July 6th, 2011 by DavidHarlow in Health Policy
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Massachusetts Attorney General Martha Coakley released her office’s second annual report, An Examination of Health Care Cost Trends and Drivers (PDF; see also press release), which contains a wealth of critical data analysis — and also highlights how little we know about certain things — providing some important context for the discussion of the proposed Part III of Massachusetts health reform, a bill filed by Governor Patrick which would create all-payor ACOs and a system of global payments.
At this late date, few would argue against a move a way from fee-for-service reimbursement for health care, or adding quality metrics to the mix, and tying financial rewards to providers to their performance measured against these metrics. (Consider the Massachusetts Blue Cross Blue Shield ACQ (alternative quality contract) experience.) The AG’s report, however, highlights the wide disparities in payments to providers based on negotiating strength, rather than quality or cost of care (as noted in last year’s AG report; check out the 2009 special commission report, too). Read more »
*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*
July 6th, 2011 by IsisTheScientist in Opinion
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This afternoon I sat in my chair, revitalized form my weekend trip to the Jersey Shore, where I can assure you I did not partake in any fist pumping, spray tanning, pickle eating, or felonious activities, when I received an email from the American Heart Association announcing new scientific findings. I like these emails and generally find them informative.
This particular email announced the placement of the first completely lab-grown human vascular grafts. The email linked to a presentation from Todd N. McAllister of Cytograft Tissue Engineering Inc. These blood vessels were apparently engineered from donor skin cells and: Read more »
*This blog post was originally published at On Becoming a Domestic and Laboratory Goddess*
July 6th, 2011 by BobDoherty in Health Policy
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For physicians, and especially those in primary care, it seems like there is a form for every purpose imaginable—often for purposes that are hard to imagine.
An ACP member in Rhode Island recently gave this example:
“I was just asked by my Medicare Advantage plan to sign a form for [a well-known pharmacy benefit manager]. This form is to be faxed to them in order for them to send me a prior authorization form for a med. So in other words, I had to complete a form in order to get another form. This is nuts!”
Or how about this, from another ACP member in a private internal medicine practice:
“The documentation that is getting to me, is that documentation that the ‘durable medical equipment people want including repetitive- recurrent documentation, whenever we see a patient to document “continued need”. The list of things we have to document, sign, approve or prior authorize, I believe is what makes most physicians think they chose the wrong field. A PBM letter to me about my prescribing practices today nearly did me in! Luckily I just shredded it. If I am kicked out of this business, I am so close to retirement it would be a blessing!”
Or this: Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*
July 6th, 2011 by John Mandrola, M.D. in News, Research
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I have said that the best tool for treating atrial fibrillation (AF) is education. I still strongly believe this, perhaps more then ever.
AF presents itself to people in so many different ways–from no symptoms to incapacitation. Likewise, the treatments for AF range from simple reassurance and lifestyle changes, to taking a medicine, and on to having a complex ablation[s].
Because knowledge is so important to patients with AF, I encourage them to do outside research. This surely means going on-line. The problem, of course, comes with assessing the quality of information. It reminds me of what an old professor used to profess, “no data is better than bad data.”
What’s more, the vast diversity of AF makes comparing notes with friends problematic. One person’s wonder drug may be another’s poison.
Last week, this provocative AF headline came through on one of my Google Alert emails: 
“Flecainide Treatment Linked to Sudden Cardiac Death.” Read more »
*This blog post was originally published at Dr John M*
July 6th, 2011 by Dr. Val Jones in Opinion
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Beginning next year, if you or your loved one is discharged from a hospital, you’d better not return to it for 30 days. That’s because the hospital may be fined for your readmission (especially if you have had pneumonia, heart failure, or a heart attack – diagnoses singled out by CMS as preventable causes of readmission). In fact, if your readmission happens to tip the scales into the red zone (where the hospital falls below the 75th percentile in its hospital readmission rate compared to other hospitals), your arrival could literally cost them millions of dollars in penalties. Needless to say, hospitals are now scrambling to put programs in place to reduce hospital readmissions, all for the sake of “improved quality of care.” In summary:
“One in five Medicare inpatients is readmitted within 30 days. The Centers for Medicare and Medicaid Services (CMS) considers 40%-75% of these readmissions to be preventable. In October 2012, CMS will begin to track readmission and impose financial penalties on hospitals with higher–than–expected readmission rates for certain conditions. Other payers will certainly follow.”
So, will these programs to reduce hospital readmissions improve the quality of care you receive at your local hospital? Forgive me if I remain skeptical.
