Reform Rodeo
1. HRW’s Frank Pasquale’s post on reciprocal transparency — the idea that companies and other entities should be more transparent with respect to their data collection practices as patients become more transparent — is featured on The Health Care Blog.
2. On KevinMD.com, Maggie Mahar discusses what she thinks would happen if health reform is killed.
3. At the New England Journal of Medicine, Timothy Jost discusses recent rules governing the controversial restrictions on medical loss ratios.
4. Kaiser Health News has a short video up of their interview with the AMA’s president, Cecil B. Wilson, where they discuss the AMA’s new strategy regarding the “doc fix” that is set to cut physician reimbursement by up to 30 percent by Dec. 1st.
5. Chris Fleming at the Health Affairs Blog describes a new Health Policy Brief from Health Affairs and the Robert Wood Johnson Foundation that covers the new process of “grandfathering” insurance plans under the health reform statute.
Reform Rodeo
Medical Loss Ratio: Kaiser Health News reports on tomorrow’s vote by the National Association of Insurance Commissioners on ACA’s contentious rules dictating minimum medical loss ratios.
Cleaning the DSHs: Health Affairs cogently explains the difficulties that the ACA will face when reforming the Disproportionate Share Hospital (DSH) framework that reimburses uncompensated care under Medicaid.
ACO Antitrust: At the Health Care Blog, David Dranove discusses what he believes is a looming antitrust crisis surrounding accountable care organizations (ACOs)
On QALYs: One of the fathers of the Quality Adjusted Life Year (QALY) — the metric often used to measure comparative effectiveness — laments its near rejection in the ACA.
Economics: In the first of a series, Maggie Mahar provides a remarkably detailed analysis of the economic impact of the ACA.
Reform Rodeo
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1. ACO Yo!: The Healthcare Economist discusses recent research into how the accountable care organization (ACO) model may be leveraged by providers to increase prices. For those looking to learn more about ACOs, the New England Journal of Medicine has recently released a video which can be found here.
2. Playing Politics?: Merril Goozner picks up on questionable appointments to the Patient-Centered Outcome Research Institute — the entity that PPACA tasked with increasing our utilization of comparative effectiveness research.
3. Mandate Mania: Tim Jost provides an update (and overview) of the constitutional mandate case in Michigan.
4. SCOTUS and Vaccine Lawsuits: The Washington Post details the Supreme Court’s effort to determine whether lawsuits by people alleging harmful effects from childhood vaccines should be allowed.
5. Certification: Jon Halamka provides the second part to his clarification of HITECH’s EHR Certification process. The first part can be found here.
6. Fragmentation Symposium: Concurring Opinions held an online book review symposium of Barak Richman, Daniel Grossman, and Frank Sloan’s chapter, Fragmentation in Mental Health Benefits and Services, in Our Fragmented Health Care System: Causes and Solutions (Einer Elhauge, ed. 2010).
Will Physicians and Hospitals Ever Get Along? Prospects for Defragmentation in a Post Health Care Reform World by Richard Saver
Waldo’s Optimal Fragmentation by Elizabeth Weeks
Why “House” is the True American Health Care Hero, And What To Do About It by Vickie Williams
Getting Mental Health Coverage Wrong by John Jacobi
Reform Rodeo
Photo by David Monniaux
1. The American Medical Association: In the face of new health reform requirements that are now in effect, many of the top insurers have dropped child-only health plans.
2. Kaiser Health News Daily Report: Health Care reform’s elimination of discrimination based on pre-existing conditions has not fully materialized; In a sign of what could be a backlash against health care reform, the 3M corporation announced that it will stop offering its health insurance plan to retirees. Click here for the Daily Report.
3. In a sea of pessimism, the New England Journal of Medicine explores the lessons of a health care success story: Grand Junction, Colorado — one of the cities that Atul Gawande detailed in his celebrated article in the New Yorker.
4. At the Health Care Blog, Michael Lake explores recent trends in HIT, while providing many helpful links.
5. Webcast 1: On Tuesday, October 5th: Maggie Mahar and others will be participating in a webcast where they will discuss health care reform. Click here for Mahar’s overview on her Health Beat blog, including a link to the freely-accessible live stream.
Reform Rodeo: PPACA Provisions Go Live; Victor Fuchs; Physicals; Google Health
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1. PPACA News: Kaiser Health News reports on the health care overhaul changes that are occurring this week, including eliminating copays for preventive services and allowing children to stay on their parents’ health plans until 26 years of age.
2. Quality not Quantity: Famed health care economist Victor Fuchs discusses the importance that health care must place on increasing the quality of life as opposed to increasing longevity.
2b. On the Health Care Blog, Matthew Holt interviews Fuchs. Maggie Mahar provides extended commentary.
3. Examining the Exam: NPR has a piece on technology’s role in the fading art of the physical examination.
4. Google Health’s Health: On the Health Care Blog, John Moore of Chilimark Research discusses a recent meeting he had with Google about the future of their once promising but recently stagnant cloud-based EHR system.
5. Mark Your Calendars: Health Affairs announces an October 5th event they will be hosting in Washington D.C. which look at comparative effectiveness research.
Reform Rodeo
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1. Stem Cell News: A ban imposed by a federal district court on the use of federal funding for embryonic stem cells has been stayed by a court of appeals judge.
2. Important PPACA Case: Kaiser Health News notes that a closely followed hearing is scheduled in Florida for a case filed by 20 state attorneys general that challenges PPACA’s individual mandate.
3. Primary Care no Panacea: Maggie Mahar discusses new research which finds that a greater population of primary care physicians is not a sufficient condition to improving the quality of care.
4. Bending the Cost Curve: The New York Times discusses a new study by The Center for Medicare and Medicaid Services that outlines the future costs of health care under PPACA. The study itself can be found here.
5. On Defensive Medicine: Joe Paduda describes recent research that reveals only a minimal cost for defensive medicine.
Reform Rodeo
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[Ed. Note: HRW welcomes back Jordan Cohen from his work in Washington at HHS this summer-- the place just wasn't the same without him]
Waste: The New York Times provides an overview of a new study detailing health care wastefulness — which the Times reports as being the first study to quantify the problem.
Berwick’s Pilots: Newly appointed Medicare director Donald Berwick is pushing for hundreds of new pilot programs that would seek to innovate the delivery of health care.
Prognostication: The Health Care Blog’s David Kibbe and Brian Klepper look beyond meaningful use and distill five future trends of patient health data and clinical health information technology.
Meaningful Use FAQs: For those with questions on meaningful use, John Halamka has created FAQs.
PPACA and Employees: Researchers at RAND have published a study predicting PPACA’s effect on workers’ health insurance coverage.
Medicaid Outside the Box: Health Affairs’ Michael O’Grady and Jennifer Baxendell Young have published a post that discusses new ideas for Medicaid financing.
Reform Rodeo: A Sick Wellpoint; Performance; EHRs; and More
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1. Really?: Reuters released an exclusive story about Wellpoint’s recent push to rescind contracts for those suffering from breast cancer.
2. Specialists: The New England Journal of Medicine has a piece on the role of specialists in performance-incentive programs.
3. EeeeekHR: In the New York Times, Pauline Chen describes her experiences as a physician attempting to come to grips with the unforeseen changes that EHR-based health care delivery has introduced into the doctor-patient relationship.
4. Myths of Health Reform: On The Health Care Blog, Maggie Mahar discusses the myths of health reform, including the belief that the reform measure was a hand out to industry.
4. When Skepticism Becomes Quackery: Steven Novella at Science-Based Medicine calls attention to the often hyperbolic demonization of the pharmaceutical industry.
5. That’s Just Your Opinion: Kaiser Health News gathers the latest opinions and editorials about health care, including pieces about children’s health care, RomneyCare, and the nursing shortage.
6. Resources: For those studying PPACA, George Washington University has released, among other things, a thorough provision-by-provision comparison of PPACA and subsequent reconciliation.
Reform Rodeo
Photo by David Monniaux
1. Duff Wilson of the New York Times discusses the lack of transparency with respect to industry’s payments to doctors.
2. John Halamka gives a nice overview of the various PPACA initiatives–including pilot programs–that involve HIT.
3. A group of lawyers discuss the impact that the recent Supreme Court decision in Citizens United could have on health care.
4. Matthew Holt at The Health Care Blog describes a new poll conducted about PHRs, and some of the results are surprising.
5. Health Affairs has a nice summary of a round table discussion on reforming CMS in the era of Don Berwick.
6. Jason Shafrin of the Health Care Economist gives an overview of a new paper by Basu and Philipson that question some of the common assumptions of the economics of comparative effectiveness research.
Reform Rodeo: Medicaid; Self-insurance; EBM; Gene Patent Smackdown; eRx; Cool stuff
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1. PPACA & Medicaid: Kaiser Health News’ Maggie Mertens discusses PPACA’s affect on Medicaid, specifically the legislation’s increase in Medicaid reimbursement.
2. PPACA & Self-Insurance: Professor Tim Jost breaks down how PPACA will influence self-insured plans.
3. Doc vs Doc: Maggie Mahar profiles two feuding medical organizations: The Association of American Physicians and Surgeons, and the newer National Physicians Alliance.
4. Preventive Problems: The New York Times’ Duff Wilson reports on the brewing controversy of the FDA’s decision to permit broader marketing of AstraZeneca’s blockbuster statin Crestor.
5. On Evidence-based Surgery: David Gorski at Science-based Medicine has a tome-of-a-piece on surgery and evidence-based medicine.
6. Patent Pending: David Post at the Volokh Conspiracy discusses the recent ruling that invalidated (for now) the patenting of a gene thought to be associated with breast and ovarian cancer.
7. E-Prescribing: John Halamka discusses the trials and tribulations of e-prescribing controlled substances.
8. Just plain interesting:
a. Parkinson’s patients who can’t walk but can ride bikes. Wow.
b. Transcranial Magnetic Stimulation appears (at least in the lab) to influence moral decision making.
c. TED Talk: The Future of Medicine — Taking health care off the mainframe.
Reform Rodeo: Latest News & Interviews; CER; the Constitution; HIT; Robotic Surgery
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1. News: Kaiser Health News keeps you up to date by rounding up various stories on the Dems’ latest down-to-the-wire push on health reform. Their coverage of Representative Dennis Kucinich’s (and other reluctant Dems’) endorsement of the bill is here.
2. Betting on Health Care: The New York Times asks health wonks for opinions on the chances of passing health reform. Respondents include Robert Reich, former secretary of labor Gail Wilensky, Project Hope; Paul Starr, professor of public policy; James C. Capretta, Ethics and Public Policy Center; Karen Davenport, Center for American Progress; Jacob S. Hacker, political science professor.
3. Evidence-based Medicine: A group at the New England Journal of Medicine proposes 5 steps to advance one of the most promising–yet often ignored–means of reforming our health care system: comparative effectiveness research.
4. Deem and Pass: Jonathan Adler at the Volokh Conspiracy discusses the constitutionality of the “deem and pass.” Regardless of its constitutionality, Ezra Klein exposes some factual inaccuracies in recent reporting on the tactic.
5. The Blues: The Pittsburgh Post-Gazette alerts us to a lawsuit by Highmark Inc. against the Pennsylvania Department of Insurance, which claims that the Department exceeded its authority when challenging Highmark’s proposed merger with Independence Blue Cross.
6. Meaningful Use Partial Credit: John Halamka at Life As A Healthcare CIO discusses the aggressive thresholds for meaningful use that have been set in the most recent rules, and what the HIT Policy Committee is doing to assuage those concerns.
7. Wild Card: A new TED talk about the current state of robotic surgery. An article covering the topic can be found here.
Reform Rodeo
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1. The Final Push: Kaiser Health News compiles the latest news stories detailing the final push that is underway by Democrats and the White House to try and pass their comprehensive health reform plan.
2. Rep. Paul Ryan: Ezra Klein interviews Republican Rep. Paul Ryan of Wisconsin; the two discuss the economic impact of the Democrats’ health reform plan.
3. Abortion: Tim Jost does a yeoman’s job of laying out the differences between the House and Senate bills regarding abortion funding.
4. Health Summit Redux: Ewe Reinhardt discusses the lessons learned from the Health Summit.
5. Health IT: John Halamka covers the new HITECH-related NPRM that HHS recently released. The newest NPRM deals with the process of certifying EHR systems under the CMS’s incentive-based framework for meaningful EHR use.
6. Health IT Review: For those trying to catch up on health IT developments, Computerworld has a critical yet thorough account of the high speed push towards EHR adoption.
7. Isn’t That Nice: A feel good story about the The Oracle of Omaha and Dr. Atul Gawande.
Reform Rodeo! The Summit, Speed Dating, and More.
Photo by David Monniaux
1. Summit!: Fretting about how to get your dose of tomorrow’s “summit”? Don’t worry, CSPAN has got you covered for the Health Care Summit that is kicking off at 10am.
2. Managed Care Meltdown?: Joe Paduda at Managed Care Matters points out that the Anthem rate increases have shown an inability for private insurers to control costs. What Paduda is missing in his piece is advice to private health insurers about how to manage costs without another “managed care backlash” like we had in the 1990s.
3. The Cost Conundrum’s Conundrum, or Just a Canard?: Maggie Mahar has a beef with the New York Times’ channeling of Dr. Bach’s New England Journal of Medicine article, where Dr. Bach criticized the Dartmouth Atlas researchers’ methodology by claiming that they failed to risk adjust. Dr. Atul Gawande also believes the criticism is misplaced.
4. Health Care and Reconciliation are BFFs: NPR reports on a somewhat cozy relationship between reconciliation and previous health care initiatives.
5. What do speed dating and OB/GYN docs have in common? Kevin MD discusses how hospitals are utilizing speed dating techniques to match obstetricians with potential patients.
6. HIT, Yeah You Know Me: Dr. John Halamka with a slew of handouts from the HIT Policy Committee’s recent meeting, as well as notes from a recent meeting of the HIT Standards Commitee.
Reform Rodeo
Photo by David Monniaux
1. Principle or Posturing (or both)? –Kaiser Health News discusses the sudden plea from certain Senators for a reintroduction of the public plan into the Senate’s bill.
2. Starting From Scratch? — The Hill highlights polling indicating that many Americans favor scrapping the health bill and starting over, an option that President Obama has repeatedly said is not an option.
2a. Presidential Preemption? — Interestingly, the New York Times details the possibility of Obama posting his own health reform bill on the Internet ahead of the much-hyped health care summit. Could Obama use his “new” bill as evidence of a “fresh start” to appease Republicans?
3. Back to Basics — Maggie Mahar details the longstanding debate about whether health insurance actually saves lives.
4. Scoop on Standards — Dr. John Halamka, a physician who serves as CIO of Beth Israel Hospital and Chairman of the Health Information Technology Standards Panel (HITSP) at the ANSI, shares his thoughts on the vocabulary standards that will come to be the Esperanto of HIT.
5. HIT Funding — On Febuary 12th, the first $1 billion of federal funding for HIT promised under the HITECH Act was made available, with $10.6 million going to Massachusetts for the creation of a health information exchange.
6. Health Reform “Casualty”: The New York Times reported that former Congressman-turned head of PhRMA Billy Tauzin is resigning. Betting on the passage of health reform, Tauzin offered billions in concessions to the White House in exchange for, among other things, favorable patent exclusivity periods for pricey biologics.
7. Health 2.0 — The Health Care Blog reports on the purchase of online pain management company ReliefInSite.com by PatientsLikeMe.com–the popular patient web site which claims to be the “leading online community for patients with life-changing diseases.” Don’t be to surprised to see further growth of similar “Health 2.0″ websites that seek to take advantage of the increasing digitization of health care delivery and research.
8. The Science Behind Reform — Stephen Novella at Science-Based Medicine revisits the question of the effectiveness of colonoscopies.
Reform Rodeo
Photo by David Monniaux
1a. Health Reform Post-Brown: Kaiser Health News Staff Writer Jenny Gold discusses the Democrats’ seemingly new strategy of focusing on repealing health insurers’ antitrust exemption.
2. Bending the Curve, Success Story: Maggie Mahar over at Health Beat has a wonderful overview of Maryland’s successful approach to reducing health care costs.
3. Comparative Effectiveness: Dr. Nortin Hadler offers a forceful and nuanced view on the role of comparative effectiveness research.
4. Medicare and Technology: The New England Journal of Medicine has an interesting piece on how Medicare determines which health-related technologies to reimburse.
5. Quack Attack: Over at Science-based Medicine, Dr. Steven Novella covers the retraction of Andrew Wakefield’s 1998 article that claimed to link autism with the mumps-measles-rubella (MMR) vaccine.
6. Neuro News: The New York Times reports on how new studies may question some bedside techniques used to diagnosis the degree of brain activity in severely brain-injured patients.
7. Bonus: For those interested in more health-related links, Joe Paduda at Managed Care Matters hosts the current Health Wonk Review
Posts from Health Reform Watch have been cited by media sources throughout the country, including The New York Times, Washington Post, L.A. Times, Kaiser Health News, The Health Care Blog, NPR's Planet Money Blog, Duke Univ. Med. Center News, American Health Line Alerts, BusinessWeek.com, Concurring Opinions, Balkinization, The New England Journal of Medicine, Harvard's Nieman Foundation for Journalism, Las Vegas Sun, Maggie Mahar, Ezra Klein, Tom Geoghegan, and the official homepage of the Office of the Democratic Majority Leader of the House of Representatives, Steny Hoyer.
