Weekender 8/24/18

Weekly News Recap

• Medicaid Transformation Project signs up 17 leading health systems to develop solutions to improve the healthcare and social needs of the 75 million Americans who are on Medicaid
• Employer-focused primary care clinic operator Paladina Health gets a $165 million investment
• A New Yorker article describes the hostile shareholder attack launched last year on Athenahealth by activist investor Paul Singer’s Elliott Management and the company’s history of using shady tactics to pressure CEOs to cave
• CNBC reports that primary care group One Medical is discussing a possible $200 million fund raise
• The VA gives its providers the ability to automatically view the immunization and medication histories of those patients who are also Walgreens pharmacy customers
• Anthem settles its huge 2015 data breach for $115 million

Best Reader Comments

New generations can learn from pioneers’ and predecessors’ successes and failures, not make same mistakes on new technology. A patient automated post-discharge call system is a part of larger business (financial, clinical, CRM) and technology ecosystems. Technology is key component of effective “solution,” but no more than culture, goals/metrics,org structure, supportive processes / technologies, and right staff (level, role, skills). Payments models are complex and in flux; Medicare and Medicaid future uncertain, human factors play a huge role in these processes. ROI is challenging. (Ann Farrell)

The IT vendors game the system, and with these scores submitted by profit-driven IT vendors, CMS seems to come up with comparative ratings. I’m hoping some sensible person can establish a true and accurate performance evaluation system. I wonder if all this has contained the rate of Medicare spending? (Mipsvendor)

Watercooler Talk Tidbits

Readers funded the teacher grant request of Ms. F in Florida, who asked for action cameras and storage for her STEM charter school third grade class. She reports, “Thank you for donating to my students’ project. This project was one that they specifically asked me to write. They love taking pictures and videos and even more so they love watching or looking at pictures or videos of themselves and their friends. They were so excited when I told them this project was funded, and even more excited to start using the cameras. It has become a reward in the class to be the class photographer for the day. With this I have started to teach them how to upload their pictures, edit them and publish them. This project is one that will continue to be fun for my students and will be extremely useful for class projects, class field trips, and memories of our time together in class. Thank you for your support!”

A GAO report finds that while the perceived high cost of health insurance turned some consumers away from buying policies on Healthcare.gov, HHS also intentionally reduced the 2018 coverage numbers by slashing advertising by 90 percent, cutting navigator funding by 42 percent, and shortening the enrollment period.

This week sees a second huge investment in primary care practices – Paladina Health (DaVita’s former employer clinic business that was sold this year for $100 million) raises $165 million for expansion and acquisition. One Medical has raised $350 million and Iora Health has taken in $100 million in investment. The Bloomberg article notes that UnitedHealth Group’s Optum now has at least 30,000 doctors on its payroll, while companies like Walmart and GM are contracting directly with health systems to provide employee health services. 

A New York Times article observes that while FDA requires drug manufacturers to prove that their products are safe and effective, that doesn’t answer the question of how their safety and effectiveness compares to that of similar drugs, which would help prescribers choose more wisely.

Another New York Times article says NYU’s elimination of medical school tuition for all students is noble but misguided, suggesting that the med school should follow the lead of NYU’s own law school in waiving tuition only for those students who commit to lower-paying public service jobs or who practice in underserved areas.

A Tincture article decries the healthcare expense of erecting billion-dollar hospital buildings such as those of Stanford, Boston Children’s, and the Denver VA hospital. A snip:

It is true that hospitals (excuse me, “health systems”) are diversifying — building/buying satellite locations, freestanding emergency rooms, urgent care centers, and physician practices — but those big buildings remain the locus, and their sunk costs weigh on hospitals’ finances …  What I want to see are images of services being delivered where I am, focused around me, aimed at my convenience — not at the convenience of the people delivering my care … Don’t donate money for hospital expansion / renovation plans. Don’t buy bonds for them, either. Don’t sit passively on hospital boards that push for them or expensive new equipment. Instead, we should be questioning: how can a “hospital” most impact our communities’ health? What kinds of investments in our communities’ health can they be making? How we do push healthcare and health down as close to where and how people live as possible?

The Boston endocrinologist whose questionable claims that vitamin D deficiency is “pandemic” spawned creation a billion-dollar lab and supplement industry has been paid by companies that sell those products. Just about every other researcher has concluded that Americans get plenty of vitamin D and wouldn’t benefit from supplements or tanning beds.

A contract firm’s security guard is arrested at St. Francis Hospital (TN) after being caught having sex with the corpse of a patient whose body was being prepared for organ harvesting.

TV news always tries to leave you laughing with a vapid, irrelevant story, so here’s one that’s hilarious yet relevant. A Deloitte survey of C-level executives finds that 74 percent of those in healthcare say their understanding of blockchain technology is “excellent” to “expert.” These are no doubt the same executives who can’t perform even basic laptop tasks unaided, who pay secretaries to print out their emails so they can read them on paper, and who sympathize with hospital departments who send an employee off to Best Buy with a procurement card to buy PC and networking equipment because the IT process isn’t immediately gratifying. Only 39 percent of executives in all industries think blockchain is overhyped and 43 percent say blockchain is among their top five strategic priorities. This is the greatest gift a blockchain snake oil salesperson could ask for – clueless yet overconfident executives anxious to get on a questionable innovation bandwagon despite a complete lack of a business case.

In Case You Missed It

• News 8/24/18
• EPtalk by Dr. Jayne 8/23/18
• News 8/22/18
• Curbside Consult with Dr. Jayne 8/20/18
• Monday Morning Update 8/20/18
• What I Wish I’d Known Before … Taking Time Off for Doing Something That Turned Out to Be Motivating, Enriching, or Transformative

Get Involved

• Join my Rolodex to provide occasional news reaction or ideas
• Contribute regularly as a provider CIO, IT director, or informatics nurse (anonymous or not)
• Be interviewed (providers)
• Deliver an educational webinar (providers)
• Sponsor
• Report a news item or rumor (anonymous or not)
• Sign up for email updates
• Connect on LinkedIn
• Contact Mr. H