Report to call for state #oversight of #hospital rates in #Massachusetts

A little noticed story about a little noticed report. From the Globe:

download-1In an effort to tackle one of the biggest challenges to the Massachusetts economy, members of a special state commission on Tuesday called for regulating the growth in hospital rates to contain health care costs.

Commissioners said the Division of Insurance should have greater authority to oversee hospital-insurer contracts, including the amount hospital rates can increase each year. The controversial proposal comes after months of discussions at the commission, which was convened to study the wide variation in prices at Massachusetts hospitals. Studies have shown that price disparities contribute to higher health spending because the most expensive providers also tend to have the top reputations and attract the most patients.

On the same day, The Massachusetts Health Policy Commission (HPC) released its annual report on health care spending in Massachusetts in 2016.  Main drivers of health care cost growth are  prescription drug costs, hospital spending, health insurance enrollment changes, and  spending on long-term services. 

Why two commissions? On is a quasi-state agency, the other a one-off , set up when hospitals unions agreed not to pursue a ballot question that would have regulated insurance payment to hospitals. The commission was charged with “recommending steps to reduce price variation among different providers and issuing a report by March 15, 2017,” according to the Globe.

And this Sunday, the Globe reported on another attempt to limit the cost of Medicaid in the state”

Governor Charlie Baker “has been backed into a corner by the soaring expense of MassHealth, the state’s publicly subsidized health insurance program for lower-income residents. MassHealth now accounts for about 40 percent of the state budget, and he fears that even more people will choose it over their employer’s coverage.

To help keep that from happening, the governor last month unveiled a measure that would penalize companies that don’t offer adequate health insurance to their workers.”

 

PRI: #Diabetes undiagnosed in many Asians

From Public Radio International images

At the South Cove Community Health Center in Quincy, Massachusetts, Dr. Qiyue Hu conducts a checkup with his patient Jiping Chang. Chang is 76 and was diagnosed with Type 2 diabetes in 2009. He tells me that at the time, he was surprised. That’s because “I didn’t have any symptoms. I felt OK,” Chang says.

He wasn’t overweight either, traditionally a warning sign for Type 2 diabetes. But it turns out that isn’t uncommon among Asian Americans who develop the disease. In fact, they are two times more likely than whites to develop diabetes, despite having lower obesity rates. 

Jury: Double-booked surgery did not lead to injury

From The Globe.

A Boston jury on Monday found that a spine surgeon at Massachusetts General Hospital failed to i

nform a Westwood financial analyst that he planned to operate on two patients at once, but the jury concluded that the doctor’s divided attention did not cause the man’s quadriplegia.

As a result the jury awarded Tony Meng, a 45-year-old father of two, no financial damages…

Meng’s disastrous operation figured prominently in a Globe Spotlight Team investigation of simultaneous surgeries at MGH and other teaching hospitals. Many hospitals have since restricted the practice, also known as “concurrent surgery,” and a US Senate committee recently sought to curb it.

Two other former patients of Wood’s have sued him for medical malpractice alleging that double-booking contributed to their complications. One of the patients is former Red Sox relief pitcher Bobby Jenks, who blames Wood for what he alleges was a botched back operation in 2011 that ended his career.

For more on the Globe series, click on the link above or see this interview with Spotlight Team editor Scott Allen

At Harvard, heroes and villians, sugar and supplements

screen-shot-2017-01-16-at-9-04-30-pmGary Taubes’ sugar takedown continued in the NYTimes SundayReview, including reference to the late Fred Stare, founder of the nutrition department at the Harvard School of Public Health. In the 1970s Stare was  reportedly paid to exonerate sugar in journal supplement, “Sugar in the Diet of Man,

STATNews refers to the case of another Harvard doctor, this one who found himself on the wrong side of a supplement maker. 

The jury trial had momentous implications for the future of research into the safety of weight-loss and muscle-building pills; for the freedom of academics to speak out about matters of public health; and for our ability to learn what’s in the supplements on our kitchen counters.

 

Tonight! Meet the #STATnews team at The Burren pub in Somerville #science

Science in the News was started by Harvard students who wanted to help explain complex issues to the public. The group has expanded beyond that to events like:

Tonight! Science by the Pint with The STAT Team

The (sometimes messy) science of communicating sciencesbtp_spring2017_1pg

Monday, January 9, 6:30-8:30pm at The Burren (247 Elm Street, Somerville) (directions)

Are you interested in learning more about what the field of science journalism looks like from the inside? Panelists from the Boston-based publication STAT will discuss what led them to a career in health and science journalism, as well as the challenges and value of investigating and reporting in this field. Small group discussions will follow the panel, so you’ll have a chance to ask questions and bring up topics you want to discuss. Members of the panel will represent a broad range of careers within science journalism, including reporting, editing, social media, marketing, multimedia, and graphic design.

About STAT (from statnews.com): STAT is a new national publication focused on finding and telling compelling stories about health, medicine, and scientific discovery. We produce daily news, investigative articles, and narrative projects in addition to multimedia features. We tell our stories from the places that matter to our readers – research labs, hospitals, executive suites, and political campaigns.

 

Massachusetts #universal health coverage effort carries on

Here in Massachusetts, life goes on in terms of universal coverage.From The Boston Globe:

Health-insurance sign-ups are running ahead of expectations as the Massachusetts Health Connector wraps up the second month of the three-month open-enrollment period, according to Louis Gutierrez, executive director.

The Connector, a state agency that serves people who don’t obtain health insurance through an employer, has drawn in more than 27,600 new enrollees since open enrollment began Nov 1. And Gutierrez expects to see many more before the sign-up period ends on Jan. 31.

WBUR reports that coverage may change:

imgrese head of the Massachusetts Health Connector, Louis Gutierrez, says no matter what happens with the ACA, the Connector is committed to providing affordable coverage, as it has since the state’s own health care overhaul went into effect in 2006. Since then, the ACA has helped the state expand its Medicaid and Medicare programs.

Gutierrez is hesitant to guarantee enrollees will get to keep the exact coverage they signed up for this year, regardless of what happens in Washington. “I can’t make commitments about things I can’t personally control,” he said.

From today’s Boston Globe: Partners and Trump, health costs and another expensive drug

STAT News reports that Partners Healthcare CEO Dr. David Torchiana was among the health care executive who met with President-elect Donald Trump Wenesday. 

Torchiana has been among those arguing that repeal of the law could disrupt millions of families who have relied upon it for insurance coverage.

“De-insuring 20 million people, many of whom were probably Trump vPHS_Logooters, is a pretty difficult thing to do politically,” Torchiana said in November, according to the Boston Globe. “Figuring out what the pathway is to altering the ACA and doing so in a way that actually doesn’t increase the cost of health care is pretty difficult. There’s not a simple policy solution to it.”

Torchiana did not reveal what he said about the Affordable Care Act to Trump. Partners spokesman Rich Copp told STAT that Torchiana was invited by the president-elect. “They had a conversation that touched on a wide range of health care policy issues, including affordability, access, quality and biomedical research,” Copp said.

$370,000 drug

Also,  Adam Vacaro of the buiness section reports that Biogen Inc.’s new drug “to treat a rare  genetic disorder in children will be priced at about $375,000 a year per patient — its most expensive medicine ever — the Cambridge biotech company said Wednesday.”

File_000Worth noting that drug companies were once so reluctant to make drugs for rare disease that Congress had to pass The Orphan Drug Act to entice them. It seems that now they just charge a lot of them.  Could it be that these rare diseases the low-hanging fruit for the developers of biologics?

Worth revisiting former Globe reporter Steve Heuser’s 2009 piece on how Genzyme sought out patients around the world with a rare condition and convinced governments to pay the full-price for the drug–  $160,000 a year.

Jose Gonzalez felt indescribably lucky that his little girl, wasting away beneath hibiscus vines in Central America, had been found. But for Genzyme, it wasn’t luck. It was another step in a remarkable business strategy: In countries from Colombia to Taiwan to Libya, the Cambridge firm has compiled an extraordinary track record of searching out patients like Tania, providing desperately needed treatment, and then successfully pressing their governments, even poor ones, to pay full price for the most expensive drugs in the world.

That strategy has helped Genzyme bring in more than $1 billion a year on Cerezyme alone, and to develop an arsenal of similarly expensive drugs for other rare diseases. And Costa Rica would soon learn a lot about Genzyme’s determination to be paid when it considered the cost of saving Tania Gonzalez, how it would drain resources from other patients, and decided that its answer was “no.”…

What (Genzyme)  won’t do is offer a discount. Although discounts are becoming more common on pharmaceuticals sold in lower-income countries, Genzyme follows a “full price or free” model, and works hard to be sure it’s the former.

“If you’re going to give on the price someplace, everyone’s going to ask for a deal, and then you’ve got a massive mess – so from day one, it was one price,” said Alison Taunton-Rigby, a former Genzyme executive who was with the company when it began setting its price policy.

Geoff McDonough, current head of the division that sells Cerezyme, says the policy allows the company to maintain the profit margin needed to research future drugs, while also keeping a door open for the truly impoverished.

“We’ve chosen a way here that’s been consistent across the company, and has met the specific needs and complexities of patients suffering from very rare diseases,” he said.

It is a balancing act, he says, that amounts to an “extreme example” of a discounting policy: the company currently provides the drug free to more than 300 patients worldwide.

Back to Partners, this time on costs

 letter from BU’s Alan Sager on the many confusing interpretations of health that is health care costs in Massachusetts:

David Torchiana,  president and CEO of Partners HealthCare, once again has recited Commonwealth Fund analyses of federal survey data showing that Massachusetts health insurance premiums are a lower share of median income than prevails nationally (“First, do no harm”).

But federal data on actual health spending contradict Torchiana. Massachusetts health spending per person was 36 percent above the US average, the highest in the world. After deducting Medicare and Medicaid dollars, private Massachusetts health costs per person were 40 percent above the US average, an excess of $11 billion over national average costs. Meanwhile, median income here was only 20 percent above the US average.

 

 

 

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