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.”
April 04, 2012
9:37 am
When you examine the rising costs in our healthcare system, an important starting point is the care required by the so-called dual eligibles, those Americans who are eligible for both Medicare and Medicaid. There are nearly 10 million individuals nationwide who fall into this category and they utilize a disproportionate share of healthcare services because of a high propensity for chronic disease and need for acute care.
Dual eligibles account for 27 percent of Medicare’s spending, although they represent only 16 percent of beneficiaries. That gap is even wider in Medicaid. According to a Wall Street Journal article last year, one reason costs are so high for this patient group is imperfect coordination between Medicare and Medicaid which is contributing to “hundreds of thousands of hospitalizations that could be avoided.”
A new report released this week shows that progress can be made in providing better, more cost-effective care to the dual eligible population. Avalere Health, a highly-regarded research and analysis firm specializing in health policy, has studied an integrated care model developed by SCAN Health Plan, a health insurer serving 130,000 Medicare Advantage beneficiaries in California and Arizona. (SCAN is also a member of the Healthcare Leadership Council.)
The Avalere study found that SCAN’s team-oriented case management approach for dual eligible patients, utilizing individually-tailored care plans, has resulted in hospital readmission rates that are 25 percent lower than traditional fee-for-service Medicare. SCAN also outperformed conventional Medicare by 14 percent in prevention indicators, maintaining patient wellness and keeping them out of the hospital.
As Avalere senior vice president Bonnie Washington put it, “Better coordinated care for low-income elderly patients is a critical imperative for federal and state governments. This study shows that well-developed care management models can result in measurable differences in quality, hospitalization and rehospitalization – and cost savings – for a vulnerable population in need of close care coordination.”
March 22, 2012
8:42 am
There is broad agreement that one of the keys to achieving a sustainable, cost-effective healthcare system is to emphasize wellness and disease prevention. After all, with 75 cents of every healthcare dollar going toward the treatment of chronic disease, it’s essential that we curb the escalation of preventable illnesses in order to contain healthcare spending. The question is, though, whether there is a cohesive game plan for doing so.
The Healthcare Leadership Council and the Congressional Wellness Caucus are hosting a briefing this Friday, March 23 on the innovative actions hospitals and health systems are taking to strengthen patient and community wellness. Our speakers will include Baylor Health Care System CEO Joel Allison, Dr. Michael Roizen of the Cleveland Clinic, and Dr. Donald Hensrud of the Mayo Clinic. Under Allison’s leadership, Baylor has been recognized as one of the top facilities in the country when it comes to medical research and innovative approaches to care. Roizen is the author of books on wellness that have hit the top of the New York Times bestseller charts. Hensrud is an author and recognized expert on nutrition, diabetes, and wellness.
The briefing is being held from 12:00pm-1:30pm in the Capitol Visitors Center, room SVC 203-02. For more information, contact Teresa de Vries at 202-449-3436 or tdevries@hlc.org.
And for more information on the latest and most effective approaches to disease prevention in the private sector, take a look at the examples contained in the HLC Wellness Compendium.
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.
January 30, 2012
3:33 pm
If you smoke tobacco, you’re not going to be hired for a job by the Baylor Health Care System. For that matter, you don’t need to waste time filling out an employment application form at the Cleveland Clinic either. Both healthcare providers have made it clear that they will not accept smokers within their respective workforces.
In its editorial today, USA Today says this type of policy is wrong. The newspaper argues that employers like Baylor CEO Joel Allison and Cleveland Clinic CEO Toby Cosgrove (both members of the Healthcare Leadership Council) have every right to offer smoking cessation programs to their employees and even to make smokers pay more out of pocket for their workplace-provided health insurance. But, USA Today says, it is improper to penalize a job applicant for practicing a legal habit on their own time.
According to the newspaper’s editorial, “A bit further down (this) road lies hiring based on genetics. In that world, inheriting that shows a predisposition to a costly disease could cost you a job.”
USA Today is wrong, and not just because of its nonsensical comparison of a voluntary activity like smoking to an individual’s genetic makeup.
Today’s healthcare providers are expected not only to provide excellent care for the patients, but also to encourage wellness, disease prevention and healthy behaviors among all individuals they have the ability to influence. As Dr. Paul Terpeluk of the Cleveland Clinic said in his “opposing view” in USA Today, “We have a unique perspective on the burden of chronic disease. We not only treat disease, but we also play a vital role in educating patients and employees about lifestyle choices. It is only right to practice what we preach.”
There’s also a significant economic issue involved here. When an employer, particularly one who provides health coverage, hires an individual, they are assuming the burden of his or her healthcare costs. An individual may smoke on their own time, but the employer winds up footing much of the bill for the chronic illnesses associated with smoking. Should an employer be allowed to consider the increased health costs, absenteeism and loss of productivity associated with a voluntary, unhealthy behavior like smoking? It’s hard to argue that they shouldn’t.
And in an environment in which five percent of the population is responsible for 50 percent of our healthcare costs, this is a concern that goes well beyond Baylor and the Cleveland Clinic.
I know both Joel Allison and Toby Cosgrove. They are both gentlemen who have dedicated their lives and careers to providing better health to their fellow citizens. Their no-smoking policies are neither mean-spirited nor discriminatory. Rather, they are intended to make a vitally-needed statement about wellness and healthy living both within and outside the confines of their respective institutions.
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