Ticking all the boxes for a health care upgrade at Strata Rx

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Heres what we all know: that a data-rich health care future is coming our way. And what it will look like, in large outlines. Health care reformers have learned that no single practice will improve the system. All of the following, which were discussed at OReillys recent Strata Rx conference, must fall in place.

Although this cocktail of treatments is complex, all commenters concur on the ingredients importance to a remarkable degree. There is no Greek or Jew, no Democrat or Republican in the consensus over health care: anyone who has looked at the system comes up with the same vision.

Ill warrant you cant find a single doctor who says, It works great to wait for people to get sick and then come to me to be fixed up. No insurer will say, Were happy taking our cut from the 18% of gross national product that goes to health care, and were looking forward to it reaching 24% (a figure Ive heard batted around for future costs). Everyone realizes the system will collapse, taking their livelihoods with it, unless we change.

In modern statistics, a model is not just a way of approaching problems mentally, but a set of directions to a computer program for solving those problems Tuan Dinh, who wrote a recent article on new medical practices, traced the history of model-based medicine at Strata Rx. Dinh rang up most of the themes of modern health reform: collecting data from multiple sources, patient engagement, analytics.

In the 1970s and 1980s (when the casual meaning of model applied), models were based on clinical judgment and expert opinion. They were not supported by well-established evidence, but were based on gross oversimplifications and errors.

Then evidence-based medicine (EBM) emerged in 1990s, based on systematic reviews of available evidence, of which randomized clinical trials are the gold standard. EMB is seen everywhere now: pay for performance, care processes, EHRs, etc.

But EBM was designed for the pre-computer era, to let doctors focus on one variable at a time. Dinh said there are already 10 established models for treating cardiovascular disease, 50 for diabetes, etc. But most are poor because they are based on a small and inappropriate selection. And different models give different advice, so what do doctors trust?

The upcoming stage of analysis, model-based medicine, requires the analysis of large numbers of variables, and huge sets of patient information that are not obtainable through clinical trials. Model-based medicine can handle information on real patients (clinical trials used idealized patientspeople who are healthy except for a single condition) and gather up complex inputs: lab information, genetic information, family history, comorbidities, and patient preference.

A number of talks at Strata Rx dealt with reducing readmissions shortly after a hospital discharge. Why the obsession with this particular cost reduction? Well, Medicare fairly recently announced strong penalties for hospital readmissions, so it catapulted suddenly to the health care fields favorite application of data analysis.

In one such talk, Miriam Paramore and David Talby showed the value of big data. There have been models for predicting readmissions for some time, but they were based on a single institution, or at best a single geographical area, and did not necessarily apply to other locations with different demographics. The older models were based on a few thousand to at most 1,700,000 samples. Paramores and Talbys was based on 4.7 billion medical claims, from 120 million patients seeing 500,000 providers.

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Ticking all the boxes for a health care upgrade at Strata Rx

Health care reform and the opportunities for startups

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A key provision of the Affordable Care Act is going into effect as statewide insurance exchanges opened up around the country.

But thats just the latest in a series of changes to theU.S. health care system that will open up new opportunities for entrepreneurs.

With the passing of theHealth Information Technology for Economic and Clinical Health (HITECH) Actin 2009, doctors got new incentives to move from paper-based to digital systems. As a result, investors poured funding into new electronic medical record providers, like CareCloud and Practice Fusion.Since then, doctors use of electronic systems has shot up in May, the department of Health and Human Services announced that doctors and hospitals use of health IT has nearly doubled since 2012.

Smart entrepreneurs are paying equally close attention to the Affordable Care Act (ACA, also known as Obamacare). Weve already seen new companies form to offer private health insurance exchanges so consumers can shop for affordable care. These exchanges are open for business today, Oct. 1, enabling individuals to sign up online, by phone, or in-person, with health insurance coverage starting next year.

However, top health investors are thinking about the long-term impacts of the ACA, the biggest expansion in coverage in nearly 50 years. I caught up with investors from Emergence Capital, Venrock, Kleiner Perkins Caufield & Byers, and Google Ventures at a health IT dinner earlier this week to discuss new opportunities for health-tech entrepreneurs.

Heres what these expert investors think are the hot areas for health-tech startups to focus on.

A Boston-based health care system, Partners Healthcare, invested ina new suite of devices and tools to monitor patients at home and on the go. The connected health program was an expensive endeavor, but Partners reported promising early results.

Partners may be among the first to experiment with a connected health initiative, but it certainly wont be the last. The goal of the ACA is to help hospitals move from volume-based care to value-based care, meaning that doctors wont make money by ordering expensive tests. Instead, physicians will be motivated to keep patients healthy and prevent readmissions to the hospital.

Doctors in the Partners network use new devices that can track and monitor patients at home. According to a recent estimate by Rock Health, investors have already poured $102 million into the development of these new devices.

Entrepreneurs are building some seriously cool devices totrack body metrics, like a patients blood pressure and heart rate. Patients with chronic conditions, like diabetes, are purchasing glucometers, blood pressure cuffs, smart Wi-Fi scales, and pulse oximeters. Check out InformationWeeks list of the most promising remote patient monitoring devices.

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Health care reform and the opportunities for startups

Health care providers raise concerns about KanCare

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Topeka A long line of health care providers today appeared before a legislative committee to complain about problems under KanCare, the privately run managed-care program that provides medical services to nearly 400,000 Kansans.

Hospitals across the state have complained about delays in payments and unwarranted claim denials from the three private insurance companies that run the program. And prior authorization requirements for treatments have in some cases created significant delays in patient care, health officials have said.

But state officials and representatives of the companies said many of the concerns are being addressed and that some problems were inevitable in the transition to KanCare, which is administered by three private insurance companies: Amerigroup Kansas Inc., Sunflower State Health Plan and United Healthcare Community Plan of Kansas.

"Claims are being overpaid, underpaid and in some areas, not being paid at all," Tom Bell, president and chief executive officer of the Kansas Hospital Association, told members of the House-Senate oversight committee on KanCare, which held its first meeting.

Lawrence Memorial Hospital, however, has reported not running into similar problems with KanCare.

Cindy Luxem, chief executive officer of the Kansas Health Care Association, said nursing homes were having serious problems with KanCare.

"There has been a huge administrative price to pay with the new systems. These are dollars and resources not being used for patient care, not going into the quality of care for our residents," Luxem said.

But several health care groups said while there have been serious concerns, they acknowledged that the Kansas Department of Health and Environment was working hard to address them.

Kari Bruffett, director of the Division of Health Care Finance at KDHE, said the agency and the managed care organizations were making progress on resolving problems.

Jean Rumbaugh, chief executive officer of Sunflower State Health Plan, said the company was taking steps to ensure improved care.

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Health care providers raise concerns about KanCare

Health care hikes put herbs in the spotlight

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With rising costs in health care, families are paying more out of pocket for doctor visits and common medications.

Today, a trip to the doctor for the common cold can set you back an average of $740, before insurance deductions. Analysts say that health care costs will continue to rise, and reforms tied to the Affordable Care Act could mean a 32 percent cost increase for families across the board.

In order to cut back, families are considering more natural remedies to soothe ailments, making alternative medicine more popular then ever.

Clinical herbalist, Maria Groves, of Wintergreen Botanicals, LLC, in Allentstown, N.H., teaches families how to use home-grown herbs for their everyday needs and said that more families are interested in herbal remedies then ever before.

The idea of getting things back into their own hands was really important," said Groves. "And being able to cut down costs in the long run, being able to take care of themselves and their families was really important and herbs do really well for mostcommon illnesses.

Groves also said that using herbal remedies may be better for you than most common medications you can find at the drug store, but noted that it's important you do your research before administering any herbal remedies to yourself or your family.

Herbs, I think, are much more effective than over-the-counter remedies.," said Groves. "Most over-the-counter remedies are just masking symptoms, and usually they are suppressing the immune system. So in the long run, they are making you feel more comfortable, but they are not actually helping.

As cold and flu season approaches, Groves noted that there are several herbs that are safe and effective for the whole family, including elderberry.

What elderberry seems to do is block out those receptor sites that viruses use to get into the body, she said.

Using the right herbal treatments can be an easy, inexpensive and effective way to save a trip to the doctor and time sitting in the waiting room with other sick patients.

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Health care hikes put herbs in the spotlight

Is Obamacare slowing health care spending?

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Health care spending is at record lows, but should Obamacare get credit?

NEW YORK (CNNMoney)

Myth: Obamacare has slowed health care spending growth.

Reality: President Obama likes to stress that health care spending has fallen to record lows in recent years thanks in part to Obamacare.

It's true that after years of skyrocketing increases, America's health care spending growth has slowed to record lows. The Office of the Actuary in the Centers for Medicare and Medicaid Services reported earlier this year that national health spending grew by 3.9% each year from 2009 to 2011, the lowest rate of growth since the federal government began keeping such statistics in 1960, according to the Kaiser Family Foundation.

But is Obamacare the reason?

Not entirely, according to the Kaiser Family Foundation and Altarum Institute, a health research group. They concluded that about three-quarters of the slowdown is due to the lackluster economy. The rest stems from efforts to keep spending down, including measures introduced in the 2010 health reform law, commonly known as Obamacare.

Share your story: Are you signing up for Obamacare?

People spend less on health care in weak economic times. Those who lose their jobs often lose coverage and hold off on seeing the doctor. Even workers with company-sponsored plans may still face large out-of-pocket costs that they'd rather avoid unless absolutely necessary.

Companies have tried to curb their spending, too, by raising deductibles and co-pays, as well moving toward high-deductible plans, through which enrollees must typically spend a few thousand dollars before coverage kicks in. A growing number of companies have also instituted disease management or wellness efforts that aim to cut costs by keeping workers healthier.

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Is Obamacare slowing health care spending?

This 'Futurist' Just Grabbed $50 Million In Funding For His App Search Engine

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Quixey

Tomer Kagan, cofounder, Quixey

He's a board member of the Machine Intelligence Research Institute and works with the National Science Foundation's futurist project.

His vision is that everything in our lives will be powered by software, even things like personalized food and traveling hospitals, and people will interact with the world through mobile devices.

But before you can use all of these apps, you have to find them, hence Quixey makes an app discovery search engine. It currently powers about 100 million searches a month and is used by companies like Microsoft, Sprint, and Ask.com.

His work as futurist is proving to be a profitable edge for his company. On Thursday, Quixey announced that it had landed a huge, $50 million round of funding lead by the Alibaba Group.

Alibaba is the "Amazon" of China, the largest Internet ecommerce site in that country. Google chairman Eric Schmidt's fund Innovation Endeavors also contributed (it had previously invested in Quixey). So did Atlantic Bridge, Translink Capital, US Venture Partners, and Chinese VC WI Harper.

Quickey has raised $74.2 million to date. We caught up with Kagen to ask him about his company.

Business Insider: Did your work as a futurist help him you nab this funding?

Tomer Kagan: When we're talking to investors we obviously talk to them about the future plans for Quixey and how we see the market 5, 10 and 20 years down the line. Alibaba and Quixey share the idea of thinking very long-term.

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This 'Futurist' Just Grabbed $50 Million In Funding For His App Search Engine

Washington Freedom Summit – Friday Session 1 – Mark Meckler – Citizens for Self Governance – Video

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Washington Freedom Summit - Friday Session 1 - Mark Meckler - Citizens for Self Governance
Washington Freedom Summit Presents - Mark Meckler Mark was the co-founder of Tea Party Patriots and served as National Co-coordinator until 2009 when he foun...

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Washington Freedom Summit - Friday Session 1 - Mark Meckler - Citizens for Self Governance - Video

Freedom on the internet: Hungary ranks no. 8 in study

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Independent watchdog organizationFreedom Housereleased its fourth annual Freedom on the Net report last week; in its ranking of 60 countries examined in terms of internet freedom, Hungary placed eighth to earn the country the free label, despite slipping some four points to a score of 23, where 0 is the ideal score. Iceland and Estonia were ranked in the top two places.

In announcing the release of Freedom on the Net 2013, Freedom House noted a worldwide decline in internet freedom, thanks to various incidents of broad surveillance, new laws controlling web content, and growing arrests of social-media users.

Hungarys own drop in score and increase in what Freedom House deemed Violations of User Rights was in line with the majority of the 60 nations studied as a whole: Some 35 nations assessed in the survey had broadened their technical or legal surveillance powers over the past year, and all but one received a worse score from Freedom House.

While blocking and filtering remain the preferred methods of censorship in many countries, governments are increasingly looking at who is saying what online, and finding ways to punish them, said Freedom on the Net project director Sanja Kelly. In some countries, a user can get arrested for simply posting on Facebook or for liking a friends comment that is critical of the authorities.

And in Hungary? A few excerpts from the report are as follows.

For key points in understanding Hungarian internet freedom, Freedom House noted Revisions to the criminal code, passed on June 25, 2012[,] could allow the government to block websites if host providers fail to respond to takedown notices; the Supreme Court fined two blog owners for defamation based on readers' comments, even though the comments were deleted and The fourth modification of the constitution annulled previous decisions of the Constitutional Court, causing uncertainty as to how previous legal protections, particularly regarding free speech, will be interpreted.

The National Core Curriculum for 2013 drastically decreased the number of IT classes in primary and high schools, possibly maintaining and further increasing the digital divide between social groups, as children coming from poor families may not have access to computers and other digital devices in their homes.

In June 2012, the Supreme Court fined two blog owners who were found guilty of defamation for comments that were posted by users on their websites, even though the comments were subsequently deleted. Additionally, cyberattacks against government websites continued to take place, and there was one case of physical assault against an online journalist covering a rally in October 2012.

The Fundamental Law of Hungary acknowledges the right to freedom of expression and defends freedom and diversity of the press, though there are no laws that specifically protect online modes of expression.

A series of interviews conducted with journalists in 2012 provide a picture of the extent of self-censorship in Hungary, which is due to political and economic pressure on both traditional and online media outlets. According to most of the interviewees, the media laws had not made any difference when it came to self-censorship; instead, as one respondent noted, the two-thirds majority push of executive power, the unprecedented leverage of that power, and the rise of the Fidesz party have had a greater effect on self-censorship. Another journalist added that party finance is entangled with media financing. Political and economic influence is exerted through public and private advertising. A respondent explained that there was always some other interest at play, political or from the side of business and advertisingor both simultaneously, because these two often go hand in hand.

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Freedom on the internet: Hungary ranks no. 8 in study