About healthcare IT
From security at the perimeter to security at every interaction: This article is a great overview of security architecture and how it needs to change to keep up with the increase in apps.
GAO: CMS needs to change its ID verification process: As previously reported, the Government Accountability Office is worried about HHS’s IT systems. A further concern is CMS’s ID verification process for healthcare.gov (for example, where ACA enrollment can be accessed). “While the agency employs a two-step email verification process to reduce the risks associated with knowledge-based verification, auditors contend that this process confirms only the email address that was used to create the account, but it does not confirm the identity of the individual who is applying for the account.”
4 problems industry groups have with the ONC's Trusted Exchange Framework: The Trusted Exchange Framework and Common Agreement (TEFCA) is supposed to be the “onramp” for interoperability of healthcare data exchange. This article summarizes the problems industry groups have with TEFCA as it currently exists.
About health insurance
A Targeted Affordability Improvement Proposal: The Potential Effects of Two Nongroup Insurance Reforms Designed to Increase Affordability and Reduce Costs: This paper from the Urban Institute proposes two reforms to the ACA. “The first policy would either introduce a public insurance option offering ACA compliant coverage in the nongroup market or cap private nongroup insurers’ provider payment rates at levels based on those used in the Medicare program. The second policy would extend the ACA’s premium tax credits to eligible people with incomes above 400 percent of the federal poverty level; today, no one with income above this level is eligible for those credits.” If both recommendations were implemented, the government could save $12 billion in 2020, total household spending would decrease by $9.2 billion and average premiums would be $200 per month cheaper for those at 400% or more of the poverty level.
Key Drivers Behind Continued Medicare Advantage Penetration:This thought piece from LEK consulting not only discusses the drivers behind Medicare Advantage growth but also predicts that predicts that its market penetration could grow from about 35% now to 60-70% between 2030 and 2040.
About the public’s health
Maine becomes latest state to legalize physician aid-in-dying; AMA continues opposition: While the headline is self-explanatory, one interesting feature is naming this process: “physician aid-in-dying.” It used to be called physician-assisted suicide.
Low prices of some lifesaving drugs make them impossible to get: Sometimes very affordable off-patent drugs are not available because the profit margin is so low. If manufacturers raise prices significantly, competitors will enter the field and drive prices down again. Consider that if the government is involved in price lowering, should it also be involved in price increases to assure medication availability?
Read the story (Washington Post, but appears to be open access)
Poorer countries have more confidence in vaccines: This article is a fascinating cultural study from the Wellcome charity. The percent of populations who thought vaccines were safe are: 92% in east Africa, 95% in south Asia, 59% in western Europe, and 50 % in eastern Europe. The research names France as the most “skeptical” country, “ where only 47 per cent agreed that vaccines were safe — a level that varies little with education, age, gender, urban or rural status and even whether the respondents have children. Thirty-three per cent said they were not safe and the rest were unsure.”
Read the article(Financial Times, subscription required)
Pediatric powerhouse? Big hospital merger shelved between University of Minnesota, Children's Minnesota: Different names, same issues. These two institutions did not merge because of “reported differences over control, medical staffing and finances.” Recall the Stanford and UCSF merger?