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The Aspen Health Forum just gathered an impressive group of around 250 people to discuss the most pressing issues in Health and Medical Science.
1- Global health problems require the attention of the scientific community. Richard Klausner encouraged the scientific community to focus on Global Problems: maternal mortality rates, HIV/ AIDS, clean water, cancer.
2- “Let’s get real.Ideology kills”. Mary Robinson, former President of Ireland, on what it takes to stop HIV/ AIDS: “I am from Ireland, a Catholic country. And I am Catholic. But I can see how ideology kills..we need more empathy with reality, and to work with local women in those countries.” This session included a fascinating exchange where Bill Frist rose from the audience to defend the role of US aid, explaining how 60% of retroviral drugs in African countries have been funded by the American taxpayer. Which made Nobel Prize Laureate Peter Agre, also in the audience, stand up and encourage the US to really step up to the plate and devote 1% of the GDP to aid, as a number of European countries do, instead of 0.1%.
3- Where is the new “Sputnik”?: Many of the speakers had been inspired by the Sputnik and the Apollo missions to become scientists. Two Nobel Prize Laureates talked about their lives and careers trying to demystify what it takes to be a scientist and to win a Nobel Prize. Both are grateful to the taxpayers dollars that funded their research, and insist we must do a better job at explaining the scientific process to society at large. Both are proud of having attended small liberal arts colleges, and having evolved from there, fueled by their great curiosity and unpredictable, serendipitous paths, into launching new scientific and medical fields.
4- We need a true Health Care Culture: Mark Ganz summarized it best by explaining how his health provider group improved care when they redefined themselves from “we are 7,000 employees” to “we are a 3 million strong community”, moving from being a cost controller with a paternalistic attitude to a health facilitator, looking underneath symptoms to identify and deal with underlying patterns.
5- You can’t manage what you can’t measure. We heard many times how defining and measuring outcomes, so common in the private sector, is critical to ensuring a good allocation of resources in the health and scientific fields, that use so much taxpayer money. For example. NIH funding grew from $9B in 1994 to $29B in 2007, yet the results are not clear. The same happened with health care as a whole, a sector that now consumes 16% of the US GDP with health outcomes (infant mortality, patient deaths in hospitals) worse than other countries that invest far less.
6- The rising role of public-private partnerships: There are multiple initiatives launched to bridge the increasing gap between academia and industry. The Foundation for the NIH has facilitated key conversation between the FDA and pharma companies. The Gates and Clinton Foundations have launched innovative partnership models to tackle global health problems.
7- From Lifespan to Health-span. Population distribution in developed countries is shifting from a “population pyramid” to a “population rectangle”. The point of much ongoing research is not “how to spend more time on the nursing home” but how to slow down the process of aging, so we can live healthier longer.
8- Patient-advocacy groups are having an impact. We heard many examples on how small groups of motivated individuals have built large patient advocate movements that influence public policy. Michael Milken talked about the Cancer March, that helped increase NIH funding from $1.5B to 5$B. Hala Moddelmog, from the Susan G. Komen for the Cure, explained how they have 1 million people engaged in promoting cancer research and prevention. Robert Klein, key advocate of the California Proposition 71 (that will provide $6B for stem cell research through long-term bonds) explained how the proposition was passed, including engaging over 80 patient-advocacy groups.
9- There’s a new emphasis on understanding “how systems work” instead of “how isolated genes make things happen on their own”: Genomics is starting to help predict susceptibility to disease and to therapies. Now, we must keep in mind the role of our experience and environment in turning some genes on or off.
10- The importance of our Lifestyle-Each of us owns our own health. 70% of heathcare costs derive from lifestyle-related diseases (such as smoking-induced cancer). We heard several calls to action for insurance companies to incentivize behavior modification to promote good lifestyle habits that improve quality of life and can delay disease symptoms, resulting in billions of dollars of cost savings.
In short, a very stimulating inaugural 3-day conference. I hope the one next year is even better.
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Federal regulatorsunveiled today a proposed new health insurance summary formwhich will give consumers greater information regarding the details of each policy.One large county in Florida has been pressing for greater disclosure to consumers of endorsement fees paid by health insurers.Disclosure to consumers of endorsement fees is as critical, in my opinion,as information regarding coverage and deductibles because ultimately such feescome out of their pockets.Unfortunately, it doesn’t appear that the government’sproposedsummary formwill shed any new light on this issue.
Our story begins earlier this year when the Board of County Commissioners of Orange County (Orlando) Florida issued a Request for Proposals for a Group Retiree Medicare Supplemental Plan for the Countys retirees. The County has approximately 7,000 employees and retirees.
Medicare Supplemental insurance is a kind of health insurance policy sold by private insurance companies to fill the gaps in Medicare coverage. For individuals who are Medicare-eligible (in general, over age 64.5 years old) and covered under Medicare, these policies can help pay some of the health care costs that Medicare doesnt cover.
Among the firms to respond to the RFP was United Healthcare, one of the nations largest health insurance providers.
In its response, United indicated that it was the only firm that could offer a Medicare Supplemental plan that was endorsed by AARP, the leading lobby group for senior citizens. AARPs website says its a nonprofit, nonpartisan organization that helps people 50 and over improve the quality of their lives. Sounds like an organization many of the countys retirees might view favorably or even already belong to. Indeed, I am told one out of two Americans over age 65 is a card-carrying member of AARP.
United’s response went on to state that to be eligible for the Medicare Supplemental plan, retirees would have to be AARP members. Thats right, no AARP membershipno soup (or health insurance) for you. However, to soften the blow, for the first year United agreed to pay membership dues on behalf of such retirees. For those of you too young to know, membership in AARP today costs $16 per year. That includes the formulistic magazine with monthly articles profiling one movie star who is aging amazingly well (supposedly without the aid of plastic surgery); one scam to avoid and one way to cut your monthly living expenses.
The arrangement between United and AARP raised some eyebrows at the county and the countys procurement committee attempted to obtain additional information regarding any fees associated with AARPs endorsement. Here are some of the questions the committee asked in an email to United:
1. Please provide specific details regarding the royalty fee arrangement with AARP (i.e., royalty fee methodology, frequency of payment, how long the current royalty fee arrangement has been in place, total amount of royalty fee payments for 2008, 2009, 2010, etc.)
2. Please provide specific details regarding any compensation arrangement with AARP prior to the current royalty fee arrangement.
3.Please describe the services performed by AARP to receive the royalty fee payment.
4.Please provide details regarding the specific benefits Orange County retirees would receive as a result of the AARPs endorsement of the UHC Medicare Supplemental Plans.
5.Please provide a legal opinion that the current royalty fee arrangement is in compliance with applicable federal and state laws.
In my opinion, these are all reasonable questions for a county attempting to secure the best group health insurance for itsretirees to ask. The questions were designed to determinewhether theroyalty fee arrangement might amount toa commission related to the sale of health insurance products which might violate applicable law; the dollar amounts involved and whether the arrangement benefitted County retirees in any way. After all, the county reckoned the retirees are, one way or another, going to pay the cost of the endorsement.
John Thompson, Vice President of Client Development at United responded to the countys questions by saying, The AARP Medicare Supplement Insurance Plans carry the AARP name and United Healthcare Insurance Company pays a royalty fee to AARP for use of the AARP intellectual property. Amounts paid are used for the general purposes of AARP and its members. We do not pay AARP any amounts other than the royalties.Neither AARP nor its affiliate is the insurer.
This information, by the way, is simply whatAARP discloses on itspublic website. I have to admitI was surprised to learnAARPpossessed “intellectual property”which companies, such as United andCharles Schwab & Co., will pay dearly for.
Later the county procurement committee was told that no additional information could be provided by United because of a confidentiality agreement United had with AARP. Alas, it seems there are some matters that cannot be spoken of in polite society.
Fortunately, the county found a way around this ever-so-thin veil of secrecy. Behind The Veil: The AARP America Doesnt Know, a March 2011 investigative report prepared by two Republican Representatives (Wally Herger and Dave Reichert) providedsome of the answersthe countysought from United.
United is AARPs largest business partner. As part of the United and AARP business agreement all three of the Medicare insurance product lines are marketed under the AARP brand name. From 2007 to 2009, Uniteds royalty payments to AARP have grown from $284 million in 2007 to $427 million in 2009, a 50% increase. State insurance rate filings show that, in 2010, AARP retained 4.95% of seniors premiums for every Medigap policy sold under its name. Therefore, the more seniors enroll in the AARP branded Medigap plan, the more money AARP receives from United.
Bottomline: Almost half a billion in endorsement fees that, directly or indirectly, come out of seniors pockets. That’s a lotta love seniors have for AARP. Don’t forget to add to that premium-related amount theannual membership fees seniors are required to pay.
Last time the procurement committee met to review the Medicare Supplemental plan proposals, the issue was not the existence of the almost 5% endorsement fee per se but whether the information United had provided was sufficient to meet any disclosure obligations the county or United might have to participants.That is,would theinformationprovided by United, if disclosed,permit participants to make an informed decision as to whether the AARP endorsement feewas worth the price?
On the other hand, the requirement that retirees pay membership dues to AARP was,I am told, a potential deal-breaker. The procurement committee is still waiting to hear from UnitedwhetherUnited andAARPwill relent on this issue. In the meantime the committee has requested the County Attorneys Office to review both the disclosure and mandatory AARP membership issues.
Regardless of whether youlove or hate AARP, if counties around the nationcanraise awareness of the cost to consumers of health insurance endorsements, they should. Disclosure, in my opinion, will bring an end to these payments that provide no apparent benefit to consumers– only to AARP.
The Tech Innovators Series is supported by Lenovo. Lenovo does not just manufacture technology. They make Do machines — super-powered creation engines designed to help the people who do, do more, do better, do in brand new ways.
I’m from Los Angeles, went to college in Philadelphia, grad school in Chicago and now live in New York — there is no one place to find my complete and comprehensive medical history. And I’m not alone — on average, an individual has 19 different doctors over the course of his life.
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When patients see new doctors, they often spend a chunk of the appointment explaining their ailments and medical history is. They may even have bloodwork done, even if they had it done recently at a different doctor’s office.
If the system was digitized and all the information was in one convenient place, doctors visits would be quicker and less redundant. That “convenient place” is the cloud.
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More than $20 billion has been earmarked under President Obama’s American Recovery and Reinvestment Act (ARRA, a.k.a. the stimulus bill) for the transition to electronic health records. San Francisco-based Practice Fusion has taken 120,000 health care professionals digital, storing 22 million medical records in the cloud, accessible anywhere there’s an Internet connection. By digitizing medical history, physicians can eradicate inefficiencies and medical errors.
Practice Fusion was founded in 2005 by Ryan Howard, whose background is more in SaaS-based technologies than health care. Mashable spoke with Howard to learn more about the importance and the future of electronic medical records.
Howard arrived in the Bay Area during the dot com gold rush, and worked his way up from tech support to software installation for Brown & Toland, a large physician group in the area. It was there that he saw “bad technology” in the doctor’s office. “The doctors didnt want to use it, and the software was a pain in the ass. It was all incredibly complex and difficult,” says Howard. “It was through that experience that I realized the massive disconnect between the free, web-based technology, like Google, that revolutionized the consumer market, and what was going on in the health care sector.”
So he founded Practice Fusion in 2005 and launched the free electronic medical record service in 2007. Free is the operative word — at the time, Howard says, the average EMR system cost $50,000 per doctor each year.
Paper is dangerous and inefficient, it doesnt belong in health care any longer.”
FRIDAY, Oct. 28 (HealthDay News) — Because many adolescents with mental health problems are never diagnosed and treated, an expert team has come up with a “toolkit” aimed at identifying those kids and getting them the right help.
“One in 10 youths have a mental health condition that is severe enough to impair functioning, either at home, school or in the community,” said Gary Blau, chief of the child, adolescent and family branch of the Substance Abuse and Mental Health Services Administration (SAMHSA), part of the U.S. Department of Health and Human Services.
Blau spoke at a Friday news conference to unveil the toolkit, which appeared online simultaneously in Pediatrics. Although the journal is published by the American Academy of Pediatrics, that organization has not endorsed the toolkit. SAMHSA provided partial funding for the project.
“This toolkit will allow pediatricians, teachers and others that could help get the word out to families we can close the gap so the three out of four children with mental health disorders who aren’t identified do get identified,” said Dr. Peter Jensen, who was the lead investigator on the project.
About half of mental health disorders manifest themselves by the time a child has turned 14, and 75 percent manifest by age 24, Blau said.
Yet treatment is often years away for that child, added Lisa Hunter Romanelli, an assistant professor of clinical psychology in psychiatry at Columbia University College of Physicians & Surgeons in New York City.
“That is too long in the life of a child,” said Romanelli, who is also executive director of the nonprofit REACH Institute, whose mission is to shorten the length of time it takes for effective interventions to reach teens. Jensen is president and CEO of the institute.
Researchers convened over a period of several years to analyze data collected from more than 6,000 children and parents to identify the most common symptoms of mental health disorders and to see if children with these troubling signs were receiving appropriate care.
This information was then translated into warning signs that are written in “crisp, easy-to-understand language,” said Jensen, who is vice chair of research in the department of psychiatry and psychology at the Mayo Clinic in Rochester, Minn. “They don’t sound like mental health jargon. It was deliberate, to make them as parent-friendly as possible.”
Because differentiating a true mental health disorder from the inevitable ups and downs of adolescence is difficult, the authors chose to focus on the more severe end of the mental health spectrum.
“We realized there was a potential for harm for parents to worry when they didn’t need to be worried,” said Jensen. “So we decided to target not the 15 percent or so who have these problems, but the 8 percent who are at the more severe end.”
If your child has any of these 11 warning signs, he or she may have a mental health disorder and should be referred to treatment as soon as possible:
- Feeling very sad or withdrawn for two or more weeks
- Seriously trying to harm or kill themselves, or making plans to do so
- Sudden overwhelming fear for no reason, sometimes with a racing heart or fast breathing
- Involved in multiple fights, using a weapon, or wanting badly to hurt others
- Severe out-of-control behavior that can hurt the teenager or others
- Not eating, throwing up, or using laxatives to lose weight
- Intense worries or fears that get in the way of daily activities
- Extreme difficulty in concentrating or staying still that puts a teenager in physical danger or causes school failure
- Repeated use of drugs or alcohol
- Severe mood swings that cause problems in relationships
- Drastic changes in behavior or personality
“This data substantiates what we already knew, that there are warning signs of significant mental illness, but children and adolescents aren’t getting help because health care providers don’t share the same language,” said Dr. Abigail Schlesinger, medical director of outpatient behavioral health services at Children’s Hospital Pittsburgh.
“This toolkit will help mental health providers and others on the front lines, such as teachers, people in the juvenile justice system [and] parents speak the same language,” added Schlesinger, who was not part of the research team.
The U.S. National Institute of Mental Health has more on child and adolescent mental health issues.
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