The Health Leadership Council Medicare Proposal: Too Much Responsibility on Beneficiaries and Not Enough on Providers

Robert Laszewski

First posted 9/27/11 on Health Policy and Marketplace Review

The Health Leadership Council (HLC), a coalition of CEOs from many of the leading health care companies, has created a list of Medicare reform recommendations for the Super Committee tasked with finding at least $1.2 trillion in budget savings.

As we begin the national debate over what to do about Medicare’s unsustainable costs, I will suggest that the HLC proposal gives us one, of what will have to be many, outlines for discussion.
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Practical Approaches to Obesity Care and Chronic Illness In Busy Clinical Settings: Three Key Ingredients

Jaan Sidorov

First posted 9/27/11 on the Disease Management Care Blog

If anything is true about the population health management service providers, they are constantly looking for better ways to fit their programs into busy clinical settings.

That’s why this article on New and Emerging Weight Management Strategies for Busy Ambulatory Settings, courtesy of the American Heart Association, should be “must” reading for the vendor industry.  It’s chock full of practical advice on how to “engineer” the PHM-physician partnership. While the focus of the article is on a practical approach to obesity, its approach can be applied to other conditions, such as diabetes or tobacco abuse.

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Reflections on Narcissus and AMCs

Paul Levy

First posted 9/27/11 on Not Running a Hospital

Narcissus was so entranced by a reflection of his own image that he was paralyzed into inaction by looking at it, leading to an unfortunate end.  There is a lesson here for the country’s academic medical centers (AMCs).  These “crown jewels of American medicine” are lobbying to be exempt from certain federal budget cuts.  As noted in a paid op-ed page advertisement in the New York Times,* they cite their special status as “urban medical centers treat[ing] patient populations with high rates of chronic disease, coexisting conditions, and more advanced stages of illness.”  They note that “physicians and scientists at teaching institutions are the foundation of biomedical research and innovation in medicine [where] they invent and improve surgical devices and . . . inform drug discovery and development.”  Finally, they remind us of their essential role in training the next generation of physicians.

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Why Advocate For Consumer Choice in Health Care?

Wendy Lynch

First posted 9/27/11 on the Altarum Institute Health Policy Forum

There is no shortage of important topics in health care; the U.S. faces thousands of challenges, from the prevalence of childhood obesity and hospital infection rates, to the affordability of new specialty medicines and end-of-life care.  Our delivery system is far more expensive and far less safe and effective than it could be.  Providers deliver care of ever-increasing complexity within brief, often-rushed encounters, leaving limited time for dialog.  So, why invest resources and attention on an individual’s preferences about treatment?

The answer is simple: consumer involvement in care decisions results in safer, more effective, and less expensive health care. (1, 2, 3) Additionally, consumers who participate in care decisions report higher satisfaction, faster recovery from illness and better quality of life. (4, 5) Finally, care plans resulting from a shared-decision-making process result in better medication adherence and clinical outcomes. (6, 7, 8)

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Serotonin and Foul Mood

By Dov Michaeli

You know who I am talking about; yes it’s you! Here we are driving across the beautiful countryside, admiring the tall Ponderosa pines, the Big Sky country, big smiles across our faces. Then you fall quiet. Are you lost in thought? Are you contemplating the meaning of life? “Anything wrong”? I ask. “I am hungry!!!” you blurt out, not so much an answer as a cri de coer.

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Spare the Knife. Keep the Rod.

Who will tell the men?

That’s what I wondered last week when I read the abstract about prostate cancer patients’ grim prognosis for normal sexual activity after surgery or radiation for their disease. The study appeared in the Journal of the American Medical Association.  Tara Parker-Pope in the New York Times’ Well blog gave it a shot today, and led with an anecdote about a surgeon who blithely told one patient that 98% of his robotic surgeries turned out fine. Not exactly.

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Readmission Drivers, Not Stabilizers

Bradley Flansbaum

First posted 9/25/11 on The Hospitalist Leader

I am always leery of briefs from think tanks and trade associations.  They are not ideal sources for balanced takes on important issues.  I am especially wary when the same bodies espouse viewpoints that might be similar to mine.  No individual is above self-reinforcement, and basking with like-minded souls in serene waters blinds us to the sirens call.  The call in this case, and the thrust of this post, is the accountability connection as it relates to hospitals and patient readmissions.

As hospital penalties for unnecessary readmits draw near, the attention to attribution, mainly, root causes for revisits, are accelerating debate and obliging those of us on the front lines to unmask pitfalls in conventional (CMS) thinking.

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