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It's Time for Health Care Reform--Not Just Health Insurance Reform!

October 30, 2009

Analysis of:The Health Care Reform Debate We Need | blog.nj.com

With so much emphasis on changing the health insurance system, the far greater need to change the delivery and financing of care has gotten relatively little mention, at least in the sound bites where most people receiving their daily news. We should not squander this once in a lifetime change for real health care, and not just health insurance reform.

The Holy Grail of Saving Lives and Saving Money Found to be Achievable--Again!

October 23, 2009

Analysis of:Hospital Collaborative Finds Sharing Data Saves Costs, Lives | www.healthleadersmedia.com

As the health care reform march continues to drone on in D.C., we continue to hear naysayers claim that saving money will result in losing lives. Once again, in the results of the most recent study from the Premier health care alliance's national collaborative, QUEST: High Performance Hospitals, the Cassandras have been proven wrong.

Health Insurers may have Sealed their own Fate

October 16, 2009

Analysis of:A Hatchet Job so Bad It's Good | www.nytimes.com

By relentlessly attacking the major provisions of the Senate Finance Bill which would appear to be serving as the template for compromise reform legislation at least capable of overcoming a Republican fillibuster, the health insurance industry may have done itself no favors. While at least giving the impression of playing nice up until unveiling a very critical report of the Senate Finance bill on the eve of its passage, the industry at least had a seat at the reform table. No more.

Senate Finance Bill has the Greatest Potential to Reform Health Care Delivery

October 9, 2009

Analysis of:Health Care Bill Gets Green LIght in Cost Analysis | www.nytimes.com

The biggest boost that health care reform has received thus far occurred this week when the closely watched nonpartisan Congressional Budget Office (CBO) concluded that the Senate Finance Bill would actually reduce the federal deficit by $81 billion over the next 10 years and more beyond that. That set the stage for a vote on it by the full Committee next Tuesday, Oct. 13. It is expected to pass the Committee and then go to the Senate for floor debate by the week of Oct. 19.

Electronic Health Record Data will be an Industry Gold Mine

October 2, 2009

Analysis of:Survey Highights Power, Limits of EHR Data | www.healthdatamanagement.com

The real value of getting everybody on an electronic medical record in the next decade will not be realized until the data produced through this transition become easily accessible and analyzable to identify, implement and continuously improve best practices. More than three quarters of 732 surveyed executives at provider, payer and pharmaceutical organizations believ e this secondary use of data from electronic records will be their organizations' greatest asset during the next five years.

Dell Positions Itself for the Federal Health IT Spending Spree

September 25, 2009

Analysis of:Dell, Perot Merger Could Impact Health IT | www.healthleadersmedia.com

Another well known stalwart in Information Technology has stepped up to take advantage of the total federal outlay of $36.2 billion (net $19.2 with projected $17 billion in savings) about to flow. In merging with Perot Systems, Dell has followed the well worn route of acquisition of business services consulting followed a year ago by Hewlett Packard's takeover of EDS and IBM's earlier takeover of PricewaterhouseCoopers Consulting to provide a full panoply of both products and services.

For Medicare, There's No Place Like Home

September 18, 2009

Analysis of:Medicare to Fund 'Medical Home' Model | online.wsj.com

The Obama Administration said Medicare will help fund state pilot projects that use primary care doctors and teams of coordinators to manage patient care and reduce costs. The government will begin soliciting applications this fall and aim to implement the three year initiative early next year. States that want to get the extra funding from Medicare will have to demonstrate that their programs will actually produce better results with lower health care costs.

Are Health Courts the Last Best Chance for Bipartisan Reform?

September 11, 2009

Analysis of:New Nationwide Poll Finds Most Americans Want Medical Malpractice System Changes as Part of Health Care Reform | www.philipkhoward.com

One of the few things which President Obama said in his Address on Health Care to a Joint Session of Congress this past week which brought Republicans to their feet was the offer of changing the current medical malpractice system as part of health care reform. To the extent that the President is still serious about attracting more than Senator Olympia Snowe (R-ME) to support an ultimate bill, he would be wise to include this is any final legislation coming out of the Joint Conference Committee.

What True National Health Care Reform Must Accomplish

September 2, 2009

Analysis of:Bending the Curve:Effective Steps to Address Long-Term Health Care Spending Growth | www.brookings.edu

With so much of the spotlight the past month on "death panels" and other myths of health care reform, the more prosaic (but ultimately most significant) goals and objectives of reform have been lost amongst the cacophony. Ten undisputed national experts of various stripes across the bipartisan political spectrum have tried to bring us all back to a more cool headed reality as we enter the momentous make or break Autumn period for national health care reform.

Hospitals Must Upgrade Their Data Centers for Electronic Medical Record Surge

August 28, 2009

Analysis of:Hospitals Update Data Centers | www.healthdatamanagement.com

The whole point of the Health Information Technology Economic and Clinical Health (HITECH) portion of the Economic Stimulus Law is to improve the quality, safety and efficiency of care delivery through the freer exchange of electronic patient information among treating practitioners. However, if hospitals' current data centers can't handle the inevitable great increase in data, the federal government's outlay of $36.5 billion to subsidize electronic health records will all be for naught.

To Get Health Care Reform: Take Two...They're Small(er)

August 21, 2009

Analysis of:New Rx for Health Plan: Split Bill | online.wsj.com

Democrats may have stumbled on a brilliant (albeit Machiavellian) strategy to get what they want in health care passed this year: Split the bill: Pass one half that contains the controversial stuff through the reconciliation process which requires only 50 votes in the Senate (plus VP Biden) and the less controversial stuff (which might even get some token Republican support) through the regular legislative process (requiring at least 60 votes in the Senate even to be brought up for a vote).

Have You Looked at Clouds from Both Sides Now?

August 14, 2009

Analysis of:Making the 'Big Switch' to Cloud Computing | www.modernhealthcare.com

Are we at an inflection point in the history of computing? Are we entering a period of inevitable conversion from mainframe, client server and local network technologies, overwhelmingly the dominant models in clinical health care computing today, to the next generation of offsite, remotely hosted ad managed services via the "World Wide Computer" (otherwise known as 'cloud computing')?

How Accountable Care Organizations may Provide the Bridge to a Bipartisan Bill

August 7, 2009

Analysis of:Health Policy is Carved out at Table for 6 | www.nytimes.com

It would seem that at least until September 15 (the deadline imposed by Max Baucus, D-Montana, and Chairman of the Senate Finance Committee when there will be a vote on the legislation crafted by that time with or without Republican support), national healthcare reform is being held hostage by a "Gang of Six" U.S. Senators--sometimes known in recent military lingo as the "Coalition of the Willing". The other 529 members of Congress appear to be mere pawns in the process until that fateful day

Could Health Insurers be Part of the Cost Containment Solution After All?

July 30, 2009

Analysis of:OMB Director Questions Insurance Giant's Approach to Reform | www.washingtonpost.com

Everybody and his brother has been beating up on the health insurance industry as one of the major causes of the cost explosion. Much of that can be justified in fact when comparing the administrative costs of our predominantly private insurance system relative to those of other countries' where public insurance is more prevalent.

The American Medical Association Endorses "Socialized Medicine"

July 17, 2009

Analysis of:AMA Endorses House Democrats' Health Care Bill | www.businessweek.com

What could make the venerable AMA, after fighting the bogeyman of "socialized medicine" since at least the Truman Administration support the recent U.S. House Democratic Party's national healthcare reform legislation which includes a public option health plan?  According to its leaders, the promise of covering the 50 million uninsured and the prospect of improving the quality of care through the patient centered medical home and other innovations.

Hospitals Must Remove their Revolving Doors to Fare Well in a Reformed Health System

July 10, 2009

Analysis of:On National Scale, New York Hospitals Fare Poorly on Readmissions | www.nytimes.com

It's yet another of hospitals' well kept secrets (until recently).  Many of them have high readmission rates especially for patients with conditions such as heart attacks, heart failure and pneumonia. However, as a result of healthcare reform,  treating such patients with these conditions may be "bundled" as a basis for prospective reimbursement over the course of an "episode of illness".  These episodes may include both an original hospitalization and a TBD period for follow up treatment.  This post-hospitalization period could include one or more readmissions (e.g. during a 90 day period).    In that scenario, hospitals with higher readmission rates will fare much worse financially than those with lower rates.  The bundled prospective payment they receive at the beginning of the period won't suffice to cover the expenses of one or more readmissions. 

Institute of Medicine Posts its "Top 100" List of Comparative Effectiveness Research Priorities

July 5, 2009

Analysis of:Panel Suggest U.S. Medical Priorities | www.nytimes.com

This past Tuesday morning, on schedule, the Institute of Medicine of the National Academies of Sciences released a highly anticipated report listing the nation's top 100 priorities for spending $1.1 billion to compare the relative effectiveness of competing drugs, medical devices, other treatments and operations for specific health conditions.  This is all part of broad effort by the Obama Administration to shift the focus of medical practice toward more consistent adherence with the best scientific evidence on what works and what doesn't.

A Trillion Here...A Trillion There...Pretty Soon You're Talking Real Money!

June 25, 2009

Analysis of:New Study Says an Insurance Exchange Could Save U.S. Trillions | www.healthcarefinance.news.com

With apologies to the late Senator Everett Dirksen concerning an updated paraphrase of his famous quote for the title of this article, what is it about the highly touted health insurance exchange which could produce this level of savings?  President Obama has made it a centerpiece of his reform asprirations spending a good portion of his Primetime Town Hall in the East Room of the White House last night on ABC News extolling its virtues.

The Health IT Industry's New Holy Grail: 'Meaningful Use' of their Products

June 18, 2009

Analysis of:First Look at 'Meaningful Use' | www.healthdatamanagement.com

Not since the definition of a DRG (diagnosis related group) has another term been so important to articulate in a certain way to those in the healthcare industry than that of what it means to "meaningfully use" a certified electronic medical record.   According to the American Recovery and Reinvestment Act of 2009 (otherwise known as ARRA or the Economic Stimulus Law) in order for hospitals and physicians to tap into the total of $34 billion in  government incentive payments for adopting electronic records between 2011 and 2015, they must be able to show federal officials that they are "meaningfully using" them.  The race is on among health IT vendors to ensure that their customers will be able to clear this threshold of "meaningful use", lest they could well see their fortunes dwindle dramatically after next year. 

Green Bay's Healthcare may Soon Rival the Packers in Notoriety

June 12, 2009

Analysis of:Obama Administration Finds Health-Care Model in Green Bay | www.washingtonpost.com

As the debate on national healthcare reform becomes white hot, the biggest question remains how to pay for it.  The notion of taxing employee health benefits and/or limiting itemized deductions for higher income taxpayers will surely alienate both unions and  well-heeled Republicans, respectively.  However, the most politically promising route is to be able to identify ways of decreasing the excess costs of the healthcare system, without compromising its quality, to find sufficient funds to cover the costs of providing insurance to nearly 50 million Americans.

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