Your insurer knows a lot about you, according to a ProPublica/NPR report. “With little public scrutiny, the health insurance industry has joined forces with data brokers to vacuum up personal details about hundreds of millions of Americans.” Data on race, income, TV habits, name changes, credit, online activity, etc. is fed into algorithms designed to predict what your health care will cost insurers. Aside from the privacy issues, the data often isn’t accurate. As one salesman told the reporter: “God forbid you live on the wrong street these days.” (
NPR)
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Walmart and Microsoft recently announced a five-year strategic partnership “aimed at overhauling the retail experience using cloud computing and artificial intelligence.” The alliance will create opportunities to use AI and machine learning to enhance the consumer experience. According to
Healthcare Dive
, the addition of AI and broad cloud capabilities could also help Walmart accelerate its move into health care. The article points to several other health care implications of the partnership—and notes that last month, Microsoft formed a unit to advance AI and cloud-based health care tools.
(
Healthcare Dive
)
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Innovation & Transformation
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Mention “blockchain” to most people, and they think of Bitcoin and the “dark web.” But deployed correctly, blockchain has the potential to improve the pharmaceutical supply chain, allow for secure data transactions and even track opioid use. A recent commentary in
The Conversation
points out that Estonia has been using blockchain technology since 2012 to secure health care data and transactions. All of the country’s health care billing is handled electronically, and 99 percent of its prescriptions are digital. “That’s a future the U.S. could look forward to, as it experiments on its own and learns from the experience of these existing projects.”
(
The Conversation
)
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Shortages
—
or maldistribution
—
of providers mean patients in rural areas often don’t get the care they need. The
National Rural Health Association warns that nearly 12 million patients are at risk of losing direct access to care. The situation with cardiologists is especially precarious, so some are finding creative solutions. For example, visiting consultant clinics (VCCs) serve
communities too small to support their own cardiologist. The VCC is staffed by a neighboring cardiologist who visits at least once a month. In Iowa, for instance, 89 of the state’s 99 counties are using cardiology VCCs. Other VCC models include oncology and orthopedics.
(
Cardiovascular Business
)
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Health systems may have trouble accommodating the Deaf community, but one Starbucks certainly doesn’t. The coffee chain announced plans to convert one of its Washington, D.C. shops into a Signing Store. It will be staffed by deaf and hard-of-hearing people (and their allies), all of whom are fluent in American Sign Language. Not coincidentally, it will be located at 6th & H, near Gallaudet University, which Abraham Lincoln chartered for the deaf and hard-of-hearing.
(
People;
announcement
)
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Physicians interrupt patients and often replace the patient’s agenda with their own, according to an analysis published in the
Journal of General Internal Medicine
. Researchers analyzed a random sample of 112 clinical encounters recorded during trials testing the efficacy of shared decision-making tools. Clinicians seldom (36 percent of the time) elicit the patient’s agenda; when they do, they interrupt patients within about 11 seconds. Physicians in specialty care elicited the patient’s agenda less often compared to physicians in primary care. “Our results suggest that we are far from achieving patient-centered care,” says Naykky Singh Ospina, MD, an author of the study.
(
Journal of General Internal Medicine
)
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Oncologists don’t adequately address cancer patients’ financial distress related to the high cost of care, according to research published in
Cancer
. Notably, of the 945 women surveyed who worried about their finances, nearly 73 percent reported their physicians and their staff did not help. “Clinician assessment and communication regarding financial toxicity must improve; cure at the cost of financial ruin is unacceptable,” the researchers concluded.
(
Cancer
;
Becker's Hospital Review
)
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Kentucky waiver still in play?
Late last week, the Centers for Medicare & Medicaid Services opened a second 30-day comment period on Kentucky's Medicaid demonstration project, which included controversial work requirements. CMS lost the case (Stewart v. Azar) last month. (
comments page)
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VA chief confirmed: Robert Wilkie is the new VA secretary of the Department of Veterans Affairs, giving the sprawling agency its first permanent leader in months. The vote was 86-9.
(
Wall Street Journal
)
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An investigation by NPR and the Center for Public Integrity looks at the brazen and sometimes illegal steps companies take to get their medication on Medicaid's “preferred drug lists.” The report found that drug companies “have infiltrated nearly every part of the process that determines how their drugs will be covered by taxpayers.” (
NPR)
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MarketVoices...quotes worth reading
“I wanted to see more. If LexisNexis had health risk scores on me, I wanted to see how they were calculated and, more importantly, whether they were accurate. But the company told me that if it had calculated my scores it would have done so on behalf of its client, my insurance company.
So, I couldn’t have them.”—ProPublica reporter
Marshall Allen, on trying to access his own health risk scores, on
NPR
.
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Editor
Sandy Mau
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