November 8th, 2010 by DavidHarlow in Better Health Network, Health Policy, News, Opinion, Video
No Comments »
Like Tom Friedman, who lampooned some of this year’s unreasonable campaign rhetoric in a recent column, I, too, would be in favor of reality-based political campaigns, but that seemed to be too much to ask for this year. Instead of truth, we now have truthiness.
The joke news shows (and their joke political rallies) seemed to be more popular than the evening news. (I wish Jon Stewart and his 200,000 fans on the Washington Mall last weekend had stayed home, canvassing for their candidates of choice.) Fact-checkers told us that many political ads this season were in the “barely true” or “pants on fire” zones according to the Truth-O-Meter. But in the end, the buzzwords seem to have worked their magic, and many “insiders” are out, and “outsiders” are in.
The angry and the impatient on the campaign trail have, in some cases, adopted the line from the movie Network: “I’m mad as hell, and I’m not going to take this anymore,” perhaps forgetting that while that line garnered the Howard Beale character strong ratings, network bosses arranged for his on-air assassination when his ratings fell.
The Utopia tune below, “Swing to the Right,” comes to you from the Ronald Reagan era, and perhaps we are seeing the generational swing of the pendulum back to the right. It does seem to happen every 30 years or so. But don’t blame me — I’m from Massachusetts (home to a Democratic sweep on the recent election night).
The last two years have seen a tremendous amount of change in Washington. The question of the moment, of course, is: How will the election results affect implementation of healthcare reform? Read more »
*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*
October 31st, 2010 by DavidHarlow in Better Health Network, Health Policy, News, Opinion
No Comments »
I [recently] attended the Connected Health Symposium in Boston. I enjoyed many of the sessions (sometimes wished I could have attended two simultaneously, though the livetweeting — #chs10 — helped on that front), and as usual enjoyed the hallway and exhibit floor conversations too. As is often the case at conferences these days, I had the opportunity to meet several online connections in real life for the first time.
(I will not attempt to give a comprehensive report of the symposium here. Please see the livetweeting archive and other reports to get a sense of the rest of the event.)
This year’s exhibit floor included a diverse mix of distance health tools. Most striking from my perspective was the fact that most of these tools do one of two things: Enable patient-clinician videoconferencing, or upload data from in-home monitoring devices. The best of the second category also trigger alerts resulting in emails or PHR/EHR alerts to clinicians if vital signs are out of whack, or phone calls to consumers or their caregivers if, for example, meds aren’t taken on time (one company had a pill bottle with a transmitter in the cap that signals when it’s opened; another had a Pyxis-like auto-dispenser, that looked like you’d need an engineer — or a teenager — to program it). One tool — Intel’s — seemed to combine most of these functions, and more, into one platform, but it’s barely in beta, with only about 1,000 units out in the real world.
The speakers this year seemed to return again and again to several major themes: (1) Is any particular connected health solution scalable? (2) Who will pay for connected health, or mobile health (mHealth)? and (3) Does it work? Read more »
*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*
October 11th, 2010 by DavidHarlow in Better Health Network, Health Policy, News, Opinion, Research
No Comments »
Last month, PricewaterhouseCoopers (PwC) issued a report, Healthcare Unwired, examining the market for mobile health monitoring devices, reminder services, etc. among both healthcare providers and the general public. One of the big take-away points seems to be that 40% of the general public would be willing to pay for mobile health (or “mHealth”) devices or services ranging from reminders to data uploads — and the reaction by insiders is either joy (40% is good) or dismay (40% is not enough).
PwC estimated the mHealth market to be worth somewhere between $7.7 billion and $43 billion per year, based on consumers’ expressed willingness to pay. Deloitte recently issued a report on mPHRs, as well — and there is tremendous interest in this space, as discussed in John Moore’s recent post over at Chilmark Research. I agree with John’s wariness with respect to the mHealth hype — there is certainly something happening out there, but significant questions remain: What exactly is going on? Is there reason to be interested in this stuff or is it just something shiny and new? Can mHealth improve healthcare status and/or healthcare quality and/or reduce healthcare costs? Read more »
*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*
October 4th, 2010 by DavidHarlow in Better Health Network, Health Policy, News, Opinion
No Comments »
Federal health reform and Massachusetts health reform may find a point of convergence in the development of ACOs (accountable care organizations) and the payment mechanisms that will make them tick (or hum, or do whatever it is that we want them to do). The Federales will be holding a listening session next week on the issues raised by ACOs across the HHS and FTC landscapes. Meanwhile, back in Boston, the inner circle of health care regulators and the regulated community are busy hashing out an approach to global payments that could be ready for prime time by January 1.
The need for payment reform in Massachusetts has been well-documented — see the health care market report from the AG’s office, as well as an earlier report on the imperative to keep insurance risk on insurers and place performance, or quality, risk on providers. Now, this may be easier said than done, but we’ve got some of the best and brightest working away at the issue.
Unfortunately, the Massachusetts legislature blinked, and has not mandated the approach across the board — at least not yet. Initially, the global, or bundled, payment for episodes of health care approach is being tentatively applied to just a couple of types of episodes of care. (See Section 64 of Chapter 288 of the Acts of 2010 – the small group market reform legislation enacted this summer.) Read more »
*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*
September 28th, 2010 by DavidHarlow in Better Health Network, Health Policy, News, Opinion
No Comments »
The Office of Inspector General (OIG) of the U.S. Department of Health and Human Services scrapped its old self-referral voluntary disclosure program in 2009 (it dated back to 1998, and was revisited in 2008), and the Patient Protection and Affordable Care Act (PPACA) mandated that it be replaced. Just like clockwork, on the deadline for its promulgation the OIG obliged, and the new Self-Referral Disclosure Protocol is now posted and effective.
The new protocol could be clearer and offer more comfort, but it doesn’t. Makes one pine for the old policy’s clarity: In the old days, voluntary disclosure bought you a discounted fine for Stark violations — not like the new protocol’s wishy-washy, maybe-we’ll-give-you-a-discount language. The new protocol also fails to help a provider seeking to disclose past wrongs voluntarily in dealing with the Federales on a number of fronts simultaneously (e.g., for false claims violations, anti-kickback violations, etc., all arising from the same set of facts). We can perhaps blame Congress for that failure, rather than the OIG — the OIG is just implementing the statute as written.
Keep your eyes peeled for some tinkering on this front as the OIG gains some experience working under the new regime.
*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*
