Health Wonk Review –April 14, 2011

It’s not such a wonderful time to be a doctor, patient, hospital, health plan or pharma company, but judging by the quality and quantity of entries received for this edition of the HWR, it’s a wonderful time to be a wonk. A couple weeks ago CMS released draft rules for Accountable Care Organizations. Several bloggers weighed in on that development:

• Mark McClellan and Elliott Fisher at Health Affairs provide some historical context and argue that “those who care deeply about health care reform all have a common interest in the success of ACOs as a way of avoiding more classic fee-for-service payment cuts to providers.”
• On a more downbeat note, The Road to Health concludes, “Dr. Berwick and his colleagues at CMS appear to have taken the ACO concept and made it into a financial program that only delusional practice administrators, or physician organizations bent on financial self-destruction, could love.”
• The Healthcare IT Guy expects ACOs to be “far more lucrative and disruptive than Meaningful Use and likely to yield more patient quality improvements.”
• GE Healthcare puts the emphasis on ACO change management challenges: “Healthcare executives and management teams are left to focus on preparing their organizations for a cultural shift of seismic proportions.”
• HealthBlawg reviews the proposed rules and produces 8 takeaways. #2: “This is the Frankenstein regulation: A Medicare beneficiary must sit on the board of the ACO, CMS must approve all marketing materials before they are used.”

In the midst of the battle over funding the 2011 budget, House Budget Chairman Paul Ryan came out with a plan to radically restructure Medicare and Medicaid starting in 2012:

• The Apothecary likes much of what he sees and thinks the proposal may force Democrats to devise a credible plan of their own
• John C. Goodman’s Health Policy Blog contrasts PPACA and the Ryan plan. “Obviously, the path we are on leads to an impossible place. So the only question is whether we are going to get off the current path in a planned, orderly way or whether we are going to let unplanned chaos do the trick.”
• Wright on Health is less impressed and wonders, “if Rep. Ryan is so adamant about reducing the deficit, why is he cutting taxes for the wealthy and cutting programs for the poor and the elderly?”
• Managed Care Matters is decidedly unswayed. “If you were looking for real solutions to the health cost problem, you’re going to be sorely disappointed… Unfortunately, he’s fallen into the same trap his Democratic colleagues did with their version of health reform – the Ryan plan does little to address costs.”
• The Incidental Economist takes issue with Ryan’s plan to convert Medicaid to block grants and cut spending. “Should Medicaid be cut back, more people will be uninsured. Contrary to what some wish you to believe, those who become uninsured will suffer worse health outcomes”

As if the ACO rules and Ryan plan weren’t enough, there’s more on Medicare in the blogosphere:

• The Covert Rationing Blog –always good for a lighthearted pick me up– “asserts that we are one giant step closer to the day when it will become illegal for all Americans to spend their own money on their own healthcare.”
• Dr. Liberty discusses CMS’s deliberations on whether to pay for Provenge, a pricey prostate drug. “Decisions are made on the basis of politics, and the drive is to cover everything, leading to higher costs.”

Amid all the federal policy blogging, there’s still some room for technology talk:

• Healthcare Talent Transformation has had it with Health Net’s repeated goof up’s leading to loss of confidential data. Although it may seem like there’s not much the average person can do, the blog argues, “You can make an impact on the security of your sensitive data by conducting due diligence when it comes to your insurance provider.”
• The Healthcare Blog offers a video collage of the new Kaiser Permanente Center for Total Health. “The Center is a pretty fascinating place–part tech and idea showcase and part meeting room. Certainly no other health care organization that I’m aware of has spent so much on a place designed to stimulate the imagination and enhance conversation–under the nose of the folks on Capitol Hill.”
• Meaningful HIT News features a podcast with mHealth Initiative’s Peter Waegemann, who’s shifted over from EMRs to ride the mobile wave
• Healthcare Economist delves into new papers that, “examined how to develop accurate algorithms to account for cancer stage in studies using claims data.”

It was encouraging to receive a couple submissions about journalism:

• Disease Care Management Blog asks, “Is the kerfuffle over National Public Radio (NPR) the long delayed comeuppance for liberal bias run amok, or a narrow-minded attack on the inconvenient truths from journalistic excellence?” The blog reaches into the world of medicine and discusses of “framing” and its impact on patient decision making to provide an answer
• HealthNews ReviewBlog cites, “daily evidence of the need for improvement in health care journalism – especially when we see examples like hype of a tiny, preliminary study of strawberries for esophageal cancer.”

We always have room in the Health Wonk Review for some posts on medical ethics:

• Nuts for Healthcare looks at the pharma industry and concludes, “Doctors need to take a more definitive stand against the specter of industry influence. A good target? Industry sponsorship of continuing medical education.”
• Health Care Renewal is concerned that so-called government run programs are more private than we think. “The majority of Medicaid has been out-sourced to private health care insurance companies… We need to have some real discussions about the rise of corporatism in US health care, in other aspects of US society and around the world.”

And finally, a few odds and ends

• Workers’ Comp Insider provides resources for employers concerned about radiation exposure
• Colorado Health Insurance Insider chronicles the decline of bipartisanship in the creation of a health insurance exchange for that state. “Healthcare reform has become such a polarized topic that it’s difficult for lawmakers to have any stance other than for it or against it. Even though the health insurance exchanges would be marketplaces that sell private health insurance, the word ‘exchange’ has been thrown around so much during the reform debates that many opponents of the PPACA see it as synonymous with ‘ObamaCare.’”
• Last week I went to a health care direct to consumer marketing conference to see former TimeWarner CEO Jerry Levin interviewed by OrganizedWisdom CEO Steve Krein. I also shared my thoughts in the video clip below

  Thanks for reading the Health Wonk Review! The Incidental Economist hosts the next edition.