The Cost of Patient-Reported Outcomes

In a January 25, 2018 post in NEJM Catalyst, authors Judith F. Baumhauer, MD, MPH, Christopher Dasilva, BS, David Mitten, MD, Paul Rubery, MD & Michael Rotondo, MD outline the several options and costs of implementing patient-reported outcomes in a clinical practice.  The authors outline the costs of a custom-built, an EHR solution, and standalone commercial product, citing the costs, advantages and disadvantages of each.

 

Amazon, Berkshire Hathaway and JP Morgan Chase announce health care company

The New York Times reports that Amazon, Berkshire Hathaway and JPMorgan Chase just announced they would form an independent health care company to serve their employees.

The three companies noted the new entity would initially focus on technology to provide simplified, high-quality health care for their employees and their families, and at a reasonable cost. 

The partnership brings together three of the country’s most influential companies to try to improve a system that other companies have tried and failed to change: Amazon, the largest online retailer in the world; Berkshire Hathaway, the holding company led by the billionaire investor Warren E. Buffett; and JPMorgan Chase, the largest bank in the United States by assets.

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Drop in life expectancy in the U.S. a Reflection of the American health system

According to David Blumenthal of the Commonwealth Fund, Americans are dying younger which is a reflection of the failure of the American health system. 

Blumenthal notes that while it is easy to blame the nation’s opioid epidemic, the abysmal new life expectancy data from the Centers for Disease Control and Prevention show the data for what they are — an indictment of the American health care system.

According to the CDC, the average life expectancy at birth in the U.S. fell by 0.1 years, to 78.6, in 2016, following a similar drop in 2015. This is the first time in 50 years that life expectancy has fallen for two years running. In 25 other developed countries, life expectancy in 2015 averaged 81.8 years.

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The US Department of Health and Human Services announces funding for learning networks

The Department of Health and Human Services (HHS) awarded $685 million to 29 “practice transformation networks,” including some hospitals and health systems, and 10 supporting organizations to help clinicians improve patient outcomes and lower costs for Medicare, Medicaid and Children’s Health Insurance Program enrollees through its Transforming Clinical Practice Initiative.

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Medicare deaths, length of stay and costs decrease over past 15 years

According to a new study in the Journal of the American Medical Association, over the last 15 years the number of deaths, hospital stays and healthcare costs decreased among older Americans on Medicare.

"Although our health care system has its failings, we are making remarkable progress," said Dr. Harlan Krumholz, the study's lead author from Yale University in New Haven, Connecticut.

"People are much better off today than they were 15 years ago," he told Reuters Health in an email. Researchers used data on over 68 million people on Medicare, the U.S. health insurance for the elderly and disabled.  In particular the study found:

  • Deaths from any cause fell among Medicare beneficiares from 5.3 to 4.45 percent between 1999 and 2013.  
  • The number of hospital stays per 100,000 people per year fell by 8,344 between 1999 and 2013.
  • The amount of money spent on care among those beneficiaries in hospitals fell by nearly $500 per beneficiary during that time.
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ProPublica publishes scorecard on complication rates

ProPublica has published a scorecard of complication rates for almost 17,000 individual surgeons at more than 3,500 hospitals nationwide based on an analysis of Medicare data.  The scorecard allows users to search by location, by surgeon, or by hospital.

For its analysis, ProPublica analyzed Medicare data from 2009 to 2013 for eight common elective procedures, which accounted for 2.3 million total surgeries:

  • Knee replacements;
  • Hip replacements;
  • One type of spinal fusion on the neck;
  • Two types of spinal fusions in the lower back;
  • Gall bladder removals;
  • Prostate removals; and
  • Prostate resections.

IOM report establishes framework for standardized measures set

A recent Institute of Medicine (IOM) report, Vital Signs: Core Metrics for Health and Health Care Progress, identifies fundamental problems with the current state of health care quality measures as too many, unfocused, and unorganized and identifies a framework to streamline the measures.
The IOM report uses four domains—healthy people, care quality, lower cost, and engaged people—to propose the following 15 standardized measure sets that represent a more wholistic, organized and focused approach for required measures at the national, state, and local levels and recommends steps to implement the measures:
1. Life expectancy
2. Well-being
3. Overweight and obesity
4. Addictive behavior
5. Unintended pregnancy
6. Healthy communities
7. Preventive services
8. Care access
9. Patient safety
10. Evidence-based care
11. Care match with patient
12. Personal spending
13. Population spending
14. Individual engagement
15. Community engagement
The  report was published online April 28, 2015 in The Journal of the American Medical Association by the Commonwealth Fund's David Blumenthal, M.D. and the Institute of Medicine's J. Michael McGinnis, M.D. 

Patient ratings on website found to correlate with quality of care

A study by the British National Health Service (NHS) has found a correlation between positive patient ratings of their healthcare experience and higher quality care, according to a study in the Archives of Internal Medicine.
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MAP has released list of quality and efficiency measures being considered for 2012

As part of the Patient Protection and Affordable Care Act, the Measure Applications Partnership has released the list of quality and efficiency measures the Centers for Medicare & Medicaid Services is considering adopting in 2012, according to AHA News Now.
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