Today's News and Commentary

About insurance

Shift to medicare Advantage Ratchets Up Pressure on Hospitals: In the decades after the 1980s, hospitals needed to adjust to the rise in private managed care utilization and payment arrangements- starting with HMOs then PPOs and other variations. Despite the fact that Medicare managed care has been around since the mid 1980s, only recently have the numbers in the latest iteration (Medicare Advantage) started to reach significance. Some states have as many as 40% of beneficiaries in these plans. Now hospitals really need to adapt to the realities of doing business with these private insurers. This article is a nice summary of this issue.

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CMS launches new model for paying ambulance crews—even if they don't transport to the ER: CMS is launching alternate payment models to keep Medicare beneficiaries out of the hospital. One of these initiatives is paying EMTs to treat non-critically ill patients in their homes rather than transport them to the hospital regardless of their condition. This home treatment can be accomplished with the aid of telemedicine if needed.

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About science and health

Ribosomal DNA harbors an evolutionarily conserved clock of biological aging: How old is your body? Not chronologically, but how has it aged? There are a variety of online tools that ask about your habits, diet and weight; but they are just guesses at your true biological age. New discoveries have found a biological marker that is an accurate measure and possibly a modifiable target for aging: Ribosomal DNA. The article (particularly the abstract) is readable, even for those without a science background.

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About the public’s health

Breast surgeons say all breast cancer patients should be offered genetic testing: Commentary on this article is not about the specific recommendation but how we approach disease in this country. Instead of a targeted approach we tend to use a “shotgun.” For example, in the US we immunize everyone against influenza. In other countries only the highest risk populations or reservoirs of disease (like children) are vaccinated. How much more effective is our approach and at what cost?

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Survey: Flexibility, wellness key to employee retention: This article reports on what employees want in the workplace. The healthcare implication is summed up in the subtitle: “Forty-one percent of respondents in a recent survey say they’d take a 10 percent pay cut for a company that cared more about employee wellness.”

Read about the survey (Free site signup)

About healthcare IT

Tech companies see health data as a huge opportunity, but people don't trust them: It is obvious that the ability to access your medical records across the healthcare system regardless of provider type or geography is very important. But where should the actual information reside? One clue was provided by this recent study looking at whom people trust with their medical information. According to the survey, here are the willingness to share percentages:

  • My doctor 72%

  • My health insurer: 49%

  • My pharmacy: 47%

  • Research institution: 35%

  • Pharmaceutical company: 20%

  • Government organization: 12%

  • Tech company: 11%

So much for using Facebook/Google/Amazon to store your medical data.

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Surescript’s CEO Tom Skelton on efforts to take on high prescription drug prices, interoperability: Given all the proprietary IT systems, how will we achieve interoperability? The one organization that is a likely candidate to help is Surescripts- which has been processing e-prescriptions for a number of years and interfaces with all certified EMRs and insurers’ systems. This interview with the company’s CEO provides some insight into what Surescript can do to fix this major problem.

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Xcertia Releases New mHealth App Guidelines, Adding 3 Categories: Xcertia is a non-profit organization launched in 2016 by the Healthcare Information and Management Systems Society, American Medical Association, American Heart Association and the DHX Group. This article explains the mobile health (mHealth) app guidelines the organization has recently issued.

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 About pharma

New Government Funding Bill Provides FDA With Additional $269 Million: Now that the new budget is passed, the FDA is funded again- but now at a record level.

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