Category Archives: Uncategorized

Health Care Payment Is Shifting to Reward Value, but Can Information on Health Care’s Value Be Shared?

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https://morningconsult.com/opinions/rewarding-value-means-sharing-information/

If you wanted to know the headlines in 1962, you watched the evening news, read the daily newspaper, or listened to the radio. Those were your only options.

But if you want to know the headlines today, the range of sources available to you is nearly limitless.

As news has evolved, we also have seen a rapid transformation in access to health care news and information. When the Food and Drug Administration began to regulate communications around the marketing of pharmaceuticals in 1962, neither the FDA nor Congress could have predicted the evolution of our health care system or the information explosion we have seen in the past 20 years.

When Congress enacted the Food and Drug Administration Modernization Act of 1997, which created a pathway through Section 114 for pharmaceutical companies to proactively communicate health economic information with specific stakeholders, health care looked dramatically different than it does today. We did not yet have biologics or personalized medicine. We got our information through paper health care records, not real-time feedback from mobile health devices, searchable electronic health records, and other data sources. We have revolutionized how we treat many conditions, and who pays for medications now includes Medicare Part D, exchanges, and consumer directed health plans.

Given these changes, broader exchange and communication of how treatments work in the “real-world,” how they compare to alternatives, and their related impact on the total cost of care is needed. In fact, the ability to communicate valid, reliable information from many sources is critical to helping us achieve the common goal of delivering more efficient, high-quality health care.

Unfortunately, despite the best intentions of FDAMA Section 114, the exchange of information remains limited.

Ambiguities in the law’s language, coupled with a continued lack of guidance about its scope, have led to a lack of information exchange due to concerns from biopharmaceutical companies regarding the risk of penalties for violating standards.

Healthcare Coverage Reform Proposals

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Click to access RyanPlanAnalysis-brief.pdf

 

Boeing Contracts Directly With California Health System For Employee Benefits

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http://khn.org/news/boeing-contracts-directly-with-california-health-system-for-employee-benefits/?utm_campaign=KHN%3A+Topic-based&utm_source=hs_email&utm_medium=email&utm_content=31951328&_hsenc=p2ANqtz–1HG-Jyei7aqz_SWbkRKhJG3Jw-W5nU83bCCryWsDE_3IBpyXne8Y1g4rT4k4e1DlPo9TS25nZBfQF85pxcSd5aXiVuQ&_hsmi=31951328

Los Angeles, United States - March 9, 2015: Boeing manufactuing facility. Boeing manufactures and sells aircraft, rotorcraft, rockets and satellites. It is the second-largest defense contractor in the world.

In another sign of growing frustration with rising health costs, aerospace giant Boeing Co. has agreed to contract directly for employee benefits with a major health system in Southern California, bypassing the conventional insurance model.

The move, announced Tuesday, marks the expansion of Boeing’s direct-contracting approach, which it has already implemented in recent years in Seattle, St. Louis and Charleston, S.C.

Other large employers are also pursuing this idea in regions where they have big concentrations of workers. In some cases, they refer employees to nationally top-performing hospitals for select surgeries.

MemorialCare Health System said Chicago-based Boeing selected it from a group of bidders for the five-year contract in Southern California, where the company has roughly 37,000 employees and dependents. Financial terms weren’t disclosed.

“More employers are interested in moving in this direction,” said Barry Arbuckle, chief executive of the MemorialCare Health System, based in Fountain Valley, California. “It reflects the desire of these employers to participate in bending the cost curve for health care, and it allows the provider to have a more unfettered relationship with the employer and employees.”

Mortgages For Expensive Health Care? Some Experts Think It Can Work

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Michelle_032916_Two

A Massachusetts Institute of Technology economist and Harvard oncologist have a proposal to get highly effective but prohibitively expensive drugs into consumers’ hands: health care installment loans.

Writing last month in the journal Science Translational Medicine, the authors liken drug loans to mortgages, noting that both can enable consumers to buy big-ticket items requiring a hefty up-front payment that they could not otherwise afford.

Some consumer advocates and health insurance experts see it differently.

“Isn’t this why we have health insurance?” asked Mark Rukavina, a Boston-based health care consultant whose work has focused on affordability and medical debt. “Insurance used to protect people from financial ruin for these unpredictable, costly occurrences. Now, with large deductibles, we’ve got coverage for preventive care but not for treatment.”

Andrew Lo, a financial economist at MIT’s Sloan School of Management, and Dr. David Weinstock, an oncologist at the Harvard-affiliated Dana-Farber Cancer Institute, agree that insurance would be a better option. But for many consumers that isn’t enough protection these days.

Sounds Like A Good Idea? Selling Insurance Across State Lines

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Presidential candidates like to propose solutions to long-standing problems. Health care is no exception.

But there’s a reason some problems are “long-standing.” They may have no easy solution. Or the solution is not politically feasible. Or there’s a solution that sounds good on the campaign trail but is not likely to actually work.

In this first of a series of videos of health policy promises that “sound like a good idea,” Julie Rovner explores why increasing competition in health insurance by allowing sales of policies across state lines might not be such a good idea after all.

If You Want To Spend A Bundle On Your Bundle Of Joy, Go To Northern California

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Everyone knows that real estate is no bargain in Northern California. It turns out that giving birth ain’t cheap either.

New research on the cost of childbirth in the nation’s 30 largest metropolitan areas ranks Sacramento and San Francisco as the two most expensive for both vaginal delivery and Cesarean sections.

Sacramento is No. 1, San Francisco No. 2.

The study, based on private health insurance claims from this year and other data, shows the totals actually paid for childbirth by employees and employers. It was conducted byCastlight Health, a San Francisco-based health care information company that analyzes medical costs to help consumers and purchasers compare prices.

A vaginal delivery costs an average of $15,420 in the Sacramento area and $15,204 in San Francisco — nearly $4,000 more than the third-most expensive location, Minneapolis. In the least expensive metropolitan area, Kansas City, a vaginal delivery costs $6,075.

C-sections are even more expensive, costing an average of $27,067 in Sacramento — nearly four times as much as in Pittsburgh, the cheapest city. San Francisco had the second highest cost for C-sections, at $21,799. San Diego came in fifth at $16,810.

The data show that prices vary widely even within the most expensive regions. In San Francisco, for example, the cost for a Cesarean delivery ranged from $8,399 to $41,191 — a five-fold price difference. Patients, however, rarely know how much a procedure will cost until they receive the bill.

Why we trust leaders who admit their mistakes

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Why we trust leaders who admit their mistakes

Mountain climbing

Anyone in a leadership position knows that mistakes are inevitable.

They can hit at any time and it may not even be a direct result of your actions. But there is one mistake that is worse than the actual mishap.

If you want to dig a deeper hole for yourself then refuse to admit to your mistakes.

You can take the route of blaming someone else for the outcome of your decisions and deny accountability until someone else finds their head on the chopping block. Anyone but you, right?

Or – and this is a big or – maybe you could take responsibility for the blunder and ask for the assistance of your team members to remedy the situation.

So, why is failing to admit to mistakes so harmful to leadership? And what can you gain for owning up to the fault?