Health care spending: some room for optimism

http://blog.academyhealth.org/health-care-spending-some-room-for-optimism/

This chart, produced by the Bipartisan Policy Center based on CBO data from 2011, shows the projected spending on health care, social security, discretionary, and mandatory by the federal government, as a percentage of GDP. As you can see, for all our hyperventilation about social security, it’s relatively stable once we get about 20 years out. Discretionary and other mandatory spending are similarly flat over time. But healthcare… that’s what’s going to get us.

 

What constitutes Low Integrity vs. Gamesmanship?

Integrity

Integrity

At its core, integrity is about honesty. If we purport to be taking an action to advance a noble cause yet really are mostly trying to increase our own wealth, then we may be guilty of low integrity?

CERTIFICATE OF NEED: STATE HEALTH LAWS AND PROGRAMS

http://www.ncsl.org/research/health/con-certificate-of-need-state-laws.aspx

Map of 50 states with or without CON programs, 2015

 

Certificate of Need (C.O.N.) programs are aimed at restraining health care facility costs and allowing coordinated planning of new services and construction.  Laws authorizing such programs are one mechanism by which state governments seek to reduce overall health and medical costs.  Many “CON” laws initially were put into effect across the nation as part of the federal “Health Planning Resources Development Act” of 1974.  Despite numerous changes in the past 30 years, about 36 states retain some type of CON program, law or agency as of 2016.

Medicare has funding through 2028, trustees say, 2 years less than earlier thought

http://www.healthcarefinancenews.com/news/medicare-has-funding-through-2028-trustees-say-2-years-less-earlier-thought

However, Medicare Trustees said the 2028 date is 11 years longer than they projected in 2009 before the passage of the Affordable Care Act.

AMA leaders denounce Florida gun gag law and physician advocates double down on stance

http://www.healthcarefinancenews.com/news/ama-leaders-denounce-florida-gun-gag-law-and-physician-advocates-double-down-stance?mkt_tok=eyJpIjoiTjJWbE5qYzROelZtWkdJeSIsInQiOiJRaHpNZytEeFYzY09wZkZcLytucXI5YmJXc2twblQ0eDZodllBN1Vka1lJS2E2Q2twR1V6cHF2cUg5OHFaV2hPUHZ0TmluN215bm15eHdSeEl4bFBGYmlCekYxeDJyY1VyOHlPemplXC9SMHdzPSJ9

Police respond to the mass shooting at the Pulse night club in Orlando, Florida (Orlando Police Department photo)

AMA President Andrew Gurman said 2011 law “inserts the state into the patient-physician relationship and threatens open communication in exam room.”

 

 

IBM Watson aligns with health systems, imaging firms to fight cancer, diabetes, heart disease

http://www.healthcarefinancenews.com/news/ibm-watson-aligns-health-systems-imaging-firms-campaign-against-cancer-diabetes-heart-disease

IBM Watson Health has formed a medical imaging collaborative with more than 15 leading healthcare organizations. The goal: To take on some of the most deadly diseases.

The collaborative, which includes health systems, academic medical centers, ambulatory radiology providers and imaging technology companies, aims to help doctors address breast, lung, and other cancers; diabetes; eye health; brain disease; and heart disease and related conditions, such as stroke.

Watson will mine insights from what IBM calls previously invisible unstructured imaging data and combine it with a broad variety of data from other sources, such as data from electronic health records, radiology and pathology reports, lab results, doctors’ progress notes, medical journals, clinical care guidelines and published outcomes studies.

How Kaiser Permanente is reinventing emergency care

http://www.fiercehealthcare.com/healthcare/how-kaiser-permanente-reinventing-emergency-care?utm_medium=nl&utm_source=internal&mrkid=959610&mkt_tok=eyJpIjoiTkRkaU9UQXdObVF4TVdNMCIsInQiOiJweklVS1JVa0ZzblAyTGpKaHUxK0VBTWZWaU9ncXgyOE5KMmFsZnhsMURQVUdGYVwvYmxzSUhYNytLNTdGcVZJMnBQRk5FT0RDV2l4MjNRK3lSUmJhMWkyY1o1TlRJMzZPUVFwUzZSeUdiOE09In0%3D

Sign that says "Emergency"

Multispecialty hubs that integrate office-based primary and specialty care with traditional emergency department functions have improved clinical care, increased access and lowered costs compared with the traditional model of medical offices and community hospital EDs, according to the Kaiser Permanente executives pioneering the hub model.

Kaiser Permanente, Mid-Atlantic States (KPMAS) pioneered the multispecialty hub model beginning in 2012 with five full-service medical buildings, each of which serves about 100,000 patients in Virginia, Maryland and the District of Columbia, according to an article in NEJM Catalyst.

http://catalyst.nejm.org/how-multi-specialty-hubs-fill-a-major-gap-in-the-care-continuum/

 

Filling A Prescription? You Might Be Better Off Paying Cash

http://khn.org/news/filling-a-prescription-you-might-be-better-off-paying-cash/?utm_campaign=KHN%3A+First+Edition&utm_source=hs_email&utm_medium=email&utm_content=30971433&_hsenc=p2ANqtz–rAQj-sGWH-JKBDVyBtJzuODQFe-bAF_J8z_ZoKZ4dV_VPRMdYkly_MVrJhTdTD6w_9hQLCFr7zZ59qZbt0C5LRhBjsw&_hsmi=30971433

Pharmacist scanning product

Some consumers who use health insurance copays to buy prescription drugs are paying far more than they should be and would be better off paying with cash, especially for generics. The added cost runs as high as $30 or more per prescription, say pharmacists, and the money is largely being pocketed by middlemen who collect the added profit from local pharmacies.

Cash prices started to dip below copays a decade ago when several big box stores started offering dozens of generics for as little as $4 per prescription. But as copays have risen and high-deductible insurance plans become more common, more consumers are now affected.

The phenomenon illustrates the complexity of how drugs are priced in the U.S. and has led to finger-pointing about who is benefitting or who’s to blame.