Scale of Medical Decisions Shifts to Offer Varied Balances of Power

A Los Angeles Times article noted: “Patients never used to worry about making healthcare decisions. They didn’t have to. Their doctors made just about all of their decisions for them. Everyone simply assumed that doctors knew what was best.”

“But that paternalistic view of doctors as know-it-alls has gone by the board, says Dr. Clarence Braddock, vice dean for education at the David Geffen School of Medicine at UCLA. “Now doctors are seen as the experts on medical information and choices,” he explains, “but patients are seen as the experts on what those choices mean in their own lives.” Read more

Clashing Visions on Medical Care Practice Prove to Be Hurdle

A Modern Healthcare article noted: “Clashing visions of how physicians should practice medicine in the 21st century bubble beneath the surface of nearly every controversial issue in delivery system reform. On the one side is ….a ‘last-century perspective. It reflects a time when patient outcomes were considered unmeasurable and when the idea of team care meant everyone following the orders of whichever physician was in charge.’”

“This approach put heroic practitioners at the center of the diagnosis, treatment and healing process. It posited that the best therapy for any patient should be discerned and delivered by someone with years of training and experience and, hopefully, a personal relationship with the individual in need of care.” Read more

Fee-for-Service Thwarts Value-Based Care’s Intention

A Modern Healthcare article noted: ”Society wants the healthcare system to improve the population’s overall health while caring for the sick at a lower overall cost. The term of art is providing value-based care. Yet system leaders are stuck with a reimbursement system that still rewards volume through fee-for-service medicine.”

“Those differing approaches to providing healthcare—actually, only value-based care can truly be called healthcare since fee-for-service medicine is more properly called sick care—present providers with two diametrically opposed incentive schemes.” Read more

Chemo Costs in U.S. Driven Higher by Shift to Hospital Outpatient Facilities

A Kaiser Health News article noted: “The price of cancer drugs has doubled in the past decade, with the average brand-name cancer drug in the U.S. costing $10,000 for a month’s supply, up from $5,000 in 2003, according to a new report by IMS Institute for Healthcare Informatics, a health information, services and technology company.”

“And those are just average prices; some drugs may cost as much as $30,000 a month.In Europe, where governments negotiate for national discounts, the list prices of cancer drugs are at least 20 to 40 percent lower than in the U.S., the report found.” Read more

Hospitals’ Purchase of Doctors Leads to Higher Prices, Spending, Study Finds

A Kaiser Health News article noted: “A new study gives ammunition to what health economists and health insurers have argued for years: When hospitals buy physician practices, the result is usually higher hospital prices and increased spending by privately insured patients.”

“The study, published … in the journal Health Affairs, was based on an analysis of 2.1 million hospital claims from workers of self-insured employers between 2001 and 2007.  The analysis by Stanford University researchers found prices were most likely to increase when hospitals bought physician practices, as opposed to hospitals forming looser contractual relationships with physicians.” Read more

The Costs of 10 Top Commercially Insured Readmission Conditions

A Becker Hospital Review article noted: “Of the 10 most common readmissions conditions for patients with private insurance, chemotherapy resulted in the highest costs for hospitals, according to an Agency for Healthcare Research and Quality statistical brief.”

“Here are the costs of the 10 most common readmissions among the commercially insured, according to the AHRQ brief. Note: Costs were defined as the actual expenses incurred in the production of hospital services (such as wages, supplies and utility costs). A readmission was defined as a patient who was hospitalized within 30 days of a previous hospital admission. Read more

Hospitals Boost Patient Safety, but More Work Is Needed

A Kaiser Health News article noted: “Two major safety shortcomings in America’s hospitals—the frequency with which patients get hurt during their stays and the large number who are readmitted—have decreased as government penalties and other programs targeting them kick in.”

“The Obama administration credited the new quality initiatives created by the federal health law. But some of the improvements in patient safety preceded that law. Even with the improvements, one out of eight patients is injured during their time in the hospital.” Read more

Who Really Pays for Health Care? It Might Surprise You

A USA Today article noted: “Eight million people have signed up for subsidized private health insurance under the Affordable Care Act, President Obama said this month. Millions more obtained new coverage through the Medicaid program for the poor. Full implementation of the health law and its wider coverage, new taxes and shifting subsidies have renewed discussions of winners and losers, makers and moochers”

“Here’s a corrective to common misconceptions about who pays for health care. Read more