News & Commentary

The development of new therapies for pediatric cancer largely depends on federal and philanthropic funding because the pharmaceutical industry focuses on the vastly larger potential market for adult cancer drugs. Plans can help by covering the costs for doing the genomic analysis that helps place patients in specific trials.

Viewpoint
Richard G. Stefanacci, DO
;
Scott Guerin, PhD

American health care has been moving away from dependence on PCPs for decades. The continued erosion of primary care practice by non-PCPs such as patient navigators, and nurse practitioners will surely mean that the corner PCP office serving FFS Medicare patients is quickly going, going, gone....

The Hippocratic oath says, “First, do no harm.” The early 21st century push to make health care more convenient seems to add, “and make it snappy.” Retail clinics are perhaps the most prominent and market-proven aspect of the move to convenience. But there are many variations on the theme.
Q&A: A Conversation With Ateev Mehrotra, MD
Interview by Peter Wehrwein

Ateev Mehrotra, MD

This expert on retail clinics, telemedicine, and other convenient care delivery models says that the insatiable American appetite for convenience is spreading to health care. Quality may actually improve in some areas, his research has shown, but any cost savings may be offset by greater utilization.

Two hundred seventy provider-sponsored plans (PSPs), in which health systems and insurers join forces to create an integrated model, are in operation today—up from 107 just two years ago. More and more PSPs continue to outperform their competitors as they have learned the hard lessons from the late 1990s, when many providers entered and exited the PSP business often with sizable and embarrassing losses. Today, however, many powerful global drivers such as downward pressure on costs, aging population, and the embrace of value-based models, have made the market ripe for PSPs’ emergence as a potentially disruptive industry innovator.

News & Commentary

Because there are always minute tremors in even the best surgeons’ hands, this breakthrough depends on imaging technology that is guided by a computer program, not a human being. The program incorporates best surgical practices in determining when and how to suture.

Viewpoint
Rita E. Numerof
;
Michael N. Abrams
Private health insurers are in a perilous position these days. But along with peril comes the opportunity to make disruptive changes and seize substantial market share. Leaders throughout the health care insurance industry must be proactive about initiating business model innovation.
Paul Terry

With the support of the Robert Wood Johnson Foundation, 35 of us visited the Lincoln Cottage, a hilltop retreat overlooking D.C. where Lincoln found solace, but also connected more closely with people, during the Civil War. Our group was there to inaugurate a national dialogue on health equity. Later dubbed the “Lincoln Cottage Assembly,” we were welcomed by health futurist Jonathan Peck at the staircase Lincoln climbed every day to write about the most vexing issue of his time.

Tomorrow’s Medicine
Thomas Morrow, MD

Robotized tele-echography system

The possibilities are endless. For instance, an orthopedist can view X-rays done in the prison infirmary, diagnose the fractures common to this environment and talk a cast tech, who is onsite, through simple reductions and casting—any time of the day or night from the comfort of his office. It costs $1,000 just to transfer a prisoner to the hospital.

Convenience Medicine
Jan Greene

Karen Marlo
NBGH

There’s a term used in the digital world: “stickiness.” Digital engagement doesn’t just happen. Insurers should develop apps that will make patients want to return to view their health data, perhaps in those empty moments waiting in line or during a lull in the action during a child’s soccer game.

Convenience Medicine
Joseph Burns

Kenneth Coburn, MD
Health Quality Partners

While it’s still rare to find a physician who will make house calls, a growing number of doctors and other clinicians are bringing the old-fashioned practice back, especially when it comes to dealing with the frail elderly. Problem: The doctors who do this aren’t getting paid enough.
Jonathan Gavras, MD
Chief Medical Officer, Prime Therapeutics

Our country is in crisis. We have an epidemic on our hands that crosses geographic boundaries, socio-economic status, gender, and many other categories. According to the American Society of Addiction Medicine, drug overdoses kill nearly 50,000 Americans each year. The media is certainly putting a microscope on it. Legislators are acting on it. Every stakeholder in the medical delivery chain is analyzing it–and I encourage physicians and other prescribers to take a look at their role in the problem.