ strengths around Amalga (the Microsoft product) and Qualibria (the GE product). Brandon and Nate described the challenges facing these products thus: Qualibria needs to be able to pull in data from multiple sources better (Microsoft can help), and Amalga needs to be able to share best practices across sites better (GE can help).
Put another way (to quote John Moore at Chilmark Research), Amalga is “more a toolset than a product.” McLemore acknowledged that Read more »
*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*
November 30th, 2011 by DavidHarlow in Health Policy, Opinion
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Harvard Pilgrim Health Care is re-launching Let’s Talk Health Care, which started life as former CEO Charlie Baker’s blog. There’s a series of related discussions going on now in the Let’s Talk Health Care Linked In group, sponsored by Harvard Pilgrim. I’ve been participating (at the request of the group organizer; disclosure: client) and would like to invite you to do the same.
A salient characteristic of the site and of the group is the focus on three broad categories of care and cost: fostering health and wellness, balancing quality and cost, and redefining care coordination — all of which are informed by a focus on chronic health care issues.
One of the great successes of modern medicine is the conquest of most infectious disease. (Equitable global distribution of the tools necessary for eradication is another story — and some of the more compelling chapters of that story are being told these days by The Bill and Melinda Gates Foundation.) One of the great failures of the modern consumer state is Read more »
*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*
November 24th, 2011 by DavidHarlow in Health Policy, News
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The Wall of Shame welcomes Sutter Health. Another computer with unencrypted protected health information on over 4 million patients – gone. Now, those guys are pretty smart, so why don’t they encrypt all computers with PHI? One of life’s persistent questions. I mean, I can accept the fact that a health plan operator like Cignet Health might have issues with getting a grip on HIPAA compliance, but Sutter Health? What were they thinking? Can’t happen here? Encryption is a drag? It’s an easy way to avoid major egg-on-face and to avoid spending significant coin on PR, credit reporting services, and potentially on court judgments — all in addition to significant administrative fines payable to HHS and state regulators.
So the federales are piloting the HIPAA audit program. I know it’s required by the HITECH Act, but who believes that it will motivate behavior change? Anyone? Sutter Health was clearly not motivated to seek a safe harbor that would have made the loss of 4 million patient records a non-event. I know encryption can be a drag, but I’m not a techie. If you are, I invite you to educate me (and the other non-techies out there) on the question of how miserable it really is to have to deal with encrypted data; if you’re really a techie, write a program to enable light-touch encryption that doesn’t interfere with use of data.
Whether or not encryption is miserable, we should be asking: Read more »
*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*
November 10th, 2011 by DavidHarlow in Health Policy, Opinion
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On my way to the annual two-day blowout health law seminar put on by Massachusetts Continuing Legal Education (MCLE) on Monday — I was second in the lineup, speaking about post-acute care and some of the innovations in that arena for dual eligibles, among other things — I heard a fascinating piece on NPR on one of the ideas floating around the supercommittee charged with cutting $1.2 trillion from the federal budget. The idea: increase the minimum age for Medicare eligibility from 65 to 67, and save a bundle for Medicare in the process.
The problem with this deceptively simple idea (Social Security eligibility is migrating from 65 to 67, too, so it seems to be a sensible idea on its face), is that while it would save the federales about $6 billion, net, in 2014, it would cost purchasers of non-Medicare coverage (employers and individuals) about $8 billion, net. Why? The 65 and 66 year olds are the spring chickens of Medicare — they actually Read more »
*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*
