Midweek update

As the FEHBlog mentioned on Sunday, the big HIMSS conference is underway this week in Orlando. Aetna’s CEO Mark Bertolini gave the first keynote speech. According to Healthcare Informatics   Mr. Bertolini  spoke about the need for payment reform, taking care of the chronically ill better, investing in wellness for the next 25-30 years and reducing waste in healthcare in order to control health care spending. Agreed.  The head of CMS Marilyn Tavenner speaks tomorrow but Modern Healthcare reports that she likely will not give any ICD-10 extension to the medical community. The Orlando Sentinel reports on some of the healthcare technology shown off at HIMSS, including one of OPM’s favorites, the Blue Button Connector.

Picking up on one of Mr. Bertolini’s points, the Wall Street Journal discussed various initiatives to create transparency in healthcare pricing. The article notes one the initiative that the FEHBlog likes — reference pricing:  

“[R]eference pricing” has yielded some savings. Where local prices differ substantially for a service like a colonoscopy, an insurer publishes a list of providers’ rates and agrees to pay a set amount. If patients choose a provider that charges more, they must pay the difference themselves.
In one pilot project, the California Public Employees’ Retirement System, found prices for hip and knee replacements ranging from $15,000 to $110,000 in the San Francisco area. It agreed to pay up to $30,000, and some 40 hospitals cut their prices to match. Such initiatives have helped Calpers save nearly $3 million in the past two years, one study found.

The Wall Street Journal and the Philadelphia Inquirer reported on the results of the first large scale study of patient centered medical homes. The FEHBlog thinks that PCMHs which involve greater coordination of primary care make sense but the study found “almost no benefits.”  Nevertheless, it’s not a matter of going back to the drawing board because according to the stories the PCMHs were making improvements to their operations as the study progressed. So perhaps this is just a baseline. The Wall Street Journal points out that the study may have focused too heavily on whether the PCMH achieved NCQA accreditation.

Speaking of medical homes, USA Today reports that the pediatrics association is complaining that convenient pharmacy based clinics are interfering with doctors’ medical home efforts. More likely the clinics are hitting the pediatricians bottom line but if this study creates better communication between the clinics which aren’t going away and the doctors offices all the better.

Finally the Wall Street Journal published a great article on how people can avoid falls in later years by improving their balance in young adulthood.  The article includes tips for older folks like the FEHBlog too. It’s important information because

In the U.S., falls are the leading cause of injury for people over 65, according to a 2005 report by the Centers for Disease Control and Prevention. Every 17 seconds, someone in this age group is treated in an emergency room for a fall. Every 30 minutes, one will die from injuries caused by falling.