The National Governors Association (NGA) met in Philadelphia this week, where my City of Brotherly and Sisterly Love is witnessing some sobering discussions about health care.
On the one hand, Bill Clinton called in his opening keynote speech for the states to be laboratories of democracy.
But how much health-democracy can each governor afford when balancing their budget in the face of declining revenues? According to the NGA’s 2008 Fiscal Survey of the States, not a whole lot.
People enrolled in high-deductible health plans tend to make more risky health
decisions than those enrolled in lower-deductible plans, according to a study published in the July/August issue of Health Affairs.
In Do Consumer-Directed Health Plans Drive Change In Enrollees’ Health Care Behavior? the authors find the answer is, "yes," probably.
Enrollees in the high-deductible CDHP were more likely to forgo medical care to save money.
Consumers are interested in a variety of financial instruments to help them purchase health care. However, even when given a choice to shop for and eventual purchase insurance, millions of people don’t.
Consumers are confused about health plan choices and need help in financial decision making. Data from McKinsey presented in an essay, "What consumers want in health care," analyzes results from a survey of about 3,000 retail health consumers. According to McKinsey, "many consumers aren’t accustomed to shopping for health insurance, so they are not prepared for this additional responsibility."
One of the most surprising, sobering findings is that people were more concerned about the cost of illness than about the illness itself.
Last week two new excellent new reports on health spending asked, do
we get what we pay for?
The answer is, well, sometimes — particularly when you follow the perverse incentives that lead you on the money trail of waste, ineffectiveness and, worst of all, poor health outcomes.PricewaterhouseCoopers’ Health Research Institute and the Center for Studying Health System Change offer their views on this topic with slightly different lenses.
In You Get What You Pay For, PwC examines 20 health systems and finds that managing costs is the top ranked factor for re-engineering payment systems throughout. Costs are put ahead of quality, efficiency, or meeting demand. While prospective payment (a la DRGs) has been adopted in 20 countries belonging to the OECD, and two-thirds of those countries believe their payment methods will change as they’re not stemming cost increases.
"Better informed patients" are seen as an optimal way to manage demand — not increasing out-of-pocket payments, at least not as a strategy on its own.
Consumers, employers, payers and providers agree that information flows are critical to helping stem health care costs. While there is shared concern about health care costs, there is also a shared desire for more, accessible information and better online tools for managing it.
TriZetto’s report, Research Shows Healthcare Market Constituents Seek Information as Key to Solving the Affordability Crisis, surveys the landscape of stakeholders in American health care and lays out a rational approach to what the IT services firm calls integrated health care management.
TriZetto lays out five key themes that drive the imperative toward integrated health care management:
By 
The relationship between patients and doctors is fundamentally changing. Transparency in medical records, patients’ accessibility to health information online, and online social media driving patient-to-patient conversations are some forces at the base of the future of health care.
This, according to a thought-provoking report that addresses the evolving nature of patients vis-à-vis physicians in the National Health Service (NHS) in the U.K. These factors are also driving change in health and health care in the U.S.
The Talking Cure: Why Conversation is the Future of Health Care is an essay published in mid-May 2008 by two smart guys at Demos. As the National Health Service in the U.K. approaches its 60th birthday, the Demos research organization launched The Healthy Conversations project (now known as The Talking Cure) to engage stakeholders in and outside of the NHS in a dialogue of how to move patients to the center of health in the U.K.
The cost of health insurance is the No. 1 problem cited by small business owners. Health costs beat gas prices — the No. 2 most severe problem cited by small business, in a March 2008 survey.
This week, small business leaders convened at the annual National Small Business Summit conference of the National Federation of Independent Business (NFIB).
The report notes the downturn in the economy during the second half of 2007 when the NFIB Small Business Optimism Index dropped to 94.6 in December, the lowest since 2001.
Employees are split on whether employer wellness programs intrude on privacy, according to an Issue Brief from the Center for Studying Health System Change (CSHC).
The report details the results of interviews conducted in 2007 in 12 metropolitan American communities: Boston, Cleveland, Greenville, Indianapolis, Lansing, Little Rock, Miami, northern New Jersey, Orange County, Phoenix, Seattle, and Syracuse.
Employee wellness programs are growing in the marketplace as employers try to stem ever-increasing costs, both direct and indirect. This is real money: a report from the American Hospital Association estimated that three chronic diseases — asthma, diabetes and hypertension — accounted for 164 million days of absenteeism each year which cost cost employers $30 billion.
The return on investment of health care information technology isn’t uniformly positive, according to a recent analysis from the Congressional Budget Office titled, Evidence on the Costs and Benefits of Health Information Technology.
The underlying rationale for the report, which was requested by the Senate Budget Committee, is to sort out the federal government’s role in health IT. The report asks, "Whether — and if the answer is yes, how — the federal government should stimulate and guide the adoption of health IT."
The federal government is already in the health care IT fray. President Bush set the goal in 2004 that every American have an electronic health record by 2014. This was a vision, however, without a funding source. There are also several proposals in Congress that would expand the federal government’s role in health IT by mandating the use of electronic prescribing, provide financial incentives to providers who use health IT, and offer grants to purchase systems for providers.
The CBO report points out a major benefit of health IT that has been largely overlooked: IT’s role in research on the comparative effectiveness of medical treatments and practices. When individuals’ health data is in electronic format, it can be depersonalized, aggregated, and analyzed for a range of uses, such as medical effectiveness, quality, and system efficiency, among other research questions.
One sentence in the 48-page report encapsulates the Mother of All Barriers to Health IT Adoption: "How well health IT lives up to its potential depends in part on how effectively financial incentives can be realigned to encourage the optimal use of the technology’s capabilities."
Consumers, at least Californians, do a lot of looking for health
information on the Internet — but very little health management.
California HealthCare Foundation (CHCF) has taken a snapshot of
Californians’ use of the Internet in health care. The profile is
presented in CHCF’s report, Just Looking: Consumer Use of the Internet
to Manage Care.
Topline: insured, more affluent, and younger people use the Internet in health searching.
As the chart at right details, the most popular care-related uses on the
Internet include searching for information about conditions and drugs,
finding a physician, checking ratings, and looking for claims and
benefit information online.
Some 13 percent of Californians are lucky enough to be making appointments online, and 12 percent are filling Rx’s online.
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