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A group of Dallas doctors has tapped the power of social networking to communicate with its patients.
During a dinner Tuesday night to celebrate the second anniversary of the Partnership for Peak Healthcare Performance, Karen Kennedy, CEO of the Medical Clinic of North Texas, reported that the medical group had recently "tweeted" patients who had previously agreed to receive communications via Twitter to alert them about the availability of the H1N1 vaccine.
This innovation is part of the medical group's ongoing effort to serve as a “medical home” for its patients, she explained. The medical group, which has had electronic medical records for 10 years now, is also preparing to communicate via e-mail with patients, according to Ms. Kennedy, who is negotiating with insurers about how doctors will be compensated for doing so.
The Medical Clinic of North Texas' strategic vision is to become the “premier multi-specialty group in the nation,” as well as “the most cost-efficient deliverer of patient-centered care,” Ms. Kennedy said during her presentation at the dinner, which was organized by the Dallas-Fort Worth Business Group on Health and sponsored by drug maker sanofi-aventis U.S.
The dinner also featured updates on the Partnership, a collaborative program launched by DFWBGH in 2007 to improve the quality of care for patients with chronic conditions.
In May, the Partnership distributed reports on diabetes care quality to 1,300 primary care physicians and endocrinologists throughout Dallas and Fort Worth. It was the group's first step toward future public reporting of such information.
The retail clinic market has grown about 15% over the past two years, despite the recession, according to a report released today by the Deloitte Center for Health Solutions.
But I think it's more likely to be growing because of the recession, not in spite of it, particularly as more unemployed workers lose their health insurance and turn to lower-cost alternatives for seeking medical care.
The report, “Retail Clinics: Update and Implications,” suggests that consumer adoption of retail medicine is strong and growing. The report also suggests that the industry's potential to expand its revenue opportunities will support its long-term sustainability.
Retail clinic growth will likely slow from 2010 through 2012, partly because of labor shortages, price pressures from new entrants and regulatory pressures from state governments, according to the report. It says that some states and local government regulators are actually afraid that retail clinics could compromise care. Moreover, some physicians have campaigned against retail clinic openings and discouraged their patients from using them.
Despite these impediments, Deloitte expects the market to begin picking up steam again in 2013. The four factors the report cites that will likely contribute to the sector's growth are: increased use and satisfaction by consumers; increased use and acceptance by commercial insurers and large employers; increased services provided through the retail medicine model; and increased demand for preventive and primary care services as a result of health reform.
Another contributor could be the increasing popularity of high-deductible consumer-driven health plans, in which plan members pick up a greater share of their health care expenses. According to a recent survey by Aon Consulting, the portion of employers offering HSA-linked CDHPs has risen from 48% in 2006 to 56% today,
I dare you to ask a hospital executive what he thinks about the possibility that health reform could reduce the size of hospital payments.
That's what the ever-provocative Peter Lee, executive director of national health policy at the Pacific Business Group on Health, did at the recent National Business Coalition on Health meeting in Phoenix.
During a panel discussion on health reform, he just about got his head bit off!
"You've encouraged us to build new facilities. We've built hospital beds, we've built imaging centers, we've built surgical centers, largely in the interest of convenience and access," said Scott Malaney, president and CEO of Blanchard Valley Health System, and a member of the American Hospital Assn. board.
"If we change that too quickly, I will tell you there's another banking disaster waiting to happen. There is a huge amount of dollars--It's in the trillions--tied up in system-related debt sitting in banks and bonds around this country. If we move too many people too quickly out of that, you're going to have a massive shock to our banking system. So that's a perspective you have to keep in mind," he warned.
Despite the crisis in the financial services industry that triggered the current economic downturn, demand for mental health care services at JP Morgan Chase are not out of the ordinary, according to Dr. Wayne Burton, medical executive.
Speaking at the recent National Business Coalition on Health annual meeting in Phoenix, Dr. Burton said the company has been tracking claims data for 25 years, and that every year from March through September utilization of mental health care services spikes, and that this year is no exception.
But perhaps more notable is the fact that the upward trend was no higher this year than in past years despite the turmoil that has plagued the financial services industry.
At the other end of the spectrum, Peoria, Ill.-based Caterpillar has had difficulty implementing its post-disability return-to-work program because of severe workforce reductions.
“There's no place to put them,” said Dr. Mike Taylor, medical director for health promotion, who also spoke at NBCH. “We're struggling to survive.”
Meanwhile, Dr. Bob Galvin, director of global heealthcare at General Electric Corp., says that "Generation 2" of health care payment reform is starting to take shape, but it could become an exercise in futility if the federal government fails to address cost containment in the reform bills pending before Congress.
He's concerned that hospitals' attempts at creating so-called “Accountable Care Organizations” could turn into the health care industry's version of “too big to fail.” Will they integrate to provide better outcomes at lower cost, or will they consolidate and become monopolies that dictate price at the expense of consumers?
“The idea of coordination and forming teams is good, but we have to be thoughtful,” Mr. Galvin warns.
The hand-washing habits of doctors and nurses in Maryland hospitals will be secretly monitored and recorded as part of a state-run initiative financed with $100,000 in federal stimulus funds.
The Maryland Hospital Hand Hygiene Collaborative campaign is being supported, in part, through a cooperative funding agreement to support surveillance and prevention of hospital-acquired infections, which the Maryland Department of Health and Mental Hygiene received from the Centers for Disease Control and Prevention under the American Recovery and Reinvestment Act.
I reported on the availability of these grant opportunities in September: The American Recovery and Reinvestment Act of 2009 established a $1 billion prevention and wellness fund, of which $650 million has been designated for efforts to address chronic disease through evidence-based clinical and community-based prevention and wellness.
This certainly sounds like a good use of those funds, particularly if they prevent the spread of viruses and bacteria that can cause potentially lethal infections. But I'm a bit concerned about Lt. Gov. Anthony Brown's pledge not to penalize individuals who fail to scrub.
“This certainly is not an effort to do a gotcha," he said in a press release announcing the sanitary surveillance program. "We're better off with providers actually using proper hand hygiene than calling out those who don't, so a big component of this in every hospital will be that continual education and awareness."
Health reform legislation wending its way through Congress could cover Christian Scientist “prayer treatments” if an amendment introduced by Sen. Orrin Hatch, R-Utah, is included.
The Senator introduced the amendment to the bill passed by the Senate Health Committee, with the backing of Democratic Senators John Kerry and the late Ted Kennedy, both of whom are from Massachusetts, where the Church of Christ, Scientist is based.
Although some atheist and agnostic groups are up in arms about the amendment, it is unlikely to add much to the cost of the legislation, some observers say, since such treatments generally cost between $20 and $40 each, far less than a visit to a primary care physician.
The Center for Inquiry, an advocate for "secular society," opposes any legislation that covers alternative medicine or spiritual care, calling it, “pseudoscience.”
But isn't alternative medicine already pretty much mainstream in America? More than $33 billion is being spent each year on dietary supplements, acupuncture and chiropractic care, according to a recent report from the Center for Complementary and Alternative Medicine that estimated nearly 38% of American adults use some form of alternative medicine.
Then again, wouldn't such a provision conflict with other elements of the legislation that supports coverage for “evidence-based” medical care?
At a time when most employers are shifting a greater share of health care costs to employees, IBM Corp. is applying a little reverse psychology and will begin waiving copayments and deductibles for primary care in 2010.
Employees enrolled in IBM's health plans will receive full coverage for in-network primary care from their internist, family practitioner, pediatrician, general practitioner or primary osteopath.
The company also announced a new Personal Vitality Rebate for employees and their covered dependents to encourage them to adopt healthier habits. Each rebate is worth $150 in cash, and employees can receive up to two each year for a total of $300.
IBM's new approach is in keeping with value-based benefit design, a concept that the Armonk, N.Y.-based company has long championed. The idea is to eliminate barriers to preventive care now to prevent the manifestation of disease that leaders to even higher health care costs later on.
In fact, IBM says its long-term investment in wellness has paid off. It has saved nearly $191 million in health care-related costs on its investment of $79 million in wellness programs between 2004 and 2007.
When opponents to health reform began citing studies showing how a mandate might erode employer-sponsored health care coverage, they probably didn't consider what might happen to such plans if health reform doesn't occur.
The Economic Policy Institute released a report this week that shows the strain that the escalating cost of the current system is placing on employers, families and individuals. The report, "Employer-sponsored health insurance erosion continues," shows that employer-sponsored health care coverage has declined every year since 2000, leaving a disproportionate number of young, Hispanic, lower-educated and lower-income people uninsured.
The report also projects that another 10 million people could be without employer-sponsored insurance by 2010 unless the economy makes an unpredicted swift rebound or there is large-scale health reform.
The EPI asserts that without health reform, the total number of uninsured Americans under the age of 65 could swell to more than 50 million by next year. To give us an idea of just how many people that is, the EPI points out that it's the number of people living in California and Illinois combined.
Interestingly, Massachusetts and Hawaii--two states that require employers above a certain size to provide health care coverage to their workers—has the highest employer-sponsored coverage rates: 72.5% and 71.5%, respectively. Conversely, states that have the lowest employer-sponsored coverage rates are Michigan, Tennessee, Missouri, South Carolina and North Carolina.
The recession has taken a toll on the growth of medical tourism, which dropped 13.6% between 2007 and 2009, according to a new report by the Deloitte Center for Health Solutions, which was released at the Medical Tourism and Global Health Congress in Los Angeles this week.
However, as the economy improves, Deloitte expects the practice of patients traveling to receive medical treatments away from home to increase by 35% in 2010.
"Barring any tempering factors, such as supply constraints, resistance from health plans, increased domestic competition or government policies, we project that outbound medical tourism could reach upwards of 1.6 million patients by 2012," said Paul Keckley, executive director of Deloitte's Center for Health Solutions, based in Washington.
"Medical tourism has transitioned from a cottage industry to an acceptable alternative for elective care that despite the setbacks of the economic downturn may begin to recover in 2010," Mr. Keckley said in a press release announcing the report's findings.
Mr. Keckley expects this growth to come from the development of new business models and the testing of medical tourism's savings potential by insurers, legislators and employers setting up pilot projects. He also predicts that health care providers will become increasingly involved in coordinating care.
According to the report, "Medical Tourism: Update and Implications", more than 750,000 Americans traveled abroad for medical care in 2007. This compares with 540,000 in 2008 and 648,000 in 2009.
The down economy is causing blood pressure to rise among patients at the Person Family Medical and Dental Center in Roxboro, N.C.
Jean Davison, a nurse practitioner at the medical practice located north of Durham, attributed the spike in blood-pressure readings among patients to the loss of health care coverage after being laid off.
Because of the cost, many patients stopped taking their antihypertensive medication, while others put off seeing a doctor to monitor their conditions, she told a local newspaper.
"And it's stressful being unemployed," she added. "People are feeling broken."
The unemployment rate in Person County hit 12% this summer, higher than the state and national averages.
To draw its conclusions, practitioners at the clinic compared blood pressure readings taken last fall on patients who had been seen at the clinic over the past two years against readings taken in January. While nearly 70% of the patients had satisfactory blood pressure levels last fall, just 47% did so in January.
Ms. Davison said the findings were particularly disturbing since she and her colleagues have been counseling patients regularly to help them better manage their conditions.
