The Healthy Muse

 


 

After NRA Mocks Doctors, Physicians Reply: ‘This Is Our Lane’ (NPR)

November 11, 2018

TL;DR

  • American College of Physicians recently published a paper detailing possible solutions for reducing gun-related deaths and injuries
  • The NRA responded, attacking the study’s sources of evidence aggressively, while suggesting that physicians “stay in their lane”
  • Several Physicians replied to the NRA on Twitter with graphic images of trauma room scenes caused by gun-related situations

Muse

  • The discourse reveals the increasing tension facing gun control efforts on both sides, which appears to have been prevalent in the U.S. for quite some time. More telling to me, however, is the fact that physicians are taking the time out of their busy schedules to insert themselves into the discussion in a powerful way.

 

Health and wellness are booming, but we’re fatter than ever (Axios)

October 22, 2018

TL;DR

  • Health and wellness programs are kicking off, but that isn’t leading to a healthier population
  • The main reason is because Americans do not have healthy diets, are generally stressed, and do not sleep enough
  • According to Axios, obesity and not enough exercise costs roughly $117 billion in annual healthcare spending, and leads to 10% of premature deaths

Muse

  • Seems that Americans eat poorly. What’s new?

 

When Hospitals Merge to Save Money, Patients Often Pay More (NY Times)

November 14, 2018

TL;DR

  • Hospital mega-mergers cause hospital stay prices to increase, according to the New York Times, increasing from 11% all the way up to 54%
  • The study finds that reduced competition (caused by consolidation) results in negative consequences for patients, including lower quality of care.

Muse

  • This study appears to contradict the typical point of mega-mergers, where economies of scale lead to increased synergies and cost efficiencies, therefore theoretically reducing price
  • In fact, these mega health systems carry a lot of weight, which results in increased payor leverage and favorable rates, driving up the cost for the consumer
  • As consolidation continues, especially vertically, the consumer loses in terms of cost.
  • In the current environment, it appears that health systems are incentivized to transfer the site of service to a hospital, or hospital department, for the purpose of receiving higher reimbursement.

 

1 big thing: Pharma’s grip on health care profits (Axios)

November 12, 2018

TL;DR

Related:

Muse

  • The media is all over drug pricing lately. The fact that Express Scripts feels enough pressure publicly to adjust (however slightly) their pricing strategy exemplifies a push for lower, more transparent drug pricing.

 

Medicare Costs Drop As Humana Shifts Doctors To Value-Based Models (Forbes)

November 13, 2018

TL;DR

  • Humana released an internally-conducted study on its value-based Medicare Advantage plans, stating that medical costs were 16% lower as compared to fee-for-service Medicare Advantage plans

Muse

  • Not so fast. Fee-for-service plans aren’t going anywhere anytime soon.
  • According to the report, the physicians included in these value-based models have access to more resources, which gives them the ability to treat patients more effectively. These types of resources are apparently not available everywhere.
  • Still, the report shows the potential for value-based models, if implemented correctly. Something to keep an eye on.

 

The new health care agenda: gridlock, lots of hearings (Kaiser, Axios)

November 8, 2018

TL;DR

  • Due to midterm results, the U.S. government is now divided (Republican Senate, Executive branch; Democratic House).
  • No material healthcare legislation is expected to pass due to the legislative divide
  • Medicaid expansion passed in Idaho, Nebraska, and Utah, with pushes now expected in Kansas and Maine

Muse

  • Expect most healthcare changes to come from state initiatives, for now
  • It’s almost guaranteed that there will be some Democratic grandstanding in the House
  • Healthcare reform may be a big campaign issue in 2020. Be on the lookout for the term “Medicare for All,” but be cautious – this moniker means something different depending on who you’re talking to.

 

Athenahealth Enters Definitive Agreement to be Acquired by Veritas Capital For $135 Per Share in Cash

November 12, 2018

TL;DR

Muse

  • Similar to physician practices, private equity firms are in the process of rolling up healthcare tech companies

 

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