Archive for December, 2011

Innovation with Integration- Healthcare in 2012

A top Google Executive recently inferred that the United States can regain its economic footing by being the global leader for innovation. This innovation focus directly relates to the innovation and integration themes that are driving the 2012’s Federal healthcare initiatives. Specifically, Centers for Medicare and Medicaid Innovation’s (“CMI”) focus is to test innovative ideas and unique models to improve patient care for population health at a lower cost. In order to spawn innovative ideas, CMI constantly funds and supports models that use innovation to change how healthcare is delivered.

Just in the last two months, CMI announced $2 Billion in additional funding for innovative programs that will be implemented in early 2012. $1 Billion was allocated for grant funding. The grants may be awarded to either for-profit or nonprofit organizations or collaborations that meet the objectives of the program. Specifically, the Healthcare Innovation Challenge will …

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I Have to Buy What?

One of the more controversial provisions included in the Patient Protection and Affordable Care Act (the Affordable Care Act) is the requirement for individuals to purchase and maintain health insurance coverage. Commonly referred to as the individual mandate, the constitutionality of this requirement is the subject of litigation. The Supreme Court has agreed to hear appeals from an 11th Circuit Court ruling that struck down the individual mandate. Both the 6th Circuit and the Washington, DC Circuit have issued opinions upholding the legality of the individual mandate.
The issue from a layman’s view appears to be whether Congress can pass a law that: (1) requires individuals to purchase something (in this case health insurance) from a third party and (2) imposes a financial penalty those who fail to make the required purchase.
The government’s rationale for the individual mandate is as follows. By requiring everyone able to pay the cost of insurance coverage to do so, …

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The Year of Uncertainty

The year 2011 could be called the year of uncertainty in health care. With so many of the details on the implementation of the Affordable Care Act yet to be determined the entire health care community spent much of the year engaged in contingency planning. States, Georgia among them, began to move forward on developing implantation plans while awaiting draft regulations that would give them guidance as to how to proceed. The Federal government slowly released regulations and analysis that would help clarify matters, but often passed the responsibility for decision-making back to the states.

A clear illustration of this uncertainty was provided over the last 10 days. The Governor’s Exchange Advisory Committee’s Report released this week outlined broad principles for implementing health insurance exchanges in Georgia contingent on the direction of Federal regulations. A major uncertainty identified by the committee was the determination of the essential health benefits …

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Happy Holidays and Medicare cuts for the New Year!

A report out today says that 2.5 million more young Americans have health insurance. This is attributed to the health reform act. A significant achievement but much more work has to be done. Over 16% of people living in America are now uninsured which is up from 13% in 2000. Most of the loss is in the employment insurance sector because of the high unemployment that we have experienced over the past few years. So it seems to be some progress but it is overshadowed by the economic state of this union.

The need for significant changes in the US health system is becoming more and more of a needed priority. Medicare is threatening an across the board payment reduction of 27% in 2012.  Every year this time doctors are lobbying and gritting their collective teeth in hopes that  these type of cuts can be averted. Low reimbursement along with high demands are literally driving some would be physicians and other health care professionals to choose other careers.

That’s the …

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The Quiet Revolution

I spent some time last week at the mHealth Summit in Washington DC and walked away with an incredibly favorable impression.  Unbeknownst to most consumers and even some industry experts, a quiet revolution is occurring in the world of mobile technologies in health. 

Last month I spoke of the value of telehealth in my blog post.  Telemedicine has an incredible opportunity to improve health outcomes and change the way health is delivered to the patient.  The use of the cell phones for health, in particular, is proliferating and producing break-throughs at an unbelievable pace.   

Eric Topol, MD, a keynote speaker at the conference, noted several examples of where cell phones are changing the way medicine is practiced today.  Specifically, he noted one mobile application (Zeo) that measures how you sleep at night and the amount of REM you are actually getting.  Another mobile application (AliveCor) can use an iPhone to diagnosis a heart attack.  Even for him as a …

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Should Kagan Recuse herself from the healtcare debate?

If you have listened to any of the media coverage since the Supreme Court officially decided to hear constitutional challenges to the Affordable Care Act (i.e. Obamacare), you have undoubtly heard rumbles about whether or not Justice Elena Kagan should recuse herself from hearing the case.

Why, might you ask, would Justice Kagan even think about recusing herself? While the Act was being heavily debated in Congress, she was the Solicitor General of the United States, which basically made her the chief litigator for the United States. I won’t bore you with the Federal Law on the issue. The gist of the Judicial Code of Conduct for a Federal Judge is that a Judge should not hear a case on which he or she worked, advised, or has previously expressed a strong opinion on.

Allegedly, there exist emails that Kagan was included on regarding the constitutionality of the Act. There are also allegedly emails from her to outside parties expressing opinions on the pending issues. The …

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Improve Patient Care by Creating a 21st Century FDA

The U.S. Food & Drug Administration (FDA) regulates virtually everything that Americans consume or put on their bodies. Those FDA-regulated products account for about 25 cents of every dollar spent by American consumers each year — products that touch our lives every day.

But there is a problem. The FDA is trying to do its job with 20th Century tools, technology, culture, and regulatory approach. Innovation is driving 21st Century medical breakthroughs but the FDA does not have the capacity or the capability to help bring these breakthroughs to the American people.

But it gets worse. If we do not transform the FDA, there will be significant consequences. Currently, more than half of the population has at least one chronic disease. Bringing new, innovative treatments to market for diseases such as cancer, diabetes and heart disease will have tremendous human and economic benefit.

The Partnership for Chronic Disease indicates that chronic diseases kill more than 1.7 million …

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Top Ten Trends for Healthcare & Wellness in 2012

The Wall Street Journal recently published their annual “CEO Council” edition, where industry experts and members of the WSJ CEO Council addressed many of the challenges facing our country and world, including the global economy, international relations, energy resources, and of course, healthcare. Among the healthcare topics discussed, the top-two recommendations for improving our healthcare system were 1) prevention and awareness of chronic diseases; and 2) the advancement and importance of healthcare technology.

This article, among many others, got me thinking about what 2012 holds for our industry. Throughout this past year familiar themes rang clear, giving us insights to what will play vital roles for healthcare in our future. Below are my top ten for 2012:

1) Technology Will Lead the Way: No doubt that technology will pave a way for a better overall healthcare system, providing a more efficient and effective experience between consumers, healthcare providers, …

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