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Contributing Voices
Steven Peskin, MD

Steven Peskin MDAmericans’ girth is growing at an alarming rate. Many are too sedentary, too stressed, suffering from insomnia, making bad food choices. The drumbeat of “We need a culture of health versus a sickness culture” is a refrain that we now often hear and that I have espoused.

Contributing Voices
Steven Peskin, MD

Steven Peskin MD"You Can't Outrun Your Past"........ The title of a slide in a grand rounds presentation by Dr. David Kountz, senior VP for medical and academic affairs at Jersey Shore Medical Center and professor of medicine, UMDNJ-Robert Wood Johnson Medical School. The subtext is that the impact of being black in our society confers incremental risk across a range of cardiovascular and cardiometabolic conditions irrespective of socioeconomic status.

Contributing Voices
Robert Goldberg

Robert M. Goldberg

There has been a lot of discussion of the Food and Drug Administration’s decision to revoke approval for the use of Avastin in metastatic breast cancer. Most of it takes at face value FDA Commissioner Margaret A. Hamburg’s 69- page decision in which she claims that the “objective” evidence of benefit did not exist to support approval relative to the serious side effects of the drug.

Contributing Voices
Steven Peskin, MD

Steven Peskin MDA recent conversation reminded me of the forgotten population in health care — the non-utilizers. I was speaking with a physician leader in Lancaster, Pa., about his program that emulates the good work of Dr. Jeff Brenner and his team in Camden, N.J., that has targeted the 1 percent of patients responsible for 30 percent of the cost.

Contributing Voices
John Marcille

I was amused and somewhat unsettled when I heard of Kaggle, a company with a novel approach to data analysis. As I understand it, Kaggle is a middleman between companies that have large amounts of data and are looking for certain kinds of analysis and the people or companies that can provide that analysis. But with a twist.

Contributing Voices
Steven Peskin, MD

Steven Peskin MDThree times during the past month a friend has asked for advice regarding his/her personal health care or that of a family member out of frustration and concern stemming from not receiving clear communication/information about the health problem(s). This scenario is all too common.

Contributing Voices
Paul Terry

Paul Terry, PhD The Affordable Care Act codified the worksite wellness exemption to the federal medical underwriting provisions in the group health plan market. This means companies are allowed to use an “outcomes-based” incentive model that provides financial rewards for those who satisfy a prescribed health standard such as a BMI of less than 30 or who meet a “reasonable alternative standard” or obtain a waiver from their physician. What some see as “rewards” others view as penalties or surcharges and, given the absence of evidence to confirm the role of such incentives in actually improving population health, the new provisions have unleashed a debate about the ethics and putative effectiveness of the new provisions.

Contributing Voices
Al Lewis

When an employer group shifts from one health plan to another, why not allow them to take their claims data to the next health plan? That way, the new plan would gain immediate knowledge of the specific disease burden faced by its new members and be able to act accordingly vis-à-vis care management programs and other interventions. As it stands now, the new plan would have to wait many months and even then would lack the history that the earlier plan no longer needs. And when the new plan “finds out" about a member's condition, it might be due to a claim for an event that could have been prevented had the carrier had access to the earlier data.

Here’s how the system would work. When a group signs up with a carrier, it could reserve the right to have its data transferred if it changes carriers. Obviously, it wouldn’t be able to “see” its own patient-identified data any more than it does now, but the data would accompany the change of carriers.

Contributing Voices
John Marcille

Life is change. We here at Managed Care are breathing new life into our website by changing its look, but not only the look. Sure, it is more streamlined and easier on the eyes, but the change that excites us is in the content, which is richer and more interactive.

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