Highlights of the important and the interesting from the world of healthcare:
The case for private-practice primary care: There’s been lots of handwringing in recent years about the slow and continuing disappearance of private-practice physicians. The reasons are numerous–including the obvious (finances) and the slightly less-obvious (hassles with insurance companies). As private-practice primary care docs are replaced by hospitalists, some argue that it might not be such a bad thing. For example, doctors working in the same health system with the same electronic medical records systems presumably should be better at coordinating care. Dr. Rob Lamberts disagrees. In a spirited defense at The Health Care Blog, Dr. Rob lays out why independent primary care docs are key to providing a better-functioning health system.
While we’d all like to think that doctors are motivated solely by what’s right for the patient 100 percent of the time, logic (and McAllen, Texas) tell us that financial concerns can be a factor some of the time. The crux of Dr. Rob’s argument lies in the word “independence.” Since hospitals often lose money on primary care, the biggest reason why they employ primary care docs is for the referrals they generate, which lead to costly (and profitable) tests and procedures. So aside from the negotiating power with insurance companies that primary care docs provide to hospitals–which Lamberts does a fine job explaining—their real financial value comes in adding costs to the system. Many a hospitalist will no doubt cry foul, but Lamberts’ post illustrates why the death of private practice is a problem for American medicine and American patients. That’s why the health-reform provisions that boost primary care Medicare reimbursements are a step in the right direction, but we should remember that it’s only a step.
With the Rise of AI, What IP Disputes in Healthcare Are Likely to Emerge?
Munck Wilson Mandala Partner Greg Howison shared his perspective on some of the legal ramifications around AI, IP, connected devices and the data they generate, in response to emailed questions.
Lump sums’ time has come: A number of California’s largest and most prominent health systems in August will begin a pilot project that involve paying for knee and hip replacement procedures in lump sums, also known as bundling. That’s a big deal for anyone who’s experienced the baffling ordeal of the traditional methods of paying for healthcare in the U.S., in which hospitals and doctors charge separately for each visit, procedure and test. Similar Medicare projects are happening in other states, spurred by provisions of the health reform law. “The idea is to provide an incentive for doctors and hospitals to sit down together to figure out the best way to care for their patients,” says one advocate.
While one doctor warns that bundling is “no panacea,” it’s certainly an idea worth trying so no one has to repeat the experience of Tom Taylor. Taylor is a California man who paid $55,000 for a knee replacement in one hospital and $95,000 for the same procedure by the same doctor, but at different hospital, the L.A. Times reports.
A first in Seattle? The eyes of the biotech world turn this week to Seattle’s Dendreon Corp., which has produced what could be the first-ever cancer vaccine to come to market in the U.S. The FDA is expected this week to green-light the company’s prostate cancer vaccine, Provenge, and that’s sent investors’ hearts aflutter. The Seattle Times provides an excellent overview of the company and the wider implications Provenge could hold.
As the first product of its type to emerge from decades of often-frustrating research, Provenge could help open doors for immune-based therapies against a range of cancers. “It gives me a lot of hope,” said one cancer-vaccine researcher. “I think the Dendreon vaccine will be the first in a long line we’ll see approved over the next eight years or so.”
A Personalized Approach to Medication Nonadherence
At the Abarca Forward conference earlier this year, George Van Antwerp, managing director at Deloitte, discussed how social determinants of health and a personalized member experience can improve medication adherence and health outcomes.
A way for patients to fight back? Two consumers groups have joined to create an online survey that patients can use to report incidents of medical harm. The survey prompts respondents to provide the details of the incident including the state where it occurred, the type of provider involved, contributing factors, whether they considered litigation and providers’ response following the event. Patients have the option of submitting the surveys anonymously. The real value of the survey–if a critical mass of patients ever use it–will be the groups’ plans to mine the data they collect for patterns that form around incidents of harm. Here’s hoping the consumers groups have hired a solid search engine optimization person.
Photo from flickr user Jonas B
