WBUR, Globe cover health cost hearings

Check out the Globe & WBUR for reporting on the ongoing health costs hearings.

The Globe reports that hospitals caught on the wrong side of the lopsided payment line support costs controls. And, Partners, does not.

During a second day of hearings on health care costs yesterday, three of four hospital chiefs who testified said government controls on prices are needed to close the wide gap between what insurers pay hospitals and doctors’ groups with the market leverage to demand high prices and what they pay to those without it.

“Fundamentally, I believe in the market,’’ said Andrei Soran,  chief executive of MetroWest Medical Center in Framingham. But “the market got out of hand,’’ he said. “Intervention will bring it back to the appropriate level.’’

 

Globe says state reform works so far; week of hearings predicts the future.

The Globe has a huge take-out on the impact of health insurance reform in the state and it basically says – it’s working so far.

Taken in sum, it is a far cry from what critics of Romney, and of Obama, are saying about the Massachusetts plan. The attacks often rely on distortions, omissions or flagrant inaccuracies, and typically ignore the fact that the law accomplished its principal goal — expanding coverage to nearly every citizen.

“Health reform is virtually a fact-free zone in Washington,’’ said Jon Kingsdale, who was the first executive director of the Commonwealth Health Insurance Connector, the marketplace for insurance plans set up by the 2006 law, and is now a consultant to states preparing to comply with the national law.

“Massachusetts has, since 2006, been the prism through which ideologues attack or promote national policy on health care coverage,’’ Kingsdale said. “In this country, 99.9 percent of the people don’t understand the mind-numbing complexities of the financing of our health care system, so people are free to use factoids to promote or attack any reform.’’

Get ready for more complexities. The state starts four days of hearings on health care costs tomorrow. And, the AG just issued a report that found accountable care organizations – which will offer all of your care one price – have yet to control costs. 

The single-payer advocates over at Mass-Care continue to point out what they see as the pitfalls of the mandated coverage approach. They refer to the AG’s report as a case in point. This came via email: 

WBUR’s online health care blog, “CommonHealth,” has a flashy headline article today titled “Massachusetts Attorney General Drops Health Reform Bombshell.” What’s the bombshell? That the state’s proposal to control health care costs by moving people into accountable care organizations (ACOs) is unlikely to work, because patients who are currently covered by similar arrangements receive care that as just as expensive as everyone else. ACOs are supposed to control costs using old managed care tactics that led to patient and provider revolts in the 1990s: forcing patients into limited networks, where they have a limited choice of doctors and hospitals, and paying providers on a “capitated” basis. Capitation means that providers get paid a fixed amount for treating a patient for a whole year, regardless of how much or how little it ends up costing to treat them.

The theory is that this will remove the incentives for providers to over-use certain types of care, since they actually lose money by providing more care. The reality is that it gives providers an incentive to avoid people with serious health issues, and to provide less care (appropriate and inappropriate) to those they do cover.

June 2011 Health Wonk Review: Hockey, hoodlums and hot rod angels

Welcome to the Big Men edition of HWR. Congratulations to the Stanley Cup winning Boston Bruins. Good-bye to Big Man Clarence Clemons, Springsteen’s sax player and side man, who died last week after a stroke. And hello to Whitey Bulger, the Boston crime boss captured last night after 16 years on the run.

Wingers: Politics

Joe Paduda explains: Why health reform will not be repealed at Managed Care Matters.  He writes: “Once people again actual real-life experience with a government program, they abandon their fear of the unknown, see its benefits more clearly, and become invested in its future.We’ve seen that with Medicare, which consistently pleases its beneficiaries. Part D has similar traction, and now we’ve learned that the citizens of Massachusetts are increasingly happy with that state’s health  reform.”

Jared Rhoads interviews Sally Pipes on doctors, students, and activism at The Lucidicus Project. A free-market advocate, Pipes, head of the Pacific Research Institute, says medical students are being ”indoctrinated by their professors who constantly tell them that a government-run system would bring about affordable, accessible, quality care for all.”

Avik Roy at Forbes argues that “The McKinsey Health Insurance Survey Was Rigorous, After All”  Supporters of the new health care  law “have worked themselves into a tizzy” over a survey that concluded 30 percent of responding employers would likely cut coverage for their workers. “Because McKinsey had refused to release details of the methodology… Democrats and left-of-center writers accused the company of having something to hide.”

Assist: Shared Decision Making

Gary Schwitzer offers: Telling the story of variations in health care and shared decision-making in a TV news story posted at HealthNewsReview Blog. A model for how journalists – even those on local TV – can cover shared decision-making stories. Also see his side note on the decision making process re: implantable heart devices.

Jessie Gruman asks: Check-In-The-Box Medicine: Can the Blunt Instrument of Policy Shape Our Communication with Clinicians? posted at Prepared Patient Forum: What It Takes Blog. One example: counseling at the pharmacy, which she says has been” transformed into the time-saving strategy of asking us to check the box and sign the book or screen pad…(T)he vast majority of us now add our signature, pay the bill and walk away, oblivious to the substantial benefit we have rejected.”

Jonena Relth responds to a CNN blog, on ”dumb things” patients do at the doc’s office with 10 Things Docs and Clinicians Can Do, posted at Healthcare Talent Transformation, Her version offers advice for docs and staff so they can be a little smarter when it comes to dealing with patients.

Stick Handling: Quality of Care

David Williams presents Readmissions: Hard to predict who it will be and why posted at Health Business Blog, saying, “Reducing readmissions is hard, especially when no one can predict who will bounce back and why.”

Don’t Just Count Heads, Weigh Them! at The John A. Hartford Foundation blog, Health Agenda, discusses a recent JAMA article on the importance of making sure physicians are trained to provide proper care to older patients.

Glenn Laffel offers another installment in a series about online interventions designed to foster healthy behavior: Posted at Pizaazz.

Slashing: Costs

Jason Shafrin note the Share of Federal Budget Spent on Health Care Jumped in 2009  at Healthcare Economist, saying, “In 2009, 54 percent of federal revenues were spent on health care. The Healthcare Economist reviews other interesting healthcare statistics from the California Health Care Foundation’s Report.”

Jon Coppelman writes about Managing Chronic Pain at Workers Comp Insider, saying, “With chronic pain being a major cost driver for many workers’ comp claims, payers are looking to control costs. He comments on the Chronic Pain Treatment Guide issued by the Mass Department of Industrial Accidents (DIA) Health Care Services Board.”

Joseph White offers The Mixed (De)Merits Of ‘Bending The Cost Curve’ on the Health Affairs Blog. He traces…” the development of the phrase ‘bending the cost curve’ and argues that the risks of the now ubiquitous metaphor outweigh its benefits.”

Slap Shot: HIT

Shahid N. Shah offer a  Guest Article: How to sell your EHR and other health IT products into clinics and physician practices posted at The Healthcare IT Guy. ”Healthcare IT is a hot topic these days and lots of new people are starting new ventures in the field. Developing your product is the easy part; the hard part is commercializing and selling it into a fragmented, diverse, and increasingly skeptical healthcare industry”

Jane Sarasohn-Kahn comments on a study that found “U.S. patients are looking for from their doctors: more self-service options, more online access, and more self-health care tools in patient portals in a post at Health PopuliIn HHS, Privacy, and Your PHI  Henry Stern, at InsureBlog, reports on newly relaxed privacy rules, and wonders if they’re a good thing.

Checking: Health law

Health Care Renewal reports: The First Contaminated Heparin Case Verdict: Making Money by Giving Patients “the Cheap Stuff” “Since the case of the contaminated heparin that allegedly killed over 80 patients began in 2008, this is the first legal case about it that has been resolved.　 Documents revealed during the litigation referring to the heparin from China that apparently was deliberately contaminated with a potentially deadly chemical as “the cheap stuff” suggested how the current management of supposedly “ethical” pharmaceutical companies has allowed cost-cutting to trump their core mission.”

Finally, Dan Diamond at California Health Line allows us to mix our sports metaphors, by noting that lawyers defending the new health law in the lower courts are like minor league ball players getting ready for the majors: “Opponents of health reform rushed to challenge the law in court — but the flurry of anti-overhaul cases may have helped the government build its own case to defend it. Lawyers explain the Obama administration’s rare approach to the unprecedented legal battle.”

We’ve filtered out all the spam, so you’ll have to look elsewhere for reports on weight loss miracles, cures for bipolar disorder, personal trainer classes and DNA testing (“Did Jason Sudeikis Admit to Being the Father of January Jones’ Baby?”)

And, the dramatic events of the past two weeks led us to abandon our  original theme – Thanks anyway for the birthday wishes. We had art for the Bruins and they nailed Whitey just last night. (See The Departed for a character inspired by the Boston gangster.)  And we had to squeeze in Big Man. Clarence used to step out of the shadows and into the spotlight for his soulful “Jungleland” solo. Now he’s stepped back, and those of us who worship at the House of Bruce will miss him in a big, big way.

Globe obit: Former BU med school dean Ephraim Friedman

From the Globe:

To administrator, professor, ophthalmologist, surgeon, and researcher in the field of age-related macular degeneration, he added challenging pursuits outside work. An avid outdoorsman, he hiked the Sierra mountains in the West and carved a vacation home out of the Maine woods. An accomplished sculptor, he shaped clay into figures of delicate beauty.

Dr. Friedman, who also formerly served as president of the Massachusetts Eye and Ear Infirmary, died Saturday  at his home in Beverly Farms, more than six years after being diagnosed with a glioblastoma brain tumor. He was 81.

“He was really a renaissance man,’’ said Dr. Joan W. Miller,  chief of ophthalmology at Mass. Eye and Ear and chairwoman of the ophthalmology department at Harvard Medical School.

“Beast Hunter” faces his toughest challenge yet: cancer

When Pat Spain, 31, stepped up to th podium this morning, he looked much thinner than he does on his Animal Planet show, “Beast Hunter.” That’s because the unpleasant feeling he noticed at the end of the  show’s taping turned out to be colon cancer. He’s since lost 30 pounds.

Spain stopped by the Cancer Action Network’s New England Research Breakfast at the Museum of Science to talk about coping with colon cancer.  (First, he shot a photo of the museum’s huge cricket model for his Facebook page. ) After the talk, he was off to chemotherapy.

“So,” he said “…this is the best I’m going to feel for two  weeks,”

A Genzyme scientist and wildlife biologist, Spain was discovered by National Geographic after spending all his money and free time producing a show on You Tube called “Nature Calls TV.”

But as the NatGeo show was about to wrap, he began to feel “not quite right.”

Having recently visited Sumatra, Mongolia and the Amazon, he thought he had picked up something traveling.  After five months and numerous misdiagnoses, his doctors did a colonoscopy and, in January, discovered the cancer.

Without blaming anyone, he said found the experience “pretty embarrassing and dehumanizing.” A low point – waking up from an induced coma to learn he had undergone an ileostomy.

The experience made him understand why people don’t talk about cancer.

“That’s why I’m very happy to speak to everybody and anybody,” Spain said. “When you are on TV and you’re in front of the camera as much as I am all the time, you tend to make your mistakes in public and that tends to remove that embarrassment factor.”

Since then, his ostomy has been reversed and his bedsores have healed.

But, he noted that chemotherapy is “much harder than I  thought it would be.” He compared it to a ritual he went through for his show – being bitten hundreds of times by bullet ants which, he said, “have the worst sting in the animal kingdom.”

He thought if he could handle that, he could handle anything. But, he said “cancer has been harder…Chemo is my bullet ants.”

So, he got involved with the American Cancer Society because  he wants people to know: “There is no rule that only smokers and people over 50  get cancer.”

And, he got a standing ovation.

Globe: #Allergic #RedSox fans can now sit in Fenway’s peanut-free section

Can’t help it:

Take me out to the ball game

Take me out to the crowd

I’ll pass on the peanuts and Cracker Jack

If I don’t, you can bet that I’ll never come back.

The Globe  reports  that the Red Sox are among the MLB teams offering a peanut-free section for fans with allergies.

Peanuts have permeated Fenway Park for a century: cracked
between fingers, crunched beneath feet, and hurled through the air by vendors
with the arms of center fielders. The song tells fans, “Buy me some peanuts and
Cracker Jack,’’ and the faithful comply. At a typical game at Fenway,
spectators peel 3,000 bags of peanuts, haphazardly scattering a half-ton worth
of shells.

The story goes on to tell the story of a couple who had to leave the game because everyone around them was eating
peanuts and their kid was getting sick.

Children’s Hospital Boston took note of the Globe story  and offered some more info for those trying to cope with allergies :

The Food Allergy Coping Skills Workshop lasts
about half a day and meets at Children’s Hospital Boston in the morning.
Patients of Children’s Allergy Program will receive a flyer in the mail with
information on up coming workshops, and whenever possible the workshops are
opened to the community at-large. If you and your child are interested in
attending, please email Dr. LeBovidge to inquire about future availability.

jennifer.lebovidge@childrens.harvard.edu

For do-or-die game, Bruins say no to “playing through” concussions — and win!

Kids! Play clean and stay out of the penalty box.

6/16  update–  From the Globe:

Bruins complete a stunning run

Title wrapped up in inspired fashion

————–

6/15

A nasty hit will keep Bruins right wing Nathan Horton off the ice. A wise move now that BU researchers are documenting the disturbing long-term impact of concussions.

But he’ll be in Vancouver for the celebration! Go Bruins!  From New England Cable News.

There were a lot of smiles when Horton appeared on the TD Garden jumbotron during Game 6, waving yellow Bruins’ towels in both hands, and even more when it was learned he had hopped on the B’s team charter and was traveling to Vancouver for the decisive Game 7 against the Canucks.

There were rumblings from Rogers SportsNet that Horton was trying to convince the Bruins to let him play on Wednesday night but there’s no shot of that, given the right wing was still suffering concussion symptoms just prior to Game 6 in Boston. His attitude is more about continuing to be a part of the Bruins as they attempt to finish off the job that Horton helped them start. It’s also about potentially participating in the celebration if the Bruins are able to win at Rogers Arena.

The Bruins will set up Horton’s equipment and sweater in his dressing room stall as he if was going to play.

“That’s something the guys wanted to do,”  said coach Claude Julien. “They
wanted him to be part of our group here. Until the third game of the Final, he
was a big contributor to our hockey club. If the doctors would let him, he
would play [Wednesday] and we all know that that’s the way he feels right now.
He would be willing to play through what he’s gone through.”

Harvard on how #ovariancancer spreads

Anyone who has ever had a friend or family member die of ovarian cancer knows –it is a beast. Early detection is rare and survival rates are depressingly low.

New research out of Harvard helps explain why. From the Harvard news office:

A team led by Joan Brugge, the Louise Foote Pfeiffer Professor of Cell Biology at Harvard Medical School, recently shed light on how ovarian cancer spreads. In a paper to be published in the July issue of the journal Cancer Discovery, the newest journal of the American Association for Cancer Research, Brugge and colleagues found that ovarian cancer cells act like bullies, using brute force to plow their way through tissue and colonize additional organs.

Can Mass. close the gaps on #insurance for #kids, hospital care for #minorities?

@ White Coat Notes, a report on a new Health Affairs study:

The state’s program scores hospitals according to the quality of care they provide to minority patients in five clinical areas: prevention of surgical infection, pneumonia, pediatric asthma, and the health of mothers and of newborns. But many hospitals had too few non-white patients within each group to statistically compare their care to that of white patients.

Even when the researchers combined the statistics for each hospital to compare care statewide, they did not find significant differences between racial groups.  The authors said that does not mean that the disparities don’t exist. Nationally, they are well-documented.

But the state, which distributed $32 million in incentive payments last year, may be looking in the wrong place, the authors said. 

The paper also offers an advance on today’s announcement re:kids and health insurance:

A monthlong campaign to search out and enroll many of the estimated 3,300  remaining uninsured children has resulted in new coverage for 1,479  youngsters, according to Health Care for All,  a Boston-based consumer group that is leading the initiative. But advocates say the campaign has also highlighted burdensome paperwork requirements that often result in children being booted off of Medicaid, the state and federal program for low-income people, though they are still eligible 

 

Scalpel, sponge, Flip camera?

Or, could you move your hand so I can get a better shot of that incision?

The Globe had a brief this morning about a bill that would allow patients to videotape surgery. It wouldn’t be like dads who stand around waiting to get a shot as the new baby pops out. According to the story:

The measure would let licensed medical videographers  record the procedures. They would not have to be in the operating room at the time. A copy of the  video would be given to the hospital for its records.

The Boston Public Health Commission tweets: “I feel there is a bigger story behind this.”

Find out what at tomorrow’s public hearing on proposed patient safety bills. Other include:

By Mr. Eldridge, petition (accompanied by bill, Senate, No. 1090) of Eldridge and Kocot for legislation to prohibit the participation of health care professionals in the torture and abuse of prisoners [Joint Committee on Public Health].

By Mr. Moore, petition (accompanied by bill, Senate, No. 1136) of Moore for legislation to shorten the time period for reporting disciplinary actions taken against physicians [Joint Committee on Public Health].

By Mr. Moore, petition (accompanied by bill, Senate, No. 1148) of Moore for legislation to require hospitals to notify patients of physician discipline [Joint Committee on Public Health].