Thursday, December 04, 2014

Health Wonk Review: Post-Turkey Day edition [UPDATED]

As we count down the days from Thanksgiving to Christmas, there's always this incredibly exciting sense of anticipation in the air. This is no less true of us health care wonks, as you can see from this eclectic assortment of bloggetry:

Mea Culpa Update: In the rush to get this put together, I inadvertently left out two great contributions, from HWR regulars, no less (I've put them in the top two spots).

Please make sure to click on through, you'll be glad you did:

Jason Shafrin (my favorite econ-blogger) wonders about the curious phenomenon of provider networks converting freestanding urgent care centers to emergency departments. It's not as obvious as one might think. The NCPA’s Health Policy Blog's John R. Graham takes a look at the skyrocketing cost of developing new drugs and what’s changed to cause the increase (according to Mr G, it costs $2.6 billion to develop a new med, more than twice what it cost in '03).
First up, Kip Piper wonders if undocumented illegal immigrants are in line for ObamaCare subsidies, not to mention abortion coverage and the Halbig/King cases [ed: um, you just mentioned them...].

Next, the folks at Wing of Zock (which, I'll repeat for the umpteenth time, would make a great name for a rock band)  present a post by two co-founders of a scholarly collaborative that promotes and shares best practices on medical student scholarship across institutions. In it, they describe the benefits of, and barriers to, undergraduate medical student research. As a great poet once observed, the children are our future.

Uber-wonk Roy Poses takes a look at PR, medical errors and the Great Texas Ebola fustercluck mismanagement/debacle. His (eminently reasonable) conclusion is that the interests of hospital management appear to conflict with those of public health. Not exactly confidence inducing.

And speaking of Uber-wonks (and all in a very good way!), David Williams takes on the very real problem of providers getting clobbered financially if they take on too many Medicaid patients. On the other hand, David observes, there are policy solutions at hand if we are willing to discuss them. In particular, the disparities between Medicaid, Medicare and commercial payments should be reduced, and we should move away from fee-for-service toward risk-based models [ed: risk? Isn't that the purview of insurance?]

Peggy Salvatore has a tale of mystery, intrigue and data (but mostly data), as she examines changes at the top echelon of CMS. Seems they have a new First Chief Data Officer, Niall Brennan, who understands how effective data usage can be in achieving value and accuracy.

Our good friend and colleague Jay Norris takes on the oft-misunderstood CSR (Cost Sharing Reduction) component of certain Exchange-based ACA plans. For example, if a family with kids and a CSR-eligible income is shopping for coverage, they’re not going to see CSR plans in the browsing tool nor will they see CSR plans in any quotes.  That makes it tough to compare plans prior to enrolling, since the CSR plans offer such a good value and definitely need to be considered by anyone eligible for them. This makes shopping at "The Marketplace" even more exciting challenging.

Chris Fleming, proprietor of the Health Affairs Blog, sends along a Contributing Voices post by the executive director of the Catalyst for Payment Reform, Suzanne Delbanco. In it, she summarizes lessons learned, comparing and contrasting different payment models (eg Pay for performance, “payment for non-visit functions”).

Count on the folks from Blog to come through with a timely (it is, after all, Open Enrollment season) and cautionary post on ACA "benchmark" plans and renewals. The story of a low-income family in Philly who, if they renewed a plan they were told would cost  “pennies per month,” could pay almost $200 a month helps illustrate the dilemma [ed: um, that is "pennies per month:" 20,000 of them].

HWR co-founder - and all-around good egg - Julie Ferguson looks at the seismic impact that the executive order related to immigration is likely to have on workers’ compensation. Here’s a hint of the scope: “…one-fifth of work injuries are likely sustained by foreign-born workers, 10% by undocumented workers, whether or not they are reported.” Yikes!

And last, but (hopefully) not least, our own small contribution: Even (especially?) in Jolly Olde, the Much Vaunted National Health System© proves inadequate for the task, this time missing key targets for critical cancer care.

Thanks to our great contributors, and to you for dropping by! Please join us next time at Julie's place.
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