May 15, 2012
2:30 pm
This month, we’ve seen even more evidence that states enacting medical liability reform are having a significant impact in reducing the number of frivolous lawsuits, thus providing speedier justice to plaintiffs who have suffered legitimate injuries and deserve compensation. Pennsylvania is the latest state spotlighting the value of reform.
Of course, Pennsylvania reforms are not exactly new. The state took action back in 2003 to address a situation in which, according to a Philadelphia Daily News columnist, “courts were clogged with cases and lawyers hit Vegas-level jackpots.” The state began requiring attorneys to produce certificates of merit from medical professionals to prove that a legitimate case existed and it declared that cases must be tried in the same jurisdiction in which the alleged injury took place. That put an end to ‘venue shopping,’ in which attorneys strived to get their cases tried in Philadelphia with its notoriously free-spending juries.
What’s new is the evidence that these reforms have had an effect. The state Supreme Court announced last week that the number of medical malpractice cases filed in the state was down 44 percent in 2011 compared to the years before liability reforms were instituted. With higher standards being required, attorneys are less likely to invest time and resources into questionable litigation.
There are still cases, though, that must have less than impeccable merit. In 2011, seven of every 10 liability cases were won by the defendant health providers.
It should be noted that Pennsylvania physicians and hospitals insist that further reforms are still necessary, that it is difficult to recruit new physicians to a litigation-heavy state and too much defensive medicine is being practiced.
Still, this is significant progress.
April 23, 2012
8:23 am
In a Forbes commentary, Eli Lilly and Company CEO John Lechleiter underscores the need for new medicines and medical technologies to provide better healthcare to our aging society. While U.S. healthcare innovators have an unmatched history of success in saving and improving lives – testing more potential new medicines each year than the rest of the world combined – the challenges posed by illnesses like diabetes, osteoporosis and neurodegenerative diseases threaten millions of people throughout the world. And, unless successfully addressed, they will place unprecedented stress on our healthcare system.
In his Forbes op-ed, Lechleiter outlines four vital components that must be in place in order to have a vibrant, successful “innovation ecosystem” to tackle these illnesses. They include:
- Intellectual property protection to enable scientists and investors to stay in the business of innovation.
- Open access to healthcare markets, a component that is threatened by new public policies like the creation of the Independent Payment Advisory Board (IPAB), which could slash Medicare spending and limit seniors’ access to healthcare innovations.
- Free-market pricing, which hinges on the avoidance of real or de facto government price controls on medical innovators.
- A regulatory system that is “timely, predictable, consistent, transparent and scientifically rigorous.”
The agenda Lechleiter has outlined should be at the forefront of Washington, DC health policy discussion. As he put it, entirely correctly, “Our policymakers must do everything they can to….ensure that the dreams and discoveries of today turn into the lifesaving treatments of tomorrow.”
March 08, 2012
3:32 pm
We’re all concerned about how our healthcare workforces will keep up with an increasing patient population. Not only is Medicare growing at the rate of 7,500 new beneficiaries per day, but the Affordable Care Act will lead to millions more Americans having health coverage when fully implemented.
We’re seeing one answer in the form of technology that is helping to reduce hospital readmissions and enable health facilities to evaluate patient conditions and needs without requiring them to come to the doctor’s office.
This week, the Geisinger Health Plan and AMC Health announced the results of a two-year evaluation of a telemonitoring program developed by AMC. Geisinger found that home telemonitoring of patients with congestive heart failure reduced 30-day hospital readmission rates by more than 40 percent.
Here’s how the system works. Patients receive scheduled calls from an interactive voice response system. The patients report their symptoms, with those responses immediately stored in their electronic health record and evaluated. A determination is made whether the patient needs a follow-up with a nurse or a case manager. 96 percent of the Geisinger case managers said the system was allowing them to monitor heart failure patients more effectively.
This also bolsters our argument that there are better ways to address healthcare’s cost issues than simply axing dollars out of the system and consequently reducing patient access and care quality. There are technological solutions, as shown in this innovative work by AMC Health and Geisinger, that can make the system more cost-effective while providing even better care to patients.
February 28, 2012
2:12 pm
Tomorrow (Wednesday, Feb. 29), the House Energy and Commerce health subcommittee is scheduled to vote on legislation that would repeal the Independent Payment Advisory Board (IPAB). IPAB is the provision within the Affordable Care Act health reform law that empowers a 15-member board of political appointees to make recommendations to cut Medicare spending, cuts that would take effect unless Congress provides its own alternative plan. It’s a startling transfer of authority from the legislative branch to the executive, without any judicial review to provide checks and balances.
The nation’s physicians have made it clear that they think IPAB is, to put it bluntly, a bad idea that will do more harm than good to Medicare beneficiaries.
On Monday, the American Medical Association sent a letter to the health subcommittee leadership, referring to the struggles Congress has had with the issue of Medicare payments to physicians, writing, “adding additional formulaic cuts through IPAB is just not rational and would be detrimental to patient care, especially as millions of Baby Boomers enter Medicare.”
And, prior to the AMA’s communication, a group of 24 medical specialty societies sent its own letter to the Energy and Commerce health subcommittee, sharing the concern that “the strict budgetary targets and other limits imposed on the IPAB will ultimately threaten the ability of our nation’s seniors and disabled to obtain the health care they need, when they need it.” The specialists added, “Leaving Medicare payment decisions in the hands of an unelected, unaccountable body with minimal congressional oversight will negatively affect timely access to quality health care.”
The physicians have diagnosed the system correctly. At a time in which Medicare needs structural reforms to continue providing quality care, but with an emphasis on value and cost-effectiveness, IPAB is a blunt instrument that will indiscriminately cut Medicare spending in a way that undermines both quality and patient access to care.
By the way, over 290 patient and health care organizations, including the Healthcare Leadership Council, have also sent a letter to Capitol Hill urging IPAB elimination.
Let’s hope tomorrow’s subcommittee markup is the first step toward repeal of an ill-conceived idea.
February 24, 2012
7:59 am
Massachusetts received the lion’s share of attention, but one other state had also created a health insurance exchange before Congress passed the Affordable Care Act health reform law. The Utah Health Exchange (UHE) is an experiment that warrants close watching.
The Utah approach is focused heavily on the value of consumer information. As the state’s lieutenant governor Greg Bell puts it, the UHE is an Internet-based portal. In his words, “It is a single shopping point where consumers can evaluate their options, and then brokers, agents and employers can share information.” This is a consumer-centered approach that has appeal to other states. In fact, U.S. Senator Tom Coburn (R-OK) recently recommended that his state adopt the Utah model.
At the Healthcare Leadership Council, we’ve witnessed firsthand the benefits of equipping consumers with comparative health insurance information. When we launched an initiative called Health Access America a few years ago, we commissioned public opinion research that found 50 percent of uninsured Americans had no idea how or where to find information on health plan benefits and costs. By setting up web-based portals that allowed consumers to compare different plans, we saw a difference in the number of people purchasing health coverage.
It will be interesting to see statistics emerging from Utah in terms of the impact consumer-friendly information has on insurance acquisition without an individual mandate (a key difference between the Massachusetts and Utah approaches to health reform) and how head-to-head competition between plans in the web-based exchange affects coverage cost and value.
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