Mistreated is a comprehensive and brilliant analysis of American health care by Robert Pearl, the CEO of the Kaiser Permanente Medical Group. The book’s subtitle aptly summarizes the author’s point of view: “Why We think We’re Getting Good Treatment–and Why We’re Usually Wrong.”
Women are a key focus segment for health care organizations both because of the medical services they utilize as individuals and the influence they have on the health care of others. In one survey, 59% of women and 94% of working moms reported making or heavily influencing health care decisions for their entire families.
Baby boomers and millennials are the hardest hit by the heroin and opioid epidemic. Boomers, born between 1946 and 1964, top the list, having 27% greater chance of dying from prescription opioids than people born in 1977 and 1979, the baseline group. They also have a 33% chance of dying from a heroin overdose.
Broadening the Hospital Readmissions Reduction Program so that it is hospital-wide and not just focused on the five conditions currently included in the program would mean that safety-net hospitals would be hit with higher penalties. However, there may be ways to level the playing field if the switch ever takes place.
CMS chief Seema Verma wants to reshape the entitlement program that covers about 62 million people. Verma endorses “community engagement”—work or community service— as a condition for “able-bodied” people to get Medicaid coverage and accused the Obama administration of the “soft bigotry of low expectations” for opposing such a requirement.
Opioids remain the go-to products because they target the mu opioid receptor, which has been shown to be the most effective pathway to reduce pain. The holy grail for drug developers is an agent that stifles pain without producing the euphoria and addiction of opioids.
Building on a similar effort in California, Catalyst for Payment Reform is proposing a standardized set of 50 ACO measures. Some of the country’s largest purchasers are taking it to their health plans.
In order to get the most out of EHRs, providers need to think outside the box—the box in this case being CMS’ meaningful use requirements. Providers who strategically implement EHRs tend to have a much more positive view of them.
The Pew Charitable Trusts says that “health spending per inmate varied dramatically in fiscal 2015, as it had in past years—from $2,173 in Louisiana to $19,796 in California.” Pew researchers could not determine what exactly causes the variation.
For instance, in the case of Sanford Health’s acquisition of Mid Dakota Clinic in North Dakota, the agency challenged the deal, claiming that the merged entity would control 75% or more of primary care and other health services in the Bismarck–Mandan metropolitan area.
Whether in a red or blue state, the state commissioner jobs do require decent working relationships with insurance companies, particularly in precarious times as insurers threaten to leave some areas with no ACA coverage because of poor market conditions or dithering in Washington, D.C.