SAN FRANCISCO & MINNEAPOLIS--(BUSINESS WIRE)--

Castlight Health, the leading provider of health care transparency solutions for employers and payers, and Minnesota (MN) Community Measurement announced that Castlight has incorporated MN Community Measurement quality performance metrics into its health care management suite. With MN Community Measurements rich dataset of provider quality information, Castlight users can make more informed decisions based on personalized information to drive higher-quality, better-value care.

Our goal is to improve health outcomes by imparting greater transparency in the health care system, said Jim Chase, president of MN Community Measurement. In partnering with Castlight, we are able to get our powerful quality and service data into the hands of more individuals empowering them to take control of their health care.

MN Community Measurement works with medical groups, clinics, physicians, hospitals, health plans, employers, consumer representatives and quality improvement organizations to report health care quality measures. MNCM developed MNHealthScores, a comprehensive site for quality and patient experience of care metrics on clinics, hospitals and medical groups. The information is based on nationally endorsed standards, to support preventative care and treatment of chronic conditions for consumers in Minnesota, North and South Dakota, Wisconsin and Iowa.

Carlson, a global hospitality and travel company with headquarters in Minneapolis, recently selected Castlights health care management suite to help its employees take control of their health care spending and wellness. Shawn Leavitt, vice president of global compensation and benefits, said that Castlight combines accurate cost and trusted quality information to help our employees improve their wellness, lowering costs both for themselves and Carlson. We believe the addition of MN Community Measurement quality data will make the Castlight suite even more valuable for our Minnesota-area employees, as well as the company.

Consumers are under pressure to manage the rising cost of health care, but have lacked the tools and data they need to manage their care and costs, said Cathie Markow, senior director clinical quality, Castlight Health. Our collaboration with MN Community Measurement is a prime example of how we are partnering with organizations across the health care industry to deliver transparency and change into a traditionally closed-off market.

About MN Community Measurement

MN Community Measurement, (MNCM) is a nonprofit organization dedicated to improving the quality of health care in Minnesota by working with physicians, hospitals, health plans, employers, state government and consumers to collect, validate and publicly report performance data.

Through MNCM, the Minnesota health care community has pioneered collaborative health care quality reporting since 2004: building 76 measures that are widely accepted by payers and providers; establishing a process that allows efficient collection of data from hospitals, medical groups and health plans; and reporting results on more than 672 sites of care. MNCM measures have received national endorsement from the National Quality Forum, and Medicare now uses its measures nationwide for its value-based purchasing initiatives. See http://www.mnhealthscores.org for more.

About Castlight Health

See the original post here:

Castlight Health Bolsters Health Care Management Suite With Minnesota Community Measurement Quality Data

11-09-2012 20:18 Paul Solman compares and contrasts health care reform proposals from the Romney and Obama campaigns. Economists on both sides of the political debate discuss increasing efficiency, technological innovation, market competition and vouchers.

More here:

Making Sen$e: Competing Claims About Healthcare Reform - Video

Denver-based DaVita is expanding its push to dominate health care for all Americans, not just kidney patients, with the opening of a LoDo clinic offering primary care to the public.

A subsidiary of DaVita now has primary doctor clinics in 11 states, with plans for many more, including a build-out of a Denver network under the Paladina Health brand name.

The DaVita clinics operate under the "concierge" model, and are open to customers ranging from individuals to large, self-insured businesses.

Individuals pay $99 a month, or $59 for children, to receive most of their health care needs through the clinic. The doctors give cell phone numbers and are available 24 hours a day, coordinating preventive care, tests and specialty care.

For more specialized and expensive surgical or other procedures not handled by the clinic, patients are encouraged to have a backstop or catastrophic insurance plan with a high deductible. Paladina said that most patients will get 90 percent of their annual care through the clinic, for about $1,200 a year.

With two major acquisitions of a clinic group and a physician management company in the past year, DaVita is rapidly testing its premise that data-driven, wellness-focused care will improve health and turn big profits. Outsiders have warned the strategy transforms a dialysis company into a riskier insurance model, and that patients in the past have rebelled against cost-control efforts.

Paladina officials said their doctors have 700 to 800 patients each instead of the usual 3,000 to 4,000, and are compensated in part based on patient satisfaction and improving health.

Other branches of DaVita want to win government pacts to manage care for Medicare patients, for example, in arrangements where DaVita shares in any savings as long as it meets quality goals.

"That's how you fix health care. And we want to be those providers," said Rebecca Steinfort, senior vice president of Paladina Health.

DaVita acquired clinics in 10 other states when it bought operator ModernMed in January, and will consolidate them under Paladina.

Read more:

DaVita expands push into all health care with new Denver clinic

I’m trying to figure out just where Mitt Romney stands on health care reform. Obviously, so is Mitt Romney.

See the original post:

Eugene Robinson: Romney's health care flip-flops

Last week, two important reports underscored the potential for improving the value of health care in the United States.

The first of these, "Best Care at Lower Cost: The Path to Continuously Learning Health Care in America," issued by the Institute of Medicine, highlights two crucial facts. The first is that the health system provides a great volume of care that doesn't help patients. The authors write "there is evidence that a substantial proportion of health care expenditures is wasted, leading to little improvement in health or in the quality of care. Estimates vary on waste and excess health care costs, but they are large" -- possibly amounting to more than $750 billion in a single year.

As the report notes, that is enough to pay the full salaries of all the nation's firefighters, police officers, and emergency medical technicians for more than a decade.

Complexity engulfs doctors

Second, medicine is becoming so complex that it is virtually impossible for an individual doctor to keep pace -- especially without help from computers, the institute says. Consider that the number of medical journal articles has risen to more than 750,000 a year, from 200,000 in 1970. "Diagnostic and treatment options are expanding and changing at an accelerating rate, placing new stresses on clinicians and patients, as well as potentially impacting the effectiveness and efficiency of care delivery," the report concludes.

This report reaches well beyond diagnosis, however. It recommends sensible steps to move us toward a "continuously learning" health system. One of these is to give doctors and other providers expanded real-time access to the latest knowledge through the widespread use of clinical-decision- support computer software, bolstered by continuously updated data on clinical experience.

A second set of recommendations involves health-care payment policies, which, as the institute argues, "strongly influence how care is delivered." The U.S. needs to move faster away from paying providers a fee for each service and instead pay for what they accomplish toward helping patients. The report also calls on health-care leaders to promote and develop a culture of learning among doctors, while also empowering patients by giving them more information about their own medical decisions.

The second important health-care report last week, published in Health Affairs, is based on a comparison of health-care costs and quality among various regions. Although a vast body of previous research has explored the wide variance within Medicare -- and has shown that there is no apparent correlation between cost and quality -- this analysis used data from the private insurer UnitedHealth.

For common chronic conditions, for example, the least-expensive costs per medical episode (those at the 10th percentile of all episodes) were about one fifth to one third less than the median, while the most expensive costs per episode (at the 90th percentile) were three to five times the median. In other words, the highest costs are more than 10 times the lowest -- for treating the same condition.

This variation might be understandable if the higher spending bought better results. However, according to the researchers, "for the conditions that we analyzed, we found essentially no correlation between average costs and the measured level of care quality across markets."

Go here to read the rest:

PETER ORSZAG: It's not hard to find health savings

11-09-2012 07:50 Vermont gubernatorial candidate Randy Brock sits down with NewsChannel 5's Bridget Shanahan to discuss his views on health care and his campaign.

Go here to read the rest:

Commitment 2012: Randy Brock discusses health care - Video

NEW YORK, Sept. 12, 2012 /PRNewswire/ -- As the US health care industry continues its transformation to a patient-centric system, health care providers face a new imperative to collaborate with other entities to deliver quality care and improved outcomes with greater efficiency at lower costs. Whether driven by financial pressures, demands to improve quality of care or new payment and delivery models focused on quality outcomes, health care organizations are faced with challenges that require collaboration with others. These and other observations were released today in New horizons: collaboration, Ernst & Young LLP's annual publication for the US health care provider industry.

"The forces at work today are unprecedented," said Jon Weaver, Provider Care Sector Leader, Ernst & Young LLP. "Collaboration with stakeholders to share knowledge, pool resources and synergistically enhance patient care has become a common theme. We are in a time when silos are being razed, connections made, and shared purposes linked."

New horizons builds upon Ernst & Young's industry knowledge by featuring insights from in-depth interviews with the following industry leaders:

The report explores new forms of collaboration taking place in the health care sector and examines areas where stakeholders can focus their energies, including:

"As we enter a new era of health care delivery, boundaries between industry stakeholders are continuing to dissolve, leading to exciting improvements in the delivery of patient care," said Jim Costanzo, National Practice Leader, Health Care Advisory Services, Ernst & Young LLP. "With the market and regulatory forces driving the industry toward an outcome-based care delivery model, the highly fragmented majority of health care providers and insurers are seeking ways to work collaboratively."

About Ernst & Young's Provider Care practiceErnst & Young's provider care practice is helping the nation's leading health care providers (including hospitals, health systems, managed care organizations, home health companies and post-acute care facilities) navigate market changes, government activities and care delivery innovations. For more information, please visit http://www.ey.com/US/en/Industries/United-States-sectors/Health-Care.

About Ernst & YoungErnst & Young is a global leader in assurance, tax, transaction and advisory services. Worldwide, our 152,000 people are united by our shared values and an unwavering commitment to quality. We make a difference by helping our people, our clients and our wider communities achieve their potential.

Ernst & Young refers to the global organization of member firms of Ernst & Young Global Limited, each of which is a separate legal entity. Ernst & Young Global Limited, a UK company limited by guarantee, does not provide services to clients. For more information about our organization, please visit http://www.ey.com.

Read this article:

Ernst & Young LLP health care report explores collaboration as key to a patient-centric system

WASHINGTON--(BUSINESS WIRE)--

The National Retail Federation told a congressional panel today that the Departments of Health and Human Services, Labor and Treasury have used too much informal guidance and not enough formal rulemaking in developing regulations to implement the new health care reform law, complicating retailers and other employers ability to plan for what will be required in 2014. NRF is concerned that the situation is the latest example of regulatory uncertainty that is hampering businesses attempts to expand and create jobs.

Our nation cannot afford for the ACA to stumble out of the starting gate, NRF Vice President and Employee Benefits Policy Counsel Neil Trautwein said. A cascade of last-minute regulations will create confusion and thus could encourage more employers to back out of coverage. We are trying to help prevent what threatens to become a regulatory train wreck.

Trautwein is scheduled to testify at a hearing being held this afternoon by the House Ways and Means Committees Health Subcommittee on implementation of health care exchanges and other provisions that will be required under the Affordable Care Act beginning in January 2014.

Trautwein said retailers typically plan health care benefits for their employees six to nine months in advance, meaning that details of the 2014 requirements need to be known no later than the end of the first quarter of 2013. Retailers would like to have regulations in place this year, and are greatly concerned that fast-approaching deadlines for key issues might not be met.

Federal agencies have been working hard and fairly cooperatively with business groups, Trautwein said. But rather than issuing formal proposed rules and seeking comments as is normally done under the Administrative Procedures Act, the Administration has issued bulletins, guidance and frequently-asked-questions documents that are welcome but do not make up for the lack of good and fair regulations, he said.

NRF is concerned that the lack of formal regulations is slowing down creation of health care exchanges, which would be established in each state as a new marketplace for health care coverage. In particular, the basic level of coverage that would be required in policies offered through the exchanges and small group plans has yet to be determined because HHS has not yet said what will be included in the essential health benefits package required by the law.

NRF has backed repeal of the Affordable Care Act, arguing that it emphasizes mandates that drive up costs for employers more than steps to make health care more affordable. In the meantime, however, NRF has encouraged fair and effective implementation of the law, and has worked with its member companies and a wide variety of coalitions on compliance. The complexity of the law and the number of coalitions focused on varies issues led NRF to form the Employers Health Care Clearinghouse to coordinate the work of the groups.

As the worlds largest retail trade association and the voice of retail worldwide, NRF represents retailers of all types and sizes, including chain restaurants and industry partners, from the United States and more than 45 countries abroad. Retailers operate more than 3.6 million U.S. establishments that support one in four U.S. jobs 42 million working Americans. Contributing $2.5 trillion to annual GDP, retail is a daily barometer for the nations economy. NRFs Retail Means Jobs campaign emphasizes the economic importance of retail and encourages policymakers to support a Jobs, Innovation and Consumer Value Agenda aimed at boosting economic growth and job creation. http://www.nrf.com

Read testimony

Originally posted here:

NRF Warns of ‘Regulatory Train Wreck’ with Health Care Regulations

By Tom Philpott For The Times

Republican presidential nominee Mitt Romney has proposed opening military TRICARE networks of civilian health-care providers to veterans who cant get timely mental health care from the Department of Veterans Affairs.

TRICARE networks currently exist to provide health care to military personnel and retirees, their families and survivors.

Two days after Romneys pledge, President Barack Obama signed an executive order with several new initiatives to improve access to mental health-care services for veterans, service members and their families.

One initiative directs the VA and Department of Health and Human Services (HHS) to establish at least 15 pilot programs involving community-based health providers to expand mental health services in areas not well served by the VA.

Another establishes an interagency task force on military and veterans mental health co-chaired by the VA, the Department of Defense and HHS.

Not mentioned is an initiative to allow the VA to refer veterans in need of immediate mental health care to the TRICARE network, but Rep. Jeff Miller, a Florida Republican and chairman of the House Veterans Affairs Committee, said the Romney idea has real merit.

The former Massachusetts governor unveiled it in a speech last week to the American Legion conference in Indianapolis.

Miller, during an interview, suggested Romneys notion is a reasonable step on a path Miller wants to travel giving veterans more access to private sector health care, at the VAs expense, rather than forcing them to commute long distances to a VA facility or to endure long delays to get a VA appointment.

Romneys idea, Miller said, would swiftly address the VAs shortage of providers of mental health care to treat post-traumatic stress and traumatic brain injury and the epidemic of suicides among veterans by immediately doubling the number of available mental health-care providers.

Continue reading here:

Military Update: TRICARE networks eyed to improve veterans' access to care

MCLEAN, Va., Sept. 12, 2012 /PRNewswire/ --RxAnte, Inc., a health care improvement company providing a new and innovative approach for improving medication adherence, announced today that it has raised a Series A financing led by Aberdare Ventures with additional support from the West Health Investment Fund. The financing will be used to further develop RxAnte's proprietary technologies, commercialize its current offerings, and expand the company's impact on the quality of medication use.

"Adherence to prescribed medicine is a critical issue for a variety of health care organizations, and one of the biggest opportunities to improve health care," said Dr. Josh Benner, Founder and CEO of RxAnte. "RxAnte has pioneered a promising new approach to getting the right adherence interventions to the right patients at the right time. In collaboration with Aberdare and West Health, we're excited to expand our offerings and help more organizations achieve higher quality care at lower cost."

RxAnte uses its patent-pending analytics platform to predict medication adherence for individual patients, target interventions to those most likely to benefit, and monitor and manage programs over time. The RxAnte system reveals which patients respond best to interventions, helping organizations improve the cost-effectiveness of their adherence improvement efforts.

"We are elated to be teaming up with RxAnte," said Paul Klingenstein, Managing Partner at San Francisco-based Aberdare Ventures. "Drug adherence is a simple way to improve care for individuals and get more for our health care dollars. RxAnte has developed a set of superb data tools to accomplish these goals. It is exactly what our health care system needs, and the kind of thing we are trying to do at Aberdare."

RxAnte is currently working with major health plans, providers, care management organizations and pharmaceutical companies to help improve the effectiveness and efficiency of their adherence efforts.

"Through targeted investments in companies focused in advancing cost-effective models of care, West Health can impact the cost of health care externally," said Nicholas J. Valeriani, chief executive of San Diego-based West Health. "RxAnte highlights the kinds of new approaches to medication adherence that have great potential to disrupt the current delivery model and lower the cost of health care."

About RxAnte RxAnte is a health care improvement company that provides a new and innovative approach for driving medication adherence by helping organizations target, manage, and evaluate their adherence support initiatives. The company's patent-pending predictive analytics and decision support solutions turn ordinary claims data into actionable insights and management recommendations that help health care organizations deliver the right intervention to the right patient at the right time. For more information, please visit http://www.rxante.com.

About Aberdare Ventures Formed in 1999, Aberdare Ventures is a San Francisco-based venture capital firm investing in health care innovation, often at the earliest stages. Aberdare invests in visionary entrepreneurs and technologies that are transforming global inefficiencies in health care with new biological, engineering, and information technologies. Eight investment professionals oversee a committed capital base in excess of $400 million in aggregate. The firm has attracted and partnered with many superior early stage companies, repeatedly backing start-up enterprises that have grown to values exceeding $1 billion.

Historical successes have included Pharmion, Ironwood Pharmaceuticals, and Ablation Frontiers. More recently, Aberdare has been among the first to focus on the transformational opportunities created at the intersection of emerging information technologies with health care, and has established a leadership position in this ecosystem. In addition to the investment in RxAnte, existing commitments to Aviir, Clovis Oncology, Elation EMR, goBalto, Jiff, Omada Health, mc10, and Sonitus reflect this strategy.

About the West Health Investment FundThe West Health Investment Fund's mission is to lower health care costs by investing in innovative patient-centered solutions that deliver the right care at the right place at the right time. This fund, seeded with $100 million from pioneering philanthropists Gary and Mary West, strategically provides capital to early stage mission-aligned companies. The Investment Fund is unique in its philanthropic nature as it commits any returns made from investments to medical research and other charitable activities. The West Health Investment Fund is part of West Health, which also includes the West Health Institute, West Health Policy Center, and West Health Incubator. For more information, find us at http://www.westhealth.org and follow us @westhealth.

View post:

RxAnte Closes Series A Financing

SAN DIEGO, Sept. 12, 2012 /PRNewswire/ --The West Health Investment Fund, West Health's fund focused on lowering health care costs, has announced it participated in the recent venture financings of GlySens, Inc. and RxAnte, Inc., two startup companies with innovative technologies that could lower the cost of health care. Financial terms of the investments were not disclosed.

(Photo:http://photos.prnewswire.com/prnh/20120912/DC72771LOGO)

"Through targeted investments in companies focused in advancing cost-effective and cost-saving models of care, West Health can impact the cost of health care externally," said Nicholas J. Valeriani, chief executive of West Health. "These two innovative companies highlight the kinds of new approaches to diabetes treatment and medication adherence that have great potential to disrupt the current delivery model and lower the cost of health care."

San Diego-based GlySens is developing an implantable, long-term continuous glucose monitoring sensor designed to provide a wireless means to track glucose levels and improve the lives of people with diabetes. The sensor resides completely under the skin and transmits glucose measurements wirelessly to a convenient external display device, so patients may control their blood sugar levels more effectively. The American Diabetes Association reports that in the United States alone, diabetes and its complications are estimated to be responsible for more than $117 billion in direct medical costs.

Virginia-based RxAnte is a health care improvement company that provides a new and innovative approach for driving medication adherence by helping organizations target, manage and evaluate their adherence support initiatives. By using predictive analytics, RxAnte's service helps identify the most effective outreach method to ensure that patients take their medicines as directed by their health care professional.

"Patients get no benefit from drugs they do not take, complex regimens they cannot follow or care they cannot afford," said Dr. Joseph Smith, chief medical and science officer of West Health. "These investments reflect our commitment to increasing the efficiency of health care delivery while decreasing the burdens of complexity and cost."

The $100 million West Health Investment Fund was launched in October 2011 to provide venture capital for companies with cutting-edge health care technologies and services that offer the potential to lower the cost of health care. The Fund is unique in its philanthropic nature as it commits any returns made from investments to medical research and other charitable activities.

ABOUT THE WEST HEALTH INVESTMENT FUND

The West Health Investment Fund's mission is to lower health care costs by investing in innovative patient-centered solutions that deliver the right care at the right place at the right time. This fund, seeded with $100 million from pioneering philanthropists Gary and Mary West, strategically provides capital to early-stage mission-aligned companies. The Investment Fund is unique in its philanthropic nature as it commits any returns made from investments to medical research and other charitable activities. The West Health Investment Fund is part of West Health, which also includes the West Health Institute, West Health Policy Center and West Health Incubator. For more information, find us at http://www.westhealth.org and follow us @westhealth.

Continued here:

West Health Investment Fund invests in GlySens and RxAnte

11-09-2012 12:16 Bill and Judd Legum of Think Progress take on Mitt Romney's latest stance on health care. In the wake of Romney's appearance with David Gregory on Meet the Press, both sides of the aisle are scratching their heads. Legum says, "I think ultimately there is panic in the Republican Party that as soon as (health care reform) gets implemented, the whole thing will be different." According to Legum, Romney's position is now to fully appeal the latest health care legislation. Every weekday morning on Current TV at 6e/3p

Read the rest here:

'Panic in the Republican Party' over Romney's health care stance - Video

President Obamas health care law has helped millions of Americans obtain insurance coverage, prescription-drug discounts and premium rebates but with only part of the overhaul in place and widespread confusion about what it does, the administration is still struggling to sell it to voters.

In the 2 years since Mr. Obama signed the Affordable Care Act, the administration has been frenetic in highlighting tangible benefits. On Tuesday, it announced that Americans saved $1 billion from rate increases that never happened but could have if the law didnt force companies to publicly justify any increases.

But the heftiest parts of the law, including a massive Medicaid expansion and the insurance exchanges estimated to cover 40 million uninsured, wont take effect until well after the November election, meaning most Americans arent seeing major changes.

Even when they are seeing benefits, they dont connect them with the law.

A lot of people may have noticed their flu shot was free this year, but might not have credited it to the Affordable Care Act, so I think a lot of the effects may have gotten unnoticed, said Tim Jost, a professor at Washington and Lee University who is a specialist on the health care law.

Meanwhile, health care costs continue to rise, complicating matters for the president, who promised that the law would bend the cost curve.

An annual survey released Tuesday by the Kaiser Family Foundation found that family insurance premiums cost $15,745 on average this year, 4 percent higher than last year. While the recession has slowed growth in recent years, premiums have nearly doubled since 2002.

The administration said the increases werent good but promised better news when the law is fully implemented.

We certainly arent happy to see any increase in health insurance premiums, and we look forward to when the provisions of the Affordable Care Act go into effect which will reduce premiums for American consumers and businesses, said Gary Cohen, who directs the Center for Consumer Information and Insurance Oversight at the Department of Health and Human Services.

Polls show that half the country opposes the law, and Mr. Obama didnt mention it in his speech last week at the Democratic National Convention in Charlotte, N.C.

Follow this link:

Selling health care law tricky on campaign trail

WASHINGTON, Sept. 11, 2012 /PRNewswire/ --Health care is better with the health information exchange among members of the Care Connectivity Consortium, according to providers and patients.

Carol McNair, 75, and her husband Steve, 81, live in Herron Island, Wash., and have experienced the benefits of health information exchange firsthand. They travel each December from their home to Desert Hot Springs, Calif., for several months of sunshine, and say this winter reprieve would not be possible without the collaboration between their primary care physician at Group Health Cooperative and their Kaiser Permanente physician in Palm Springs, Calif.

During a recent visit to California, Carol began feeling poorly and suspected it could be because of her medications. "I was helping my daughter pick out a wedding dress and just wasn't feeling right. My Kaiser Permanente physician, Dr. Kirk Pagel, was able to review my medications on my electronic medical record and adjust them right away. It's important to me that my doctors have this kind of connectivity and can communicate, so I know I'm always getting the best care."

The Care Connectivity Consortium was created in April 2011 by five health systemsKaiser Permanente, Mayo Clinic, Group Health Cooperative, Intermountain Healthcare and Geisinger Health Systemto connect doctors electronically, enabling them to have comprehensive access to patients' medical record information and provide better patient care.Since its formation, the Consortium has developed standards-based information technology to connect doctors across the country. Today, CCC partners can exchange information across all five organizations in select geographic and specialty areas.

By connecting seamlessly to another member of the Care Connectivity Consortium, Kirk Pagel, M.D., the McNairs' Kaiser Permanente physician in Palm Springs can view the McNairs' most recent Group Health Cooperative medical records.

"Dr. Pagel is able to care for us as if we were his year-round patients," said Steve McNair. "Even though we only see him three to four months out of the year, I feel like he's always up to date on our health and a large part of that is due to the data connectivity between Group Health Cooperative and Kaiser Permanente."

Through the work of the Care Connectivity Consortium, clinicians are finding that having access to their patients' comprehensive medical history makes them feel more equipped to provide high-quality, safe care.

"The health information exchange capability with other providers in the Care Connectivity Consortium gives me a more thorough picture of my patients' health before they even walk into the exam room," Dr. Pagel said. "Armed with the right information at the right time, I can give my patients the best care possible."

With patient privacy and security as overarching priorities, the CCC partners are taking the practical steps needed to link pertinent patient data between the separate care systems and medical records, therefore demonstrating the possibility of higher quality and safer care with improved data availability.

Leaders of the five health systems believe that achieving electronic health information interoperability and connectivity will be a critical next step in the United States moving toward 21st century, information-enabled health care.

View original post here:

Care Connectivity Consortium Takes Care Coordination To New Levels For Patients And Providers

By Peter Orszag 2012-09-11T22:30:47Z

Last week, two important reports underscored the potential for improving the value of health care in the U.S.

The first of these, Best Care at Lower Cost: The Path to Continuously Learning Health Care in America, issued by the Institute of Medicine, highlights two crucial facts. The first is that the health system provides a great volume of care that doesnt help patients. The authors write there is evidence that a substantial proportion of health care expenditures is wasted, leading to little improvement in health or in the quality of care. Estimates vary on waste and excess health care costs, but they are large -- possibly amounting to more than $750 billion in a single year.

As the report notes, that is enough to pay the full salaries of all the nations firefighters, police officers, and emergency medical technicians for more than a decade.

Second, medicine is becoming so complex that it is virtually impossible for an individual doctor to keep pace -- especially without help from computers, the institute says. Consider that the number of medical journal articles has risen to more than 750,000 a year, from 200,000 in 1970. Diagnostic and treatment options are expanding and changing at an accelerating rate, placing new stresses on clinicians and patients, as well as potentially impacting the effectiveness and efficiency of care delivery, the report concludes.

This report reaches well beyond diagnosis, however. It recommends sensible steps to move us toward a continuously learning health system. One of these is to give doctors and other providers expanded real-time access to the latest knowledge through the widespread use of clinical-decision- support computer software, bolstered by continuously updated data on clinical experience.

A second set of recommendations involves health-care payment policies, which, as the institute argues, strongly influence how care is delivered. The U.S. needs to move faster away from paying providers a fee for each service and instead pay for what they accomplish toward helping patients. The report also calls on health-care leaders to promote and develop a culture of learning among doctors, while also empowering patients by giving them more information about their own medical decisions.

The second important health-care report last week, published in Health Affairs, is based on a comparison of health- care costs and quality among various regions. Although a vast body of previous research has explored the wide variance within Medicare -- and has shown that there is no apparent correlation between cost and quality -- this analysis used data from the private insurer UnitedHealth.

The private-insurance data also show tremendous variation. For common chronic conditions, for example, the least-expensive costs per medical episode (those at the 10th percentile of all episodes) were about one fifth to one third less than the median, while the most expensive costs per episode (at the 90th percentile) were three to five times the median. In other words, the highest costs are more than 10 times the lowest -- for treating the same condition. The team also found significant variation both within and across regions.

This variation might be understandable if the higher spending bought better results. However, according to the researchers, for the conditions that we analyzed, we found essentially no correlation between average costs and the measured level of care quality across markets.

Link:

How Much Savings Is Left in U.S. Medicine? Lots.

BOSTON--(BUSINESS WIRE)--

HighRoads, the industry leader in employer health care regulation compliance and benefits management, today shared eight tips for employees as they navigate their annual employer benefits open enrollment period. Following these simple steps may save employees hundreds of dollars on their health care costs while ensuring that they make the most of their benefit plan programs.

Employers are making more changes than ever to their benefits plan designs and as a result employees need to take extra precautions to assure that they have the benefits coverage they expect, for a price they can afford, during this years open enrollment period, said Cynthia Weidner, vice president H&W consulting, HighRoads. This is the time for employees, retirees and their families to consider all of their options, including health savings accounts and wellness programs, to make the most of their benefits while minimizing out of pocket costs for the year to come.

Now that the Supreme Court has upheld the Affordable Care Act (ACA), employees will see some changes in their annual open enrollment benefits materials. For many employees this will include the addition of a Summary of Benefits and Coverage (SBC) document. SBCs are benefit plan summaries that are intended to benefit employees by creating clear, understandable and straightforward information on what health plans will cover, what limitations or conditions will apply, and what they will pay for, according to the U.S. Department of Health and Human Services.

However, reading the SBC alone may not provide employees with everything they need to make informed decisions during open enrollment. Following these eight tips can help to eliminate an employees risk of unexpected plan changes or cost increases:

1. Get your plan materials Pay attention to how your employer is making your SBCs and the traditional Summary Plan Descriptions (SPDs) available to you. Many are making them more accessible online, via mobile apps as well as on paper. Its good to know how you can access this information during open enrollment and throughout the year, in case you want to review it again when you are in need of a particular medical service.

2. Do your homework Take the time during open enrollment to truly read through your plan materials, including the SBCs and SPDs, to make yourself familiar with each of your plan options. Reading each of these materials will give you the detailed plan descriptions you need to decide on the best plan for you and your family in the coming year.

3. Calculate your costs Many employers provide cost calculators to help project your total cost for the coming plan year. The total cost includes the premium you pay as well as your share of the deductible and coinsurance. Take the time during open enrollment to think through your potential medical needs and calculate your anticipated expenses before selecting a plan. It may save you hundreds in the long run.

4. Consider an account If your employer offers you the option of a healthcare account, whether it is a flexible spending account (FSA), a health reimbursement account (HRA) or a health savings account (HSA), take a good look at it. These accounts can help you save money on qualified medical expenses that arent covered by your health care plan, such as deductibles and coinsurance. Each account has a different set of rules about how and when you can spend the money, but each are worth considering because the savings youll see can add up quickly.

5. Ask if you have a grandfathered plan. One of the benefits of health care reform is an extended list of preventive care benefits that must be offered by new health care plans for free. Preventive services such as colonoscopy screenings for colon cancer, Pap smears and mammograms for women, well-child visits, and flu shots for all children and adults must be offered without out-of-pocket costs. However, these benefits are only for new health plans and dont apply to grandfathered plans that havent significantly changed in a few years. Find out if your plan is considered to be grandfathered and identify exactly what preventive services are covered for free.

Visit link:

Eight Tips for Participants of Employer Sponsored Health Insurance During Open Enrollment

10-09-2012 21:33 Consistency may be the hobgoblin of little minds, as Ralph Waldo Emerson said, but a total lack of constancy has sure created a tough situation for Mitt Romney, whose own campaign, of course, first used the Etch A Sketch metaphor to describe him, to all journalists' delight. Yesterday's new chapter in the unraveling of Mitt as a clear-thinking person came in his effort to thread the needle once again on health care. Tune in Weeknights at 8e/5p on Current TV

The rest is here:

The Etch A Sketch returns: Eliot Spitzer deems Mitt Romney's latest flip on health care a flop - Video

WASHINGTON -- Mitt Romney's pledge to guarantee access to health insurance for people with longstanding medical problems highlighted the difficulty of repealing the new health care law while keeping some of its popular features.

"I'm not getting rid of all of health care reform," Romney said over the weekend on NBC's "Meet the Press." "Of course, there are a number of things that I like in health care reform that I'm going to put in place. One is to make sure that those with pre-existing conditions can get coverage."

Romney did not explain a significant feature of his proposal: He would explicitly guarantee insurance for people with existing conditions only if they have maintained coverage without a significant gap.

That could exclude millions of Americans with medical problems like cancer, heart disease and asthma.

This qualification was clear in a statement Romney issued in March, when he called for repeal of the 2010 law and presented his own vision for health care. Romney said then that he would "prevent discrimination against individuals with pre-existing conditions who maintain continuous coverage." Thus, aides to Romney said, he was not breaking new ground with his comments over the weekend.

Brad Woodhouse, a spokesman for the Democratic National Committee, said Monday, Sept. 10, that Romney's comments were misleading because they left an impression that he supported protections for people with existing conditions like those in President Barack

And what about people with medical problems who have never had health insurance or have had a gap in coverage for months or years?

Breaks in coverage are common. A recent report by the Commonwealth Fund found that 89 million Americans went without health insurance for at least one month in the period from 2004 to 2007, perhaps because they had lost jobs, been divorced or lost eligibility for a public insurance program. Of those, 23 million saw their insurance lapse more than once in the four-year period.

Romney says many of them could obtain coverage through health plans known as high-risk pools. Many states have such pools, which generally operate at a loss. And the federal government is running a high-risk pool, as a temporary measure under the new health care law, in more than 20 states.

Romney has not said whether or how he would regulate premiums or subsidize the costs of coverage in a high-risk pool.

Excerpt from:

Romney's pledge shows repealing health law complex

In a talk and book signing event Sunday in Chatham, a local author tried to shed light on one of the most contentious issues of the past three years and during this election season: health care reform.

Link:

Local author talks health care reform

Published: Monday, September 10, 2012, 12:01 a.m.

Tricare networks currently exist to provide health care to military personnel and retirees, their families and survivors.

Two days after Romney's pledge, President Barack Obama signed an executive order with several new initiatives to improve access to mental health care services for veterans, service members and their families.

One directs the VA and the Department of Health and Human Services to establish at least 15 pilot programs involving community-based health providers to expand mental health services in areas not well served by the VA. Another establishes an interagency task force on military and veterans' mental health co-chaired by the VA, Defense Department and HHS.

Not mentioned is an initiative to allow the VA to refer veterans in need of immediate mental health care to Tricare network. But Rep. Jeff Miller, R-Fla., chairman of the House Veterans Affairs Committee, said the Romney idea has real merit. The former Massachusetts governor unveiled it in a speech recently to the American Legion conference in Indianapolis.

Miller, in an interview, suggested Romney's notion is a reasonable step on a path Miller wants to travel -- giving veterans more access to private sector health care, at VA expense, rather forcing them to commute long distances to a VA facility or to endure long delays to get a VA appointment.

Romney's idea, Miller said, would swiftly address the VA's shortage of mental health care providers -- to treat post-traumatic stress and traumatic brain injury and the epidemic of suicides among veterans -- by immediately doubling the number of available mental health care providers.

The VA in April announced plans to hire 1,600 more mental health care providers and 300 support staff. But Miller is skeptical that the VA can do so in a timely way, given that it already had 1500 vacancies for mental health providers when it announced the new hiring effort.

"If you can't fill those 1,500," Miller said from his Florida district Thursday, "it's hard to imagine that the VA would be able to double that number and be able to hire them any quicker. Their hiring process is more than cumbersome. It takes a tremendous amount of time ... and in many cases, (applicants) are being lost to the private sector because they just can't wait for the VA to make a decision."

The VA already has authority to refer patients to civilian providers when they can't get timely care inside the VA. But it has used this authority sparingly to hold down costs.

See the rest here:

Mental-health care solutions for veterans