Now that the Florida primary is over and we await super Tuesday, it’s time to look closely at health proposals of Republicans. Unlike Democrats, they’re turning to market rather than governmental solutions. Governor Romney, of course, led the effort in Massachusetts to create a universal solution requiring every individual to buy insurance, but he now says that solution applies only to Massachusetts and shouldn’t be applied to other states.
Republican candidates want more options for individuals. They would create new deductions or tax credits for health insurance. Lower income people would get subsidies to purchase private insurance.
People could purchase health insurance across state lines, and regulations and mandates would be reduced to make health insurance less costly. Reduced premiums would bring new buyers into the market, expand competition, and force insurers and providers to offer more affordable options.
Here’s what the surviving GOP presidential candidates are saying.
- John McCain: "It is good tax policy to take away the bias toward giving workers benefits instead of wages. It is good health policy to reward having insurance no matter where your policy comes from. To use their money effectively, Americans need more choices."
- Mitt Romney, "The federal government needs to loosen regulations on the nation's health-insurance providers, increasing competition and thereby lowering patient costs. The right answer is less government, less regulation, more individual responsibility, and more of the market dynamics that propel the rest of our economy."
- Mike Huckabee: "I advocate policies that will encourage the private sector to seek innovative ways to bring down costs and improve the free market for health-care services. We can make health care more affordable by making health insurance more portable from one job to another, and making health insurance tax deductible for individuals and families as it now is for businesses."
The Republican presidential candidates want to give people the same tax benefit whether they purchase a policy on their own or they get it at work. They don’t want insurance tied to the workplace. Nor do they want individual mandates requiring everyone to buy insurance as Senator Clinton proposes. Senator Obama supports a mandate for children to get health insurance but not everyone. "The reason Americans don't have health insurance isn't because they don't want it, it's because they can't afford it.”
Major candidates of both parties support:
- More prevention
- greater use of electronic health records
- more information for consumers on choices and prices
- better chronic-care management
- medical malpractice reform. (assuming John Edwards has been effectively eliminated from the race)
- more consumer choice and control over health insurance
Barring a sweeping Democratic victory in the fall with control of Congress and the presidency and a veto-proof majority, complete transformation of the health system is unlikely.
Wednesday, January 30, 2008
Tuesday, January 29, 2008
U.S. health care system, regional variations - Listening to Floridians About Health Care
Fort Worth, Florida - I’ve learned two things from engaging Floridians in conversation and listening to what they have to say.
One, conversations start with weather. Weather obsesses Floridians. It justifies their living here.. Once they learn you hail from the North, they respond, “How cold was it there?” “You must be so happy to be here!” Or, apologetically, “I’m so sorry about our cool (or overcast, or rainy) weather. It’s usually much nicer.”
Weather opens and closes conversations. It dominates everything in-between. There’s no escaping it. Weather is an obsession.
Two, health care preoccupies, flummoxes, and irritates them. Once they know you’re a doctor, verbal floodgates open. Seldom is heard an encouraging word. Of the health care system, they say, “It’s broken.” “It costs too much.” “It’s a mess.” Or, “I like my doctor, but the rest of it sucks.” Still, they can’t seem to get enough of it.
There’s no single complaint theme. This should come as no surprise. For health care, like Florida itself, is diverse. Florida, our 4th most populous state, has Crackers to the North, New Yorkers and Yankees to the East, Midwesterners to the West, Cubans to the South, and Immigrants, Snowbirds, Retirees, Canadians, Transients, and Veterans (2 million of them, mostly for McCain) Everywhere.
Here are four excerpts I heard on my Listening Tour.
• A 6o-ish woman, a PhD in French literature, a textbook writer, an industrial consultant to French companies in America, and a breast cancer survivor, complained, “My surgeon, my pathologist, and my internist don’t communicate with each other. In reformspeak, we call this “fragmentation” and “lack of coordination.” We say it can be eased electronically by EMRs, PHRs, and e-mail visits.
• A 42 year old married, woman housecleaner, mother of four, whose husband had lost his job, told me, “I had to drop my insurance because we couldn’t afford it.” In reformspeak, we call her one of the”working uninsured,” who comprise 82% of America’s 47 million uninsured. Democrats propose to solve this problem by pouring in more federal money and subsidizing care for all. Republicans say we can solve it through tax credits for all and market innovation.
• A 70 year old married former well-to-do businesswoman, informed me she and her husband have joined a concierge practice. They pay $1500 a year each for personal attention, 24/7 access, and other amenities. She and her husband are immensely satisfied with the care they receive. In reformspeak, depending on your political point of of view, we deem concierge care as “two –tier luxury care,” or “innovative practice design.”
• A 50-ish married, fully-insured Bed and Breakfast proprietress, related this story. She awoke at night with intense rib cage pain. . Not knowing what to do or where to go, she hastened to an emergency room where herpes zoster was diagnosed. She added she has aortic stenosis and will have a valve replaced later this year. In reformspeak, we often say ERs are overcrowded with the uninsured, but the reality is the insured, particularly Medicare patients,. comprise the majority of ER patients. It’s a question of access during off-hours. This partially explains why retail clinics and urgicare centers are proliferating. As for her heart surgery, in reformspeak , we proclaim hospital costs have to come down, but we have yet to find a way to lower them. The problem is we just love those life-saving and lifestyle-saving hospital-based technologies.
Today is the Florida primary. Bringing down the cost of care and covering the uninsured will be on every politician’s lips. Meanwhile and hereafter, more retail clinics and urgicenters will sprout, more obstetricians and neurosurgeons will flee Florida for colder climes in search of lower malpractice premiums, and shortages of 120,000 nurses and 50,000 doctors will make most reform proposals impractical. What good is expanded coverage without access to care?
In a perfect health care world, which I described in an essay “2020: The View from 2006,”October 3, 2006, in healthleadersmedia.com, everyone will be insured, medical bankruptcy will be a historical curiosity, all will have a medical home rooted in a primary care practice, people will shed all bad habits, pricing and quality will be transparent to all, and freedom to chose the doctor and institution of one’s choice, will be unlimited.
That isn’t going to happen soon. Massachusetts universal health plan’s cost
overruns have mounted to $400 million, California’s plan will likely fail because of its $14 billion cost, San Francisco is promising to cover all, and the resilient U.S health system shows no sign of collapsing, Stay tuned.
One, conversations start with weather. Weather obsesses Floridians. It justifies their living here.. Once they learn you hail from the North, they respond, “How cold was it there?” “You must be so happy to be here!” Or, apologetically, “I’m so sorry about our cool (or overcast, or rainy) weather. It’s usually much nicer.”
Weather opens and closes conversations. It dominates everything in-between. There’s no escaping it. Weather is an obsession.
Two, health care preoccupies, flummoxes, and irritates them. Once they know you’re a doctor, verbal floodgates open. Seldom is heard an encouraging word. Of the health care system, they say, “It’s broken.” “It costs too much.” “It’s a mess.” Or, “I like my doctor, but the rest of it sucks.” Still, they can’t seem to get enough of it.
There’s no single complaint theme. This should come as no surprise. For health care, like Florida itself, is diverse. Florida, our 4th most populous state, has Crackers to the North, New Yorkers and Yankees to the East, Midwesterners to the West, Cubans to the South, and Immigrants, Snowbirds, Retirees, Canadians, Transients, and Veterans (2 million of them, mostly for McCain) Everywhere.
Here are four excerpts I heard on my Listening Tour.
• A 6o-ish woman, a PhD in French literature, a textbook writer, an industrial consultant to French companies in America, and a breast cancer survivor, complained, “My surgeon, my pathologist, and my internist don’t communicate with each other. In reformspeak, we call this “fragmentation” and “lack of coordination.” We say it can be eased electronically by EMRs, PHRs, and e-mail visits.
• A 42 year old married, woman housecleaner, mother of four, whose husband had lost his job, told me, “I had to drop my insurance because we couldn’t afford it.” In reformspeak, we call her one of the”working uninsured,” who comprise 82% of America’s 47 million uninsured. Democrats propose to solve this problem by pouring in more federal money and subsidizing care for all. Republicans say we can solve it through tax credits for all and market innovation.
• A 70 year old married former well-to-do businesswoman, informed me she and her husband have joined a concierge practice. They pay $1500 a year each for personal attention, 24/7 access, and other amenities. She and her husband are immensely satisfied with the care they receive. In reformspeak, depending on your political point of of view, we deem concierge care as “two –tier luxury care,” or “innovative practice design.”
• A 50-ish married, fully-insured Bed and Breakfast proprietress, related this story. She awoke at night with intense rib cage pain. . Not knowing what to do or where to go, she hastened to an emergency room where herpes zoster was diagnosed. She added she has aortic stenosis and will have a valve replaced later this year. In reformspeak, we often say ERs are overcrowded with the uninsured, but the reality is the insured, particularly Medicare patients,. comprise the majority of ER patients. It’s a question of access during off-hours. This partially explains why retail clinics and urgicare centers are proliferating. As for her heart surgery, in reformspeak , we proclaim hospital costs have to come down, but we have yet to find a way to lower them. The problem is we just love those life-saving and lifestyle-saving hospital-based technologies.
Today is the Florida primary. Bringing down the cost of care and covering the uninsured will be on every politician’s lips. Meanwhile and hereafter, more retail clinics and urgicenters will sprout, more obstetricians and neurosurgeons will flee Florida for colder climes in search of lower malpractice premiums, and shortages of 120,000 nurses and 50,000 doctors will make most reform proposals impractical. What good is expanded coverage without access to care?
In a perfect health care world, which I described in an essay “2020: The View from 2006,”October 3, 2006, in healthleadersmedia.com, everyone will be insured, medical bankruptcy will be a historical curiosity, all will have a medical home rooted in a primary care practice, people will shed all bad habits, pricing and quality will be transparent to all, and freedom to chose the doctor and institution of one’s choice, will be unlimited.
That isn’t going to happen soon. Massachusetts universal health plan’s cost
overruns have mounted to $400 million, California’s plan will likely fail because of its $14 billion cost, San Francisco is promising to cover all, and the resilient U.S health system shows no sign of collapsing, Stay tuned.
Monday, January 28, 2008
Harvard Med
Lake Worth, Florida - I take along a book on my trips. For this trip, I chose Harvard Med: The Story Behind America’s Premier Medical School and the Making of America’s Doctors (Adams Media, 1996).
I’m not a Harvard med man. I went to Duke. But I knew the author, John Lagone, a journalist who died last year in his 70’s of lymphocytic lymphoma. John worked for newspapers and wrote 15 books on social, medical, and technology issues. One of his books, for the Smithsonian, The Way Things Work, became a best seller. John also reviewed scores of health-related books for the New York Times.
Harvard Med recounts a year in the life of a Harvard Medical School class. John describes the mix, backgrounds, skills, drives, and dreams of incoming students. He focuses on the culture of the school - its history, attitudes, biases, strengths, and ambience, “It is, “ he says, “and is likely to remain a haven for 3Ms – male medical magistri, gowned gurus who are far more scholar, researcher and specialist than empathetic, readily available healers – and for the students who want to emulate them.” It is not, he says again and again, not an ideal breeding round for primary care physicians.
In one chapter “Science is Easy, Humanity is Hard.” John notes how hard it is to insert compassion into course work. The problems, he observes, are dominance of science and technology, massive amounts of hard facts to be absorbed, sheer constraints of time, and realities of where rewards lie in our high tech health system. It is not an environment conducive to teaching primary care. Most training takes place in hospital acute care pressure cookers. Most outpatient training occurs in clinics at one of Harvard’s twenty hospitals, which serve poor and disenfranchised minorities many of whom are struggling to learn English. This may not be ideal training ground for caring for mainstream Americans.
Don’t misread me. John is a huge fan of Harvard Med, its eminence, its world class faculty, and its reputation as a research facility. He is just saying much of the Harvard students’ medical education occurs in a tertiary, indeed quaternary, referral hospital setting.
As I read John’s fine book, I’m reminded the more things change, the more the rhetoric heats up about health reform, the more things remain the same. The emphasis in American medicine remains on acute care, technological fixes, and research breakthroughs. In these areas reside the missionsof Harvard Medical School, and it does them superbly. But these missions leave little time for primary care. For aspiring primary care physicians, the rewards, incentives, peer approval, and personal gratification are not there.
I’m not a Harvard med man. I went to Duke. But I knew the author, John Lagone, a journalist who died last year in his 70’s of lymphocytic lymphoma. John worked for newspapers and wrote 15 books on social, medical, and technology issues. One of his books, for the Smithsonian, The Way Things Work, became a best seller. John also reviewed scores of health-related books for the New York Times.
Harvard Med recounts a year in the life of a Harvard Medical School class. John describes the mix, backgrounds, skills, drives, and dreams of incoming students. He focuses on the culture of the school - its history, attitudes, biases, strengths, and ambience, “It is, “ he says, “and is likely to remain a haven for 3Ms – male medical magistri, gowned gurus who are far more scholar, researcher and specialist than empathetic, readily available healers – and for the students who want to emulate them.” It is not, he says again and again, not an ideal breeding round for primary care physicians.
In one chapter “Science is Easy, Humanity is Hard.” John notes how hard it is to insert compassion into course work. The problems, he observes, are dominance of science and technology, massive amounts of hard facts to be absorbed, sheer constraints of time, and realities of where rewards lie in our high tech health system. It is not an environment conducive to teaching primary care. Most training takes place in hospital acute care pressure cookers. Most outpatient training occurs in clinics at one of Harvard’s twenty hospitals, which serve poor and disenfranchised minorities many of whom are struggling to learn English. This may not be ideal training ground for caring for mainstream Americans.
Don’t misread me. John is a huge fan of Harvard Med, its eminence, its world class faculty, and its reputation as a research facility. He is just saying much of the Harvard students’ medical education occurs in a tertiary, indeed quaternary, referral hospital setting.
As I read John’s fine book, I’m reminded the more things change, the more the rhetoric heats up about health reform, the more things remain the same. The emphasis in American medicine remains on acute care, technological fixes, and research breakthroughs. In these areas reside the missionsof Harvard Medical School, and it does them superbly. But these missions leave little time for primary care. For aspiring primary care physicians, the rewards, incentives, peer approval, and personal gratification are not there.
Saturday, January 19, 2008
Blogging, doggerel - Global Cooling
Fort Lauderdale, Florida - I’m down here to escape global cooling. Snow, ice, and frigid temperature grip almost 70% of the U.S. today. It seems like global cooling, but you and I and the rest of the intelligentsia know it’s actually the perverse effects of global warming. It just doesn’t feel that way.
When I left New England yesterday, it was 5 above – much warmer than Northern Minnesota, where it plunged to 36 below. I’m reminded of an essay I wrote some years ago, when I lived in Minnesota, “Warming UP Cold Statistics: Or, How to Talk to Floridians about Minnesota Winters.”
Here are a few tricks I mentioned when kibitzing with warm-blooded Floridians:
• Discuss Distances – Inform the aghast Floridian that International Falls is 310 miles north of the Twin Cities. To judge Minnesota weather on the basis of International Falls is ridiculous. It’s like comparing frost-prone Jacksonville to frost-free Miami, 345 miles south of Jacksonville.
• Emphasize the “Heat Shield” hovering over major Minnesota Cities. Big northern cities have big heat shields. The temperatures of these cities are much hotter than International Cities.
• Think High and Hot – Here are the hottest historical temperatures in the Twin Cities during winter months.
November, 1933 – 77 degrees
December, 1939 - 63 degrees
January, 1846 – 59 degrees
February, 1896- 63 degrees
March, 1910 – 83 degrees
• Avoid Speaking about Wind Chill Factor – Do not discuss the wind chill factor. Who wants to know a 20 miles wind on a 20 degrees day feels like 9 below and what it does to exposed flesh. The Floridian already knows enough about exposed flesh.
• Talk about the Discomfort Index - Instead of discussing the Wind Chill Factor, push the Discomfort Index. The higher the heat and humidity, the greater the Discomfort Index. Tell the Floridians an index of 75 is uncomfortable for most people, an index of over 80 is uncomfortable for everybody, when the temperature is 95 everybody is uncomfortable no matter what the humidity. Provide him with a chart showing him how to calculate the Discomfort Index. This chart has nothing to do with Minnesota weather. That’s the point. The Discomfort Index is a diverting maneuver.
• Tell him Minnesota has a “dry cold.” This is the kind of cold you don’t really feel (unless you go outside, of course). Besides, the Mean Absolute Hi8midity (whatever that is) reaches its lowest point in the coldest months. Florida, on the other hand, has a “wet heat” – the kind that drenches you with sweat and makes you feel uncomfortable (and attracts Yankees in droves).
• Unleash The Sunshine Quotient -_ Then there’s the Sunshine Quotient – the % of days with sunshine + number of clear days + Snow Glare Intensity factor. You can find these facts on google Remind your listener that in Minnesota sunglasses are an absolute necessity to protect against the blinding glare of Minnesota winters. Compare the Sunshine Quotient of the Twin Cities against major Florida Cities, use a Snow Glare Intensity factor of 100, and the Twin Cities wins hands down.
• Pay the name game – Pull out the Miami and Twin Cities telephone directories and look up cold and warm names. Miami has 72 winters, nine Shivers, 6 Colds, One Ice, 37 Snows, two Snowballs, 12 Blizzards, 45 Frosts, and One freeze. At the other pole, Minneapolis-St. Paul has 46 summers, four Springs, two Hotts, one Heater, 74 Beaches, and two Warms, two Warmings, One Sunn, 59 Sands, 10 Sweats, and 129 Palms.
These are the cold facts
When I left New England yesterday, it was 5 above – much warmer than Northern Minnesota, where it plunged to 36 below. I’m reminded of an essay I wrote some years ago, when I lived in Minnesota, “Warming UP Cold Statistics: Or, How to Talk to Floridians about Minnesota Winters.”
Here are a few tricks I mentioned when kibitzing with warm-blooded Floridians:
• Discuss Distances – Inform the aghast Floridian that International Falls is 310 miles north of the Twin Cities. To judge Minnesota weather on the basis of International Falls is ridiculous. It’s like comparing frost-prone Jacksonville to frost-free Miami, 345 miles south of Jacksonville.
• Emphasize the “Heat Shield” hovering over major Minnesota Cities. Big northern cities have big heat shields. The temperatures of these cities are much hotter than International Cities.
• Think High and Hot – Here are the hottest historical temperatures in the Twin Cities during winter months.
November, 1933 – 77 degrees
December, 1939 - 63 degrees
January, 1846 – 59 degrees
February, 1896- 63 degrees
March, 1910 – 83 degrees
• Avoid Speaking about Wind Chill Factor – Do not discuss the wind chill factor. Who wants to know a 20 miles wind on a 20 degrees day feels like 9 below and what it does to exposed flesh. The Floridian already knows enough about exposed flesh.
• Talk about the Discomfort Index - Instead of discussing the Wind Chill Factor, push the Discomfort Index. The higher the heat and humidity, the greater the Discomfort Index. Tell the Floridians an index of 75 is uncomfortable for most people, an index of over 80 is uncomfortable for everybody, when the temperature is 95 everybody is uncomfortable no matter what the humidity. Provide him with a chart showing him how to calculate the Discomfort Index. This chart has nothing to do with Minnesota weather. That’s the point. The Discomfort Index is a diverting maneuver.
• Tell him Minnesota has a “dry cold.” This is the kind of cold you don’t really feel (unless you go outside, of course). Besides, the Mean Absolute Hi8midity (whatever that is) reaches its lowest point in the coldest months. Florida, on the other hand, has a “wet heat” – the kind that drenches you with sweat and makes you feel uncomfortable (and attracts Yankees in droves).
• Unleash The Sunshine Quotient -_ Then there’s the Sunshine Quotient – the % of days with sunshine + number of clear days + Snow Glare Intensity factor. You can find these facts on google Remind your listener that in Minnesota sunglasses are an absolute necessity to protect against the blinding glare of Minnesota winters. Compare the Sunshine Quotient of the Twin Cities against major Florida Cities, use a Snow Glare Intensity factor of 100, and the Twin Cities wins hands down.
• Pay the name game – Pull out the Miami and Twin Cities telephone directories and look up cold and warm names. Miami has 72 winters, nine Shivers, 6 Colds, One Ice, 37 Snows, two Snowballs, 12 Blizzards, 45 Frosts, and One freeze. At the other pole, Minneapolis-St. Paul has 46 summers, four Springs, two Hotts, one Heater, 74 Beaches, and two Warms, two Warmings, One Sunn, 59 Sands, 10 Sweats, and 129 Palms.
These are the cold facts
Blogging, doggerel - More Medical Groups
In a recent post, I suggested a series of group names for certain specialists. Readers recommend these additions
A Scrotum of Urologists
A Clot of Hematologists
A Phalanx of Hand Surgeons
A Tarsus of Foot Surgeons
A Pedology of Pediatricians
A Premie of Neonatologists
An Elder of Geriatricians
A Grope of Sex Therapists
A Flaccid of ED Specialists
A Clan of Family Physicians
An Implant of Plastic Surgeons
A Conduction of Cardiologists
A Cohort of Epidemiologists
A Sample of Biostatisticians
A School of Deans
A Gonad of Fertility Specialists
An Eruption of Dermatologists
A Corridor of Hospitalists
A Plethora of Proceduralists
A Triage of ER Physicians
A Polyp of Colonoscopists
A Loci of Locums
A Finding of Researchers
An AA-Ha of ENT Specialists
An A-Choo of Cold Sufferers
A Cliché of Medical Writers
A Rejection of Medical Editors
A Trivia of Medical Bloggers
A Scrotum of Urologists
A Clot of Hematologists
A Phalanx of Hand Surgeons
A Tarsus of Foot Surgeons
A Pedology of Pediatricians
A Premie of Neonatologists
An Elder of Geriatricians
A Grope of Sex Therapists
A Flaccid of ED Specialists
A Clan of Family Physicians
An Implant of Plastic Surgeons
A Conduction of Cardiologists
A Cohort of Epidemiologists
A Sample of Biostatisticians
A School of Deans
A Gonad of Fertility Specialists
An Eruption of Dermatologists
A Corridor of Hospitalists
A Plethora of Proceduralists
A Triage of ER Physicians
A Polyp of Colonoscopists
A Loci of Locums
A Finding of Researchers
An AA-Ha of ENT Specialists
An A-Choo of Cold Sufferers
A Cliché of Medical Writers
A Rejection of Medical Editors
A Trivia of Medical Bloggers
Physicians and Health Plans - 2008 Forecast for Managed Care
"Health plans often declare that they want to have good relationships with their physicians. But UnitedHealthGroup has at least 315,000 reasons to be extra nice. That number represents the 2007 slide the insurer experienced in employer-sponsored and individual memberships. The company attributed the loss, in part, to frayed relations with patients and doctors.”
Emily Berry, “Enrollment Drop has United Vowing to be Nicer,” American Medical News, January 14, 2008
I’ve never been a fan of managed care. Indeed, in 1988 in And Who Shall Care for the Sick? The Corporate Transformation of Medicine in Minnesota (Medica Medicus, Minneapolis), I predicted patients and physicians would ultimately rebel or drop HMO plans. This week UnitedHealthCare Group announced it lost 315,000 members in 2007 and wants to make amends with doctors. The bloom is off the HMO rose.
On January 31, 1:30PM -3:00 PM, The Executive Report on Managed Care and The Managed Care Information Center will sponsor a live 90 minute audio and Webinar conference, with these discussants:
• Jim Adams, Executive Director, IBM Center for Healthcare Management
• Peter Kongstvedt, M.D., F.A.C.P, Health/Managed Care Consulting Services, Accenture
• Gregory J. Pepe, Principal with the law firm of Neubert, Pepe & Monteith
Notice no representative of the practicing physician community is present at the table. It’s as if those who deliver the care don’t really count.
Issued to be discussed include:
• uneasy relationships with doctors.
• continued rebellion by doctors
• inadequate reimbursement
• increasing costs
• who is going to foot the bill,
• health benefit cost increases
• contracting and negotiation issues
• claim denials
• impact of provider pay-for-performance programs
• growth and effectiveness of consumer driven health plans
• controversial quality rankings of doctors
• transparency
• reform initiatives
• health plan consolidation.
You might want to put in your two cents at the end of the following agenda
Agenda
• Top managed care issues for 2008
• Emerging estrangement in the payer-physician arena
• Market forces and pressures leading to revolutionary change for health plans
• Will approaches to expanding coverage for all Americans be focused on individual coverage or employer-sponsored coverage?
• How entry of new health care business models might impact health plans
• changing role of the consumer
• increased focus on price and quality data transparency
• Proliferating physician ratings by consumers and health insurers
• Momentum of Pay-for-Performance into the private and public sectors
• Linking evidence-based medicine to P4P
• How physicians can successfully participate with P4P Measures
• New initiatives for improvement in quality
• Shifts away from payment for medical errors
• Need for IT support for new and disparate functions in health plans
• Resurgence of IPAs and PHOs as engines of change
This agenda will be followed by a live question and answer session. This is where you might want to weigh in.
For more information, visit http://www.healthresourcesonline.com/edu/mc08wc.htm or call
The Managed Care Information Center
PO Box 559, Allenwood, NJ 08720
1-800-516-4343
Emily Berry, “Enrollment Drop has United Vowing to be Nicer,” American Medical News, January 14, 2008
I’ve never been a fan of managed care. Indeed, in 1988 in And Who Shall Care for the Sick? The Corporate Transformation of Medicine in Minnesota (Medica Medicus, Minneapolis), I predicted patients and physicians would ultimately rebel or drop HMO plans. This week UnitedHealthCare Group announced it lost 315,000 members in 2007 and wants to make amends with doctors. The bloom is off the HMO rose.
On January 31, 1:30PM -3:00 PM, The Executive Report on Managed Care and The Managed Care Information Center will sponsor a live 90 minute audio and Webinar conference, with these discussants:
• Jim Adams, Executive Director, IBM Center for Healthcare Management
• Peter Kongstvedt, M.D., F.A.C.P, Health/Managed Care Consulting Services, Accenture
• Gregory J. Pepe, Principal with the law firm of Neubert, Pepe & Monteith
Notice no representative of the practicing physician community is present at the table. It’s as if those who deliver the care don’t really count.
Issued to be discussed include:
• uneasy relationships with doctors.
• continued rebellion by doctors
• inadequate reimbursement
• increasing costs
• who is going to foot the bill,
• health benefit cost increases
• contracting and negotiation issues
• claim denials
• impact of provider pay-for-performance programs
• growth and effectiveness of consumer driven health plans
• controversial quality rankings of doctors
• transparency
• reform initiatives
• health plan consolidation.
You might want to put in your two cents at the end of the following agenda
Agenda
• Top managed care issues for 2008
• Emerging estrangement in the payer-physician arena
• Market forces and pressures leading to revolutionary change for health plans
• Will approaches to expanding coverage for all Americans be focused on individual coverage or employer-sponsored coverage?
• How entry of new health care business models might impact health plans
• changing role of the consumer
• increased focus on price and quality data transparency
• Proliferating physician ratings by consumers and health insurers
• Momentum of Pay-for-Performance into the private and public sectors
• Linking evidence-based medicine to P4P
• How physicians can successfully participate with P4P Measures
• New initiatives for improvement in quality
• Shifts away from payment for medical errors
• Need for IT support for new and disparate functions in health plans
• Resurgence of IPAs and PHOs as engines of change
This agenda will be followed by a live question and answer session. This is where you might want to weigh in.
For more information, visit http://www.healthresourcesonline.com/edu/mc08wc.htm or call
The Managed Care Information Center
PO Box 559, Allenwood, NJ 08720
1-800-516-4343
Subscribe to:
Posts (Atom)
![The Road to Hell is Paved wtih Good Intentions: The Story of ObamaCare: The First Book of a Tetrology [Kindle Edition]](http://i57.tinypic.com/14cgxgx.jpg)
![Direct Pay Independent Practice Medicine and Surgery [Kindle Edition]](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgKJWM6SltCn4DnwWhN4vOVwSOfpffemkWEbuZ-sA3qYPS5DucGczP4X5yB9eJGpnCm41EkvBiXUgPa4B6kCMl8qW_VL_BLVMCB-EFyNzY_Yj_oMbVo58r9cbLt824oQOEnEx-ZRkiy_q19/s1600/direct-pay-independent-practice-medicine-and-surgery.jpg)
