A February Edition of the Health Wonk Review: Insightful Nuggets From the Best Health Policy Blogs
Posted Feb 28 2013 9:19am
A valuable nugget & more on the way
Welcome to the Disease Management Care Blog's hosting of the Feb. 28 Health Wonk Review.
This HWR is a summarized compendium of submitted posts by the smartest health policy bloggers in the known universe. The DMCB assures you that you're in for a special treat because you'll find some insightful nuggets that generally go unseen in the mainstream media and academic literature.
When it's not mining the HWR for information, the DMCB combines acumen, skepticism, modesty, peer-reviewed science and occasional humor about health policy, care coordination, population health management as well as primary care, the medical home, health insurance and the electronic record.
It's so glad you stopped by.
The DMCB has organized the posts by topic: Obamacare's key reforms, various health economists' latest divinations on health care costs, hospitals, Medicaid, the internet, California, medical education and some British humor. The quotes that head each section should give you a hint about what you're in for.
“This is a big f—-ing deal.” – Vice President Joe Biden What's to Know About the Go-Go Growth of ACOs?
Lots, thanks to this Health Affairs Blog post by Leavitt Partners' David Muhlestein . He counts 428 accountable care organizations (ACOs). While all eyes are on the Medicare versions, it turns out the private sector has been on a less visible parallel track with "full or partial capitation models, bundled payments, retainer agreements, in-kind services and subsidies provided by payers, and pay-for-performance incentives." Did you know that most ACOs are in the West Coast and Northeast, or that there's an even split between physician and hospital-led sponsors? Mr. Muhlestein also points out that 2013 will be the year that we'll get to see some early ACO data. David and the DMCB will be watching very carefully and, if we report Medicare's outcomes are less than expected, the DMCB is looking forward to getting a "you'll regret it" email from somewhere in the Administration.
What's to Love About the Individual Insurance Market?
Could be lots, says Nicole Fisher of Wright on Health . She wonders if there is a silver lining in the growing evidence that some employers will drop their sponsored health insurance benefit and force their workforce into the individual market. That may force the individual market to have better transparency, less discriminatory underwriting, more choice and increased competition. As result, costs could be lower than expected, consumers will better understand the true costs of health care and portability could paradoxically improve. If things go really well, we could see a self-reinforcing cycle of market demand. And, wonders the DMCB, long lines outside doctors' offices .
Maybe, But What's NOT to Love About the Individual Insurance Market?
"Governor Brown's budget plan also counts on $488.4 million in savings from a 10% cut to Medi-Cal reimbursements. Medi-Cal is California's Medicaid program." 1/30/13 News Report . Here's A Free Baby Elephant!
Jonena Relth of Healthcare Talent Transformation points out that the times they are a changin' . The steady increase in medical tourism is challenging the notion that U.S. domiciled health care is the best, especially when international health systems are adopting U.S. methods and employing U.S. trained physicians who are using state-of-the-art electronic health records that are modeled on U.S systems. The salvation, according to Ms. Relth, is the "Lean" approach that, according to a LinkedIn discussion group, helps providers 1) put patients first, 2) cut waste and 3) eliminate tasks that don't add value. The DMCB's experience leads it to believe that many of its physician colleagues can accomplish much of that third goal by staying away from LinkedIn. Maybe it's time to change its mind.
"There is science, logic, reason; there is thought verified by experience. And then there is California." - Edward Abbey
California's Health Insurance Exchange Chassis Unveiled. Next Up: The Hard Part
Roy Poses of Health Care Renewal looks at examples of small town hospital CEOs being compensated with lavish pay . Dr. Poses is particularly exasperated because the hospitals are not only public, but they've had to make tough trade-offs between being profitable and having enough nurses and docs to care for their underserved populations. Roy has little difficulty finding numerous news reports - and most are from California - that amply demonstrate that there is little correlation between hospital administrators' $800K salaries and their institutions' financial performance. Roy blasts the gimmicky talking points that have been used justify these outlandish compensation packages, the cluelessness of hospital boards and the public's need to wake up and smell this coffee. The DMCB looks forward to what Roy discovers in 2013 when he compares ACOs' financial success with their executives' compensation packages.
"Beware of the young doctor and the old barber." - Benjamin Franklin
Did you know that 15 new allopathic and 10 osteopathic medical schools have opened since 2002 and that most operate campuses located in Republican Congressional districts? Wing of Zock's James Lewis reviews the political implications of this , pointing out that these Republicans will gain a new appreciation for the value of our national health care infrastructure. What's more, they'll probably be reluctant to go along with their House colleagues' enthusiasm to reduce the U.S. budget with sacrifices in graduate medical education funding. What delicious irony!
"Bollocks!" An oft-heard exclamation "with a long and distingished history." - Wikipedia Merry Old En-gland?