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"Meaningful Use" of Health IT: The Commandments are Revealed

July 16, 2010

Since the passage of the Health Information Technology and Economic and Clinical Health (HITECH) portion of the Stimulus Law on February 17, 2009, seventeen months of speculation concerning how the federal government was going to define what it meant by the "meaningful use" of electronic medical records to qualify for up to $27.4 billion in federal incentive payments finally came to an end this past Tuesday, July 13. The requirements are out and the race is now officially on to comply.

A Trillion Here, a Trillion There, Pretty Soon, You're Talking Real Money

June 18, 2010

Analysis of:A Path to Eliminating $3.6 Trillion in Wasteful Healthcare Spending | factsforhealthcare.com

A recent report from Thomson Reuters indicating that there are realistic ways to save at least $3.6 trillion over the next decade by eliminating waste in the health care system without compromising quality or access recalls the old saw attributed to the late Senator Everett Dirksen: "A billion here, a billion there, pretty soon you're talking real money". For the 21st Century, you have to substitute trillion for billion to get people's attention when it comes to saving money in health care.

$163 Billion in Pharmacy-Related Waste Annually

April 30, 2010

In what will become ever more stepped up efforts to find and eliminate waste in the nation's $2.6 trillion health care industry to free up sufficient funds to cover 32 million additional Americans by, a recent study published in Express Script's 2009 Drug Trend Report has found $163 billion in wasteful spending on pharmaceuticals.

Accountable Care Organizations: The Next Big Thing in Health Care

April 23, 2010

Despite all the criticisms by Republicans and some Democrats, the new Health Care Law actually does provide for a quite a few pilot projects aimed at controlling the costs of the Medicare Program, without compromising safety or quality. Unlike the demonstration projects of the past which never went anywhere following their completion even when successful, pilot projects may be expanded nationally and made permanent by the HHS Secretary without the need for Congressional approval.

Health Associated Infections Still on the Rise

April 15, 2010

The Agency for Healthcare Research and Quality (AHRQ) issued its latest National Health Care Quality Report this week and the news was not good. Despite all the publicity around the finding that up to 100,000 Americans die annually due to health care associated infections, most of the infection rates are not going down, and some are still rising.

Health Cost and Quality Transparency On the Rise

April 9, 2010

A new website introduced this week by the Centers for Medicare and Medicaid Services (CMS) has a dashboard that will permit tracking of how much is spent on Medicare patients in hospitals for many treated illnesses and conditions. The new site is one of the Dept. of HHS' efforts in response to the White House's Open Government Directive to open up and publish its data for public review and analysis.

Center for Medicare and Medicaid Innovation Key to Delivery System Reform

April 2, 2010

Despite all the claims on both sides of the aisle that the new Health Law does little to alter the root cause of health care inflation and uneven quality, viz. the fee for service reimbursement system, the Center for Medicare and Medicaid Innovation (CMI) which will be established within CMS goes a lot further than all previous efforts at laying the foundation over the next decade to do exactly that.

Value Based Purchasing an 11th Hour Addition to Enacted Health Care Reform Bill

March 26, 2010

To obtain the votes of 30 members of the House representing the Quality Care Coalition to ensure passage of this week's historic national health care reform legislation, HHS Secretary Sebelius, Speaker Pelosi and the White House Director of Health Care Reform, Nancy An Min-DeParle, approved a letter from the Secretary indicating that Medicare may soon be moving away from a fee for service system to a more quality and value-based system.

How Health Care Reform can Save that $1.3 Trillion the CBO Projects in 20 Years

March 19, 2010

The nonpartisan Congressional Budget Office (CBO) finally produced its projection of the extent of deficit reduction for the reconciled health care reform legislation coming up for a final vote by the House on Sunday. While it is projected to save $138 billion between 2010 and 2019, the CBO projects that between 2020 and 2029, it will save an additional $1.2 trillion. Why are the vast bulk of these savings not expected to occur until the second decade after its passage? Are they realistic?

Electronic Medical Records Taking Off Even Before the Money Starts to Flow

March 12, 2010

Although the federal government will not pay a dime to either hospitals or physicians for meaningfully using electronic medical records prior to this October for hospitals and next January for physicians, there is already growing evidence that just the prospect of this is driving the health care industry toward adoption faster than originally anticipated.

Order in the Health Court!

March 5, 2010

Analysis of:Health Courts Could Become Tort Reform Option | www.healthleadersmedia.com

To demonstrate an effort to be bipartisan in health care reform, President Obama this past week proposed up to $50 million to fund alternative demonstration projects, such as health courts, for resolving medical liability actions. A nonpartisan group called the Common Good, funded by the Robert Wood Johnson Foundation, has been working the past eight years with the Harvard School of Public Health and others to develop a proposal for how the U.S. could establish a health court system.

Waste Not Want Not: The Real Issue for Health Care Reform

February 26, 2010

Analysis of:Media Advisory: Download the Thomson Reuters Report on Healthcare Waste Cited Today in President's Healthcare Summit | thomsonreuters.com

Despite the flurry of political points sought to be landed during yesterday's seven hour Health Care Summit Marathon at Blair House, what got totally lost were the excellent points made early by Physician-Senator Tom Coburn concerning the magnitude of the waste in the U.S. Health Care System which needs to be addressed at least simultaneously with (if not prior to) extending insurance to 30 million more Americans. Dr. Coburn's conclusions came from a just released study from Thomson Reuters.

Comparative Effectiveness Research Here to Stay

February 19, 2010

Analysis of:Health Care Reform and Comparative Effectiveness: Implications for Surgeons | archsurg.ama-assn.org

Regardless of what does or does not emerge from the Bipartisan Health Care Summit at Blair House next Thursday, comparative effectiveness research is here to stay. In addition to the $1.1 billion allocated to this area (much of which is now being dispensed by various federal agencies), the Obama Administration recently called for yet an additional $286 million for this in the budget of HHS' Agency for Health Care Research and Quality (AHRQ) for Federal Fiscal Year 2011.

Cart Before the Horse Time for Health Care Reform

January 29, 2010

Analysis of:Can a New Health-Care bill Meet Cost Curve Goal? | www.marketwatch.com

With the juggernaut of national heath care reform now stalled pending and likely not to pass before the jobs picture starts looking better (perhaps by this Spring), as President Obama advised in his State of the Union Address, it's time to give what has been passed a "second look". However, even more importantly, it's time to decide what features have bipartisan support and could really control costs before we commit to bringing on 35 million new beneficiaries.

HHS Told How to Prove the Worth of its Huge Investment in Electronic Records

December 17, 2009

Analysis of:Meaningful Measurement of Quality Health Care Using Electronic Health Records | www.ncvhs.hhs.gov

The overriding reason why HHS is going to invest $34 billion in getting hospitals and physicians to "meaningfully use" electronic medical records over the next six years and beyond is to improve the quality, safety and efficiency of care. The National Committee on Vital and Health Statistics recently advised HHS on how to go about determine progress toward achieving this goal.

Health IT Gets a "Gentlemen's 'C'"

December 11, 2009

Analysis of:Ten Years after IOM Report, Expert Gives Health IT a "C+" | www.healthcareitnews.com

Despite all the attention to Health IT since 2004, when President Bush first proclaimed that every American should have an electronic medical record by 2014, one of the nation's leading experts on patient safety and health care quality (which health IT is intended to promote) has only given it a "C+" in his most recent evaluation. What's worse, using the same grading criteria, this expert gave Health IT a "B-" five years ago. So Health IT is headed in the wrong direction.

A Quarter of a Billion Bucks to Spread Models of Electronic Health Record Use

December 4, 2009

Analysis of:U.S. Offers Grants for Implementing Electronic Health Records | www.dallasnews.com

A couple of recent studies have questioned the cost savings potential of electronic health records, one from long time advocates of a single payer system at Harvard. This has given those on both extreme ends of the political spectrum some fresh ammunition to try to shoot holes in the Administration's claims of long term cost savings deriving from their proposed reforms (especially through the greatly increased use of electronic health records). But the Administration has fought back.

Congress Will Be Fast on the Trigger to Get a Health Bill Passed

November 25, 2009

Analysis of:Triggering a Victory on Health Bill | www.online.wsj.com

Even though at most a public insurance option would enroll between four and six million people, it nevertheless has become the flash point of disagreement among moderate Republicans (like Senator Snowe, R-ME), centrist Democrats (like Blanche Lincoln, D-NE), Independents (Joseph Lieberman, I-CT) and more liberal Democrats (like Roland Burris, D-IL). Despite its red herring status (see my immediately previous post) a compromise must be struck to save health care reform.

Is the Controversy over the Public Option the biggest Red Herring Ever?

November 20, 2009

Analysis of:Reid Pushes for Votes on Health-Care Bill | www.washingtonpost.com

Nothing has raised the hackles of partisan Democrats and especially Republicans more this year than the public health insurance option. On the left, liberals consider it to be the indispensable component of true healthcare reform. On the right, conservatives refer to it to the first step on the slippery slope to socialism, if not a return to the Third Reich this time in America. Yet, the truth is that its impact will likely be so small, its presence (or absence) hardly merits any debate.

Will Bundles of Healthcare Payments Bring Joy to Anybody?

November 13, 2009

Analysis of:RAND: Bundled Payments the Best Way to Contain Healthcare Costs | www.fiercehealthcare.com

Analysts at RAND Corp. have thrown their weight behind the use of bundled fees to pay physicians and hospitals. They have concluded that although difficult to implement, doing so is probably the most effective way to contain health care costs which could spin even more out of control under the current health care reform proposals and ultimately bankrupt the federal government without dramatic changes to the current fee for service system.

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