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Tag Archives: cms
Healthcare Reform is Coming to Town!
Last year about this time of year I wrote a parody of Twas the Night Before Christmas about the coming of healthcare IT and meaningful use. I decided to make these holiday parody songs an annual event. I figure I have years of material, as there are so many ways of ruining an otherwise joyous holiday gem by mixing it with healthcare and public policy.
This year’s victim: Santa Claus is Coming to Town, was written by J. Fred Coots and Haven Gillespie in 1934. The original lyrics to the song can be found HERE. The song is a little weird because it lets kids know that Santa Claus is watching them all the time like some sort of red velvet-clad big brother machine. If the children aren’t good they won’t get any presents for Christmas, so the song has the extra-added attraction of veiled threat. Kind of reminded me of what’s happening with health reform and the Patient Protection and Affordable Care Act (PPACA). For those in the healthcare industry, there is definitely a feeling the eyes of government are upon them. Insurers, employers, medical device and … (read the rest)
Posted in Healthcare, Healthcare Policy, Healthcare Reform, Uncategorized
Tagged affordable care act, cms, healthcare, healthcare reform, PPACA, psilos
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96 Ways To Say “Bite Me”
Once upon a time we marveled at the fact that Baskin Robbins had come up with 31 flavors—what a smorgasbord of opportunity. Then they branched out into seasonal flavors, regional flavors, even frozen yogurt, which vaulted them upwards into having more than 50 flavors. What a joy to behold: more is definitely better when it comes to ice cream.
Same story for television. Some of you, those that are resting comfortably next to me in a nursing home, will remember the old days when we had ABC, CBS, NBC and Channel 13 as the primary TV channel choices. Then there were 13 channels, then around 20, and now my mercenary cable providers shows me more than 700. This example is a little sketchier. More than 4 channels is definitely better. As many as 700? Well, I guess it works if you figure that they are trying to capture everyone in the world’s tastes, even those that want to watch Jersey Shore and Deadliest Catch.
So what do we make, then, of the Center for Medicare and Medicaid’s (CMS) recent announcement of the updating of the diagnosis codes that … (read the rest)
Posted in Diagnostics and Screening, Healthcare, Healthcare Information Technology, Healthcare Policy, Healthcare Reform, Random Thoughts of the Day
Tagged cms, diagnostic codes, healthcare, healthcare IT, healthcare private equity, healthcare reform, healthcare venture capital, icd-10, icd-9, psilos
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Follow the Money
This weekend’s NY Times had an Op-Ed by doctors Peter Bach and Robert Kocher about why medical school should be free for people willing to pursue a career in primary care. Drs. Bach and Kocher note that primary care is critical to the successful improvement of quality and cost in the healthcare system and yet the American Academy of Family Physicians has estimated a shortfall of 40,000 primary care doctors by 2020. Their point is that despite these statistics, the system is somewhat rigged against primary care physicians (“PCPs”)….it costs them just as much as specialists to go to medical school but they come out making 58% of the money ($190K vs. the $325K of the average specialist). Thus, since we need PCPs far more than we need more specialists, let’s pay for PCP candidates to go to medical school but effectively cause those going into specialty care to cover the costs of those who remain as PCPs. In other words, let those who will financially benefit from their career choice (specialists) subsidize those that, for all intents and purposes, go into a life of “medical public service” (my term, … (read the rest)
ACO: A Care Odyssey
http://www.youtube.com/watch?v=p3MiD_U4CHQ”
Recently PriceWaterhouseCoopers (PwC) put out a report that included their top health industry issues of 2011. The list includes these six items:
- #1: Booming business in health information technology
- #2: Gearing up to redefine health insurance: From MLRs to insurance exchanges
- #3: ACOs: Is this the next big thing or not?
- #4: Nowhere else to cost shift: Consumers could continue to reduce utilization
- #5: M&A: Deals will bond the familiar and unfamiliar as organizations look to fill strategic gaps
- #6: Follow-me healthcare: Patients look to health organizations that are always on
While they are all interesting issues with a lot of implications, the one that makes my head spin is number 3: ACO’s.
ACO, which stands for Accountable Care Organization, is one of those healthcare policy wonk terms that is about to go mainstream, in large part because of their prominent role in the PPACA (national health reform law). The federal government, and especially the Centers for Medicare and Medicaid Services (CMS) has put this concept front and center as the great white hope to reform its healthcare delivery programs.
The idea behind ACOs is that physician groups, hospitals and … (read the rest)
Posted in Health and Wellness, Healthcare, Healthcare Policy, Healthcare Reform, Uncategorized
Tagged ACA, accountable care organization, ACO, affordable care act, capitation, cms, health insurance, healthcare, healthcare reform, healthcare services, healthcare venture capital, psilos
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Orange is the New Black
It is early November and that means it is time to deal with the fall-out from the pivotal races that took place in the days and weeks leading up to early this week. Of course by this I mean that we should all be celebrating the SF Giants’ devastating annihilation of the Texas Rangers. 1 million people showed up for their victory parade yesterday in SF. Go Orange and Black!
And speaking of pivotal races that end with winners that are primarily orange, John Boehner is our new Speaker-elect of the House of Representatives. One of the first things out of Boehner’s mouth after the election was “The American people are concerned about the government takeover of health care. I think it’s important for us to lay the groundwork before we begin to repeal this monstrosity.” He was, of course, referring to the Patient Protection and Affordable Care Act (ACA) that became law this year and promised sweeping changes in our country’s approach to providing health insurance.
After a few months where the focus had moved squarely away from health reform and towards the election, jobs and taxes, healthcare … (read the rest)
Posted in Health and Wellness, Healthcare, Healthcare Information Technology, Healthcare Policy, Healthcare Reform, Healthcare Venture Capital, Uncategorized
Tagged ACA, affordable care act, cms, healthcare, healthcare reform, healthcare services, healthcare venture capital, john boehner, psilos
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CMS & CMMI: Taking A Flying Leap
Let me start with what’s important: The Giants are up 2 games to 1 over the Phillies in the NLCS. I am looking forward to collecting on my bet with my partner, Joe Riley, who is a seriously misguided Phillies fan. What the hell is that mascot anyway? Looks like a mutant bigfoot that ran into a brick wall face first.
But back to the subject at hand.
Yesterday I had the opportunity to speak as an invited guest at a public meeting hosted by the Brookings Institution and CMS. The focus of the meeting was “Accelerating Health Care Innovation to Improve Quality and Lower Costs: The Role of the Center for Medicare and Medicaid Innovation.” This meeting was the sequel to a private meeting that occurred several months ago in which many people from all facets of the healthcare industry provided input and suggestions to the joint Brookings-CMS team that is defining how the Center for Medicare and Medicaid Innovation (CMMI) will set its goals, operating plans and procedures. As you may recall from an earlier post, CMMI was established as a result of the Affordable Care Act … (read the rest)
Posted in Health and Wellness, Healthcare, Healthcare Information Technology, Healthcare Policy, Healthcare Reform, Healthcare Venture Capital, Patient Safety, Uncategorized
Tagged ACA, affordable care act, brookings, Center for Medicare and Medicaid Innovation, Center for Medicare Innovation, cmi, cmmi, cms, don berwick, healthcare, healthcare IT, healthcare reform, healthcare services, healthcare venture capital, innovation, Office of the National Coordinator, ONC, psilos, richard gilfillan, triple aim
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Is that Rome I Smell Burning?
In my last post I talked about the risk of unintended consequences that may lead 2 million people to be dumped onto the States’ Medicaid rolls if the federal government continues to contest the validity of mini-med health plans, such as those in place for McDonald’s employees. This is a highly controversial situation and the States are already in a tizzy over the potentially disastrous budget consequences of the new healthcare reform legislation known as PPACA without this added treat.
The reason for the States’ fury? PPACA will result in about 20 million additional Medicaid beneficiaries that will become, at least in part, the financial responsibility of the States around 2014. California alone, for instance, estimates that the additional cost to the state of the resulting 1.6 new Medi-Cal recipients would be about $3 Billion/year. If Meg Whitman becomes Governor, she can pay for that herself, but short of that, there is no plan on how to stretch already waning tax revenues to cover this new bill.
Not since DeTocqueville have we heard so much talk about Federalism (okay kids: remember your high school class on U.S. government? We’re talking … (read the rest)
Money don’t get everything it’s true; What it don’t get I can’t use…
According to an August 18th, 2010 Reuters article, a new study suggests that a patient’s odds of having an orthopedic operation may depend on whether or not the surgeon has a financial stake in the treatment center. Patients receiving care for their wrist, rotator cuff or knee from a provider with ownership in the facility were up to twice as likely to have surgery compared to those treated by non-owners according to a study performed by Georgetown University’s Public Policy Institute in Washington, D.C. and published in the Archives of Surgery.
Not to put too fine a point on it, but……duh. I hope they didn’t spend a lot of money on that study.
Your lovin’ give me such a thrill,
But your lovin’ don’t pay my bills;
Financial incentives, at least in America, appear to be one of the most powerful motivators of behavior one can find. There have been numerous studies demonstrating the somewhat insidious connection between physician financial ownership and over-utilization of services. The Stark Law was passed more than 20 years ago for this very reason–to break the connection and remove financial incentives to over-treat. … (read the rest)
Posted in Healthcare, Healthcare Information Technology, Healthcare Reform, Healthcare Venture Capital, Uncategorized, Venture Capital
Tagged affordable care act, ARRA, brain fitness, cmi, cms, healthcare, healthcare IT, healthcare reform, healthcare services, healthcare venture capital, healthy eating, pay for performance, posit science, seechange health, venture capital, wellness
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Happiness? That’s nothing more than health and a poor memory
That’s a great quote from Nobel prize winner Albert Schweitzer and it would have served me well a few days ago when it felt like nothing was going right. I was whining via email to my partner Steve and he wrote back simply, “Positive Mental Attitude.” Steve’s point, a valid one that would resonate with most of us, was that if I could adopt a positive mental attitude, I would likely have a better outcome (or at least stop whining to him).
This body-mind connection is a concept that is commonly accepted among both pop-psychologists and serious scientists. Significant amounts of research have gone into proving that a positive mental attitude, or “happiness” as I will refer to it in shorthand here, is highly predictive of numerous positive attributes. Notably, people who consider themselves to be generally happy are also those found to be in better physical health. We can screen all we want for cancer, and diabetes, but screening for happiness appears to be may tell us more about healthiness.
If that is the case, wouldn’t logic tell us that promotion of happiness would also have a direct positive … (read the rest)
Government as an Engine for Innovation
I’ve been thinking a great deal about the newly formed Center for Medicare and Medicaid Innovation. (CMI). This entity was established as a result of the Affordable Care Act (the new healthcare reform legislation) and its purpose is to “research, develop, test and expand innovative payment and service delivery models that will improve the quality and reduce the costs of care for” patients covered by CMS-related programs. The legislation gives this entity over $10 billion dollars initially and broad authority to figure out new ways of doing things better and differently than before. What is great about CMI is that they have the authority to run their programs much more like a business would without many historical governmental constraints. That’s great news for innovation, which is sorely needed in the U.S. healthcare system.
Among the key objectives that the administration has discussed is how to transition the collective mindset from one of healthcare to one of health. In other words, if a person is healthy, they do not need health CARE. This is a very important distinction; it puts the emphasis on prevention and wellness as opposed to what … (read the rest)