Photo used under Creative Commons from j9sk9s
This month, we health care wonks and basketball fans each have our own version of March Madness. As the 2010 NCAA Men’s (and Women’s) Division 1 Basketball Tournament play begins this afternoon, policymakers are hurtling toward what may well be the last round of health care reform. (This week, we at the Foundation are also giving primetime spotlight attention to health insurance coverage issues, as part of our 8th annual Cover the Uninsured Week.)
Like the health reform debate, the NCAA basketball tournament is full of make-or-break, game-changing moments. In the nineties, we watched Chris Webber’s infamous time-out call that led to the end of Michigan’s “Fab Five”, and Christian Laettner’s “buzzer-beater” shot that led to Duke’s ultimate glory. Two years ago, it was “Mario’s Miracle” three-point shot in the last few seconds of regulation game time that led to Kansas’ big OT win against Memphis.
Today, I present you with the latest Health Wonk Review (HWR) – the March Madness edition. For those who may not know, the HWR is a bi-weekly collection of top scoring posts from the health policy world. So with a nod to the tourney’s artful, alliterative lingo – think “Final Four” and “Sweet Sixteen” – we review the health wonk game from the following angles: Players’ Pool, Fans’ Favorites, Referees’ Records, Coaches’ Corner, Commentators’ Color, and the League’s Landscape.
As this edition’s sideline reporter, here’s the highlights reel from the health reform blogosphere.
Each team roster is full of players with different styles of game. At the New Health Dialogue blog, Joanne Kenen writes about respecting each player’s perspective for palliative care treatment.
John Goodman selects a few chronic disease management projects that might deserve the “Most Outstanding Player” award for their work over at his Health Policy Blog. He takes a shot at RWJF in the elbow, but we're not calling a foul: hard elbows are a part of the game.
Joan Alker is cheering for team Medicaid in her latest post at the Say Ahh! Children’s Health Policy Blog. Alker notes that Medicaid provides both children and adults access to care, and suggests that increasing reimbursement rates would help us expand the system.
As ultimate cheerleaders, we cross our fingers and hope that this will be the year our Cinderella team (or cause) rises to the top. This loyalty sometimes clouds our judgment (and perhaps our bracket choices). But over at Managed Care Matters, Joe Paduda asks fans to take a moment and step out of their fantasies, to consider the consequences of expanding coverage now while controlling costs later.
And while there is little doubt that EHRs were the crowd pleaser at this year’s Healthcare Information and Management Systems Society conference (aka HIMSS10), Peggy Salvatore at Healthcare Talent Transformation believes that fans need more guidance on the role of Health IT in future gameplay.
While on the subject of EHRs, EHR Blogger Glen Laffel tells us that a new official, the FDA, wants a bid in the regulatory shuffle to ensure that systems are safe. Glen suggests that too much officiating can cause an upset, and argues that ONC should remain the head official to evaluate the safety and efficacy of EHRs.
Fred Lee at Health Care Hacks reports on a series of fouls (aka medical errors). Doctors who studied patients over the age of 65 found that patients who did not receive referrals were less likely to receive recommended follow up treatment. Unlike game refs, the researchers stray away from finger pointing to assign blame, and instead insist that doctors and patients play nice and work together as a team to produce better outcomes.
Health care leaders must be careful not to abuse home court privileges (an advantage the NCAA team prevents by not allowing teams the chance to play on their own turf). Roy Poses at Health Care Renewal reminds us about the dangers that conflicts of interest present in the health care arena by reviewing the details of a deal between a for-profit medical school and a NY-based hospital corporation.
And while game official Anthony Wright issues a technical foul to Anthem on its proposed rate hikes over on Health Access, referee Louise Norris at Colorado Health Insurance Insider finds Anthem at midcourt in insurance rates in Denver and calls for play to resume.
In the words of Rick Pitino, (the man who first introduced me to the world of college basketball in the nineties with his fast-breaking, full-court pressing Kentucky Wildcats,) “Excellence is the unlimited ability to improve the quality of what you have to offer.”
When assessing the quality of care provided in nursing care settings, the INQRI Blog coaches examined past plays and their results (aka processes and outcomes). They also reviewed patients’ feedback, noting the importance of including patients’ voices in improving care delivery models. *editor’s disclaimer: INQRI is a program supported by the Robert Wood Johnson Foundation
David Harlow over at the HealthBlawg thinks that educators need to go back to the books. According to the results of a recent study produced by the Lucian Leape Institute and the National Patient Safety Foundation, faculty need to spend more time in the classrooms consistently teaching students important “chalk talk” lessons about patient safety.
And now it’s time to step into the play booth. Over at InsureBlog, Henry Stern provides us with a play-by-play summary of his recent interview with Rep. Joe Wilson. The Congressman discusses coverage mandates at the state-level, stimulus funds and the reconciliation process.
On the Disease Management Care Blog, Jaan Sidorov outlines his must-picks to implement pilot Accountable Care Organization models. According to Jaan, we need to select pilots that have physicians who have “a track record of exposure to the ‘systemness’” of disease management programs and patient-centered medical home settings, and thus experience with patient engagement and care management.
And Workers’ Comp Insider sportscaster Tom Lynch takes us from hoops to the world of baseball to recount former athlete and soon-to-be retired Sen. Jim Bunning’s latest actions at bat, with regard to COBRA benefits and the Sustainable Growth Rate.
Finally, we close out the commentary section with Sens. Tom Harkin and Mike Enzi, who weigh in with their thoughts on the Health Affairs Blog about the latest national and local efforts to battle obesity.
In the beginning, the NCAA men’s basketball tournament featured just eight teams. In today’s championship battle, we have 65, (plus constant chatter that the NCAA may add more teams to the mix). Similarly, as our health care market expands, we must continue to look at ways to restructure the system to ensure that we are providing high-quality, cost-efficient care.
When considering ways to rebuild the system, we must look to the individual teams (aka states), who often provide invaluable insight for national reformers. RWJF Senior Program Officer Brian C. Quinn and Lynn A. Blewett, director of the State Health Access Data Assistance Center, share findings on our blog from a recent report that highlights the growing challenges states face in meeting the needs of the middle class. As they write, “Just 66 percent now receive insurance through their employer, a drop of seven percentage points since 2000”. As part of our Cover the Uninsured Week, we aim to foster discussion to expand coverage across all states.
Austin Frakt from The Incidental Economist also examines local-level data, and gives us a detailed look at the history of the relationship between Medicare Advantage payments and traditional fee for service Medicare costs. He suggests that we restructure benchmark rates to control costs.
In another post on payment reform, Chris Langston at health AGEnda writes, when it comes to providing care, we can’t assume that “what IS, is what OUGHT to be.” If physicians are not currently providing recommended care, they will report less time spent on treatment, which will lead to lower Medicare reimbursement fees, and another reduction in the amount of care provided.
As sports fans and health reform analysts, we’ve waited all season for the Big Dance. And now that we’ve made our predictions and selected our best picks, we sit back to watch the game unfold.
Thanks for letting me call the shots for this edition of HWR. Don’t forget to tune-in on April 1 to the next edition over on the Health Technology News blog, as host Rich Elmore breaks down the latest health policy rebounds, slam dunks and results.