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Contributing Voices
Frank Diamond

New regulations for managed Medicaid promise to shake up an industry that, apparently, needs very much to be shaken up. The implications of last week’s Kaiser Family Foundation (KFF) report (http://files.kff.org/attachment/issue-brief-reading-the-stars-nursing-home-quality-star-ratings-nationally-and-by-state) on the state of nursing homes (hint: not so good) builds even more anticipation about CMS’ plan to unveil the regulations any day now.

Contributing Voices
Frank Diamond

Aetna is mighty bullish these days, at least according to Investors.com. Aetna wants to buy either Humana or Cigna. The great man theory of history might be in play here, although only history can judge who’s great and who’s not.

Aetna CEO Mark T. Bertolini seems to want to do great things, with his talk—and action—about social justice getting play in high-brow publications.

Contributing Voices
Frank Diamond

Well, one of us was wrong and it wasn’t you. That is if you were a bit skeptical about our October 2013 article unveiling a golden age of registries. There’s the headline: “Registries Retooled for Better Data Mining.” There’s the deck: “Simple to create and to extract data from, registries are becoming essential to effective patient and population management.”

Contributing Voices
Frank Diamond

One of the paradoxes of human nature is that people who have little money are often the most generous. My old Uncle Joe (dead for over 30 years) had half his stomach blown away in the Battle of the Bulge and suffered the rest of his life from what we today would call post-traumatic stress syndrome and what they referred to then as battle fatigue.

That Uncle Joe carried this burden only occurred to me years after his death because those among the Greatest Generation who most experienced the horrors of war tended not to talk about it.

Contributing Voices
Frank Diamond

A sweeping proposal for improving veterans’ health care would use the Kaiser Permanente model of separating the insurance and payer arms of the Veterans Health Administration (VHA), making the provider an accountable care organization (ACO) and allowing vets to purchase insurance from consumer plans. Concerned Veterans for America, a bipartisan policy taskforce that is pushing the Veterans Independence Act, includes some heavy hitters such as former Republican Senator Bill Frist, and former Democratic Congressman Jim Marshall.

Contributing Voices
Frank Diamond

Ingrid Bergman as Ilsa Lund in Casablanca.

Well-crafted articles sit in mental medicine cabinets; handy for when the next time the malady they address surfaces. This story yesterday (http://tinyurl.com/AP-gene) made me think immediately of this gem that ran in Managed Care back in 2000 (http://tinyurl.com/Bee-Moz). No one’s yet pinpointed the expiration date for spoiler alerts: Does Ilsa Lund run off with the crafty/noble Rick Blaine or the noble/crafty Victor Laszio? Watch the movie.

So, you’ve been alerted.

Contributing Voices
Frank Diamond

Maybe it’s because cars are fun and we’re young when we start driving that we slide easily into the habit of paying automobile insurance. Or maybe it’s because cars are dangerous and our parents and/or the state wouldn’t let us drive without it. The metaphor of allowing beneficiaries to buy health insurance as they do car insurance (just this side of hoary when we used it back in 1998: http://tinyurl.com/98-story) left reality in the dust ages ago. It sounds so nice, but it’s still not happening, according to a Kaiser Family Tracking Poll released in April 2015 (http://tinyurl.com/KFF-poll).

This, despite all the talk of transparency and the overabundance of evidence that two providers can charge very different prices for the same procedure in the same town and get the same outcomes. This, despite the continuing shift in costs to beneficiaries. In the poll, 2 out of 3 people say that finding out how much doctors or hospitals charge is too difficult. Only 6% of people use quality rankings to make a decision about an insurer, doctor, or hospital.

Contributing Voices
Frank Diamond
Mehmet Oz - World Economic Forum Annual Meeting 2012

In the land of Oz, you can take a pill that makes you lose weight. In the land of Oz, endive, red onion, and sea bass decrease the likelihood of ovarian cancer by 75%. In the land of Oz, acupuncture can help patients stop smoking, lose weight, and even avoid colds.

Mehmet Oz, MD, a national talk show host started his career as one of the best heart transplant surgeons in the world, practicing at Columbia and New York-Presbyterian Hospital.

Now, he’s under fire for allegedly peddling quackery. Ten physicians wrote to Columbia on Wednesday demanding that the school cut ties with the celebrity doctor who, they wrote, “has manifested an egregious lack of integrity by promoting quack treatments and cures in the interest of personal financial gain.”  

Contributing Voices
Frank Diamond

There are few issues that unite the political polarities these day, but there seems to be consensus emerging about this: We dump too many people in prison, including dumping them on a former coal ash landfill, a situation sparking controversy in a corner of Pennsylvania.

Liberals might see overpopulated prisons as resulting from, say, police profiling, while conservatives might believe, for instance, that there are just too many nonsensical laws on the books. The bottom line: The United States imprisons more people than any other country.

State Correctional Institution (SCI) Fayette County in Pennsylvania, housing 2,000 prisoners and opening in 2003, rests on top of a former coalmine and next to a 500-acre coal ash dump in rural Luzerne township. Not good and possibly unconstitutional, charge two human rights organizations, the Abolitionist Law Center (ALC) and the Human Rights Coalition (HRC) in a recently issued study (http://tinyurl.com/coal-prison).

They cite the Eighth Amendment, which forbids cruel and unusual punishment, and building a prison on a “massive toxic coal waste dump” might be just that. Over 40 million tons of coal waste had been dumped on the site “at depths approaching 150 feet in some places.” The study states that, “Ash is regularly seen blowing off the site … and collecting on the houses of local residents as well as the prison grounds at SCI Fayette.”

Contributing Voices
Frank Diamond

There’s a gap in the proverbial health care safety net that’s big enough for a whale to swim through.

People who are incarcerated, on probation, or on parole — what a recent study calls the “justice-involved population” — make up 22% of the 13 million newly eligible people.

“The justice-involved population has a higher disease burden than the general population, yet as many as 90% of justice-involved people lack health insurance at the time of their release from incarceration,” says the study, published in Health Affairs. “This disparity between disease burden and access can drive up the cost of health care, result in worse outcomes, and cause patients to seek care later than appropriate and in care settings that are often isolated and lack care coordination.”

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