Health Business Blog

I’ll be posting the Health Wonk Review blog carnival here later this week. Please submit health policy related posts via email or using the contact form on the new Health Business Group website. Deadline is Wednesday March 13 at 9 am EDT.

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Welcome to the 178th running of the Cavalcade of Risk blog carnival. We’ve got a little bit of everything this time around, and I hope you’ll enjoy it all.

Disease Management Care Blog has important advice for boards of health service companies that use the results of their company’s sponsored or conducted research. Public domain, published or peer-reviewed research is highly vulnerable to data manipulation, conflicts of interest, skewed results, suppression of negative results and spin. Boards need to give it the enterprise risk management (ERM) it deserves.  He offers 10 approaches for audit committees.

Healthcare Economist investigates whether expansion of Medicaid crowds out private coverage.

The individual insurance market is set to undergo major changes next year. Colorado Health Insurance Insider has made a graphic to explain the shifts.

There’s a risk that EHR adoption will lead to improper billings that will wipe out any savings that accrue from better efficiency. Although some see this as a reason to gut the Meaningful Use incentive program, Health Business Blog is much more sanguine.

InsureBlog shares upbeat news on the breast cancer front: a new “smart bomb” that could reduce the risk of dying from the disease.

It’s one thing to sign your life away when you go sky-diving, but should parents really have to sign a comprehensive waiver of liability so that their children can participate in public school field trips?  Insurance Coverage Law in Massachusetts doesn’t think so, and blog author Nina Kallen is trying to do something about it through her testimony to the Boston School Committee.

Workers’ Comp Insider agrees with OSHA’s director that “A worker’s first day at work shouldn’t be his last day on earth.” She posts about a temporary worker killed at a Bacardi Bottling plant on his first day of the new job. 

Workers Comp Roundup counsels that employers should work with their employees who are filing claims rather than letting them fend for themselves.

Data breaches seem to be occurring a lot more frequently. Risk Management Monitor notes that what used to be a once-a-week data breach email alert from DataLossDB.org, an open security foundation, now comes as multiple emails, several times a day. Quite frightening.

That’s it for the Cav. Our next host is Jacob Irwin from My Personal Finance Journey.

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I’m covering the #HIMMS13 conference today, but meanwhile am quoted in a US News Money article (To cover medical bills, the uninsured get creative).

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I sent out a press release to celebrate the 8th birthday of the blog.

Health Business Blog Celebrates Eighth Birthday

Award-winning weblog by Health Business Group President David E. Williams covers health care business and policy every business day. Will cover #HIMSS13 conference this week

March 3, 2013 – The Health Business Blog, the first weblog devoted exclusively to health care business and policy, has turned eight years old. The blog is celebrating the event with a special birthday edition, highlighting a popular post from each of the past 12 months. This week, the blog will cover the Healthcare Information Management and Systems Society (HIMSS) conference in New Orleans, LA.

You can read the full release at the new Health Business Group website.

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The Health Business Blog turns eight years old today. Continuing a tradition I established with birthdays one, two, three, four, five, six, and seven I have picked out a favorite post from each month. Thanks for continuing to read the blog!

March 2012: Should medical debt count against your credit rating?

As far as I’m concerned, a lot of medical debt isn’t real debt. Real debt is borrowing money from a bank to buy a car or using a credit card to finance a vacation or taking out a student loan to pay for college. Borrowers know ahead of time that they are incurring a financial obligation for a known amount of money for specific goods or services. Hospitalized patients receive bills that are often indecipherable, incorrect, and owed by an insurance company. Even when technically correct the amounts can be non-sensical and vary widely from provider to provider. So it’s seems wrong to me that even medical bills that are paid off –sometimes just to end the nuisance– can have a long-term, negative effect on one’s credit rating.

April 2012: I don’t really want my $127 medical loss ratio rebate

Under the Affordable Care Act, health plans have to issue rebates to policyholders if they don’t spend at least 80 or 85 percent of premiums on medical costs. Now that the law is in effect, about $1.3 billion is to be paid out.  I support the ACA but I don’t like the notion that any dollar spent on medical claims is good and anything spent on administration is bad. The rule discourages administrative spending to reduce medical costs and that’s a shame.

May 2012: Interview with Blue Cross Blue Shield of Massachusetts CEO Andrew Dreyfus

Blue Cross Blue Shield of Massachusetts (BCBS MA) is the largest health plan in the state, and is making waves with its innovative Alternative Quality Contract (AQC). In this interview, BCBSMA CEO Andrew Dreyfus and I discuss the role of BCBS in cost containment, why premiums are stabilizing, opportunities for employers to play a role, and how state government fits in.

June 2012: Is the GOP ready for a substantive debate on health reform?

There’s a good debate still to be held in this country on health reform, but only if the Republicans step up to the plate with serious ideas. I’m unimpressed with the five main ideas I’ve heard: buying insurance across state lines, small business purchasing pools, tort reform, block grants for Medicaid, and tax deductibility for individuals who buy insurance.

July 2012: Hey friend, can I interest you in a lung transplant?

It’s no surprise to me that hospitals are starting to advertise high profit services on Google and Facebook. According to a Kaiser Health News piece, University of Pennsylvania Health System is trolling for lung transplant patients. Spending $20,000 generated 4,600 clicks, 36 appointments, and at least one prospective patient. With lung transplant revenue in the range of $100,000 per patient, even one patient may be enough to justify the media spend.

August 2012: Medtronic’s doctor centered approach helps patients, too

Orthopedic device makers are putting more control in the hands of patients to make adjustments that used to be handled by physicians. It’s more convenient for patients, but the key to the business model is that such moves reduce the demands on physicians, who otherwise would have to participate in these low-margin, unexciting activities.

September 2012: Private insurance exchanges in the mainstream

I’m bullish on employer-sponsored health insurance exchanges and am happy to see the general media pick up on the theme. I understand why observers are nervous that the use of these exchanges will contribute to cost shifting but I think the concerns are overblown.

October 2012: New England Compounding Center –the Avastin/Lucentis connection

Genentech got a lot of grief back in 2007 for trying to keep Avastin away from compounding pharmacies, who were re-packaging the cancer drug to make a cut-rate version of Lucentis for wet age related macular degeneration. I defended the company and pointed out that the New England Compounding Center had been issued a warning letter about its lack of sterility control. Five years later nearly everyone was taken by surprise when New England Compounding Center was in the news for a contamination scandal that led to many deaths. Regulators have no excuse for not dealing with the company when they had a chance.

November 2012: All Payer Claims Database launches in Colorado

Colorado is taking a unique approach to its All Payer Claims Database (APCD).

The Colorado legislature mandated payers to submit data, but the effort is privately operated (by CIVHC) and financed by private health care conversion foundations rather than the government. Independent financing and governance make a significant difference. Initial reports are being made public soon after the data is submitted, unlike in other states that don’t make the data public at all or do so under major constraints or time lags.

December 2012: Facility fees for hospital-owned physicians offices –A nasty surprise for patients

When hospitals purchase free-standing physician offices they often convert them into outpatient clinics. The shift isn’t visible on the surface, but underneath the covers a powerful economic transformation has taken place, with the new owners now able to charge a so-called “facility fee” to cover the cost of their infrastructure. Medicare and commercial health plans routinely pay such fees. But patients are pushing back, as well they should.

January 2013: Health tracking apps –Not yet ready to make a big impact

Almost no one really uses smartphone apps to track their health. That’s my takeaway from the latest Pew Research report. Although the report says close to 70% of adults are tracking some health statistics such as weight, diet or medical symptoms most of them do so either in their head (49%) or on paper (34%). Until we get to really smart, passive devices, which will take a decade or more, you should expect to see successive editions of the Pew report saying more or less what this one says.

February 2013: EHRs and improper billing –Should we worry?

Concerns are emerging that the adoption of electronic health records is leading to inappropriate increases in billings to payers, including Medicare, and that these higher billings could undermine or even overwhelm any cost savings generated by the digitization of providers. The concerns are legitimate but overall I’m not worried about this phenomenon, at least in the long term.

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Thanks again for reading the blog!

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Dr. Jaan Sidorov hosts a characteristically thorough, biting, and informative Health Wonk Review at the Disease Management Care Blog.

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Gorkana, a UK based media intelligence company, just published an interview with me (Gorkana meets…David Williams). In it I discuss how the Health Business Blog has evolved over the past eight years, issues I cover, my sources, and my favorite podcast of 2012.

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Check out the latest Cavalcade of Risk blog carnival at Nerd Wallet. I host next time.

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Last week’s Health Business Blog posts featured a mixture of policy pieces, podcasts with entrepreneurs and speculation about novel technologies:

• EHRs and improper billing: Should we worry? discussed the emerging controversy over whether savings from EHR usage are being lost to inappropriate billings. The post explains why this concern is overblown
• Informedika automates diagnostic lab ordering and results reporting is a podcast with the CEO of a startup company seeking to improve lab connectivity
• Bionic eye: seeing the future reports on a new medical implant and speculates on the ethical implications of the next few decades, as bionic parts exceed the performance of our original equipment
• Putting the brakes on health care costs is an optimistic (naive?) look at what would happen if health care cost inflation continues to decelerate
• Rejecting Medicaid expansion is effectively raising the minimum wage notes that it’s not so easy for opponents of the Affordable Care Act to maintain their ideological purity

Visit the blog to read the full stories, subscribe to the blog via email or RSS, or follow David Williams on Twitter.

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I’ve heard that February 14 can be a difficult and depressing time of year. Luckily the Valentine’s Day edition of the Health Wonk Review is up at Healthcare Talent Transformation, so that should ease the pain somewhat.

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