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Contributing Voices
Paul Terry

The recent Health and Productivity Conference sponsored by the National Business Group on Health (NBGH) signaled the arrival of what social scientists have long held as vital to the success of wellness: a balance between personal and organizational engagement in health.

Contributing Voices
Randy Vogenberg, PhD, RPh

Although the results overall are not too surprising, after two rounds of end-to-end ICD-10 testing, the results at the North Carolina Healthcare Information and Communications Alliance are “scary,” executive director Holt Anderson told the Medical Group Management Association annual conference last week.

Contributing Voices
Jessica Cherian, PharmD, RPh

The Pioneer Accountable Care Organization (ACO) was an additional ACO model offered by Medicare, designed for groups that were already experienced in coordinating patient care across the care continuum. The shared-savings payment policy in this case is aligned with higher levels of both sharing and risk than that of the basic Shared Savings Program. Many had high hopes for the Pioneer groups and anticipated positive results when it came time for reporting in 2013.

Contributing Voices
Tom Ewers and Munzoor Shaikh

In several posts, Tom Ewers and Munzoor Shaikh of West Monroe Partners discuss the dynamics of health care payer mergers. Here, they describe the need for comprehensive operational and IT diligence.

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Success in health care mergers and acquisitions begins with getting the right people on the right teams.

If coordinating M&A transactions is not a common occurrence, then the chances of successfully completing a profitable transaction are slim. Studies show that most M&A transactions fail exactly for this reason.

Contributing Voices
Steven Peskin, MD

In doing research for a Grand Rounds needs assessment on humanism in medicine, I re-acquainted myself with a classic lecture by Dr. Francis Peabody, "The Care of the Patient" published in the Journal of the American Medical Association. (Peabody, FW: The Care of the Patient. JAMA 1927; 88:877–882.)

The words that Peabody spoke to his students in 1927, as Peabody himself faced his own mortality, having been diagnosed with cancer at age 45, are resonant and worthy of daily reminder for any of us involved in caring for patients, designing care models, influencing benefit plans, organizing systems of care, integrating technology into patient care, or serving in adminstrative leadership.

“Medicine is not a trade to be learned, but a profession to be entered,” he told his students. “The treatment of a disease may be entirely impersonal; the care of a patient must be completely personal.... the secret of the care of the patient is in caring for the patient.”

Steven R. Peskin, MD, MBA, FACP, is associate clinical professor of medicine at the University of Medicine and Dentistry of New Jersey – Robert Wood Johnson Medical School, and is governor of the American College of Physicians, New Jersey South.

Contributing Voices

Princeton’s Uwe Reinhardt, PhD, renowned health care economist, sits down with Managing Editor Frank Diamond to discuss the economic effects of the Affordable Care Act, wellness programs, and the state of health care in the United States in general.

Contributing Voices
Craig Keyes, MD, MBA

I saw my doctor last month for an annual physical. I cannot imagine a better primary care physician; he’s so thorough, so kind. After an exhaustive review, he said all seemed pretty much “ship shape,” but he had to add one dig: “Hey, I was glad to hear you finally went for your screening colonoscopy. Thing is … I can’t find any evidence that it actually happened. No claim, no entry into the electronic medical record, nothing. Did you end up having the procedure?” 

Contributing Voices
Krishna R. Patel, PharmD, RPh

Apps will begin to be prescribed by physicians by the end of this year. Call it disruption, innovation, or crossroad, but it will be here and the question is are we ready for it?

WellDoc has been selling type 2 diabetes apps, and will now be the first to launch a prescription app. Go ahead and search for “mobile diabetes management” on clinicaltrials.gov and what you find may surprise you. Just like drugs that must be approved by the FDA after presenting landmark clinical trials, BlueStar is a prescription app for Type 2 diabetes that was approved by the FDA upon showing efficacy and safety data.

Ford Motor Co. and Rite Aid are already catching on, as they have agreed to reimburse employees for using BlueStar through their prescription benefit plans. BlueStar manages patients’ disease by not only monitoring but also providing feedback to them and to their doctors.

Just as with any other drug, the health care provider prescribes the app for one month, along with refills. The prescription is received by the pharmacy, which runs it through the insurance company and also forwards the claim to WellDoc. A WellDoc trainer approaches the patient to set up the app on the patient’s mobile phone or laptop and also to provide instructions.

Contributing Voices
Jessica Cherian, PharmD, RPh

Will the FDA go back on a decision it made years ago? I am referring to a story that has a lot of buzz: whether or not the FDA will take recommendations from its advisory committee and change the restrictions on Avandia (rosiglitazone). Avandia was approved in 1999 and shortly became the top-selling type 2 diabetes medication in the world. In 2010, data from a number of trials convinced the FDA to severely restrict the medication through implementation of a Risk Evaluation and Mitigation Strategy (REMS), while Europe banned it entirely.

Contributing Voices
Peter Wehrwein

So last week it was all doom and gloom about Pioneer ACOs.

The buzz in health care wonkdom was all about 9 of the 32 organizations defecting from a program supposedly designed for the best and brightest of American health care organizations — with maybe more to follow. Accepting downside risk was just too perilous. Lags in getting data from Centers for Medicare & Medicaid Services (CMS) were undermining cost and quality control efforts. And the contradiction of being responsible (aka accountable) for the costs of Medicare enrollees but having no direct control over where they receive care — a central feature of the ACO model — was simply untenable.

But this morning CMS attempted to change the doleful Pioneer ACO tune with a long-awaited announcement of cost and quality results from 2012, the first year the Pioneer ACOs were in operation.

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