Lemhi Ventures News Blog

Trying to Save by Increasing Doctors' Fees

2008-08-21T16:19:00.000-05:00

Cutting health costs by paying doctors more?

That is the premise of experiments under way by federal and state government agencies and many insurers around the country. The idea is that by paying family physicians, internists and pediatricians to devote more time and attention to their patients, insurers and patients can save thousands of dollars downstream on unnecessary tests, visits to expensive specialists and avoidable trips to the hospital.

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Feds: ‘No Credible Evidence’ That Airborne Fights Colds

2008-08-21T16:18:00.000-05:00

The company that promoted the dietary supplement Airborne as a “miracle cold buster” yesterday cut a deal with the feds, agreeing to pay up to $30 million to settle charges that it didn’t have evidence to back up its advertising claims.

“There is no credible evidence that Airborne products, taken as directed, will reduce the severity or duration of colds, or provide any tangible benefit for people who are exposed to germs in crowded places,” the Director of the FTC’s Bureau of Consumer Protection said in a statement yesterday.

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How Do You Say ‘Retail Clinic’ In Spanish?

2008-08-21T16:17:00.000-05:00

A Mexican health-care company opened clinics this week in three Miami-area pharmacies whose customers are mostly Latino. Count that as a national-trend twofer — targeting the Latino market and putting clinics in retail stores.

The clinics will be staffed by bilingual physicians (a departure from the standard practice of employing nurse practitioners), and they’re affiliated with a Miami hospital. The clinics are owned by Samoho, a Mexico City-based company that already runs a few retail clinics in Wal-Mart stores there.

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CMS won’t sanction states over expanded SCHIP

2008-08-21T16:15:00.001-05:00

The CMS said it would not immediately take action against more than a dozen states that have extended enrollment under a federal children’s healthcare program to families with incomes above 250% of the federal poverty level.

“At this time, we are not taking compliance action,” according to a CMS statement. “Moreover, we will continue to assist the states in developing policies that will ensure that the most vulnerable, low-income children are covered first, without moving them from private to public coverage.”

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Survey: 22 percent of respondents have cut back on MD visits

2008-08-21T16:14:00.000-05:00

With the U.S. economy in a downturn, it appears that consumers may be responding by cutting back on medical care. According to a new survey by the National Association of Insurance Commissioners, 22 percent of respondents had cut the number of times they visit their doctors because of the economic climate. The poll, which surveyed 686 consumers, also found that 11 percent of respondents had reduced the amount of prescription medications they took, or the dosage of those medications, to make their supply last longer. Consumers are holding on to their insurance plans, however. While 2 percent had canceled their coverage due to economic concerns, 85 percent made no changes.

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Medicare Prescription Drug Premiums to Rise in '09

2008-08-21T16:12:00.000-05:00

The average monthly premium for Medicare's prescription drug plan will increase to an estimated $28 in 2009, three dollars more than this year's monthly premium, Medicare officials announced Thursday.

That 2009 figure is 37 percent lower than originally projected when Medicare's so-called Part D drug coverage was introduced in 2003, the officials added. The Part D program offers prescription drug benefits to Medicare beneficiaries.

"Part D continues to come in under budget, achieve consistently high satisfaction rates, and with it millions of Americans are living healthier, better lives," Kerry Weems, acting administrator of the U.S. Centers for Medicare and Medicaid Services, said during an afternoon teleconference.

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CMS says doctors earned $16.7M on P4P demo

2008-08-21T16:10:00.001-05:00

You've gotta love it when CMS gives out money above and beyond the usual reimbursement rates--and it's even better when the bonuses involved work out for pretty much everyone involved. That's the cheery outcome for the second year of CMS's pay-for-performance demonstration project, under which 10 physician groups earned a total of $16.7 million in incentive payments. Under the terms of the demonstration project, which addresses the quality of care for heart patients and diabetics, physician groups were asked not only to improve outcomes for Medicare patients, but also to coordinate their care.

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$420M settlement for UnitedHealth's McGuire moves ahead

2008-08-21T16:09:00.000-05:00

As just about everyone knows by this point, the courts decided last year that former UnitedHealth CEO Bill McGuire had been a bad boy when it came to stock options. McGuire was asked to give up $420 million in dicey stock-option gains and retirement pay to settle shareholder and SEC complaints over how the stock options were awarded. (We're talking a slight case of backdating for profit here.)

Despite this decision, which was arrived at by a special litigation committee, things reached a stalling point after that, notes the Wall Street Journal. A judge overseeing the case decided not to finalize the agreement, as he wanted to know whether he had to follow the word of the litigation committee. Delay, delay and more delay.

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N.J. Blues seeks to go for-profit

2008-08-21T16:08:00.000-05:00

New Jersey’s largest insurer, Horizon Blue Cross and Blue Shield, filed an application with the state’s attorney general and Banking and Insurance Department to convert from not-for-profit to for-profit corporation.

The Newark-based insurer said in its application that the switch will give Horizon financial flexibility and greater access to capital for information technology and pay-for-performance initiatives and for business operations. The Blues plan said investment during the next five years will exceed its annual $35 million budget by an estimated $20 million to $30 million per year. Conversion will allow the insurer to remain competitive and maintain its credit strength, the application said. Horizon holds 46% of New Jersey’s market, according to the document.

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Record number of patients seek care, CDC reports

2008-08-11T13:42:00.000-05:00

A record number of patients in the U.S. sought medical attention from providers in 2006, partly due to growth in both the overall general and aging population, according to statistics released by the Centers for Disease Control and Prevention. Patients across the country made an estimated 1.1 billion visits to doctors’ offices and hospitals in 2006, a 26% increase from 1996 and an average of four visits per person per year, the data show.

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GA doctors sue state for access to contract terms

2008-08-11T13:40:00.000-05:00

For the last few years, a group of physicians has been working to force the health insurer administering Georgia's state employee health benefits plan to disclose what it pays physicians around the state, as well as language found in its physician and hospital contacts. While the doctors assert that such details should be public--given state open records laws--United continues to insist that such details are proprietary. Now, it appears that the state Supreme Court will get to decide whether the group will get its wish.

In 2005, United Healthcare got a five-year, $55 million contract to service the state's self-funded plan. The medical group, the South Georgia Physicians Assn. LLC, later became aware that United Healthcare was paying different fee schedules to physicians in different parts of the state. South Georgia Physicians, an IPA, has about 280 physician members that practice in about 30 counties that are largely rural.

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NJ law caps hospital prices for uninsured

2008-08-11T13:34:00.001-05:00

Following a trend emerging in recent years across the country, New Jersey has enacted a law capping hospital prices for low- and middle-income uninsured patients. The new law is one of four bills signed by the state's governor, including a measure expanding the state's power of oversight over troubled hospitals. Under the new pricing law, hospitals aren't allowed to charge more than 15 percent above Medicare's rate for services to uninsured patients with incomes below 500 percent of the federal poverty level. (The poverty level is presently $21,200 for a family of four.) The monitoring law, meanwhile, allows the state's health commissioner to appoint an official for hospitals at risk of foreclosure, as measured by the guidelines for intervention created by the New Jersey Commission on Rationalizing Health Care Resources.

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Massachusetts Law Curbs Drugmakers’ Gifts and Boosts Primary Care

2008-08-11T11:18:00.000-05:00

Massachusetts is getting tough on drug and device reps.

Over the weekend, Governor Deval Patrick signed into law a broad health bill that requires drugmakers and medical devices companies to disclose any gifts to doctors worth more than $50, the Boston Globe reports.

But wait, there’s more. The law, whose main purpose is to rein in soaring health spending in the state, requires the University of Massachusetts Medical School in Worcester to increase class sizes to produce more primary care doctors. The law also gives state regulators the authority to call hearings when insurers want to hike rates.

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More Scrutiny for Triple-Digit Drug Price Hikes

2008-08-11T11:17:00.001-05:00

It’s natural for the price of drugs to rise a little every year, just like the price of everything else. But in the first half of this year, the average wholesale price of 17 drugs jumped 100% or more in a single cost adjustment, USA Today reports.

Last year, the price of 26 drugs increased by 100% or more, up from 15 in 2004, the article says, citing figures compiled by researchers at the University of Minnesota.

For comparison, drug prices rose about 7.4% on average last year for more than 1,300 brand-name drugs, USAT reported, based on figures from PBM Express Scripts.

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Emergency Room Visits Hit Record High

2008-08-11T11:16:00.000-05:00

There were 119 million emergency room visits in 2006, the feds are reporting this morning. That’s the most ever, and an increase of 36% in the course of a decade.

During the same period, the number of emergency rooms fell, from 4,019 to 3,833.

The authors, from the government’s division of health care statistics, duly note that the increase is driving longer wait times for minor and serious problems as well as boarding of patients in hallways.

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In Canada, Doctors Use Lottery to Drop Patients

2008-08-11T11:13:00.001-05:00

Canada’s medical system is radically different from ours, but there’s at least one thing we have in common: a shortage of primary care doctors.

Now comes word from up north that a few overwhelmed primary care docs are using lotteries to kick patients out of their practices, while others are drawing names to choose new patients.

One family physician got rid of about 100 patients in two separate draws, Canada’s National Post reports. Ken Runciman, based in Powassan, Ontario, recently bought the 2,000-patient practice, which he says was busier than he’d been led to believe. He concluded that keeping all the patients wouldn’t have allowed him to spend enough time with each.

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As Urgent Care Grows, Watchdogs Circle

2008-08-11T11:12:00.000-05:00

The number of emergency rooms has been falling in recent years, as the number of people heading into the ER has been climbing.

Urgent care centers — doc-in-a-box outfits that handle urgent health problems that aren’t life-threatening — have been growing to take up some of the slack.

But, this morning’s WSJ notes, urgent care has remained largely unregulated. Urgent care doctors and nurses do have to be licensed the same as health care providers anywhere else, but there are no national standards for what urgent care centers should offer, or what quality measures they should meet.

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City adds a doctor referral service

2008-08-11T10:51:00.001-05:00

To make it easier to find a doctor in Boston, the city's health department is starting a telephone referral service that will connect residents with primary care physicians who are accepting new patients, Mayor Thomas M. Menino announced yesterday.

"The bottom line is," Menino said yesterday in an interview, "how do we get more primary doctors to serve in our city?"

One way, he said, might be to require medical institutions to include subsidized housing for doctors in new research buildings. The mayor said he is meeting with the Boston Redevelopment Authority next week to explore the feasibility of such a mandate.

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Passport will use $232 million for strategic growth

2008-08-11T10:50:00.001-05:00

Passport Health Communications will use a $232 million investment from two private-equity firms to fuel strategic growth plans and provide cash returns to some of its early investors.

Spectrum Equity Investors and Great Hill Partners, both of Boston, led the investment round that also included Primus Capital Funds, which had been a primary investor during a $70 million equity deal two years ago for the company. Franklin, Tenn.-based Passport, which has been busy in recent months hiring new employees and completing an acquisition, will still be owned by its management team and the collective group of investors, a spokesman said. The new investment does give Spectrum and Great Hill a combined controlling interest in the company.

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Majority of patients want docs to use EHRs: study

2008-08-11T10:47:00.001-05:00

A large majority of patients say they want doctors to move to an all-electronic format for medical records and prescriptions, saying that by doing so the quality of care would improve and the healthcare system in general would become more streamlined and less fragmented.

“Information technology is certainly part of the solution,” said Karen Davis, president of the Commonwealth Fund, which released the survey as part of a broader report on improving healthcare coordination. “It’s not just a matter of the doctor having a computer, it’s about having all the information from different doctors, different emergency rooms and different pharmacies being all together in one place.”

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F.D.A. Urges Genetic Test Before Giving AIDS Drug

2008-08-04T10:09:00.000-05:00

Seeking to prevent life-threatening side effects, the Food and Drug Administration is urging doctors to use a genetic test to screen patients before prescribing a drug widely used for H.I.V. infection and AIDS.

In an advisory it is expected to issue Thursday, the agency says that patients with a particular variation in an immune system gene should not be given the drug abacavir because they are at a far higher risk of a severe allergic reaction to the drug.

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Expansion of retail clinics slowing

2008-08-04T10:07:00.000-05:00

Merchant Medicine, a Minneapolis-based research and retail clinic consulting firm, found that 12 retail clinics were shut down in June--a sign of the slow, but steady growth for retail clinics. The clinics were shuttered because of a weak economy and investment firms that have grown impatient, according to Merchant Medicine, which has been tracking the progress of retail clinics for two years. Although there are 969 retail clinics in the United States, June was the first month the firm has seen a net drop, said Tom Charland, the firm's chief executive.

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CA low-income medical providers denied payments

2008-08-04T10:03:00.001-05:00

Payments from Medi-Cal's insurance program for the poor will cease today, rattling healthcare facilities across California. Until a budget is approved, Medi-Cal payments for low-income patients will not be paid because lawmakers failed to pass a budget, causing the state to prohibit payments.

CA law requires payment for private doctors and pharmacists treating Medi-Cal patients, but healthcare "institutions," as the state calls them, will no longer be funded. These medical businesses and organizations, including 1,200 homes for the developmentally disabled--which have previously relied on funding from Medi-Cal entirely--will be cut off immediately. While most facilities don't plan on turning Medi-Cal patients away, healthcare institutions are racing to find funding from foundations, banks and their own reserves--the emergency funding that state officials had set aside in case of a budget delay is spent.

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Part D 'windfall' for pharma, report says

2008-08-04T10:02:00.001-05:00

Hear that whistling sound past your ears? It's a Medicare Part D windfall--or so says a House committee report released yesterday. The Committee on Oversight and Government Reform looked at Part D and found that taxpayers are paying up to 30 percent more for prescription drugs under that program than under Medicaid. "Medicare Part D has given the major drug companies a taxpayer-funded windfall worth billions of dollars," Chairman Henry Waxman said.

According to the committee, drugmakers reaped $3.7 billion more off Part D meds over the past two years than they would have selling the same drugs under Medicaid. As an example, Waxman cited Bristol-Myers Squibb's Plavix sales to Part D; they garnered an additional $400 million for the company, he said.

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Health Net inks $215M settlement on payment allegations

2008-08-04T10:00:00.000-05:00

A federal judge has approved a $215 million settlement ending three class-action lawsuits alleging that health plan Health Net paid unfairly low reimbursements to out-of-network providers between 1995 and 2007. The class actions had alleged that the health plan had kept out-of-network payments unreasonably low by basing their pay schedules on a database of payment rates maintained by UnitedHealth Group subsidiary Ingenix. The suits contended that Ingenix rates were well below market.

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UnitedHealthcare subsidiaries to pay $800K in fines

2008-08-04T09:59:00.001-05:00

UnitedHealthcare subsidiaries have agreed to pay almost $800,000 in fines to settle allegations by the North Carolina Department of Insurance that they'd violated state law regarding claims payment and other issues. This is the second time UnitedHealthcare has settled with the state in the past five years, having paid $2.2 million in 2004 to settle with regulators over problems with claims processing.

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UnitedHealthcare to pay $250K fine in Ohio

2008-08-04T09:58:00.001-05:00

Health plan UnitedHealthcare has agreed to pay a $250,000 fine to settle with the state's Department of Insurance over letters it sent to policyholders concerning a health system in its network. The health plan sent out letters in May informing some members that they would have to change providers, given that a central Ohio health system, OhioHealth, appeared to be on the verge of giving up its contract. The letters said that beneficiaries would need to find new providers as of June 10--making no mention of the fact that UnitedHealthcare was still in contract talks with the health system.

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Health Insurers Lightly Squeeze Medical Imaging Costs

2008-08-04T09:55:00.000-05:00

A couple of weeks ago, the Government Accountability Office suggested that Medicare consider mimicking private insurers’ use of prior approval of diagnostic imaging tests to curb unnecessary scans.

Everybody who pays health-care bills is struggling with exploding expenses from diagnostic imaging. So we noted with interest a report out this morning on the subject from the insurance trade group America’s Health Insurance Plans. The insurers also trotted out Lewis Sandy, SVP of clinical advancement at UnitedHealth Group, and George Isham, chief health officer at HealthPartners to tell reporters about their companies’ efforts to rein in spending. Interestingly, both of the execs highlighted efforts that aren’t prior authorization.

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On the Table: the Calories Lurking in Restaurant Food

2008-08-04T09:54:00.000-05:00

It's no mystery why Americans are getting fatter. We're expending less energy to work, play, travel and acquire food. And we're taking more calories in.

And how!

New York City's recent law requiring chain restaurants to post calorie counts on menus has revealed some intriguing -- and appalling -- information. Some observations:

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Select Medical plans IPO

2008-08-04T09:53:00.000-05:00

Select Medical Corp., Mechanicsburg, Pa., notified the federal Securities and Exchange Commission that it plans to have an initial public offering of common stock.

The document, however, gives little indication of how much stock will be offered and how much income the company expects from the sale. The spaces where such information should be given are mostly left blank, except in one area where it lists $100 million as the proposed maximum aggregate offering price. A footnote, however, notes that this figure is an estimate made “solely for the purpose of calculating the registration fee.”

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As Costs Shift to Patients, Fewer Fill Prescriptions

2008-07-16T14:51:00.000-05:00

Everybody seems to think that prescription drug sales are resistant to economic downturns, because people will pay for their medicines in good times and bad.

But as the number of uninsured Americans grows, and those who are insured face higher co-pays and deductibles, we’re finding out that’s not the case.

The total number of prescriptions filled in this country may be falling, the WSJ reports this morning.

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Emergency Room Patients Unclear on Doctors’ Instructions

2008-07-16T14:48:00.001-05:00

The ER can be a hectic place, and it can be hard to follow what’s going on– especially if you’re a sick or injured patient.

Overall, 78% of patients interviewed by researchers as they were leaving the ER failed to understand key information about their situation, a new study says.

The researchers broke patients’ comprehension into four categories. Among all of the comprehension problems, diagnosis and cause accounted for 15%; treatment in the ER accounted for 29%; what a patient needed to do at home to deal with the problem accounted for 34%; and instructions for what symptoms should prompt a return to the ER, 22%.

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Medicare Repo Men Find Millions

2008-07-15T12:42:00.001-05:00

Letting outside auditors scour Medicare bills sure can turn up a lot of overbilling. A pilot program that netted the government nearly $700 million from three states is now being expanded to recover more Medicare money gone astray.

In all, Medicare says the Recovery Audit Contractor program caught $1.03 billion of improper billing in New York, California and Florida in the three years ending in March. No surprise, most of it was money Medicare shouldn’t have paid out in the first place: $992.7 million. Providers were shortchanged about $38 million.

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After Medicare Victory, Dems May Push Insurance for Kids

2008-07-15T12:41:00.003-05:00

Remember SCHIP? The State Children’s Health Insurance Program was at the center one of the biggest health policy fights in Washington last year. But the issue fell out of sight after President Bush vetoed a bill that would have dramatically expanded the program, and Congress couldn’t muster the votes for an override.

Now, the Democrats’ big win on the Medicare bill — which passed with enough votes to override a promised veto — may mean SCHIP is back, Congressional Quarterly reports.

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CA insurers spent less than 85 percent of revenue on care

2008-07-15T12:41:00.001-05:00

A new report by the California Medical Association concludes that nine of the state's major health plans spent less than 85 percent of their revenue on medical care for their beneficiaries, a level which would become law if the state legislature passes a bill the CMA supports.

The CMA's medical spending report, which addresses the fiscal year ending June 30, 2007, uses data collected by the state's Department of Managed Health Care. Spending ranged from a low of 69.4 percent for Great-West Healthcare of California, to publicly-owned L.A. Care Health Plan, which spent 97.1 percent of revenue on care. Cigna weighed in at 94.3 percent, while WellPoint-owned Blue Cross of California came in at 79 percent. Kaiser Foundation Health Plan had a medical loss ratio of 90.6 percent.

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Study: CDHPs motivate patients to avoid care, discontinue drugs

2008-07-15T12:40:00.001-05:00

While some continue to encourage more use of CDHPs, a recent study suggests that they may have a significant downside. This is important data given that the number of large companies offering a CDHP has almost doubled over the last two years, according to research by Watson Wyatt and the National Business Group on Health.

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Medicare bill includes e-prescribing bonus

2008-07-15T12:39:00.000-05:00

Eligible physicians can expect some financial relief courtesy of the federal government simply by adding a jolt of modern technology to their practice.

Under a measure approved by the Senate, doctors who are paid by Medicare would become eligible for bonus payments just for filing prescriptions electronically rather than writing them out by hand. The e-prescribing requirement, which also covers a reporting initiative, is part of a broader Medicare bill that first cleared the House in June.

Electronic "prescribing is a fundamental step toward modernizing our healthcare system,” Sen. John Kerry (D-Mass.) said in a written statement. “It will save lives by reducing medical errors and save billions of dollars.” Kerry authored much of the health information technology language in the bill, which was partly based on legislation he introduced late last year.

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The Top Life Science & Health Deals of ‘08, So Far

2008-07-15T12:38:00.002-05:00

Our colleagues over at Deal Journal shot a report over to us this afternoon with some stats on recent M&A activity in life sciences and health care.

The first quarter came in a little light–with nearly two-dozen deals–compared with the same period in recent years. But the I-bankers got rolling in the second quarter, when more than 50 transactions were announced.

Deal making could be worse. IPOs in biotech have been almost nonexistent as the smart folks at the In Vivo Blog noted recently. “Without IPOs, the only real exit opportunity remains M&A, a highly unpredictable event,” In Vivo’s Roger Longman wrote.

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Obama Wants Tax Credit for Small Firms Offering Coverage

2008-07-15T12:38:00.001-05:00

Barack Obama shed some new light on his health-care proposals this weekend, suggesting a $6 billion-a-year plan to offer tax credits to small businesses offering health insurance to employees.

Our Washington Wire blog notes that Hillary Clinton had made a similar proposal for small businesses, whose problems providing health insurance are among the biggest hurdles to universal coverage. The big annual Kaiser Family Foundation survey on employee health benefits found that 59% of firms with 3-199 workers offered health benefits in 2007, compared with 99% of firms with 200 or more workers. The issue was more dire for firms with 3-9 employees, where 45% offered coverage.

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Should Medicare Stop Medical Imaging Before It Starts?

2008-07-15T12:29:00.000-05:00

Medicare has been trying to clamp down on burgeoning costs from medical imaging. But a new GAO report suggests the agency might have more success if it were to stop unnecessary CT scans, MRIs and the like before they happen in the first place.

To cut imaging costs, Medicare has been cutting certain physician payments, sifting through its data to spot improper claims, and educating medical practitioners about the issue. But the GAO’s suggestions for Medicare include weighing a front-end tactic that’s common in the private health-insurance market: prior authorization. That’s when, for a patient to get coverage, an insurer has to give permission before something takes place. “We believe that post-payment claims review alone is inadequate to manage one of the fastest growing parts of Medicare,” the GAO said.

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Electronic-Prescription Plan Is Set

2008-07-15T12:09:00.001-05:00

The country's two largest electronic-prescription networks Tuesday announced a merger, creating a single, secure network for the exchange of digital health information.

In a cashless transaction, which closed late Monday, RxHub LLC, a joint-venture of pharmacy-benefit managers, CVS Caremark Corp., Express Scripts, Inc. and Medco Health Solutions, Inc., will combine its operations with SureScripts, a private company founded by the National Community Pharmacists Association and the National Association of Chain Drug Stores. The merger isn't subject to antitrust review because the fair market value of the combined entity isn't high enough, according to the companies.

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HFMA ANI 2008: Hospitals need flexibility for outpatient success

2008-07-15T12:07:00.000-05:00

Today, hospitals are placing greater importance on developing outpatient ventures that serve their business. However, to succeed, hospital leaders need to be both flexible and opportunistic, rather than sticking to the models they're familiar with in inpatient services, said panelists at a session held this week at the HFMA ANI show. The show, which is held annually, focuses on the needs of healthcare CFOs and other industry financial managers.

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Judge rejects move to halt DME pilot program

2008-07-15T12:06:00.000-05:00

A federal judge has denied the American Association for Homecare’s request for a preliminary injunction to halt a demonstration project that requires competitive bidding for equipment providers to participate in the Medicare program. On June 9, the Arlington, Va.-based association—which represents providers, equipment manufacturers and other groups in the home-care community—filed a lawsuit seeking to stop the program, which is scheduled to begin July 1 in 10 communities.

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FL will post preventable readmissions on website

2008-07-15T12:05:00.000-05:00

In their own unusual take on transparency, Florida officials have decided to post data on potentially preventable hospital readmissions on the Web. The Florida Agency for Health Care Administration will post the data on its consumer-facing Web site, FloridaHealthFinder.gov. The data is intended not only to aid officials in tracking the rate of such relapses, but also to help hospital administrators discover when a patient is discharged from one facility and promptly readmitted to a different one. The data comes from admissions during the 12 months prior to March 31, 2007. It looks at 54 conditions and procedures for the 60,707 readmissions during that period. The readmissions were a subset of 877,228 total cases, according to the agency.

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Trend: Urgent care center growth exploding

2008-07-15T12:03:00.001-05:00

Retail clinics may be the sexiest sector in outpatient care today, but when it comes to growth, it's urgent care centers that are leading the pack. While there are about 1,000 retail clinics in operation in the U.S. today, there are approximately 8,000 urgent care centers, according to the Urgent Care Association of America. According to the group's estimates, at least 1,200 of those are hospital-owned, while others are run by chains like Concentra Urgent Care, with 324 centers in 40 states.

U.S. Health Insurers Look To China For Growth

2008-06-30T14:03:00.000-05:00

Aetna and other U.S. health insurers are wide-eyed over business opportunities in China now that the sleeping giant has lifted its own lids.

Hartford-based Aetna plans to announce today that it has opened a "representative office" in Shanghai. That is the first step of a lengthy process for foreign companies interested in doing business in the People's Republic of China.

Other insurers, including UnitedHealth Group and WellPoint, have established such offices in China, and CIGNA has already hooked up with a Chinese company to sell supplemental health insurance there.

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Consumers key to health reform, Case tells HFMA

2008-06-30T14:00:00.001-05:00

Healthcare cannot curb spending or improve quality without technology and engaged consumers, said Steve Case, co-founder of America Online and chairman and chief executive of Revolution Health Group at the Healthcare Financial Management Association’s yearly meeting in Las Vegas.

Healthcare lags major retailers and other industries, such as finance, where technology aids consumers, who have more choice, more financial risk and more responsibility for their choices, Case said.

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WI carriers vow to make some costs transparent to consumers

2008-06-24T19:54:00.001-05:00

Depending on the hospital, the doctors and the carrier, the cost of tests, procedures and other treatments can vary greatly. For example, a colonoscopy can range anywhere between $1,500 and $5,000; a spinal fusion can cost as much as $50,000 according to a recent study from Deloitte Center for Health Solutions.

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For the Wealthy, Private Health Care Consultants

2008-06-24T19:53:00.001-05:00

Confused or overwhelmed by the chaotic medical system? If you’re rich, there’s someone who’d be glad to help.

Take PinnacleCare, a Boston company founded in 2002 and profiled in this morning’s Boston Globe.

Fees range from $7,000 to $100,000 a year, excluding an initial sign-up fee; a standard family membership is $10,000, the Globe says. For that, you get services such as round-the-clock email and telephone consults, and face-to-face meetings with a personal health adviser.

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American Company Tries Western-Style Hospitals in China

2008-06-24T19:51:00.000-05:00

An American company is trying to popularize Western-style hospitals that cater to the elite in China. But it faces significant hurdles when it comes to getting the Chinese to pay for its services.

Chindex International, a Bethesda, Md., company featured in today’s Washington Post, has opened hospitals and clinics where foreign physicians and some of China’s top doctors charge as much as several hundred dollars for a single visit. That’s steep compared to the $10 or $20 per-visit charge at state-owned hospitals.

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Study: ED patients more satisfied if they know wait times

2008-06-24T16:00:00.000-05:00

Making sure patients know as much as they can about their wait times is the best thing emergency departments can do to increase patient satisfaction--not managing their pain, or even answering other questions. That's the conclusion drawn by a recent Press Ganey survey of more than 1.5 million patients in more than 1,600 EDs. Press Ganey found that while satisfaction went down the longer patients waited, helpful, consistent communication with ED staff still made patients happier. Patients ranked "how well they were informed about delays" as their top factor in satisfaction, followed by control of pain, how much nurses cared about them and how well they were informed of treatment. Interestingly, total wait time ranked last. Patients who waited more than four hours to see a doctor, but felt well-informed about the delay, scored more than twice as high on overall satisfaction as those who waited just an hour but considered communication to be "very poor."

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Why Do You Need A Doctor's Note To Get A Genetic Test?

2008-06-24T14:21:00.001-05:00

There have been a bunch of personal genetic testing services popping up over the past couple of years. One of the most well known is 23andMe, who got a PR lift for being founded by Sergey Brin's wife -- and also getting an investment from Google. Typically, the program lets people send in a cheek swab and receive back personal genetic info. These services are still in their early stages, but the few folks I know who have used 23andMe have found it to be an interesting learning process. However, now it's coming out that 23andMe and other personal genetic testing services may actually be breaking California law. California has sent a bunch of these firms cease-and-desist letters demanding they close up shop until certain conditions are met.

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Bernanke suggests Fed-like board for health reform

2008-06-24T14:19:00.000-05:00

Federal Reserve Chairman Ben Bernanke wedded fiscal policy to healthcare reform, calling the union “not only a social and scientific issue, but an economic issue as well.”

Bernanke, who helps set monetary and regulatory policy for the nation’s financial markets, said that a mix of public- and private-sector reforms is needed to correct longstanding problems of poor quality and high cost across the country’s physician offices and hospitals. “The decisions we make about healthcare reform will affect many aspects of our economy, including the pace of our economic growth, wages and living standards and government budgets, to name a few,” he said.

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Study: Patients don't typically use online ratings

2008-06-24T14:16:00.001-05:00

Though physicians fear that their business will be adversely affected by off-the-cuff online ratings, few patients actually make use of such ratings, according to new research. A Harris Interactive poll commissioned by the California HealthCare Foundation concluded that while more than 80 percent of the state's adults use the web for health information, less than one-quarter have made use of physician ratings sites. More significantly, only 2 percent of those surveyed had changed doctors based on ratings-site information. Even fewer (1 percent) changed hospitals or health plans based on data from ratings sites. All that being said, more people are looking at physician ratings sites than they were three years ago. Harris found that the number of people who looked at physician ratings sites climbed from 14 percent in 2004 to 22 percent in 2007.

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AMA debates ethics of hospital 'mystery shoppers'

2008-06-24T14:13:00.000-05:00

These days, it's far from unusual for hospitals and clinics to send undercover patients in to check out how the staff treats them. Administrators say such phantom patients--better known as "mystery shoppers" in the retail world--can help them get a realistic picture of the experience real patients have when they visit their facility. However, to date such practices haven't had the official approval of organized medicine--and some doctors actually have suggested that such patients can crowd out 'real' patients from getting the timely care they may need.

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In Baucus bill, Advantage-plan cuts would offset higher doc payments

2008-06-24T14:11:00.000-05:00

The Medicare reform bill introduced by Senate Finance Committee Chairman Max Baucus (D-Mont.) would increase spending for physician and other services by nearly $20 billion over five years and $62.8 billion over the next decade, according to a Congressional Budget Office estimate.

However, taking into account the offsets created by payment reductions primarily to Medicare Advantage Plans, the bill would actually reduce spending by $5 million over the next 10 years, according to the CBO.

Health REITs Provide Bright Spot

2008-06-18T21:32:00.000-05:00

Even as the slow economy and credit crunch push many developers to the sidelines, health-care real-estate investment trusts are providing one of the few bright spots as they expand their development pipelines.

Some of the biggest health-care REITs by stock-market value -- HCP Inc., Ventas Inc., Healthcare Realty Trust Inc., Nationwide Health Properties Inc. and Health Care REIT Inc. -- are expected to build $675.9 million of properties by year's end, up from $236.5 million in 2007, according to stock-research firm Stifel Nicolaus.

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Bernanke Talks Health Care

2008-06-18T21:31:00.000-05:00

The best way to ease the crunch of health care on the U.S. budget and economy is to make sure that patients get cost-effective medical treatment, Federal Reserve Chairman Ben Bernanke said Monday.

"From the economist's perspective, the question of whether we are spending too much on health care cannot ultimately be answered by looking at total expenditures relative to GDP or the federal budget," Mr. Bernanke said in remarks prepared for delivery to the Senate Finance Committee's Health Reform Summit. "Rather, the question, whatever we spend, is whether we are getting our money's worth."

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Massachusetts Blues Team Up With Google on Records

2008-06-18T21:28:00.000-05:00

Google Health, the Googleplex’s Web portal for medical records, has found its first health insurance partner: Blue Cross Blue Shield of Massachusetts.

Members of the plan will be able to log on for access to health-care claims information and portions of medical records starting this fall, the Boston Globe reports.

Patients will be able to view their treatment details on-line based on the insurers’ records. Information in the records would come from doctors as well as laboratories and pharmacies. Other health-care history that doesn’t come from insurance claims records would have to be entered by patients’ doctors, however.

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California Cracks Down on Genetic Testing

2008-06-18T15:03:00.001-05:00

Direct-to-consumer genetic tests, the flavor of the month in high-tech health, are getting some scrutiny from California regulators.

The state sent cease and desist letters to 13 genetic testing companies last week, ordering them to stop providing the tests to California residents until they prove they aren’t breaking state law, reports the San Jose Mercury News.

In particular, the companies must prove that a doctor orders the tests, and that the labs where the tests are done are licensed by the state.

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Why E-Prescribing Hasn’t Caught On

2008-06-18T14:55:00.001-05:00

Prescribing drugs by computer rather than in sloppy handwriting on a prescription pad seems so eminently sensible that you’d think the online approach option would take off like Amazon or Google.

Electronic prescribing reduces the risk of simple errors, and improves safety by helping doctors track all the drugs a patient is taking. But the vast majority of docs still use the prescription pad rather than the computer.

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Comparing John McCain's Health Care Plan to Barack Obama's Health Care Plan

2008-06-18T14:53:00.000-05:00

This election is different than any other on the issue of health care because both candidates are giving us serious blueprints to reorganize America's health care system and those blueprints are very very different.

As voters, you have a huge and critically important choice on health care.

There are dozens of details upon which they differ and for those I would point you to my comprehensive posts on the McCain Health Care Plan and the Obama Health Care Plan.

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Technodoc Jay Parkinson Says Hello to Franchising

2008-06-18T14:39:00.001-05:00

A virtual primary care practice started growing in Brooklyn last fall.

Jay Parkinson, a freshly minted physician, decided he had a better idea for caring for the under-40 crowd in neighborhoods not far from Health Blog HQ. He combined a pre-paid model (no insurance hassles, please) with housecalls and oodles of online support, which he told us about in an interview with us last September.

He’s still seeing patients the newfangled way. But he’s changed course a bit, joining Myca, a technology company in Canada, to produce what he calls a Facebook-like software platform for doctors to manage their practices. He’s also looking to take his care concept and the new technology to doctors nationally through a franchise branded as Hello Health. (You can watching the video for an overview and read a recent profile of Parkinson here.)

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End-of-life cancer patients lack key information

2008-06-18T14:04:00.002-05:00

A new study suggests that patients with end-stage cancer don't know enough about how long they have to live to make good medical choices. Sometimes, doctors don't share the information, and at other times, patients may engage in wishful thinking, but in either case, it can lead to decisions that aren't in their best interests, researchers say.

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Allina plans $100 million health innovation center

2008-06-18T14:04:00.001-05:00

Allina Hospitals & Clinics has launched a $100 million Center for Health Innovation dedicated to public health and healthcare quality. The 11-hospital system plans to spend $10 million annually for the first five years, and generate the remaining $50 million from donors and grants. The center's first three projects will include an initiative targeting cardiovascular disease in New Ulm, Minn., since almost nine out of 10 of the area's residents seek care at Allina's 45-bed New Ulm Medical Center, which gives it a leg up in using electronic medical record data to track the disease in the community. Allina will also work to improve health status in two diverse Twin Cities neighborhoods where the system operates an acute-care hospital and its headquarters. Yet another project is a patient-safety center that will focus on research and outcomes projects not duplicating those elsewhere in the country.

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Walgreens battles CVS for MA retail clinic market

2008-06-18T14:03:00.002-05:00

Over the past year, drugstore chain CVS has engaged in a protracted battle to get permission to open its MinuteClinics in locations across the Boston metro area. The effort involved not only getting permission from state regulators, but also fighting the displeasure of Boston Mayor Thomas Menino, who opposes the retail clinic model. Despite the struggles CVS has faced, fellow drugstore giant Walgreens has decided that it, too, wants a piece of the Boston retail clinic market, seeking state approval to open such clinics inside 16 of its Massachusetts stores. Walgreens' Take Care Health Systems subsidiary has asked permission to build clinics stretching across a broad swath of the state. Its plans also include opening a clinic in Roxbury, a move which is likely to further upset Mayor Menino. Walgreens, which already operates 173 clinics in 14 states, hopes to open its first Massachusetts clinics in the fall. All told, it expects to have 400 clinics running across the U.S. by the end of this year.

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Safeway Hops on $4 Generic Bandwagon

2008-06-18T14:01:00.000-05:00

The Health Blog just found out about another store offering bargains on generics. Safeway is the latest company to start selling selected generics at $4 for a month’s supply.

The Washington Post reported that the supermarket chain is making the offer in the eastern U.S. on hundreds of generics. The list includes antibiotic amoxicillin, the generic of GlaxoSmithKline’s Amoxil; blood pressure drug atenolol, the generic of AstraZeneca’s Tenormin; and thyroid-disease medication levothyroxine–a popular brand is Synthroid from Abbott.

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Implantable chips can save $15B a year in ER charges, study concludes

2008-06-04T16:49:00.000-05:00

A technology company that makes and markets implantable chips that identify patients and provide immediate access to their medical histories says an independent study shows the chips can save hundreds of dollars per patient in the emergency room.

The use of VeriChip to access the medical records of critically ill patients in a mass casualty scenario decreased emergency care charges by an average of $685.67 per patient, according to the study commissioned by the VeriChip Corp.

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Hospitals, practices using locum tenens physicians more often

2008-06-04T16:47:00.000-05:00

In what some deem a troubling sign that the primary care physician shortage is getting worse, a growing number of hospitals and practices are working through temp agencies to get their staffing needs met. As has always been the case, physicians are choosing the locum tenens option for their own reasons, including the flexibility of not having to maintain their own office, the ability to experiment with different regions and facilities, and the ability to limit how many hours they work.

However, hospitals and medical practices seem to be facing a new squeeze forcing them to change their habits. According to a survey by doctor temp-agency Staff Care, spending on temp doctors across the U.S. has more than doubled since 2001, and the number of days worked by physicians as temps has grown by 20 percent between 2006 and 2007 alone. Observers say a growing demand for primary care physicians is helping to fuel this boom.

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Federal spending bill could limit physician hospital ownership

2008-06-04T16:43:00.001-05:00

A group of Republican Congress members are raising objections to language in a war supplemental spending bill that they say would harm physician-owned hospitals. Sens. Jon Kyl (R-AZ) and Tom Coburn (R-OK), along with Texas republican Reps. Sam Johnson and Joe Barton, object to an amendment that would prohibit new physician owned hospitals built after this coming September, while offering no protection for hospitals still under development as of that date. They're also unhappy about rules that would force hospitals to meet what they deem "extreme qualifications" to expand, rather than grow as they see fit. In a letter to the Senate Appropriations Committee, the legislators call these provisions "a national certificate-of-need program... access to [which] would likely be denied to almost every physician-owned hospital."

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Personalized cancer treatment on the rise, cutting drug spend

2008-06-04T16:41:00.000-05:00

If research presented at this year's annual meeting of the American Society of Clinical Oncology is any indication, the time could arrive sooner than expected for "personalized medicine," in which treatments are geared toward individuals based on their genetic makeup. Specifically, it's looking like doctors may have more of an ability to target cancer treatments to specific patients.

At the meeting, much of the attention was focused on a gene called K-ras, which researchers say plays an important role in the development of varied cancers. One study noted that about 36 percent of patients with advanced colon cancer have a mutated K-ras gene, more or less guaranteeing that they won't respond to frequently used cancer drug Erbitux. Researchers note that given these circumstances, it's much better to limit use of the drug to those 64 percent who have a normal version of K-ras, which theoretically limits the size of the market for drugmaker ImClone Systems.

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Medicare reform bill may include bonuses, increases for MDs

2008-06-04T16:33:00.000-05:00

If Sen. Max Baucus (D-MT) gets his way, pending Medicare reforms will offer physicians several new payment options, including bonus payments and increased payments. That, at least, is the word coming from the Senate Finance Committee, according to a report in Modern Healthcare. Not only is Baucus amenable to halting the planned 10 percent cut in Medicare payments to doctors for more than 18 months, he's also prepared to seek a 0.5 percent increase for next year. What's more, he'd like to increase the bonus doctors receive for participating in the Physician Quality Reporting Initiative to 2 percent from 1.5 percent. His bill also would include an e-prescribing provision that would first give bonuses to doctors who install the technology, then penalize doctors by 2 percent in 2013 and beyond for those who don't adopt it.

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Kroger chain invests in retail clinic operator

2008-06-04T16:32:00.001-05:00

Retail grocery chain Kroger Co. made what it terms a "significant investment" this week in The Little Clinic LLC, a Brentwood, TN-based chain of retail clinics. The Little Clinic already operates centers inside of 26 Kroger stores, using nurse practitioners and physicians' assistants. It's operated by Solera Capital, a private equity firm that acquired the retail clinic operator's predecessor in 2005.

With the investment in hand, The Little Clinic will begin a "substantial" clinic rollout across the retailer's family of stores. It's unlikely that the pace of its rollout will allow it to catch up with competitors like Wal-Mart, which as of a year ago was beginning a 2,000-store introduction of retail clinics in its stores. However, with Wal-Mart recently hitting a snag as one of its partners fell apart financially, perhaps Kroger and The Little Clinic see an opportunity to gain some sort of ground. All told, Kroger operates a total of 2,486 supermarkets in 31 states.

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MedAssets closes Accuro Healthcare deal

2008-06-04T16:30:00.000-05:00

Group purchasing organization and revenue-cycle management company MedAssets, Alpharetta, Ga., has completed its previously announced acquisition of Accuro Healthcare Solutions, a Dallas-based provider of revenue-cycle management software for healthcare providers.

The cash-and-stock purchase agreement includes a $207 million initial cash payment and 8.85 million shares of MedAssets common stock valued at roughly $155 million, based on the company’s per-share closing price on June 2. The agreement also includes a deferred payment of $20 million in cash or MedAssets shares, payable on the first anniversary of the transaction’s closing.

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Mass. reform one year later: Fewer uninsured

2008-06-04T16:29:00.000-05:00

In the first year of healthcare reform in Massachusetts, the number of uninsured adults has dropped substantially and access to care for low-income people has improved, according to two reports published online by the journal Health Affairs.

In fall 2006, 13% of nonelderly adults were uninsured in the state compared with 7% a year later, according to one study by the Urban Institute. The findings were based on two telephone surveys of approximately 3,000 Commonwealth residents between the ages of 18 and 64, conducted a year apart. There was no evidence that the expansion of publicly subsidized insurance has crowded out employer-sponsored plans, concluded Sharon Long, a principal research associate at the Urban Institute, who conducted the study.

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FTC pans proposed Ill. bill restricting retail clinics

2008-06-04T16:28:00.000-05:00

The Federal Trade Commission staff issued a critical review of legislation backed by the Illinois State Medical Society that would place restrictions on the state’s burgeoning retail health clinics.

The bill, which had not advanced beyond the House Rules Committee when the Illinois General Assembly ended its session May 31, unless revised “could excessively restrict retail clinics to the detriment of Illinois healthcare consumers,” the commission’s staff concluded in a 12-page analysis requested by Democratic Rep. Elaine Nekritz.

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HLTH selling data-management unit to General Dynamics

2008-06-04T16:20:00.000-05:00

HLTH Corp. agreed to sell its healthcare data-management business to General Dynamics Information Technology for $225 million, thus completing one pre-requisite of its merger with WebMD.

The sale is subject to closing conditions but paves the way for Elmwood Park, N.J.-based HLTH to receive stockholder approval to finish its plan to merge with WebMD, first announced in February. Each outstanding share of HLTH common stock will be converted into 0.1979 shares of WebMD stock and $6.89 in cash, subject to adjustments, the company said in a news release. HLTH and WebMD plan to hold stockholder meetings in September to seek approvals.

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New Yorkers Get Online Matchmaker for Docs

2008-06-04T15:58:00.001-05:00

New Yorkers who spend as much time online as we do, can now at least say they’re looking for a doctor. A new Web site is trying to make finding a doctor on the Internet like buying groceries or finding flights the electronic way.

The New York Sun highlights the site, ZocDoc.com, which helps patients in New York locate doctors and dentists and schedule same-day appointments online.

The site has a list of more than 100 practitioners in Manhattan and Brooklyn, the Sun reports. That strikes us as pretty slim pickings for the 1.6 million Manhattanites and 2.5 million people living in Brooklyn. But ZocDoc tries to vet doctors through background checks and patient reviews, so that’s something.

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Sign of Success for Massachusetts Health Insurance Mandate

2008-06-04T15:57:00.000-05:00

Massachusetts cut the number of its uninsured citizens nearly in half in a single year. In fall 2006, 13% of people in the state were uninsured; in fall 2007, the rate was 7%, according to an analysis by the Urban Institute published online in the journal Health Affairs today.

The decline came as the state put one of the country’s most ambitious health reform plans into effect, requiring all citizens to buy insurance or pay a fee, with state subsidies for those who can’t afford insurance on their own. Health policy types around the country have been watching to see what happens.

The program has been more expensive than expected — the state budgeted budgeted $869 million this year, nearly $150 million more than it anticipated, largely because of high enrollment, this morning’s Boston Globe reports.

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Surgeons Oppose Plan to Pay More for Primary Care

2008-06-04T15:56:00.000-05:00

Plenty of people are saying the U.S. should ante up for primary care. But where are we going to get the money?

A couple of months back, the group that advises Congress on Medicare funding suggested raising payments for primary care in a “budget neutral” way. Translation: Somebody else’s payments would be reduced. Surgeons aren’t too happy about that. Go figure.

The American College of Surgeons recently fired off a letter to MedPac, the advisory group, and copied several senators and congressmen who control Medicare’s purse strings.

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Savings from Health-Care Computerization May Be Overstated

2008-06-04T15:55:00.000-05:00

Whizbang computer systems are taken almost on faith as the solution to all sorts of ills in health care.

In Washington, just about everyone supports the notion of beefed-up health information technology, at least in the abstract. The pitch has been that innovations like electronic health records and e-prescribing will improve patient care and safety while also saving money through increased efficiency. How much will be saved? Could be around $77 billion a year in all, according to a widely cited projection from researchers at the RAND Corporation.

Hold on, says the Congressional Budget Office, whose green-eyeshade-wearing analysts take a shot at that rosy savings estimate, and a similar one from the Center for Information Technology Leadership.

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Minnesota Doctors: No Free Frozen Yogurt for You!

2008-06-04T15:54:00.000-05:00

Amid the giant flat-panel monitors in the vast exhibit hall at a meeting of cancer doctors in Chicago, a few small signs warn that the seemingly endless drug company freebies aren’t for everyone.

WARNING: May cause regulatory harm if given to Minnesota doctors.

Where Eli Lilly is giving away frozen yogurt, for example, a plain white sign (the only plain thing in Lilly’s elaborate booth) says:

Food, beverages and/or meals will not be provided by Eli Lilly and Company for the following parties:

* Physicians and individuals with prescribing authority in Minnesota in order to comply with Minnesota statutes

* Government employees in New York (both city and state) in order to comply with New York statutes

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Funds given to research video games’ link to health

2008-06-02T11:29:00.001-05:00

The Robert Wood Johnson Foundation has awarded 12 grants totaling $2 million for Health Games Research, a national program that explores how video games can motivate healthy behaviors in children, adults and senior citizens. The 12 grantees were each awarded up to $200,000, and are leading one- to two-year studies of games that engage players—ranging in age from 8 to 98—in physical activity or games that motivate them to improve their own care through healthy lifestyle choices, prevention behaviors, chronic-disease self-management and adherence to medical-treatment plans.

Based at the University of California at Santa Barbara, Health Games Research is directed by Debra Lieberman, a researcher in the school’s Institute for Social, Behavioral and Economic Research. There were 112 research proposals from universities, medical centers and game-industry organizations nationwide for this first round of funding, and the program will issue the next call for proposals in January 2009. The second phase of funding will also total $2 million, according to the Princeton, N.J.-based foundation.

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Prime Healthcare picks up three Tenet facilities

2008-06-02T11:28:00.000-05:00

A growing but controversial hospital chain has agreed to acquire three Tenet hospitals, expanding its network of facilities that reject all forms of managed care contracts. Hospitals included in the deal include the 151-bed Encino campus of Encino-Tarzana Regional Medical Center, 167-bed Garden Grove Hospital Medical Center and 64-bed Dimas Community Hospital. Prime has closed on the Encino-Tarzana deal, but the other two deals await regulatory approval.

The deals fit Prime's pattern of acquiring financially troubled and underperforming hospitals. For example, the Encino facility lost more than $10 million in fiscal 2007, and the other two facilities' performances were "marginal," according to a Prime statement. Prime's chairman, cardiologist Dr. Prem Reddy, says that he plans to sink capital into the hospitals to help turn them around. If Prime's other deals are any indication, he'll also end up realigning the hospitals' service mix dramatically, in some cases low-profit service lines (such as psychiatric services) that, critics say, are needed in the communities the hospitals serve.

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CT sues McKesson for allegedly inflating drug prices

2008-06-02T11:27:00.000-05:00

The Connecticut attorney general’s office has filed a lawsuit accusing pharmaceutical distributor McKesson Corp., San Francisco, of illegally inflating the average wholesale price of more than 400 brand-name drugs, resulting in millions of dollars in unnecessary costs to consumers and state-funded healthcare programs, according to a news release.

McKesson officials declined to answer questions about the charges, but in a company statement said the claims appear to be based on allegations made in a 2005 class-action suit also filed in Boston. “We believe the allegations lack merit and intend to vigorously defend ourselves,” said McKesson officials in the statement.

Savings from Health-Care Computerization May Be Overstated

2008-05-22T17:09:00.000-05:00

Whizbang computer systems are taken almost on faith as the solution to all sorts of ills in health care.

In Washington, just about everyone supports the notion of beefed-up health information technology, at least in the abstract. The pitch has been that innovations like electronic health records and e-prescribing will improve patient care and safety while also saving money through increased efficiency. How much will be saved? Could be around $77 billion a year in all, according to a widely cited projection from researchers at the RAND Corporation.

Hold on, says the Congressional Budget Office, whose green-eyeshade-wearing analysts take a shot at that rosy savings estimate, and a similar one from the Center for Information Technology Leadership.

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Massachusetts Doctors Sue Over Cost, Quality Rankings

2008-05-22T14:45:00.001-05:00

The rolling national debate over how to rank and rate doctors pulled into Massachusetts this week, as the state medical society filed a lawsuit to block or change a ranking program it says harms doctors and patients.

The program, used by the agency that oversees health insurance for state and local employees, ranks doctors in three tiers based on various cost and quality measures. Patients must pay more to see a physician who isn’t in the top tier.

The president of the Massachusetts Medical Society said in a statement that the system is flawed, with doctors “assigned costs from patients they did not treat, and for procedures they did not perform. This is misleading and simply not fair.”

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Savings from Health-Care Computerization May Be Overstated

2008-05-22T14:44:00.001-05:00

Whizbang computer systems are taken almost on faith as the solution to all sorts of ills in health care.

In Washington, just about everyone supports the notion of beefed-up health information technology, at least in the abstract. The pitch has been that innovations like electronic health records and e-prescribing will improve patient care and safety while also saving money through increased efficiency. How much will be saved? Could be around $77 billion a year in all, according to a widely cited projection from researchers at the RAND Corporation.

Hold on, says the Congressional Budget Office, whose green-eyeshade-wearing analysts take a shot at that rosy savings estimate, and a similar one from the Center for Information Technology Leadership.

Article

Virtual ICU Brings Specialty Care to More Hospitals

2008-05-22T14:43:00.000-05:00

Small and rural hospitals can have a tough time keeping patients. Many will drive an hour or two to the nearest city for all but the most basic — or most urgent — care. And the sickest patients may have to be shipped out anyway, to reach the specialists that might save them.

What if high-tech tools could bring the big-city expertise to their patients instead?

That’s the pitch from Visicu Inc., a 10-year-old company acquired a few months ago by a unit of electronics giantPhilips.

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Google Health now live

2008-05-22T13:39:00.001-05:00

Google launched its much-anticipated Google Health platform Monday. Google Health combines Google's search engine capabilities with an individual's online personal health records.

Users can access the service at google.com/health.

"It's a really exciting day for us. We're really happy to be able to offer this service to all our users," Marissa Mayer, vice president of search and user products at Google, said in the Webcast Monday. The Webcast was billed as "a factory tour."

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NQF gives final OK to 48 measures

2008-05-22T13:37:00.000-05:00

The National Quality Forum gave final approval to 48 new measures for acute-care hospitals through its National Voluntary Consensus Standards program, boosting the number of its endorsed measures to 373.

The measures—mostly in the areas of re-admission, length-of-stay and mortality outcomes—include 43 measures that had been winding their way through the vetting process since March. Many of the newly endorsed measures are quality indicators developed by the Agency for Healthcare Research and Quality, which in part funded the measure development. The Alliance for Pediatric Quality, America’s Health Insurance Plans and Blue Cross and Blue Shield Association provided additional funding.

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Minnesota May Publish Doctor Info, Expand Insurance for PoorMinnesota May Publish Doctor Info, Expand Insurance for Poor

2008-05-16T10:15:00.000-05:00

The Health Blog’s never-ending tour of state health reform efforts pulls into Minnesota this morning, where the state Legislature just passed a big health bill.

Though it was scaled back in 15 months of negotiations, the bill would still add some 40,000 people to MinnesotaCare, a state insurance program for the poor, the Star Tribune reports. The bill would also make quality and cost data for the state’s doctors and hospitals public.

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What IBM Has to Do With Consumer-Driven Health Care

2008-05-16T10:07:00.001-05:00

Consumer-driven health care took another step forward this week, and IBM will be a little bit richer as a result.

Georgia will pay Big Blue $5.2 million to build a Web site that will let consumers compare hospitals on cost, quality and ratings by patients, the Atlanta Journal-Constitution reports.

Plenty of docs and hospitals say health-care quality is too complicated to report on a consumer Web site. But many business types, conservative health policy wonks and others fervently believe that patients can improve health care by becoming savvier shoppers, if only they can get their hands on good information. So these sorts of Web sites are springing up all over.

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Minnesota May Publish Doctor Info, Expand Insurance for Poor

2008-05-16T10:06:00.001-05:00

The Health Blog’s never-ending tour of state health reform efforts pulls into Minnesota this morning, where the state Legislature just passed a big health bill.

Though it was scaled back in 15 months of negotiations, the bill would still add some 40,000 people to MinnesotaCare, a state insurance program for the poor, the Star Tribune reports. The bill would also make quality and cost data for the state’s doctors and hospitals public.

Article

Health plans drop out of CT Medicaid over disclosure rules

2008-05-16T10:05:00.000-05:00

Connecticut's Medicaid program is struggling to regain its equilibrium after a standoff over new provider contracting disclosure rules prompted a handful of health plans to jump ship. In 2007, Gov. Jodi Rell (R) demanded that HMOs participating in Husky, the state's Medicaid program, share information on the details of their contracts with providers. Her position was that since they contracted with the state, they were, in essence, acting as public agencies for the purposes of participating in Husky.

The plans disagreed, however, arguing that they couldn't disclose proprietary contracting information. Two HMOs pulled out of Husky in April, leaving 120,000 Medicaid beneficiaries to transfer to other forms of coverage. A third will leave on July 1, bringing the total to 226,000 beneficiaries. Meanwhile, two participants, Anthem Health Plans and Health Net of Connecticut, are challenging the disclosure requirement in the Connecticut Supreme Court.

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PA health plans pay PCPs to track care

2008-05-16T10:04:00.000-05:00

A group of Pennsylvania health plans have come together to create a program paying family doctors and other caregivers to manage patient care more closely. Among other things, the program will make providers more accessible to patients through phone calls and email, as well as educating patients in better self-care. Plans involved, which include Independence Blue Cross, Aetna and four other insurers, are looking to spend $13 million over three years to finance the first phase of the initiative. All told, more than 150 primary care doctors are participating within 32 primary care practices, and about 220,000 patients in southeastern Pennsylvania will participate, which makes this one of the largest efforts of its kind in the U.S. The program is part of Gov. Ed Rendell's chronic-care model for the state, which should rollout statewide by year-end.

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HP acquires EDS to create a “super plumber” for data centers

2008-05-16T10:03:00.000-05:00

The services sector has proven to be one of the hottest in information technology. You need trained people to manage the ebb and flow of computing in a massive, air-conditioned data center that handles the life blood of a corporation such as its e-commerce transactions or internal business operations.

IBM has been the primary beneficiary of the services boom, but now it will face more determined competition with Hewlett-Packard’s $13.9 billion acquisition of Electronic Data Systems. Together, they can create what one analyst (at IDC) called a “super plumber” for corporate data centers.

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Healthcare wireless market to approach $10 billion by 2012

2008-05-16T10:01:00.000-05:00

Sales of wireless devices in healthcare have grown at close to 23 percent annually since 2005 and will continue to rise, pushing the total market to almost $10 billion by 2012.

These optimistic projections come from a new report by the New York-based market research firm Kalorama Information, which says hospitals are leading the way in the expansion of wireless technology.

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Repaying student loans helps MA health centers get staff

2008-05-13T14:26:00.001-05:00

Ordinarily, health centers serving the poor aren't in a great position when it comes to competing for the services of nurse practitioners and physicians. The centers, which serve largely lower-income patients, typically pay much less than other healthcare settings. However, a new program that repays medical student loans has turned things around for centers in Eastern Massachusetts.

The program, which offers $25,000 in loan repayment per year for three years, has helped community health centers in the region place 35 physicians and 12 nurse practitioners at 23 health centers, a huge success given that the centers might otherwise have spent years recruiting to bring in even a single physician. This group includes six current staffers who agreed to stay two or three years. The program is funded by a $5 million grant from Bank of America, with additional funding coming from the state of Massachusetts and a handful of health plans.

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Mass. explores plan to cover more poor

2008-05-13T14:25:00.001-05:00

Massachusetts’ Commonwealth Health Insurance Connector Authority—the agency charged with moving the state toward universal healthcare—is exploring a plan to cover low-income residents who were exempted from the state’s mandatory-coverage policy, which assesses tax penalties on residents who forgo health insurance.

Under the proposed plan, roughly 40,000 low-income residents who currently decline to participate in their employer-sponsored health plans due to unaffordable premiums would qualify for the state’s Commonwealth Care plan. To qualify, residents would have to earn less than 300% of the national poverty level—$31,000 annually for an individual and $63,000 for a family of four, according to presentation notes from a May 8 Connector board meeting. Employers would be required to subsidize an employee’s state-plan premiums at the same level as they sponsor the employer-offered plans. The state would also fund a portion of the Commonwealth Care premiums.

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