Partners’ Kvedar’s new book on “The Internet of Health Things”

Joseph  Kvedar, the VP of Partners’ Connected Health Program was on to  “The Internet of Healthy Things” way before any of the rest of us.  Now he’s collected his thoughts — aimed a “business executives” — in a new book.

More video from this year’s connected health conference here.

 

Health care in Massachusetts: Affordable or not?

Not affordable: From this week’s paper

Rising health care costs have outpaced the incomes of Massachusetts families over the past decade, despite efforts by the state to control medical expenses, according to a report released Wednesday.

Affordable: Two weeks ago.

Despite concerns about rising health care costs, the head of the state’s largest and most expensive network of doctors and hospitals said Thursday that health care is “very affordable” in Massachusetts.partners

Partners HealthCare chief executive Dr. David Torchiana, in remarks to the Greater Boston Chamber of Commerce, acknowledged that health care costs are higher here than in other parts of the country, largely because Massachusetts is home to several large teaching hospitals whose training and research programs make them expensive to run.

But considering the high incomes in Massachusetts, it’s not so bad, Torchiana said: “Health care is very affordable in Massachusetts.”

To help make sense of this and other health policy debates, check out the latest Health Wonk Review.

Boston voices in stories on telemedicine and hotels as hospital step-down units

Some Boston links in these story from Health Leaders Media.

connected healthIn a story about telemedicine, Joseph Kvedar, MD, vice president of the Partners’ Center for Connected Health in Boston, says that at two recent health industry meetings “every panel and every conversation had something on telemedicine and virtual visits.” Telemedicine is taking off, but there is resistance from regulators in at least one state, and stubborn questions about reimbursement and efficacy in general.

This column about hospitals discharging patients to hotels starts in Boston and heads out westHLM:

The Wyndham Beacon Hill hotel uses its proximity to Massachusetts General Hospital as a marketing tool. The hotel website includes a hospitals page featuring a blonde model in a white coat with a stethoscope around her neck. The hotel offers a link to each of the city’s hospitals, discounted rates for patient families, and access to a shuttle bus.  

The Wyndham isn’t alone. Often, patients have to travel long distances to places like Boston for specialized care. So hotels have grown up around large hospitals to offer shelter to caregivers. And sometimes patients, too sick to travel home or waiting for follow-up care, need a night or two of lodging as well.

But hospitals have different protocols—or none at all—when it comes to discharging patients to hotels. And hotels have different capacities for hosting them.

But the Occupational Safety and Health Administration’s bloodborne pathogens standard applies to all.

If you can’t join them, beat them: BIDMC in takes over Milton hospital

When the Harvard hospitals decided to join forces as Partners, they cut BIDMC out of the deal. So, this story from the Globe  – on Beth Israel Deaconess Hospital-Milton –is worth noting:

partnersdownloadConsolidation in the health care industry has been viewed with suspicion, leaving critics worried that the state’s biggest health care networks want to leverage increased market power into higher rates. Partners HealthCare, the largest health care system in Massachusetts, recently abandoned its bid to acquire South Shore Hospital in Weymouth in the face of such criticism and a ruling from a judge who said Partners’ growth would raise costs for consumers.

…The Milton case shows how consolidation — though it often increases costs to consumers — can also offer a lifeline to a struggling hospital. The brand alone of a big Boston health care network can be a powerful force, analysts said.

 

Hospitals consolidation: Brill says yes, new Massachusetts AG says no

From Shirley Leung’s Monday column in the Globe:

partnersNo judge or jury delivered a verdict on the Partners HealthCare settlement Monday, but we didn’t need either after Attorney General Maura Healey’s three-page court filing.

She thinks the deal stinks, and if given the chance, she would bring an antitrust suit to block Partners’ efforts to expand. And just like that, the 43-year-old rising political star dared to rock the biggest boat in Massachusetts health care. In the wake of her threat, Healey left a list of winners and losers.

From Steven Syre’s column in today’s Globe:

Maura Healey has been on the job less than a week, but we don’t have to wonder where she stands on the biggest health care conflict in Massachusetts.

And, a Q. & A. from Steven Brill, author of “America’s Bitter Pill: Money, Politics, Backroom Deals and the Fight to Fix Our Broken Health System. That book looks at focuses on the debate over the Patient Protection and Affordable Care Act. But it also returns to Brill’s indictment of high hospitals costs that filled an entire issue Time magazine in 2013. His solution looks very much like a combination of the Kaiser Permanente insurer-plus-provider approach and the Partners’ plan.

HLM: Why will this consolidation approach work to curb costs where other reforms have failed?

Brill: The reason this idea may work is it is going to happen without my writing about it. It’s going to happen. The question is, do we seize that momentum, turn it around jujitsu- style and attach a whole bunch of regulations to it?

I really started thinking about this after my [heart] surgery. I decided: New York Presbyterian, it’s a damn good place and the guy who runs it is a good guy. [Later] I was watching a panel including Toby Cosgove [CEO of Cleveland Clinic] and someone said: You’re gobbling up Cleveland and your market share is way too high.

Cosgrove said, the FTC would never let us have too much of a market share. I’m thinking, this guy Cosgrove, he’s a celebrated surgeon, a war hero. He seems like a pretty good guy to me. The idea the he wants to control and provide healthcare all over Ohio, why is that such a bad thing?partners-logopartners-logo

Does advertising from Partners taint Boston health reporting and advocacy?

Speaking of bias: Disclosure: BHN has dogs in all of these battles.
Speaking of bias: BHN has dogs in all of these fights.

Former BIDMC hospital chief Paul Levy thinks “so many people in town receive financial support from Partners that the public commentary on such issues (Partners’ acquisition of two suburban hospitals)  is biased by that financial power. ” 

“Take WBUR and its Commonhealth blog.  Yes, they do cover the Partners issues and do so as fairly and comprehensively as anyone in town.  But again, prominent among WBUR’s supporters is, you guessed it, Partners Healthcare.  Here, the issue is not that PHS influences the editorial policy of WBUR:  That clearly does not happen.

In this case, the power is more subtle but no less effective: Whatever points might be made in the Commonhealth blog on this topic–read by a few thousand readers–are dramatically reduced in impact by the quid pro quo given to Partners, i.e., repeated self-serving messages on air, heard by tens of thousands of listeners during drive time. In addition, as you see above, PHS gets to place an ad on the Commonhealth site, persisting with its message day after day.”

This is an old saw. For years, critics have charged legacy media outlets with pandering to or being influenced by advertisers. The charges rarely hold up.

But with the rise of digital media, the terrain is shifting. Traditional advertising — prints ads, radio spots, billboards and TV commercials — is on the wane. Now we have content marketing, native advertising, and pre-roll.  (Disclosure: As a journalism prof and freelancer, TR has dogs, friends and family in all these fights.)

Parnters is a powerful force in the community, for better and worse. We do bristle when we hear these ad-like messages on public radio. They somehow feel more like endorsements than display ads. But, they aren’t, and they don’t dramatically reduce” the impact of WBUR health reporting for us. These potential conflicts and muddled messages are worth pointing out, but these gripes about advertising and bias in Partners coverage feel overstated.

There are real muddled media issues out there to be concerned about. What were once called and clearly marked as advertorials are now ambiguously called sponsored-content.”  Corporations, universities and hospitals now produce websites with articles that  use the tools of journalism — reporting, research and objective voice –and look like news, but are designed for marketing and advocacy.  The difference between two identical features on BU Today and Boston.com? For one, the customer is the institution; for the other, the customer is the reader. While that may not make a difference for many stories, it makes a big difference on others.

Not a problem, if you are aware of the differences. But, many of our students can’t distinguish between sites like these, sponsored content, random blogs and straight news. The answer? More media literacy. 

Globe: For-profit hospitals in low-income communities want a cut of high fees paid to competitors #healthcarecosts

It is well documented that some Massachusetts hospitals –– read Partners — have the bargaining power to  extract higher pay rates from the feds and private payers.  Today’s Globe offers two takes on the ongoing battles.

This one is behind the paywall: 

images stewardA new coalition led by the state’s biggest health care company and its largest health care union will be pressing for higher payments to community and safety-net hospitals, saying patient care is threatened by a widening gulf between health care in rich and poor areas.

The group, calling itself the Massachusetts Healthcare Equality and Affordability League, will be formally launched Thursday by Steward Health Care System, a for-profit cluster of community hospitals, and Local 1199 of the Service Employees International Union, which represents more than 47,000 workers at sites that care for blue-collar and low-income patients.

And while it would not the odd to hear heated rhetoric from 1199, the story quote Steward’s chief executive, Ralph de la Torre, calling the disparity  “socioeconomic bias and bigotry.”

More on de la Torre in this Globe magazine profile. 

During his career, the 44-year-old heart surgeon-turned-hospital executive has shown himself to be a brilliant maestro, time and again using his relentlessness, charm, vision, and opportunism to turn an array of opponents into a symphony of supporters.

His most recent symphony was his most impressive work. As CEO of the Caritas Christi hospital network, he pushed through an $895 million deal late last year that took a group of community hospitals founded primarily by nuns to care for the poor and put them in the hands of the New York private equity giant Cerberus, a firm that takes its name from the mythical three-headed dog guarding the gates of Hades. To steer the deal through, he orchestrated an unlikely alliance of the Boston Archdiocese, Democratic elected officials, the Service Employees International Union (SEIU), and community organizers in some of the state’s poorest cities – all to support turning the struggling nonprofit hospital chain into a for-profit operation owned by a group of high-flying financiers

And an editorial calling for a correction to high rates driven by a formula designed for struggling rural hospitals. The state’s only technically rural hospitals is in tony Nantucket.

SINCE 2010, Massachusetts hospitals have benefited from an annual bonus in Medicare funding of at least $250 million. Congress is expected to vote to eliminate this windfall in early June, a blow to local hospitals, which may face layoffs and cuts in patient care as a result. But as the system is set up now, the state receives these funds due to a loophole in the national health reform law and at the expense of at least 40 other states. It’s time to find a more sustainable and equitable way to support top-notch medical care.