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Category Archives: Health Care

VA's reputation for health care takes a thrashing

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WASHINGTON The Department of Veterans Affairs' reputation for providing good health care can't stand many more thrashings like the one it took at a congressional hearing this week.

The House Committee on Veterans' Affairs met in Pittsburgh on Monday to hear testimony about problems with health care at agency facilities in that city and others.

"What you're about to hear may be painful," Chairman Jeff Miller, R-Fla., warned the audience as the hearing, which can be viewed online, began.

It was so painful that the first witness had trouble getting through her statement.

Brandie Petit spoke through sobs about her brother Joseph, who injured his knees during parachute training as a U.S. Army Ranger. After he had sought VA's help for years, the agency finally said "the problem was in his head and sent him home with meds for his head, not his knees," she told the panel.

At one point, Joseph, who suffered hallucinations, was forced to leave a VA facility, according to Petit, because he didn't have an appointment.

"The VA police physically removed Joseph and put a standing order into place to arrest him if he showed up again without an appointment," his sister said. "I'm outraged at his treatment that day."

Joseph committed suicide in the Atlanta VA Medical Center in Decatur, Ga., in November, "locked in a hospital bathroom dead in his wheelchair, a plastic trash bag tied over his head with a blue cord around his neck," reported the Atlanta Journal-Constitution.

His case calls to mind my colleague Steve Vogel's story about Daniel Somers, once a Humvee turret gunner in Iraq. He became so frustrated with his attempts to get VA medical and mental health treatment that he felt the government had "turned around and abandoned me."

He wrote those words not long before he shot himself in the head on a Phoenix street in July. The note to his family said he was "too trapped in a war to be at peace, too damaged to be at war."

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VA's reputation for health care takes a thrashing

Author of key health care expose' to discuss experience with local audience

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Journalist Steven Brills ground-breaking article Bitter Pill sent shock waves through the health care industry, highlighting the glaring difference between the industrys multimillion dollar profits and the high price patients pay for basic care.

Bitter Pill: Why Medical Bills are Killing Us was a 36-page expose' in Time magazines March 4 issue that uncovered a world of outrageous pricing and egregious profits that exists because of a lack of competition and transparency, including consumers inability to decipher incomprehensible medical jargon.

Brills article prompted the American Hospital Association, representing more than 5,000 hospitals, to publish a three-page report defending the industry and disputing inaccurate or misleading statements in the story.

Multiple media outlets, however, said the story was a wake-up call for consumers, and Brill will bring his message to Longview next week through an appearance via video conference call service Skype.

(Patients) have giant bills that bear no relation to reality. You could conceivably ask a hospital about it. If you look at the bill, its based on nothing you would be able to understand, Brill said in a recent phone interview with the Daily News.

The author will discuss his experiences researching and writing the story and the current state of the health care industry at a public forum slated for 6 p.m. at Lower Columbia College. He will be joined by three leading members of Longviews medical community: Sy Johnson, PeaceHealths Columbia Network Chief Operating Officer; Sue Hennessey, Kaiser Permanentes vice president of strategy and health plan services; and Dian Cooper, executive director of the Family Health Center, which serves low-income patients.

The Healthcare Foundation organized the event to help consumers reduce their hospital bills, said Executive Director Mary Jane Melink.

Much of the debate over medical care focuses on who pays the bills. Brill questions why those bills are so high in the first place.

Brill said all hospitals use internal price lists called chargemasters that inflate charges for supplies and procedures to levels well above what federal Medicare pays.

The practice is not illegal, and hospitals say theyd go broke charging only what Medicare pays. Brill, however, contends the chargemasters are both the real and metaphoric essence of the broken market.

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Author of key health care expose' to discuss experience with local audience

Health care insurers turn to brick-and-mortar option to lure customers

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(CBS News) America's health care system is in the middle of a major transformation. One of the biggest parts of President Barack Obama's health care law is set to roll out in just weeks. And that is leading insurance companies to re-think how they do business with millions of Americans.

Soon everybody will be required to have health insurance, and many Americans will have to buy it for themselves. That's why insurance providers are rolling out retail stores to sell their product, allowing people to comparison-shop the same way they do for things like cars and appliances.

Recently, Phyllis Simon was out shopping for health insurance, looking for better coverage for less money. She visited the Blue Cross Blue Shield Horizon Connect store in southern New Jersey, which opened last year.

Tom Vincz, an employee at the store, said, "Having a health insurance retail center where you can come in and have questions answered about purchasing a policy and understanding the benefits will be a good thing."

It's a brick-and-mortar strategy that major insurers are turning to, as millions of Americans get set to add health insurance to their shopping lists. President Obama's health care overhaul requires people sign up by the end of March, or face a penalty.

Jayne O'Donnell has been covering the Affordable Care Act for USA Today. She calls this the "retailization of health insurance." O'Donnell told CBS News, "It's up to the insurers to really compete and increase their marketing and lure as many of them as they can."

In the past, the industry's main customers have been employers. Now insurers have to sell to individuals as well.

On July 18, President Obama said, "New online marketplaces will allow consumers to go online and compare private health care insurance plans just like you'd compare over the Internet the best deal on flat-screen TVs."

But some consumer advocates say the retail stores could keep customers from getting their best deal. O'Donnell said, "These insurance companies like having their own stores so they can be in control of the customer, who, once they get them in the door, are theirs."

O'Donnell argues the best deal could be found online. She said, "You can really compare and contrast them on the state exchanges and you're not going to be able to do that at a retail store."

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Health care insurers turn to brick-and-mortar option to lure customers

AFL-CIO steps up criticism of health care law

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By SAM HANANEL/Associated Press/September 12, 2013

WASHINGTON (AP) The AFL-CIO on Wednesday approved a resolution critical of parts of President Barack Obamas health care law in spite of efforts by White House officials to discourage the labor federation from making its concerns so prominent.

The strongly worded resolution says the Affordable Care Act will drive up the costs of union-sponsored health plans to the point that workers and employers are forced to abandon them. Labor unions still support the laws overall goals of reducing health costs and bringing coverage to all Americans, the resolution says, but adds that the law is being implemented in a way that is highly disruptive to union health care plans.

Some individual unions have complained about the laws impact for months. The resolution marks the first time the nations largest labor federation has gone on record embracing that view. Unions were among the most enthusiastic backers of the law when it passed in 2010.

A labor official told The Associated Press that White House officials had been calling labor leaders for days to urge them not to voice their concerns in the form of a resolution. The official, who wasnt authorized to discuss the conversations publicly and requested anonymity, said many union leaders insisted that they wanted to highlight their concerns.

Asked about any efforts to discourage unions from passing the resolution, the White House said in a statement Wednesday night that officials are in regular contact with a variety of stakeholders, including unions, as part of our efforts to ensure smooth implementation and to improve the law.

The AFL-CIO, one of the presidents major boosters, approved the resolution just as the administration began rolling out a multimillion-dollar advertising campaign to encourage Americans to sign up for health care exchanges starting Oct. 1.

Harold Schaitberger, president of the International Association of Firefighters, said the intent of the resolution is to point out the criticisms without being overly caustic.

There have to be some changes made in the area that are giving a number of our unions great concern, said Schaitberger, who chaired the committee that hammered out the resolutions language.

The resolution was approved at the AFL-CIOs quadrennial convention in Los Angeles. It claims the new law will increase costs for health plans that are jointly administered by unions and smaller employers in the construction, retail and transportation industries. That could encourage employers to hire fewer union workers or abandon the health plans altogether and force union members to seek lower quality coverage on the new health exchanges.

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AFL-CIO steps up criticism of health care law

Health care overhaul: Illinoisans wait for online-marketplace rates

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CHICAGO With fewer than three weeks left until a key launch date for the nations health care law, Illinois residents planning to shop for insurance on an online marketplace still dont know which companies will offer plans or what the policies will cost.

The uncertainty is vexing business owners, self-employers and others who want to create their budgets for 2014.

Heightened speculation and political spin are also in the air, with Republicans stressing increases compared with some current rates and Democrats crowing about subsidies many consumers will get.

Illinoisans arent likely to know more about policies and pricing until the Web-based marketplace opens Oct. 1, according to federal officials who addressed a group of health professionals and other stakeholders this week without explaining precisely why.

More than a dozen states have released their prices, but Illinois is waiting for final word from the federal government. Washington is controlling most of the important aspects of the states marketplace because Illinois didnt move fast enough to set up its exchange.

What concerns me about repeated delays in releasing rates is, will there be a delay in opening the marketplace? said Bill Pocklington, executive director of Employers Coalition on Health in Rockford. That enrollment window is a tight window. Anything that further narrows that would be really unfortunate.

Under President Barack Obamas health law, almost all Americans will be required to have health insurance in 2014 or face fines, and insurers will be prohibited from turning away people because of poor health. The marketplaces, one for each state, are a key part of the law.

The coverage offered on the marketplaces, which are supposed to be one-stop sites for easy comparison shopping and enrollment, will start Jan. 1. About 700,000 Illinois residents will be eligible for aid in paying for marketplace-bought health insurance. An additional 600,000 will be newly eligible for Medicaid, the state-federal health program for the poor.

Small-business owners and individuals are frustrated with the lack of disclosure. Chicago insurance broker Sean Whaley said his self-employed clients are frustrated that they cant plan ahead for their families health care costs in 2014.

The whole thing is ridiculous, he told The Associated Press. Theyre trying to plan their finances and nothings set in stone at all.

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Health care overhaul: Illinoisans wait for online-marketplace rates

Coventry Health Care of Illinois and SwedishAmerican Health System Collaborate to Form High-Performance Network

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ROCKFORD, Ill.--(BUSINESS WIRE)--

Coventry Health Care of Illinois, Inc. and SwedishAmerican Health System are pleased to announced a new high-performance network in Rockford, IL.

The new product, Carelink from Coventry: A SwedishAmerican Partnership, is effective September 1, 2013. The goal of this collaboration is to improve quality of care and lower overall health care costs. This partnership shows a commitment to delivering more value to the patient, no matter what his or her health care needs may be.

SwedishAmerican is collaborating with its physicians, Coventry and employer groups to implement a model of care that aids people when they are sick, and also focuses on keeping them healthy and out of the hospital unless they are acutely sick or injured, said Dr. Bill Gorski, President and CEO of SwedishAmerican. We are creating a physician-directed team approach to foster more accountability across the continuum of care, from the patient to the physician and all health care staff in between. Our primary goal is to help the health care team manage and improve the health and well-being of the patient.

Jered Wilson, Vice President of Network Development for Coventry, said, We are excited to expand our partnership with SwedishAmerican to offer the Rockford community access to a new health care delivery model. We believe our members will receive an enhanced level of coordinated care that will result in better health outcomes. Together with SwedishAmerican, we want to improve the health of our communities.

High-performance network model drives focus on more coordinated care

A high-performance network collaboration is a group of health care providers who assume responsibility for the quality and cost of care for a group of patients.

Richard Walsh, Executive Vice President and COO of SwedishAmerican, said, One of our goals is to provide physicians with better predictors of their patients health risks earlier in life. By implementing behavior interventions early, we can improve health and outcomes long term. We will also provide tools to help physicians better manage patients with multiple chronic conditions who need immediate interventions. Such resources and tools can be used to more efficiently manage a growing patient population, maintain patient health and focus on those patients who need their doctors guidance the most.

Coventry is working with health care organizations throughout the state to develop products and services that support value-driven, patient-centered care. For more information on this specific high-performance network, please visit http://www.chcillinois.com > Health Care Solutions > Our Products > Carelink from Coventry.

About SwedishAmerican Health System

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Coventry Health Care of Illinois and SwedishAmerican Health System Collaborate to Form High-Performance Network

4 tips for savvy health care shopping

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Your employer and President Barack Obama are imploring you to become a better health care consumer. They want everyone to take a more active role in his or her care because it's vital to help slow the seemingly perpetual rise of health care expenses.

A growing number of companies offer high-deductible health plans that make their employees pay more for care out of pocket.

Some workers also are finding that the cost of their coverage now is tied to the quality of their health or whether they smoke.

President Obama's health care overhaul promises to provide insurance coverage to millions of Americans. But the uninsured first have to figure out which plan suits them best.

Becoming a better health care consumer shouldn't require prodding because it can put more money in your pocket and keep big medical bills at bay. Here are four key principles to keep in mind.

Numbers matter

Many companies now provide biometric screening to their employees, and it's not a bad idea to take them up on the offer. This involves measuring variables such as body weight, cholesterol and blood pressure that can tell you whether you're at risk for developing heart disease or other problems.

Companies do this in part because they want their workers to nip health problems before they become full-blown and costly medical emergencies such as a heart attack or diabetes. That means finding the right cholesterol drug or figuring out an exercise plan that helps you drop a few pounds and leave the cardiac risk zone.

Businesses frequently hire outside firms to coordinate these tests, so your boss won't know your individual test results, but the company may get data showing the averages for those covered under their plans.

Knowledge pays

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4 tips for savvy health care shopping

Changes to health care under the law, at a glance

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An overview of some of the key changes to health care services under the Affordable Care Act:

ESSENTIAL HEALTH BENEFITS

Under the law, health insurers must cover 10 essential benefits. This will make health plans more costly, but also more comprehensive. Starting next year, the rules will apply to all plans offered to individuals or through the small-group market to employers with 50 or fewer workers. The essential-benefits requirement does not apply to plans offered by larger employers, which typically offer most of these, already.

The covered benefits are: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative services and devices; laboratory services; management of chronic diseases, and preventive and wellness services; and pediatric services, including dental and vision care.

People will be able to pick from insurance plans with differing levels of coverage and varying costs for co-pays and premiums. But insurers will have to cover a certain percentage of the services' cost.

"Most of the important services people need are covered, though there may be a slight variation (from state to state)," says Jennifer Tolbert, director of state health reform for the Kaiser Family Foundation.

DENTAL-VISION

Need a teeth-cleaning or eye exam? You still could be reaching into your own wallet to cover the cost even after the Affordable Care Act takes full effect next year. Dental and vision care is considered an essential benefit for children aged 18 and younger whose parents or guardians get insurance through the individual or small-group plans. The law does not mandate this coverage for adults, but some states could choose to have them covered.

Still, getting dental coverage for children and teenagers might be a bit complicated depending on where you live. States can choose to offer those items as stand-alone plans, and federal subsidies would not help pay for the costs.

PRE-EXISTING CONDITIONS

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Changes to health care under the law, at a glance

Bill Gates on His Career at Microsoft, Education and Health Care – Interview (2011) – Video

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Bill Gates on His Career at Microsoft, Education and Health Care - Interview (2011)
Paul Allen and Bill Gates, childhood friends with a passion in computer programming, were seeking to make a successful business utilizing their shared skills...

By: Way Back

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Bill Gates on His Career at Microsoft, Education and Health Care - Interview (2011) - Video

Supplemental Health Care Partners With Parkland Hospital In Meeting Staffing Needs

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DALLAS and PARK CITY, Utah, Sept. 10, 2013 /PRNewswire/ --Supplemental Health Care, a national provider of healthcare workforce solutions, is pleased to have partnered with Parkland Health & Hospital System's human resources department in recruiting and hiring full-time Parkland healthcare professionals, helping reduce the Hospital's need for contract labor.

(Logo: http://photos.prnewswire.com/prnh/20110728/CL43247LOGO)

The company was selected by Parkland late last year as the sole-source recruitment process outsourcing (RPO) provider. Working closely with Parkland's human resources department and hiring managers, Supplemental Health Care designed and implemented a system-wide, end-to-end RPO process in order to fill more than 500 open positions with full-time Parkland employees.

The company is now contributing to an ongoing recruitment and hiring strategy with the hospital to provide permanent healthcare professionals who are focused on quality, patient-oriented care. This program to hire full-time Parkland employees in a variety of critical positions will help decrease contract labor costs.

Supplemental Health Care's customized RPO is an efficient and cost-effective solution, providing top-quality candidates and hiring full-time employees for Parkland at an average of one-third the cost of traditional recruiting firm placements.

In the eight months that Supplemental Health Care has partnered with Parkland, the firm has interviewed more than 1,350 candidates and at this time has hired 500 full-time healthcare professionals. These have included registered nurses, patient care assistants, medical coders, physical therapists, occupational therapists, social workers, administrative and many more. The program enhances the Parkland's ability to deliver quality healthcare throughout its entire hospital system.

"We are pleased our RPO solution is helping to meet Parkland's full-time healthcare staffing needs in a cost-effective manner. Parkland has a long-standing legacy in the Dallas community through its premier teaching opportunities, community outreach programs, and state-of-the-art healthcare centers," said Janet Elkin, president and chief executive officer of Supplemental Health Care. "Our team looks forward to making continued contributions to Parkland's ongoing recruitment and hiring strategy. Our goal remains helping attract and hire qualified healthcare professionals needed to assure Parkland continues meeting the needs of the Dallas County area."

"Parkland is pleased to have found a hiring partner that possesses a comprehensive understanding of the diverse staffing and patient care needs of our organization," said James R. Johnson, senior vice president, Human Resources at Parkland. "Supplemental Health Care's capabilities in various talent acquisition functions, complemented with its well-developed workforce tools and technology, have made significant contributions in meeting Parkland's all-important hiring needs."

Supplemental Health Care's RPO business solution ensures that high-quality healthcare staffing needs are met for a variety of hospitals, clinics, urgent and acute care, rehabilitation facilities and many others.

"The demand for innovative RPO services is a growing trend in the healthcare industry," said Elkin. "As the necessity for qualified healthcare providers increases under the Affordable Care Act, organizations are looking for ways to improve upon current recruiting and hiring practices. As we have shown at Parkland, our customized RPO solutions help provide the answers they are looking for."

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Supplemental Health Care Partners With Parkland Hospital In Meeting Staffing Needs

What’s Wrong With: "Bigger Pizzas: A Capitalist Case for Health Care Reform" – Video

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What #39;s Wrong With: "Bigger Pizzas: A Capitalist Case for Health Care Reform"
This is a video response to John at vlogbrothers on his video: "Bigger Pizzas: A Capitalist Case for Health Care Reform" http://www.youtube.com/watch?v=R7LF5...

By: Troy Fletcher

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What's Wrong With: "Bigger Pizzas: A Capitalist Case for Health Care Reform" - Video

Big Data and Health Care

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A week or two ago, I got to correspond with Danielle Brooks of Disruptive Women in Health Care about the work I do here at OReilly. The following interview is reprinted here with their kind permission.

I have mostly worked as a book editor, until just a year or two ago. I was working on books about databases, machine learning, visualization, and other relevant topics when OReilly launched its Strata conference on data science, and so I became involved in that conference. But as Strata took off, it became apparent to us that certain communities and certain types of data were special. Health care is one of those areas: the insights that data analysis can give us about ourselves and the things that ail us are enormous, but the risks of over-sharing and the resulting constraints such as HIPAA also present very real challenges.

In 2012, OReilly decided to launch a new edition of its data science conference to focus on health care, and thats how Strata Rx was born. I was asked to become its Program Chair, along with Colin Hill, CEO of GNS Health care, and so I have spent that last 18 months learning everything I can about the (very complicated!) health care industry. Colin and I are great partners because of the complimentary backgrounds we bring together Colin from the health care industry side and myself from the technology side. Ultimately, thats what Strata Rx aims to do, too: we hope that by bringing together professionals from all parts of the industry (payers, providers, researchers, analysts, advocates, developers, investors, and caregivers, just to name a few) we can begin to solve some of the large and complex problems facing us in this area.

As an Editor and Program Chair, I work primarily in the business of sharing knowledge and ideas, as well as the context for those ideas. Health care faces a number of significant challenges, from the staggering costs (about $2.6 trillion every year in the United States) to the widespread occurrence of chronic conditions such as heart disease and diabetes to the highly variable responses of different individuals to a given treatment. Im interested in helping to connect people with a deep knowledge of things like metrics, statistics, and interaction design to others with a deep knowledge of genomics, epidemiology, drug development, and patient advocacy. Data science and analytics are already making a huge difference in other fields (such as marketing, finance, and retail, just to name a few), and health care is similarly ripe for innovation and advancement.

Its not really possible to speak of the industry in monolithic terms. Just as in any discipline, there are some people doing cutting-edge work, and many others lagging behind. But there are some great examples of where progress is made. Some researchers and companies are using data and analytics to create targeted therapies for specific gene mutations. Some patient communities are sharing their own information to help each other out and identify patterns. The Quantified Self movement uses wearable devices to monitor and change their own behaviors. Doctors and hospitals are using electronic medical records to centralize information and reduce errors, and programs like the VAs Blue Button initiative and online patient portals are helping give access to those electronic records back to patients themselves.

The real advantages will come as these innovations start to cross boundaries between groups of professionals. When you can share the information from your wearable device with your doctor, who can upload that into an electronic record that works with the systems your specialists are using, and they can compare that data against the things your genome suggests you might be at elevated risk for and consider the interventions that are most likely to work for you as an individual then well really be onto something.

Despite the privacy and sharing constraints of legislation like HIPAA, it seems to me that some of the most serious challenges preventing health care professionals from making more use of data and analytics are cultural.

On the patient side, there is a generational divide between people who are used to sharing lots of personal information and people who have been trained to keep everything to themselves. On the provider side, there is an ingrained way of thinking about how to make good decisions (with an over-reliance on gut instinct and subjective experience). On the research side, the practice of publishing only successful studies some with dubious definitions of success means that failed research is never shared, and we lose a lot of available context for the studies that are published, misleading us all about the significance of various findings. In the entire system, incentives are misaligned so that the care and health of the patient isnt actually the primary concern.

The biggest difference that data and analytics can make in health care is increasing the level of granularity at which we can understand ourselves and make decisions. For example, right now most people have their blood pressure and heart rate measured once a year and thats only if they actually show up to an annual physical. Wearable devices can now measure and report those statistics multiple times per day. Thats a huge difference in how much information we can use to paint a detailed picture of our health. Another example would be genome sequencing, which is becoming faster and cheaper all the time. It can potentially tell us as individuals which conditions we may be at risk for, and which treatments were likely to respond to, and allow providers to target interventions more precisely (known asprecision/personalized medicine).

Another significant opportunity I see is to help us measure the interventions and processes that work, so we can standardize best practices. Right now, health care providers mostly rely on a combination of gut feeling and subjective experience. But by carefully tracking and assessing a much broader experience base, we can develop checklists (like the ones that already exist for airline pilots and other professionals who hold lives in their hands). These checklists and standards are already being developed around goals such as preventing the spread of sepsis in hospitals, but arent widely adhered to yet, and could be useful for so many other health care goals.

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Big Data and Health Care


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