Wednesday, August 6, 2008

Health Wonk Review

It's my turn to host Health Wonk Review--a synopsis of some of the best recent posts from the world of health blogs.

HWR founder Joe Paduda starts things off with a post critical of investment analysts handling of a recent Coventry Health earnings conference call with his assertion that "the analysts blew it." First the analysts helped HMO stocks hit historic lows this year and now seem to be supporting their resurgence. But are they asking the right questions in the first place? In a related post, I pointed out the Coventry stock rallied after the same conference call where Coventry management used the term "sort of" 63 times to explain the company's performance while the analysts gave them almost a free pass.

And you thought you had challenges in your business. Julie Ferguson at Workers Comp Insider reports that in Florida, Georgia, and Louisiana, an employer's right to establish and enforce health and safety policies on private company property has been abridged by recent laws that give employees the right to keep loaded guns in their parked cars on work property. She discusses this issue and the legal challenges put forth by several large employers such as Disney and Georgia-Pacific.

Merrill Goozner weighs in on the headline anthrax story telling us, "The FBI doesn't have a slam dunk case against Bruce Ivins, the bioterror weapons researcher at Ft. Detrick, Maryland who committed suicide last week after becoming the prime suspect in the 2001 anthrax letter-bomb attack that killed five. But once again it appears that all roads lead back to home in this seven-year investigation, including the fact that Ivins co-owned patents on an anthrax vaccine. Merrill uses the latest wrinkle in this ongoing saga as a springboard to a discussion on the impact that the War on Bioterror has had on infectious disease research.

Jason Shafrin always asks great questions and provides even better answers at "Healthcare Economist." Do people value additional income more when they are healthy and can use it things such as travel, dining out with friends, and athletics; or do they value additional income more when they are sick and can use the money for things such as additional health care, home nursing care? He reviews some arguments from a paper by Finkelstein, Luttmer and Notowidigdo in his post, "The Marginal Utility of Consumption and Health."

Roy Poses suggests that, "The current COO of a Florida hospital resigned after questions were raised about financial management of the hospital he previously ran, including allegations of diversion of more than $1 million into his personal accounts. It also turned out that he spent time in the brig for theft in and then received a bad-conduct discharge from the US Navy. This is another case suggesting, given the rising power of managers and executives of health care organizations, there should be some licensing process to ensure they have some relevant knowledge and background, and follow some ethical standards." See the details in his post, "Another "Rising Star" Health Care Executive Implodes."

Maggie Mahar, over at "Health Beat" takes Roy's post another step asking, "Should More Hospital CEOs Be Physicians?"

But over at "Amateur Economists" they're posting on, "Why Doctors Are Not Good Businessmen." This post discusses "the poor business model of a private practice and compares it to the business model of other types of businesses."

David Hamilton, at "BNET Healthcare,"warns us that, "The increasingly widespread dissemination of individual health data is a double-edged sword, offering patients the benefits of more integrated healthcare (the Health 2.0 view) and potentially disadvantaging them as insurers use the information to risk-adjust premiums or to deny coverage altogether" in his post, “Health 2.0″ vs. Health Insurers: The Looming Clash."

But, Brian Klepper gives us reason for optimism as he sees us on the cusp of a "breathtaking" breakthrough in usable health care information for both the patient and the clinician in his post, "From Description To Action: The Future of Health 2.0 Tools" at "The Health Care Blog."

While Jaan Sidorov, at the "Disease Management Care" blog, discusses the limits of HEDIS-based wellness and prevention measures. He suggests the successful HEDIS approach needs to be integrated with activities in employer settings, communities and even the PHR in, "Physician-Focused HEDIS Is Not Enough."

Matthew Holt gives us a comprehensive review of the UK's technology assessment program, NICE, in his post, "NICE job. Cost-effectiveness in the UK." Under Andrew Dillon's leadership, NICE has created an example for all of us to learn from.

According to some, there's a new "problem" looming: the "underinsured." But is there, really? InsureBlog's Henry Stern is skeptical, but takes a look in his post, "Moving the Goal Posts."

Louise at "Colorado Insurance Insider" suggests that the problem of the uninsured could get even worse. "If McCain's plan results in any decrease in employer group plans, we're going to see an increase in the number of people without health insurance, simply because of the underwriting rules that individual health insurance carriers use" in her post, "McCain Health Care And Individual Health Insurance."

What to do about Medicare and its many challenges? Joanne Kenen gives us a summary of the Medicare Conference recently ran in Washington in her post, "REFORM: Medicare versus Cassandra" at the "New Health Dialogue" blog.

At the blog, "Home of the Brave," Annie suggests that emergency departments which experience inpatient boarding may find using the Joint Commission's Leadership Standard and the regulation which demands that the appropriate inpatient standards of care and practice be enforced from the time of admission was ordered to be the key which unlocks effective strategies to address staffing, care and mechanisms of care provision to patients who are boarding "off-service." You can get the details at, Emergency Department Overcrowding Revisited: It’s The Care And Not The Geography.

Lisa Emrich continues to keep a sharp eye on drug pricing. This time she reports on a Senate Joint Economic Committee meeting she attended which examined extraordinary price increases for drugs used in rare-disease small populations in, "Price Gouging in Extremely Vulnerable and Captive Market" as well as "Small Patient Population - Big Drug Prices."


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