It may seem intuitive, but a new study in the
Journal of the American Medical Association confirms that higher prices for services and intensity of care account for more than half of health care spending. Analysis of spending by disease showed increasing use of medications and reducing hospital stays didn’t reduce overall spending. “We are not getting offsets, period,” says policy analyst Peter Bach. (
Forbes;
JAMA study)
As telehealth investments grow and service delivery via interactive video, audio or data transmission surges, the U.S. Department of Health and Human Services Office of the Inspector General announced it will take a careful look at Medicaid payments for these services. The OIG review will assess whether states’ Medicaid payments met reimbursement requirements. The Medicaid telehealth payment scrutiny follows a summer announcement that OIG will look into Medicare telehealth payments, too. (
Healthcare Informatics)
The Veteran’s Administration implemented Patient Aligned Care Teams, its version of the medical home model, beginning in 2010. A new study across more than 800 VA clinics offers fresh insight into the long-term impact of the model on chronic disease. The 77 clinics that most fully executed the PACT model showed significantly larger improvements in five of seven chronic disease outcome measures, specifically in terms of meeting patient goals for diabetes, blood pressure and cholesterol control. (
ScienceDaily)
Lack of interest was behind the Nov. 14 cancellation of a proposed test of shared decision making within Centers for Medicare & Medicaid ACO models. The initiative was designed to assess results of shared decision making involving six conditions where current evidence doesn’t support one option over another. A separate clinical effectiveness test of direct decision support appears to be moving forward, however. (
HealthExec)
Doctors spend more than a third of their patient time on EHR and desk work tasks, eroding patient face-time and generating plenty of complaints to EHR vendors. So vendors are increasingly working with users on the development side to improve patient safety and reduce the provider workflow burden. Observing how doctors actually use the software and using behavioral analytics, in real time, to assess how users interact with EHRs are two tactics vendors use to improve systems. (
Modern Healthcare)
Diversification with new lines of business—à la UnitedHealth Group--is trending among health plans. Aetna is in talks with CVS Health to develop a partnership, and the Cleveland Clinic health system linked with Oscar Health to offer individuals a health plan in Ohio. These vertical mergers may expand business opportunities, but they may also create narrower networks for patients to access physician and pharmacy services. Employers worry that vertical integration may reduce cost transparency and make it harder to negotiate directly with providers. (
The New York Times)
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No flu shot, no job:Minnesota-based Essentia Health fired 50 employees who didn’t get a flu shot or offer an approved exemption. The system’s medical director, who implemented the policy to improve patient safety, says the mandatory shot policy yielded a 99.5 percent compliance rate. The local nurse union intends to fight terminations it deems “unnecessarily intrusive.” (
Atlanta Journal-Constitution)
$57 million approved for comparative effectiveness studies: The Patient-Centered Outcomes Research Institute approved funding for 14 new high-impact research areas, including $32 million for pragmatic research on caregiver support for dementia; radiation therapy for prostate cancer; and HPV vaccination among Latino populations. (
EurekaAlert)
In Northern California, a two-year effort to change opioid prescribing habits uses tactics honed by the pharmaceutical industry. Physician educators drop by physician practices and meet with doctors one-on-one for an evidence-based sales pitch to battle overprescribing. In this “academic detailing” model, they engage doctors in focused, customized training. Ironically, it’s the same marketing approach pharmaceutical companies use to disseminate evidence-based information about particular drugs. (
Kaiser Health News)
MarketVoices...quotes worth reading
“It's fine to have this cost broken down, but I don't really know what to do with it ... It's like having one blade of scissors.”– Joseph Newhouse, Harvard researcher, on the ability to use research data about health cost and outcomes, as quoted in
Forbes.
