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Health Reform

How High-Deductible Insurance Fuels Momentous Healthcare Shifts

July 2, 2015 by Stewart Gandolf, MBA

Although the Affordable Care Act (ACA), in its final, amended version, has been the law of the land for slightly more than five years, the industry-shaking consequence of “healthcare reform,” continue to emerge almost daily. High deductibles are causing major shifts in healthcare.[read more]

Obamacare Subsidies Continue, Court Rules. Now Let’s Get to Work.

June 30, 2015 by Jeanne Pinder

The Affordable Care Act’s health insurance subsidies to low-income people will continue, the Supreme Court ruled. Now that we have that behind us, let’s focus on the important questions of costs — or charges, or prices, or all three — and effectiveness.The Supreme Court ruling marks the end of one chapter and the beginning of another one. There’s work to do to fix the system. Transparent markets benefit consumers. It’s time.[read more]

King v. Burwell: A Frivolous Lawsuit

June 29, 2015 by David E Williams

Some are surprised that Chief Justice John Roberts came out so strongly for the government in King v. Burwell, the lawsuit that aimed to bar insurance subsidies from Obamacare exchanges run by the federal government.I’m not a lawyer or Supreme Court scholar but to me Roberts’ stance isn’t surprising at all. King v. Burwell was a joke –an exemplar of the type of “frivolous lawsuit” some on the right are so fond of citing.[read more]

Long Term Care Insurance: Narrow Framing Is Not the Problem

June 18, 2015 by David E Williams

Health Business Blog readers know the Wall St. Journal is among my favorite publications, but I have to call BS on a recent piece: Why People Don’t Buy Long-Term-Care Insurance. It’s written by a couple of Wharton professors, who frankly should be ashamed of themselves.[read more]

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Effective Healthcare Requires a Social Approach

June 15, 2015 by Paul Tunnah

We all know that the healthcare ecosystem is a highly fragmented space, encompassing all manner of different stakeholders, commercial and non-commercial. However, it strikes me that we still tend to view healthcare solutions in a rather two-dimensional way. The challenge for healthcare is to drive the right sociological change alongside the technological advancement. We need doctors, carers, family/friends and so on to all work collaboratively with each other, harnessing the power of technology and big data, to deliver a 360 degree solution built around the patient.

We all know that the healthcare ecosystem is a highly fragmented space, encompassing all manner of different stakeholders, commercial and non-commercial, including healthcare providers (doctors, nurses etc.), regulators, payers, technology players, pharmaceutical companies, device/diagnostic companies and, of course, the patient and...[read more]

Hospital Selfies and Stars: Patients Look Deeper Than HCAHPS

June 9, 2015 by Lonnie Hirsch

There’s a New Consumer in your service area. No longer “merely a patient,” healthcare reform and societal dynamics have empowered a new breed of high-expectation consumers and value-aware shoppers. Before they select a hospital or provider—for themselves or family members—they are increasingly informed about outcomes, reputation, safety scores, patient experience and the cost of care.[read more]

Temporary Health Plans With Low Benefits Continue to Grow

June 8, 2015 by David E Williams

The Affordable Care Act has increased awareness that everyone needs to have health insurance, so more people who would have otherwise had a gap in coverage are purchasing temporary plans instead. Are they worthwhile?[read more]

Disruptions on the Yellow Brick Road II

June 5, 2015 by Christine Kapsa, NP, DNP

Disruptors and “creative” destroyers blew through American health care like EF5 tornadoes blow through the prairies, starting about a decade ago. Electronic health records are the Winged Monkeys of Medicine. They’ve taken the stuffing out of physicians, dented trust patients had in providers and hijacked the pleasures of caregiving.[read more]

Are We Treating Symptoms While Ignoring the Cause?

June 4, 2015 by Tim Kilpatrick
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A study by the University of Wisconsin funded by the Robert Wood Johnson Foundation shows that the CDC HRA may be ignoring 50% of the determinants of health outcomes. A Health Affairs review of several studies shows that clinical care and behaviors represents only 50-60% of health outcomes. The three determinants of health missing are social, economic and environment.[read more]

Iowa’s in the National News Right Now, and It’s for a Reason You Wouldn’t Expect

June 3, 2015 by Brad Wright

Iowa wants to hand over control of its Medicaid program to private managed care organizations. The reason that this is such a big deal is because, while Governor Branstad is making bold claims that the move to managed care will save the state $51 million a year, there is little reason to believe that will be the case.[read more]

Sorry, Captain, There's No Transparency in Medical Pricing

June 2, 2015 by David E Williams

In my view, high deductible plans are a pretty crude instrument to encourage cost consciousness and price transparency. It has no real impact on the way our family uses the insurance. The main impact is that I struggle more to understand the medical bills and EOBs that arrive. Transparency isn’t here yet and even then it will only be part of the answer. Can’t we do better?[read more]

Where the US Lags Italy in Healthcare

June 1, 2015 by David E Williams

It’s often been said that there is no US healthcare “system.” The lack of a system is very expensive in terms of administrative burden, uncoordinated care, and poor outcomes. This drug pricing issue is just one more example of how we’re kidding ourselves if we think US healthcare is so superior to others’. In fact it helps explain why we pay so much more and yet get less.[read more]