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The Red Flags Rule

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By JOHN HALAMKA

HalamkaYou may have seen the recent headlines “FTC delays Red Flags Rule
implementation until August 2009”. What is the Red Flags Rule and how
does it relate to healthcare?

The FTC has a great website that it explains it all in detail.

Basically,
the FTC requires most clinical offices, hospitals, and other health
care providers to develop a written program to spot the warning signs
of identity theft – “red flags”  If a patient’s name on a photo ID and on their insurance card do not match, that’s a red flag. If a patient visited last week as John Smith but today is Fred Jones, that’s a red flag. If patient seems to travel from provider to provider seeking numerous expensive treatments, that’s a red flag.

The
law was initially designed to cover creditors and it seems odd for
healthcare providers to be considered creditors. The FTC defines a
creditor as anyone who enables the customer to carry a balance after
services are rendered. Unless a clinician asks for payment upfront (all
balances not covered by insurance), the clinician is a creditor.

Continue reading…

Disgusting, and another reason why marriage needs to be re-defined

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By Matthew Holt

Tara Parker-Pope reveals two cases where discrimination kept a partner, and in one case the dying woman’s children, away from their loved one while they were dying in hospital.

One hospital involved is Jackson Memorial in Miami, a massive recipient of Federal dollars. In 1965 then un-integrated hospitals in the south were forced by the Federal government to take black patients as part of the new Medicare program. It’s high time that an executive order was made by Obama that hospitals receiving Federal dollars immediately change their visitation policies in this respect.

But beyond that, those bigots (including the ones who have commented on THCB) who continue to maintain that not changing the legal definition of marriage doesn’t hurt anyone should consider the stories of the people Tara reports about, and they should feel very guilty.

Reconciliation — or War?

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By ROGER COLLIER

Reconciliation. It’s an odd word for something that could precipitate a knock-down, drag-out fight in Congress, but the process that Senate Democrats agreed last week to adopt if health care reform legislation isn’t passed by October 15 was originally intended to reconcile differences among House and Senate budget bills.  What the process does is to replace the usual Senate requirement of a three-fifths majority—needed to end a filibuster, but also consistent with Senate traditions of compromise—by a simple majority.

So, with the Democrats having decided on an aggressive approach (Republican Senator Michael Enzi has called it “like a declaration of war”), what are the implications for the reform legislative process (beyond making Congressional Republicans mad)?

First, is October 15 an absolute drop dead date?

The answer is, not quite. Not only does the reconciliation process provide for up to twenty hours of debate (which could move the deadline out by just two or three days), but Senate Democratic leaders might prefer to continue negotiations on a reform bill if they felt they were close to the magic sixty votes.  This would require the vote of at least one Republican, as well as the only Independent (Joe Liebermann), but would allow Democrats to claim bi-partisan support—even if only a little.

Continue reading…

SharpBrains Releases 2009 Market Report

SharpBrains is pleased to announce the release of The State of the Brain Fitness Software Market 2009 report,
their second annual comprehensive market analysis of the US market for
computerized cognitive assessment and training tools.  Designed for
decision-makers at healthcare, insurance, research, public policy,
investment and technology organizations this report contains important
information concerning developments in the brain fitness and cognitive
health space.

The report this year expands to 150+ pages, and has added several new chapters:- Results from a market survey with 2,000+ respondents (decision-makers and early adopters)
– A proprietary Market & Research Momentum Matrix to categorize 21 key vendors into four categories
– 10 Research Executive Briefs written by leading scientists at prominent research labs
– An analysis of the level of clinical validation per product and cognitive domain

This insightful report will be available through direct purchase at a reduced rate for THCB readers strating May 7th, 2009.

UPDATE from the FRESH-Thinking Capstone Conference

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By TEAL PENNEBAKER

Fuchs

In the same week that the Obama Administration has stated its commitment to overhauling the health  care system, the FRESH-Thinking Capstone Conference adjourned yesterday morning to discuss next steps in health care reform. The event is a cross-section of health care experts—academics, practitioners, economists, industry insiders—devoted to fixing the health care system.

The morning began with Stanford Health Policy core faculty member Victor Fuchs welcoming the hundred plus attendees. Fuchs is co-director of the FRESH-Thinking Project with Ezekiel Emanuel. Emanuel stepped down from the Project to join the Obama Administration earlier this year. The Project has spent the past years considering all aspects of health care reform, and this conference is the capstone event of the group's findings. The morning talks look at the cost side of reform.

The first morning speaker was John B. Shoven, Director of the Stanford Institute for Economic Policy Research (SIEPR), who queried the crowd "is it possible to put health care on a diet?" Shoven's focus was on universal coverage and how it can be paid for. After discussing the logistics of who the uninsured are and the current taxation approach, he disavowed the crowd of two giant universal health care reform myths: shared responsibility and the middle class not having to shoulder health care costs. Shoven's take aways were "it's not necessarily that we should have new value added tax. It's that we should have a dedicated tax … We should not separate the benefits from the costs."

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Should Health Care Standards be Open Source?

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By ALAN VIARS

Recently there has been some chatter on Twitter about health standards and open
source, so I thought I would write a little commentary on the topic.

Anyone who knows me well, knows that I am huge fan of Linux and open
source.  This is perhaps why I get so frustrated with the US health
care industry and its general lack of interoperability.  I could use
many standards as an example, however, for this discussion I’m using
the ASTM Continuity of Care Record (CCR) as an example.  Now I’m not
picking on the CCR. The format is XML (good), and while there is always
room for improvement, I think the general structure is reasonable and
workable.  I’d also point out that David Kibbe and Steven Waldren, two
keep champions for the CCR, have always been nice and helpful any time
I’ve asked a question on the list serve. I’m using the CCR as example
just because the barrier to access is so low ($100).  Much of the
following is summarized from an inquiry I made to the CCR list serve
about a year ago.

Continue reading…

The Chronic Pain Educational Educational Workshop in Berkeley, CA – July 19th, 2009

In the spirit of Health 2.0 and User Generated health Care we are proud to announce:

“The Chronic Pain Educational Educational Workshop"
July 19th, 2009 – 12:00P.M – 7:00P.M – Reception 7:00P.M – 8:00P.M

Chronic pain is the 21st century’s invisible handicap, a humanitarian crisis of epidemic proportions.

Chronic pain holds back individuals, families often whole communities from their full potential.

We believe effective chronic pain prevention and treatment is possible;
it comes through education and our goal is just to do that: to raise
awareness and educate on the issues related to chronic pain. That way
individuals and their families can make educated decisions on how to
manage their chronic pain, reclaim their lives and be able to
participate and contribute to their families and communities not longer
being devastated by daily burden of chronic pain.

The event is designed to educate and fundraise on issues related to
chronic pain and to benefit "The Chronic Pain Educational Documentary
Series."
During the event there will be informational booths with educational
material available to attendees, informational sessions and a silent
action.  Food and beverages will be available.
Massage therapists will be available during the event for free chair massages.

Companies and individuals are welcome to sponsor and/or attend the event.
For more information or press releases please inquire via e-mai; at ChronicPainEducation@gmail.com

Connecting value to coverage: a first glimpse

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By MICHAEL PAINTER

MPainterWould you take a virtual walk with me across the Dartmouth Atlas map on RWJF's web site?  Just follow the link.  Now, move your cursor first over, say, anywhere in Minnesota.  There, you'll see that 2006 Medicare reimbursements were roughly $6,700 per beneficiary.  Now, move your cursor across the country, way over to Massachusetts–specifically, Boston, for instance.  There, 2006 Medicare reimbursements were almost a whopping $3,000 per beneficiary higher.  You'd sure think that the quality of care in Massachusetts must be extraordinarily better for that extra $3,000 per person–but, guess what?  It's not–it's roughly the same–maybe even worse in some cases.  Plus, Massachusetts has embarked on its own universal coverage experiment.  First in its class, Massachusetts is providing the rest of us with a real-world unfolding example demonstrating how health care cost, quality, value, and coverage intersect.  If Massachusetts could figure out how to pay for high-quality care at the level of, say, Minnesota, their coverage experiment might just get exponentially easier.

So, are our national leaders taking this unfolding lesson to heart?  We're beginning to learn.  Last week the Senate Finance Committee released a set of policy options on transforming the health care delivery system.  Their statement is really the first glimpse we've had at how our national leaders might (or might not) be linking value and coverage.

Continue reading…

The Two Trillion Dollar Promise: Can We Trust It?

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By BILL KRAMER

President Obama described it as a “watershed” in the journey toward comprehensive health reform – and it might very well be.  But many people are suspicious of the health industry leaders who promised to slow the trend in health care costs and save $2 trillion over the next ten years.  Should we be hopeful or skeptical?  The answer is both.

The joint statement by health insurers, hospitals, physicians, drug and medical device manufacturers on May 11 was very encouraging.  At no time in recent history has this group agreed on a savings target and specific steps to achieve it.  In the 1990’s, most of these industry groups made the cold, rational decision that they were better off with the status quo than under a Clinton-style reform plan.  Now, all of them know that the current path is unsustainable, and they believe that the mainstream reform proposals by President Obama and Sen. Baucus are much better for them than the other options (do nothing or single payer).  They also know that these savings are achievable; for the last 15+ years, academic experts and consultants have been pointing out opportunities for improvements in affordability and quality.  There is plenty of “low hanging fruit”.

But there are plenty of reasons to be skeptical.  In the past, no one ever lost a bet that health care costs would continue to increase rapidly.   The title of Altman & Levitt’s 2002 article in Health Affair says it all: The Sad History of Health Care Cost Containment as Told in One Chart. 

Continue reading…

TV stardom (well, sorta…)

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By Matthew HoltPicture 25

It’s just possible that you weren’t glued to the France24 cable channel (yes there is a French 24 hour news  & chat channel broadcast in English). Well yesterday they had a “debate” about healthcare hosted by the very smooth Francois Picard.

Jean-Jacques Zambrowski, a professor at Paris Descartes University got to talk about Bismarkcian and Beveridge-type systems (and why Michael Moore was wrong to call French & UK care as being the same). I was sitting in a dark studio in front of a DVD showing the Golden Gate Bridge. On the phone was Tevi Troy from the Hudson Institute (yes those right wingers) who basically spent most of his time agreeing with me—which I found pretty worrying!

Incidentally for a TV novice, I could barely hear the conversation, and couldn’t see anything, which meant that I never knew when I was on camera or not—so hopefully they don’t catch me picking my nose or something on screen!  Here’s the “debate” and here’s part 2.