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The Week’s Most Interesting Healthcare Reading (that you might have missed)

April 08, 2011
1:48 pm

As we do every Friday, here are some of the more interesting, and important, healthcare stories of the week that may not have caught your attention:

Julie Appleby of Kaiser Health News conducted a fascinating interview with new Aetna CEO Mark Bertolini in which he discusses the individual mandate, the reasons for premium rate increases and how his compelling personal story is driving his desire to improve the health coverage system.

On Wednesday, Research!America published a guest blog post by Colleen Conway-Welch, Dean at Vanderbilt University School of Nursing, which discussed the need for nurses to step up and engage in healthcare policy debate.

Top health organizations, including Healthcare Leadership Council member Mayo Clinic, announced the Care Connectivity Consortium, an initiative designed to securely share electronic medical records for their patients. The health IT collaboration seeks to improve patient care and lower costs by allowing providers to utilize available data on patient health conditions, allergies and medications.

Susan D. DeVore was spotlighted in The New York Times discussing the path her life has taken that has led her to become CEO of the Premier healthcare alliance.

If you see a story about U.S. healthcare during the week that you feel deserves a broader audience, be sure to contact us and call it to our attention.

World Health Day: A Focus on Keeping Medicines Effective

April 07, 2011
2:01 pm

picture2Today is World Health Day and this year’s theme is antimicrobial resistance, a growing problem that threatens to treat illness and prevent disease with medications.

Instead of simply issuing a commemorative statement to recognize the day, AstraZeneca CEO David Brennan appears in a video in which he outlines a multi-point approach to attacking this global dilemma. It’s well worth watching.

“A Useless Piece of Plastic”

April 06, 2011
2:48 pm

Before we get too far along in the week, I didn’t want to miss the opportunity to highlight an article by Robert Pear of the New York Times that appeared in the newspaper’s Monday edition.  Mr. Pear went to Louisiana to see firsthand the scope, or lack thereof, of healthcare services available to Medicaid patients.  If you’re concerned about the ability of our healthcare system to adequately serve at least 15 million new Medicaid beneficiaries as a result of health reform, this article won’t alleviate your worries.

The thrust of the Pear article is that states are making cuts in their Medicaid programs in order to balance their budget, and that these cuts are making it more difficult for patients to get the services they need, particularly if they need to see a specialist of some kind. 

This is not a new problem, though, but an exacerbation of an already-existing one.  There were already a significant number of physicians that do not see Medicaid patients because of the program’s comparatively small provider payments, lower than Medicare and substantially lower than private insurance plans.

For his story, Mr. Pear interviewed a woman in Opelousas, LA because of three herniated discs in her neck that require surgery.  She can’t, however, find a surgeon that will take her because she is a Medicaid patient.  Holding up her Medicaid card, she said, “It’s a useless piece of plastic.  I can’t find an orthopedic surgeon or a pain management doctor who will accept Medicaid.”

The new health reform law allows states to cut their Medicaid budget, but they can’t touch eligibility for the program.  That means cuts are going to come either through further reductions in provider payments or by limiting the scope of services beneficiaries can receive.

A critical goal of health reform is to make certain that all Americans have access to quality healthcare.  The Medicaid issue is one that remains to be addressed if this objective is to be met.

The Supreme Court and the Importance of Information

April 04, 2011
1:58 pm

Last week, my organization, the Healthcare Leadership Council, joined with two distinguished healthcare leaders, Dr. Louis W. Sullivan and Tommy Thompson, both former secretaries of the Department of Health and Human Services, in filing a ‘friend of the court’ brief with the U.S. Supreme Court.  We did so because of the critical nature of medical information and the importance of keeping databases accurate, up-to-date and accessible to medical professionals.

The case in question is Sorrell v. IMS Health and it concerns a Vermont law that bans the commercial use of de-identified patient data that is part of a physician’s prescribing history.  It’s the kind of law that plays to the kneejerk instinct to keep patient information in a sealed and inaccessible lockbox, but the ramifications of this approach to quality healthcare are quite severe.

What’s important to note here is that the Vermont law really isn’t protecting anybody.  The patient data in question is already de-identified.  Anyone making use of this information won’t see patient names.  Furthermore, there are already rigorous federal and state regulations in effect to protect against wrongful use of medical information.

The downside of the Vermont law is that barring all commercial use of such data also stops the flow of resources that is used to maintain current, accurate databases and to create new analytical tools that enable the use of data for health system improvements.

Secretaries Sullivan and Thompson and the HLC are far from alone in holding this point of view.  Over 50 organizations and individuals, including the U.S. Chamber of Commerce and the Associated Press, have also filed amicus briefs to invalidate Vermont’s statute.

Health Reform and Academic Medical Centers

April 01, 2011
9:58 am

Dr. Herb Pardes, the president and chief executive officer of New York-Presbyterian Hospital (and a member of the Healthcare Leadership Council), spoke yesterday at the National Press Club and made a number of interesting and valuable points about health reform, the value and future of academic medical centers, and the ability of the healthcare system to provide access to care to a larger insured population. Here are some key excerpts from his speech:

On physician shortages and access to care:

“The Association of American Medical Colleges projects a shortage of 130,000 physicians by 2025.  Since it takes up to ten years to train a new doctor, we are already behind.  We need at least 6,000 to 8,000 new physicians annually on top of the 16,000 that are currently produced each year…..We need measures to increase the healthcare workforce.  The caps on residencies should be repealed.  We should expand the scope of practice for nurses, physician assistants, and other healthcare providers.  Doctors must be trained in quality, safety, reducing cost, and health information technology.”

On efforts to enhance healthcare quality and the challenge faced by hospitals with economically-challenged patient populations:

“Measuring quality correctly is complex.  Many factors are involved, including the nature of the patients – how sick they are, they quality and quantity of previous care, underlying conditions such as poverty and lack of care – and other complicating characteristics.  These are circumstances facing academic medical centers as a consequence of treating the sickest, most complex cases, as well as the poorest and most vulnerable patients.”

On the ability of academic medical centers lead the charge on quality and cost control:

“Because academic medical centers treat a large portion of (patients in poverty and with multiple medical conditions), they are well situated to create innovative new care models that will improve quality and reduce cost.  The partnerships inherent in the academic medical center structure – hospitals, medical schools, physicians, community clinical networks, schools of public health, and others – provide the creative and experiential resources to develop and implement models of care based on quality metrics and cost controls.”