Tag: "health care quality"

Patient Power Works: Significant Savings for Employers and Beneficiaries

We previously discussed the executive summary of CIGNA’s 8th annual Choice Fund experience study, which reports outcomes from 2.6 million beneficiaries of CIGNA’s consumer-driven employer-based health plans (that is, plans which are paired with a Health Savings Account or Health Reimbursement Arrangement). CIGNA has just released a much more detailed presentation of the results.

The presentation clarifies that the improved outcomes control for health status. That is, they compare “apples to apples”, and the results are not due to healthier people choosing consumer-driven plans and sicker people staying in traditional plans. Newly shared outcomes include:

  • Choice Fund customers increase their compliance with recommended care in the second year, even more than in the first year;
  • They improve their health-risk status by six percent;
  • Medical cost trend goes down 12 percent versus traditional plans;
  • The improvement persists over time, up to $7.900 savings by fifth year;
  • The improvement occurs in low-risk, medium-risk, and high-risk patients; and
  • Because employers contribute to HSAs and HRAs, employees spend less money out of pocket than peers in traditional plans!

Some New Medicines are Approved More Quickly than Others

Joe DiMasi of the Tufts Center for the Study of Drug Development, and colleagues, have reviewed the time it takes for the FDA to review different types of new drugs.

seniors-and-prescriptionsFDA’s Neurology division, which approves drugs for Alzheimer’s disease, multiple sclerosis, Parkinson’s disease, and stroke, takes three times as long to approve drugs as the Oncology division. These differences cannot be explained by differences workload, the type and complexity of the drugs reviewed, or the safety of the drugs approved.

If the FDA could cut the performance gap between the divisions in half, the authors estimate that the cost of developing a new drug would decrease by $46 million — a savings that adds up to approximately $874 million per year.

Full report available from the Manhattan Institute.

Headlines I Wish I Hadn’t Seen

air-pollutionEliminating all greenhouse gas emissions from the U.S. forever would impact warming by less than one fifth of one degree by 2100.

Federal health care lobbying has declined to “only” $130 million.

Septic (blood) infections involved in up to half U.S. hospital deaths.

Secret wait list cover-up spreads to more VA hospitals; records destroyed.

Big Brother? U.S. gave Medicare patients’ private medical information to local officials during New Orleans public-health scare.

Unnecessary Care

As many as 42% of Medicare beneficiaries in 2009 underwent unnecessary medical treatments, costing the federal government as much as $8.5 billion, according to a study published yesterday in JAMA Internal Medicine. The analysis is the first large-scale examination into what Medicare spends on procedures that are widely considered to be unnecessary, such as advanced imaging for lower back pain and placing stents in patients with controlled heart disease. (KHN)

Are Doctors Really Better Than Nurses?

Confident DoctorsSimply put: the preponderance of empirical evidence indicates that, compared to physicians, NPs provide as good — if not better — quality of care. As I’ve written previously, patients are often more satisfied with NP care — and sometimes even prefer it.

The Institute of Medicine is unambiguously clear about this:

No studies suggest that APRNs [Advanced Practice Registered Nurse] are less able than physicians to deliver care that is safe, effective, and efficient or that care is better in states with more restrictive scope of practice regulations for APRNs.

More.

Headlines I Wish I Hadn’t Seen

iStock_000008945197XSmallSome hospices decline to treat the dying.

Paper: 90,000 Nevada residents could lose health insurance due to ObamaCare

Polio is spreading again.

72 percent of physicians say their peers order at least one unnecessary test per week.

U.S. is one of only eight countries where maternal deaths in childbirth rose, 2003-2013.

Massachusetts is ditching its ObamaCare exchange, replacement to cost $100 million.

Headlines I Wish I Hadn’t Seen

Stethoscope9 out of 10 doctors are unwilling to recommend health care as a profession.

Drug cost-sharing in the ObamaCare exchanges is 34 percent higher than in policies prior to the law.

One physical therapist billed Medicare $12 million in 2012: He treated 21 patients per hour, every working hour.

Pension and health care costs at DOD: “If we allow the current trend to continue, we’re going to turn the Department of Defense into a benefits company that occasionally kills a terrorist.”

Headlines I Wish I Hadn’t Seen

doctor-technologyHealthCare.gov is still missing massive, critical pieces…the system’s “back end” is a tangle of technical workarounds moving billions of taxpayer dollars and consumer-paid premiums between the government and insurers.

Measles making a comeback: Anti-vaccine activism to blame.

Panel: Federal policies to reward high-quality health care are unfairly penalizing doctors and hospitals that treat large numbers of poor people.

Only 77,000 families and individuals have requested exemptions from the ObamaCare individual mandate. That means millions will owe a fine next year.

We’re Looking More and More like Canada

doctor-mom-and-sonPatients — and physicians — say they feel the time crunch as never before as doctors rush through appointments as if on roller skates to see more patients and perform more procedures to make up for flat or declining reimbursements. It’s not unusual for primary care doctors’ appointments to be scheduled at 15-minute intervals. Some physicians who work for hospitals say they’ve been asked to see patients every 11 minutes. And the problem may worsen as millions of consumers who gained health coverage through the Affordable Care Act begin to seek care — some of whom may have seen doctors rarely, if at all, and have a slew of untreated problems.  (KHN)

What Are the Mortality Risks of Being Uninsured?

This is from Chris Conover:

Since the evidence is equivocal at best, let us — for purposes of discussion — average the point estimates from 4 studies…and compare this relative mortality risk (1.22) to other factors that elevate the annual probability of death.

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