Week of March 28-April 1, 2016


Health Care Leadership and Management
To address the issue of surgical appropriateness and to ensure that patients and surgeons engage in shared decision making that explicitly acknowledges patient goals and preferences, Blue Shield of California has developed an innovative joint replacement program.  An Innovative Patient-Centered Total Joint Replacement Program,

In 2012, the University HealthSystem Consortium (UHC) ranked Emory Healthcare’s two major hospitals in the top 10% of academic medical centers in the U.S., but Emory’s quality performance hasn’t always been so strong. Just six years earlier, the same hospitals placed in the bottom half of UHC’s rankings.  So how did Emory make such an impressive turnaround in quality performance?  The secret to Emory’s jump in care quality? Teamwork.  

But attitudes are changing. In the first NEJM Catalyst Care Redesign survey, clinicians, clinical leaders, and health care executives cite “investing in behavioral health services alongside physical health services” as the clinical practice change most likely to improve the health of communities.  Care Redesign Survey: Why Population Health Management Is Undervalued,

ACA Implementation
A recent summary of the latest evidence found reason for optimism about the potential impact of the Patient Centered Medical Home model, not only on quality but also physician morale — raising the hope that the proliferation of the PCMH model might attract more physicians to careers in primary care.  How Solid Is The Primary Care Foundation Of The Medical Home?,

Last year, 80 percent of consumers on the Affordable Care Act exchanges chose bronze or silver health insurance plans–the two lowest-cost tiers–but many did not select the cheapest plan within those tiers, according to a new report by researchers at the Urban Institute.  Marketplace Plan Choice: How Important Is Price?  An Analysis of Experiences in Five States,

Health insurers selling plans in the Affordable Care Act’s marketplaces are required to reduce cost-sharing in silver plans for low- and moderate-income people earning between 100 percent and 250 percent of the federal poverty level.  However, the degree to which consumers’ out-of-pocket spending will fall varies by plan and how much health care they use.  How Will the Affordable Care Act’s Cost-Sharing Reductions Affect Consumers’ Out-of-Pocket Costs in 2016? 

As we embark on the New Year, it’s the perfect time to take stock of which major issues remain outstanding from years past and which are coming down the pike.  Four Key Issues in Health Law That Are As Relevant As Ever In 2016,

More people will be enrolled in Medicaid than predicted a year ago, fewer will be covered through the new public insurance marketplaces and the overall cost of insurance coverage under the Affordable Care Act will be higher than expected last year, the Congressional Budget Office said Thursday. But the cost of insuring people will be substantially lower than the budget agency expected when the law was passed, on party-line votes, in 2010.  Report Offers a Mixed View of Health Care Law Costs, 

National health spending started to grow more rapidly recently after several years of unusually slow growth, and a new analysis from the Kaiser Family Foundation and the federal Bureau of Economic Analysis helps to dissect why that may be happening. A new way of measuring health costs sheds light on recent health spending trends,

A new analysis of Medicaid data finds that states that have established their own health insurance marketplace realize higher Medicaid enrollment than states relying on the federal marketplace.  Streamlining Medicaid Enrollment: The Role of the Health Insurance Marketplaces and the Impact of State Policies,

People who enrolled in insurance plans under the Affordable Care Act generated higher medical spending in the law’s second year than in the first, according to a new analysis of health-insurer data released by an industry group.  Affordable Care Act Enrollee Spending Is Increasing,

Even when the goals are common, the complexity of health care makes any change difficult. And, sadly, much of the resistance to making progress on these issues is likely to come from physicians. Let me illustrate why.  JAMA Forum: Building a Better Health Care System: the Work Ahead,

In this new policy insight, the Kaiser Family Foundation examines current rules that may discourage seniors from switching from Medicare Advantage to traditional Medicare.  Policy Insight Examines How Current Rules May Deter Seniors From Switching from Medicare Advantage to Traditional Medicare and Implications for Medicare’s Future, 

Using data from the 2015 Current Population Survey – Annual Social and Economic Supplement, this analysis presents estimates of the characteristics of those remaining uninsured after implementation of the Affordable Care Act’s coverage provisions.  Who Are the Remaining Uninsured, and What Do Their Characteristics Tell Us About How to Reach Them?,


Mobile technology has granted me and countless others the ability to collect an unprecedented amount of information about our habits and well-being. Which is why researchers are leaping at the chance to work with the oceans of data we are generating, hoping that within them might be the answers to questions medicine has overlooked or ignored.  NY Times,

Google’s brash attempt to revolutionize medicine as it did the Internet is facing turbulence, and many leaders who launched its life sciences startup have quit, STAT has found.  Former employees pointed to one overriding reason for the exodus from Verily Life Sciences: the challenge of working with CEO Andrew Conrad.  STAT, 

Wondering how many calories are in that restaurant hamburger? You may not be able to find out until 2017.  The Food and Drug Administration said this month that it will delay enforcement of menu labeling rules — again — until next year.  AP, 

Even as the debate about how to take care of an aging population grows, interest in long-term care insurance has waned. That slide has occurred for a number of reasons. First, insurance companies found themselves faced with more claims, and more expensive claims, than they had anticipated. Another factor is that the low interest rates of recent years mean their investments didn’t earn what they once did.  NY Times, 

A leading hospital system in the U.S. is courting military veterans with a multimillion-dollar ad campaign, raising concerns from some veterans groups that private sector marketing could weaken the Department of Veterans Affairs health care system.  NY Times,

Each time the general economy went into a tailspin, the great healthcare job machine kept puttering along. During the worst of the last recession in 2008 and 2009, the U.S. economy lost 8.8 million jobs. If you leave out healthcare, more than 14 million Americans lost their jobs. It was only a gain of 5.5 million jobs in the healthcare sector that prevented the Great Recession from becoming a second Great Depression.  Modern Healthcare, 

The Associated Press reporting on a Kaiser Family Foundation poll found that making sure that high-cost drugs for chronic conditions, such as HIV, hepatitis, mental illness, and cancer, are affordable for those who need them is the top health care priority, picked by more than three quarters of the public (77 percent).  Health Affairs Blog, 

The proposed merger of Advocate Health Care and NorthShore University HealthSystem has brought one issue into better focus: Hospitals are thinking more like insurance companies.  If the marriage goes through, Advocate and NorthShore plan to create a low-cost health plan that would be offered to Chicago-area employers.  Chicago Tribune,

Research into immunotherapy, which cancer experts are calling the most promising approach in decades, got a boost Tuesday when Michael Bloomberg and other philanthropists announced $125 million in donations to Johns Hopkins University for a new institute focused solely on the therapy and accelerated breakthroughs for patients.  Washington Post, 

Over the past two decades, U.S. hospitals have undergone a continuous wave of consolidation, seeking to become more profitable through mergers, partnerships, and other strategic alliances. Yet, based on our experience, most transactions have failed to deliver the promised benefits of scale. PWC,

Geisinger Health System fully integrates its high-quality care for patients with heart failure through a disseminated but well-coordinated network of nurse case managers, nurse navigators, pharmacists, and urgent heart-failure clinics. The result: fewer ED visits and better medication management. NEJM Catalyst,

Although primary care doctors frequently see patients with depression, they typically do less to help those patients manage it than they do for patients with other chronic conditions such as diabetes, asthma or congestive heart failure, a recent study found.  Kaiser and Health Affairs,

NYC Health + Hospitals CEO Ramanathan “Ram” Raju, MD, told the New York City Council that the public hospital system faces “unprecedented threats” to its survival.  Numerous factors have contributed to the system’s financial troubles, including cuts to federal aid for hospitals that care for uninsured patients. Beckers Hospital Review

The U.S. is asking Novartis AG to provide records of about 80,000 “sham” events in which the government says doctors were wined and dined so they would prescribe the company’s cardiovascular drugs to their patients.  Bloomberg,

Washington is reeling from the news of a hack at MedStar, one of the largest medical providers in the area. A computer virus infecting the organization’s computer systems forced MedStar to shut down much of its online operations Monday. Here’s what you need to know about how health-care providers became the latest digital battleground.  Washington Post, 

Hospitals are treating children with medical complexity, who number close to three million and may require a lifetime of coordinated care, at new dedicated clinics.  WSJ, 

The American College of Physicians, whose membership includes 143,000 internal medicine doctors. It published a position paper Monday calling for the government and industry to take steps to rein in spiraling costs. NPR

Telehealth has similar costs to that of traditionally delivered care while vastly improving quality and service, yet many physicians hesitate to integrate it into their clinical practice. NEJM Catalyst, 

There is ample international evidence that a high-quality, low-cost, and socially inclusive health care system must be built on a strong foundation of primary care services. Nonetheless, as a country, we spend less money on primary care than any other developed country. Milbank Memorial Fund,

Tucked in remarks the president made Tuesday on the opioid epidemic was his announcement of a new task force on mental health parity — aimed at ensuring that people with mental illnesses and substance abuse problems don’t face discrimination in the health care system. WH Press Room,

GlaxoSmithKline PLC said it would stop seeking patents for its drugs in low-income countries, a move the drugmaker said could help the world’s poorest people access copycat versions of its medicines at affordable prices.  WSJ,

The successful telehealth pilots we’ve seen are often targeted at specific needs, and the success of Stanford Medicine’s Clickwell Care offers a useful case in point. As of the end of 2015, one year into its launch, Stanford had completed more than 4,000 visits across a panel of 2,000 patients. Advisory Group,


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