February 6th, 2010 by Jon LaPook, M.D. in Better Health Network, Expert Interviews, Health Tips, Video
No Comments »
If you want to improve the health of Americans, why not look around the world for places where people live the longest, healthiest lives and try to copy whatever it is they’re doing? That’s exactly what Dan Buettner has done. He is the author of The Blue Zones: Lessons for Living Longer From the People Who’ve Lived the Longest.
Examples of areas he calls “blue zones” are Sardinia, Okinawa, Costa Rica (the Nicoya Peninsula), Ikaria (a Greek island), and Loma Linda, California. Things residents have in common include exercising regularly, eating more vegetables and less meat, engaging in social networking, and having a sense of purpose. Read more »
November 10th, 2009 by DrWes in Better Health Network, True Stories
No Comments »
“Doc, I’ve got good news and bad news.”
“What’s that?”
“Well, I’ve lost six more pounds!”
“Wonderful! What’s the bad news?”
“Well, you know that new-fangled drug you gave me that works so well for my atrial fibrillation?”
“Yes.”
“We’ll, I’m part of that AARP Medicare Advantage Part D drug plan, and I just got the “partial” approved drug list for 2010 in the mail. My drug’s not on the list, so I called and found the drug’s been moved from a Tier II drug to a Tier III drug. That means it will cost me twice what I paid for it this year. That’s gonna be tough, doc. I can’t afford it.
But I also read that if you call this ‘800’ number and speak to them, they’ll allow me to obtain an exemption to keep the drug on Tier II for next year.” Read more »
*This blog post was originally published at Dr. Wes*
February 23rd, 2009 by Dr. Val Jones in Expert Interviews, Health Policy, Uncategorized
No Comments »
Today there was a Fiscal Responsibility Summit held at the White House. Bill Novelli, CEO of the AARP attended the summit as part of the work group on health. Bill reported what he observed in his work group (which consisted of notables such as Senators Baucus, Rangel, and Specter, Nancy Pelosi, Nancy Nielsen, MD, Becky Patton, RN, Rich Umbdenstock and others) on a special media conference call today.
The over-arching theme of the work group discussion, according to Bill, was prevention and wellness. The group agreed that the key to improving Americans’ quality of life and controlling the costs of chronic disease lies in preventive health efforts. In addition to this belief, the group agreed that:
1. Healthcare reform must be achieved as quickly as possible. The path to long term entitlement sustainability requires healthcare reform. Simply expanding access to a broken system is not the solution.
2. The American people need to be engaged in reform efforts – not just as patients, but as tax payers and voters. They need to understand what they will gain and lose.
3. We must reward adherence to best practices and healthcare quality.
4. A public-private partnership is critical to achieving reform.
A few interesting points were raised by various stakeholders in the meeting:
1. Arlen Specter – believes that changes in medical approaches to end-of-life care could decrease costs substantially. He called for more advanced directives, and education about end-of-life care options.
2. Dr. Nancy Nielsen – called for Medicare to fix the physician fee schedule.
3. Becky Patton – called for increasing the nurse and healthcare workforce.
4. Rich Umbdenstock – requested that more attention be focused on pay for performance and administrative simplification initiatives.
I asked Bill how many providers were included in his work group, and he mentioned three (Nielsen, Patton, and Umbdenstock – not really a provider himself). Best I could tell, there was only one physician and one nurse at the meeting. And that is fairly shocking to me.
If healthcare reform is happening without much input from the primary providers of care (doctors and nurses) – will the reform decisions made by these well-intentioned individuals make good clinical sense?
Another reporter asked Bill what he thinks will happen with healthcare reform in the near term. His answer was telling: “We don’t know.”
October 7th, 2008 by Dr. Val Jones in Medblogger Shout Outs
1 Comment »
Thanks to my friend and fellow blogger Bob Coffield for hosting me (during my homeless period) at the Healthcare Law Blog. Here is an excerpt of my post:
Today I viewed a TV ad sponsored by the AARP. It was promoting a remote alarm device that elderly people could use to notify EMS if they fall and need help. The ad featured a surprising statistic:
“One in three people over the age of 65 will fall down this year.”
That’s a pretty common occurrence, wouldn’t you say? It certainly argues for the need for those wearable alarm buttons.
But at the same time that these ads are running on television, Medicare is moving forward with their “never event” quality program. The initiative means that Medicare will not pay for the care of patients who experience a “never event” in a hospital – funding for that patient’s care will need to come out of the hospital’s budget. Medicare argues that they shouldn’t have to pay for medical errors such as “wrong side surgery.”
While I’m sympathetic to their perspective on wrong side surgery, the list of never events reaches far beyond the limits of medical errors to include things like mental status changes, infections and…
drum roll please . . .
Falls….
July 14th, 2008 by Dr. Val Jones in Expert Interviews, Health Policy
2 Comments »
I had the chance to speak with John Rother, Executive Vice President of Policy and Strategy for the AARP about the intersection of online health, information technology (IT), and the baby boomer generation. Find out what America’s most powerful boomer organization thinks about the future of healthcare in this country.
*Listen to the podcast*
Dr. Val: Recent studies suggest that Americans age 50 and older are more Internet savvy than ever before. How are AARP members using the Internet to manage their health?
Rother: People over the age of 50 are the fastest growing set of online users, and healthcare is the major reason why they’re going online. They’re looking for health related news, help with diagnosis, and finding appropriate healthcare providers.
Dr. Val: What role can online community play in encouraging people to engage in healthy lifestyles that may prevent chronic disease?
Rother: Our experience is that online communities can be extremely helpful in several ways. First, it provides emotional support for people who have a shared experience, whether it’s as a caregiver, or being recently diagnosed with a disease or condition. Second, people seem to feel more comfortable asking questions of others with their condition than they do their own physicians. And third, online communities can reinforce needed behavior change. Whether it’s weight loss, exercise, or quitting smoking – online communities can be just as effective in encouraging behavior change as a face-to-face community.
Dr. Val: Tell me a little bit about the communities on the AARP website.
Rother: Currently our communities are organized around medical topics, but in the future I think the communities will become more geographical. An online community designed to serve the needs of people in a given location can facilitate information sharing about how to navigate a particular hospital system, for example, instead of just general information about coping with a disease or condition.
Dr. Val: Intel just announced that it has FDA approval for its “Intel Health Guide.” The unit enables caregivers to provide their patients with more-personalized care at home, while also empowering patients to take a more-active role in their own care. What do you think of this technology?
Rother: I think information technology is going to have all kinds of beneficial applications for people with health challenges. Personal health records and this Intel Health Guide are very well suited to the needs of individuals with chronic health conditions, and I expect to see more Internet based tools developed to help people to make appropriate decisions and change their behavior.
General information is helpful, but personalized information is the key. The more these technologies allow you to have your own individual information at your fingertips and allow that to be the basis for recommendations and decision support, the more powerful it’s going to be. This is all very promising technology – the next question is, can people afford it and will the people who need it be able to use it?
Dr. Val: In your opinion, what role does health IT have in reducing healthcare costs and improving access to care?
Rother: Health IT can support almost every aspect of healthcare. It can decrease costs by reducing duplication. Many people with chronic conditions see different doctors – and if you have to go through the same set of X-rays or CT scans every time you see a different doctor, that can get very expensive. A good, common medical record system is critical in reducing costs and improving care.
IT can also reduce the cost of health insurance, in the way that online car insurance has reduced car insurance premiums. If we reform our health insurance market, this could offer substantial savings to individuals.
People often use the Emergency Department inappropriately – for minor issues instead of true emergencies. A good decision support system that helps people to figure out when they need to go the ER could be helpful in reducing costs.
Dr. Val: What are the AARP’s major health-oriented initiatives?
Rother: The AARP is very focused on healthcare because our members tell us that it’s their top priority. The cost, quality, safety and accessibility of healthcare are important to us, so we are involved in a broad spectrum of initiatives.
First of all, extending coverage to all Americans, regardless of their age or health condition, is a top priority for the AARP. Second, In terms of health quality, it varies quite broadly among hospitals in the US. If we could get everyone to copy the best hospital practices, we’d have a much more manageable problem.
Dr. Val: What needs to happen to America’s healthcare system in order for it to serve the needs of baby boomers on its limited budget?
Rother: We spend almost 2.5 trillion dollars for healthcare in the United States, so I don’t think of it as a limited budget, but quite an expansive budget. There is enough money in the system to fully respond to the needs of the population. It’s just that we’re not organized very well and the system has become fragmented.
The healthcare system needs to be organized in a more person-centered way, and we need it to shift from a focus on acute care to a chronic care model. We need a different system of health delivery – one that relies more on nurses and other physician extenders. People need to join support groups to modify their behaviors and risk factors and rely on IT to help them make appropriate decisions.
So you put that all together and you have a pretty big agenda for change. I don’t know if we can achieve this all at once, or if it will occupy us for several years. The upcoming election gives us the opportunity to do this at the Federal level, though there are many private sector initiatives that are currently making important contributions.
Dr. Val: Can you give me an example of someone in the private sector who’s making an important contribution to improving healthcare?
Rother: The AARP just met with the leadership of the Mayo Clinic, one of the most outstanding medical institutions in the country. They provide excellent care at a cost that is less than most other parts of the healthcare system – and with improved outcomes. We asked them about their secret to success.
Mayo has an electronic medical record and all their patients have their information online. The physicians are on salary, so there’s no incentive to order unnecessary tests or procedures, and Mayo has an ethic of patient-centered care, with a long history of attracting the best people and rewarding them.
If Mayo can do it, why can’t everyone else? The AARP believes that the potential is there for most communities to have excellent care – we must emulate the care delivery of institutions like the Mayo Clinic, and put in place payment and information systems that will coordinate care management better. It’s a big job and will take some investment, but we have many opportunities to do a better job than we’re doing today.
*Listen to the podcast*
*Learn more about preventing chronic disease*This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
