From M.S. Patients, Outcry for Unproved Treatment

For her first appointment with Dr. Daniel Simon, Neelima Raval showed up with a rolling file cabinet full of documents. She had downloaded every word written by or about Dr. Paolo Zamboni, a vascular surgeon from Italy with a most unorthodox theory about multiple sclerosis.

http://www.nytimes.com/2010/06/29/health/29vein.html?ref=science

Pricey imaging pushes up health costs

Good article today in the boston globe.

In a nutshell (doesn't do it justice but here it goes):

Imaging costs are growing across the United States. In two years, spending on MRIs, mammograms and other imaging tests grew by at least $214 million in Massachusetts. Obviously, this fueled a dramatic rise in the cost of outpatient care.

Consultants hired by the state found that the cost of imaging for privately insured residents increased 20 percent between 2006 and 2008, to $1.2 billion, as doctors ordered more scans and X-rays and hospitals demanded higher prices.

In Massachusetts, they found that about half of the increased spending on imaging was the result of higher prices, either hospitals charging more for the same kind of scan or substituting a more costly test, such as a CT scan, for a less expensive one, such as a standard X-ray.

Noteworthy: Blue Cross Blue Shield of Massachusetts, the state's largest insurer, said the insurer pays an average $700 for an MRI in a freestanding clinic, but twice that much at a hospital.

Rick Weisblatt - senior vice president for health services at Harvard Pilgrim Health Care, one of the state's largest insurers - said some hospitals have been able to increase the number of scans they do through electronic medical records, which prompt doctors to send patients to the hospital or a satellite clinic, as opposed to an unaffiliated imaging center. When a test is done at the hospital, the results automatically become part of the patient's electronic record, a feature many doctors like because it improves coordination of care.

Source: Liz Kowalczyk, Pricey Imaging Pushes Up Health Costs, Boston Globe (March 11, 2010) (available here)

Idaho is not waiting for federal healthcare "reform"

Governor C.L. “Butch” Otter wrote a nice opinion piece (source at the bottom):

It seems like Washington, D.C., is tilting at political windmills these days. The Obama administration and Congress are still promising to slay the fire-breathing dragon of healthcare costs. But the beast they are fighting is, to a large extent, the product of the government-installed cage in which it evolved.

For 35 years now the federal government has been essentially running healthcare in America, masking market signals and supplanting the judgment of patients and physicians with the determinations of politicians, bureaucrats and lawyers. It should be no surprise that healthcare became “health management,” people became statistics, and the fear of liability became the biggest expense of all.

Now the federal government is poised to rescue us from the disaster it created, promising “reform” that amounts to little more than increasing government’s already dominant role in the healthcare system and further reducing the role of states like Idaho, not to mention individual patients and providers.

The public, policy makers and even patients contributed to the problem with their complacence. Having been lulled into a false sense of security by the promise of Medicaid and Medicare, we failed to insist on meaningful change and self-determination. But now the federal government has seized on healthcare reform as its mission in life, which means we should brace for still higher costs.

Largely missing from this discussion is the real work that Idaho and many other states are doing on their own to address healthcare needs, fulfilling their role as laboratories of the republic. That work includes controlling costs and improving access through a market-driven focus on preventive care, health promotion, building public-private partnerships, and application of technology and professional development.

I convened the Idaho Healthcare Summit in 2007 to evaluate Idaho’s healthcare system and recommend ways to make healthcare more affordable. The Governor’s Select Committee on Health Care evaluated the recommendations, gathered additional data and provided its top recommendations for implementation in a report submitted to me in 2008.

The recommendations focused on expanding the statewide use of electronic medical records to provide better coordinated patient care; expanding the use of patient-centered medical homes that shift the focus of healthcare to primary and preventive care; expanding the number of already eligible children to register for the State Children’s Health Insurance Program; and expanding the number of residency opportunities to attract primary care and specialty physicians to our state. We are making great progress on all those fronts. And at the close of 2009 I created the Governor’s Health Policy Implementation Committee, consisting of people who are experts in these fields, to foster continuing advancement of the priority areas over the next couple of years.

While there is still much more to be done, this much is clear: The federal government should not dictate our healthcare choices. The states, with public and private input, are capable of making changes to foster a better and more affordable healthcare system. We no longer can afford to be complacent and wait for the federal government to make things worse and take decisions out of our hands.

As Thomas Jefferson said, “A wise and frugal government, which shall leave men free to regulate their own pursuits of industry and improvement, and shall not take from the mouth of labor the bread it has earned – this is the sum of good government.”



Source: http://gov.idaho.gov/mediacenter/press/pr2010/prmar10/pr_017.html

HHS's Final Rule on Health Information Technology Sent to House

The House Energy and Commerce Committee has received an executive branch communication from the Department of Health and Human Services.
The assistant office manager at the HHS has transmitted, pursuant to law, [5 U.S.C. 801(a)(1)(A)], the Department's final rule - Health Information Technology: Initial Set of Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology.
The document (RIN: 0991-AB58) was received by the House on Jan. 15.

Source: Sarabjit Jagirdar, US Fed News

Grant Expected to Strengthen Children’s Mental Health Treatment

The Wyoming Department of Health has issued the following news release:

Wyoming has been awarded a federal grant to help improve healthcare quality and delivery systems for children with serious behavioral health disorders who are enrolled in Medicaid and the Children's Health Insurance Program (CHIP).

The CHIP program is known in Wyoming as Kid Care CHIP; the state's Medicaid program is known as EqualityCare.

Wyoming partnered with Maryland, Georgia and the Centers for Health Care Strategies to submit a grant application, which was awarded nearly $11 million. Wyoming's share will be $450,000 per year for five years.

Wyoming will use the federal grant to implement and evaluate provider performance measures and use health information technologies such as pediatric electronic health records. A key planned strategy is the use of a care management entity to help monitor and administer mental health services provided to eligible Wyoming children.

"We have been concerned about the number of children with behavioral health issues who have been sent away from their communities for treatment," said Rodger McDaniel, Wyoming Department of Health deputy director for mental health and substance abuse services. "We want to ensure these children receive the most appropriate care for their needs. The care management entity can help that happen by bringing together the various organizations and people involved in meeting a child's treatment and educational needs."

"Basically, we would like to use this grant to improve access to quality care closer to home for Wyoming children and youth with serious behavioral health challenges," McDaniel said.

"Wyoming will work with other states that face many of the same challenges in this area that we do," McDaniel said. "We will share our rural perspective with them and expect to also learn from their experiences."

The new grant is funded by the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA). The Wyoming Department of Health (Mental Health and Substance Abuse Services Division and EqualityCare) worked together with the Department of Corrections, Department of Family Services, Department of Workforce Services and the Governor's Office to prepare the application.

"We are honored to be selected to be a part of this effort to establish a quality mental health care system for children," McDaniel said.

For more information about the grant, please contact Eydie Trautwein, interagency coordinator with the Wyoming Department of Health, at (307) 777-6493.

AMA has formed a partnership with Ingenix

New market moves:

The American Medical Association is making progress on its plan to be the electronic platform physicians use to upgrade their practices with the latest technology.

Chicago-based AMA has formed a partnership with UnitedHealth Group's Ingenix subsidiary to "help physicians adopt and implement electronic health records," the two groups said in a statement provided to the Tribune. As part of the deal, the AMA will offer Ingenix CareTracker, a Web-based medical record system, through its Web site.

The AMA said Ingenix will be part of a yet-to-be-named larger platform being created on its site to help physicians develop new technologies to enhance their practices and improve their day-to-day work environment. The group said multiple options will be given to doctors beyond the Ingenix technology.

Full article here: AMA teams with UnitedHealth and Dell

HealthConnect is now the largest business EHR system?

Kaiser Permanente stated that it completed its rollout of electronic health records in the company's medical facilities. HealthConnect is now the largest business EHR system in the world with the addition of Kaiser hospitals in Oakland, Richmond and Vallejo in California, it said. The system securely connects 8.6 million patients to their physicians, nurses and pharmacists, plus their personal information and 'the latest medical knowledge' through a personal health record manager at KP.org. Kaiser said more than three million members were using the My Health Manager system, with 27 million logins in 2009. 

Industry Notes, Washington Internet Daily, Industry Notes (March 04, 2010)