Determining the Value of a Message by its Messenger

September 27, 2012
12:20 pm

We’re still learning exactly how to maximize the value of social media channels in communicating important health information to patients and consumers.  A number of private healthcare providers and companies, like the Mayo Clinic and Eli Lilly, have been in the forefront in using tools like Twitter and blogs to raise awareness of new healthcare trends and discoveries.

A study from Penn State University is helping healthcare providers better understand how social media users distinguish valuable information from data they choose to disregard.  According to the study, Twitter users are more likely to trust healthcare information when it’s being tweeted by a physician with a sizeable number of Twitter followers.  That only holds true, though, when the physician is tweeting original information.   When the doctor instead retweets information from other sources, then they physician’s credibility drops in the eyes of his or her followers.

This study can be immensely valuable in helping healthcare professionals and organizations become more effective in disseminating information to the patient community, particularly in an age in which social media usage continues to grow in popularity.

At the Healthcare Leadership Council, we have commissioned research in the past on how to best deliver health messages to the public.  Before the Medicare Part D program was launched, we worked with a research firm to conduct simulation exercises to better understand which information delivery system would achieve greater penetration with the beneficiary public.  We found that mass mailings and national television advertising had a limited utility when communicating prescription drug information, but local radio shows with healthcare experts and live community meetings with physicians and policy experts carried a great deal of credibility and impact.

The Penn State study indicates that what we learned in the early days of Medicare prescription drug coverage holds true today with social media platforms.  People want and trust information from an expert, reliable source delivered in a personalized manner.  Twitter, as a social media tool, allows individuals to feel connected to health experts.

These are important lessons to learn, particularly when the Patient Protection and Affordable Care Act goes into full effect and people will need information about health insurance exchanges and other health reform provisions.

Another Health Tax that Doesn’t Pass the Cost-Benefit Test

September 24, 2012
8:42 am

We’ve commented on this space previously about the damage that is and will be inflicted by the medical device excise taxes contained within the Patient Protection and Affordable Care Act (PPACA).  We’ve already seen companies announce layoffs of employees to pay for the tax, and it’s impossible to calculate the number of startup companies that won’t be sending new innovations to market because of a tax applied to revenues, not profits.

Now, Congressman Charles Boustany (R-LA) is reminding his colleagues of another tax that is part of PPACA, one that will make health coverage more expensive at a time in which we need to be emphasizing affordability.  He announced Friday that he has 218 cosponsors for his legislation to repeal the tax.

The health insurance tax, assessed on health insurance companies based upon their ‘net premiums,” is expected to raise $87 billion between 2014 and 2019.  The Congressional Budget Office has projected that these taxes will likely result in higher premiums for privately-insured  businesses and individuals, with the average family seeing as much as a $500 increase per year according to a recent study by former CBO director Douglas Holtz-Eakin.

The broader issue of fees, taxes and reduced reimbursements on various health sectors contained within PPACA is an issue that Congress needs to reexamine.  These taxes and payment cuts are essentially moving public policy in the opposite direction of the goals our country most needs to achieve – greater job creation and more affordable healthcare.

The medical device tax repeal has already passed the House and, according to Congressman Boustany , a majority of Representatives are poised to do the same with the health insurance tax.  The Senate leadership did not allow a vote on the medical device repeal and one could surmise that the legislation doing away with the health insurance tax, should it pass the House, would meet the same fate.   Hopefully, when Congress returns to work after the elections or in 2013, we’ll see action to remedy these counterproductive provisions of PPACA.

When the Shouting Recedes

September 11, 2012
2:34 pm

This week, National Journal provided a welcome reminder that the finger-pointing, bombastic rhetoric and hardened, polarized positions that characterize election-year politics can give way to reasonable discussions and collaborative problem-solving once we get beyond November.

During this election cycle, the Obama Administration has presented hard-line opposition to any kind of Medicare reform that would involve “premium support,” providing seniors with federal financial support they can use to acquire Medicare coverage from competing private plans (or, if they so choose, stay in conventional fee-for-service Medicare).  The issue has been a harsh dividing line between Democrats and Republicans not only in the presidential race, but in Senate and House races throughout the country.

But National Journal obtained e-mail exchanges between highly-respected health care experts David Cutler and Jonathan Gruber and staff of the White House-appointed Commission on Fiscal Responsibility and Reform, the so-called Simpson-Bowles commission.  Cutler and Gruber are professors at Harvard and MIT, respectively, who were health policy advisors to the Obama presidential campaign in 2008 and lent their expertise to the development of health reform legislation.

In their e-mails, Cutler and Gruber gave qualified support to moving toward a premium support plan authored by Congressman Paul Ryan (R-WI) and former Clinton Administration budget director Alice Rivlin.  Cutler said a premium support model should be built on top of the insurance reforms in the Affordable Care Act, while Gruber offered misgivings about trying a choice-and-competition model with seniors before the general population had begun using the new ACA state insurance exchanges, but said “premium support is ultimately where we need to be.”

So, in the long run, what does the National Journal story mean?  Nothing definitively, but it does underscore the point that, once the election smoke has cleared, it’s possible that cooler heads can have reasonable discussions about the future of Medicare and bipartisanship has a chance to take hold.