iLoveBenefits: Industry News Blog

Insurers and Wearable Technologies: Trends, Attitudes, and Projections

 

Accenture recently released their annual Technology Vision for Insurance report. Here are some key findings from the survey:

  • 63% of respondents believe that wearable technologies will be adopted broadly by the insurance industry
  • Almost one-third said they are already using wearables to engage customers, employees or partners.
  • 73% of insurers said that providing a personalized customer experience is one of their top three priorities
  • Half claim to already see a positive return from their investment in personalized technologies
  • 75% believe the next generation of platforms will be led by insurance players, not technology companies
  • Half (51%) said they plan to partner with major digital technology and cloud platform leaders

Source: Accenture, May 5, 2015

The Cost of Drugs is a HUGE Issue

This piece from Karen Ignagni

“A blank check in the name of innovation won’t work anymore”

Posted on July 7, 2014 by AHIP

AHIP CEO Op-Ed Drives Home Challenge of Specialty Drug Prices

What if the solution to a public health crisis was, at the same time, the biggest obstacle to success? That’s the dynamic facing the country as we try to eradicate Hepatitis C, a chronic liver disease afflicting more than three million Americans. A new treatment, Sovaldi, holds the potential to nearly wipe out this terrible disease, but at $1,000-per-pill, it’s so costly that its price threatens access for those who need it so desperately.

Taking to CNN with an op-ed this morning, Karen Ignagni, CEO of America’s Health Insurance Plans, lays out in real terms the challenge that drugmakers are presenting when they price their treatments at such astronomical levels. As Ignagni notes, Sovaldi “holds remarkable promise. But the manufacturer of this drug, Gilead Sciences, has created an enormous obstacle that is straining our health care system: its eye-popping price… If every person with hepatitis C were treated with Sovaldi alone at this price, the cost would be more than $268 billion.

For some perspective, consider that in 2012, the United States spent $263 billion for all prescription drugs.”The price of the drug “will have a tsunami effect across our entire health care system,” she writes. “Because the cost of health insurance is fundamentally a reflection of the price of health care services, the excessive price of Sovaldi unavoidably puts upward pressure on premiums for everyone with private coverage. It will also strain state Medicaid and Department of Veterans Affairs programs.

A recent analysis found that senior citizens on Medicare Part D could see premiums as much as 8% higher next year because of the price of this one drug. And it’s been projected that California’s Medicaid spending on Sovaldi and the accompanying drugs could potentially outpace what the state spends in a year on K-12 and secondary education combined.”

It would be one thing if Sovaldi were the only drug being priced at these once-unthinkable levels. But alas, “Startling as the price of Sovaldi is, it’s just the canary in the coal mine,” Ignagni continues. “More and more specialty drugs are coming on the market, with tremendous promise to save and improve lives but also with exorbitant price tags. Although these specialty drugs only account for 1% of the prescription drugs in this country, they already represent 25% of the total cost, on the way to 50%.”It’s a trend that simply cannot continue if we hope to have sustainable medical innovation.

“Asking for a blank check in the name of innovation won’t work anymore. Not when it stands in the way of solving a public health crisis. Not when it threatens state Medicaid budgets and the success of Medicare Part D, and not when the pricing threatens the very innovation that is giving so many hope,” she writes.

Read the entire piece on CNN.com here. – See more at: http://www.ahipcoverage.com/2014/07/07/ignagni-a-blank-check-in-the-name-of-innovation-wont-work-anymore/#sthash.YVOLgQdM.dpuf

How can disruptive innovation improve spine care?

The following article excerts are provided by permission of the author, John Ventura.

“It goes without saying that the field of spine care is replete with variation, waste and misuse. Direct costs for spine care have risen almost exponentially over the past three decades, while indirect costs (those typically associated with lost productivity) have followed suit. (3) In spite of these exorbitant expenditures on spine care, our outcomes as measured by disability are worsening. Many investigators have identified spine-related disorders as one of the costliest health conditions society faces. The need for change is obvious, but what change and how do we get there?”

To read more and understand the author’s proposal on how to bring Christensen’s concept of disruptive innovation to spine care go to: http://www.beckersspine.com/spine/item/21390-constructive-disruptive-innovation-first-touch-and-spine-care

 

Data, Information, knowledge, technology tools — equals better care

Electronic tool cuts medication errors by 58% in studyAn electronic system that records and reviews each child’s medication history helped Boston Children’s Hospital cut medication errors by 58%, according to data presented at the Pediatric Academic Societies annual meeting. During the study period, researchers also found the medication history documentation grew from 89% to 93%. There were no errors during the study resulting in permanent harm, intensive care unit admission or patient resuscitation. BeckersHospitalReview.com (5/6)

Health care technology and consumers meet

On April 10, PricewaterhouseCoopers’ Health Research Institute released a new report that suggests the health sector’s “center of gravity is shifting toward consumers and new tech-savvy players are moving fast to capitalize on the change.  These new entrants are poised to shake up the industry, drawing billions of dollars in revenue from traditional healthcare organizations while building lucrative new markets in the burgeoning New Health Economy.”

Does this improve outcomes or provide incremental revenue?

Is point-of-care ultrasound the new stethoscope?
A new paper espouses the benefits of hand-held ultrasound devices over the iconic stethoscope, arguing the convenience and power of ultrasound will improve diagnosis. Writing in the journal Global Heart, Drs. Jagat Narula and Bret Nelson of the Mount Sinai School of Medicine question why sonography isn’t used more widely. However, Dr. Reid Blackwelder, president of the American Academy of Family Physicians, says the stethoscope remains valuable and warns wider use of sonography could bring additional costs — both for equipment and the tests that might follow the initial assessment. CBS News (1/24), LiveScience.com (1/23), USA Today (1/24)

So, I am not against advances, but is there evidence that the outcomes are better than with a stethoscope? I know it will be more expensive. The article talks about it leading to more tests, too.

On the other hand, how about personal medicine and getting these devices as apps with sophisticated computer software that links to a ‘benchmark’ database to inform patients of potential next steps? Does that lower the number of office visits and procedures vs. putting the technology only in the hands of the clinician?

Teamwork Key to Long Term Sustainability of Health IT Systems

 

A new report from the Agency for Healthcare Research and Quality highlights the cumulative experiences of over 100 grantees that implemented major health IT projects between 2004 and 2007. The report, Effective Teamwork and Sustainability in Health IT Implementation, reviews grantee experiences related to planning, long-term use, partnerships, vendor relationships, and end-user perceptions a few years after the end of the project period. This initiative was unique because it supported planning for health IT among rural health care organizations. The most important factors reported to affect sustainability of health IT were the ability to demonstrate benefits from health IT to grantees’ organizations, clinician support, and cost-related issues. Grantees reported that most health IT products that were implemented and upgraded during the study continue to be used. However, they reported that in order for health IT projects to be successful, clinician buy-in and support must be established early in the planning period and be sustained during implementation and maintenance phases. Effective planning, including completing a detailed workflow analysis, implementation plan and process re-design assessment prior to implementation were strong markers of long term viability. Strategic partnerships were another indicator for success; trusted partners with implementation experience provided practical advice that helped grantees anticipate and overcome common challenges in health IT implementation.

 

The majority of grantees reported that health IT upgrades were beneficial to the organization and that ongoing investments in health IT infrastructure were warranted. The report includes an organizational readiness checklist to help health professionals identify and mediate obstacles to successful health IT implementation. For more information, please visit: http://healthit.ahrq.gov/THQIT.

As health care changes – innovators win

More U.S. adults turn to retail clinics
Retail clinics have gained popularity among consumers, according to a study by Kalorama Information. Researchers surveyed 2,000 American adults and found that 21.3% have visited a retail clinic, up from less than 10% six years ago. Chain Drug Review (11/27)

AHRQ’s Health Care Innovations Exchange Focuses on Increasing Patient Involvement in Health Care

The October 10 issue of AHRQ’s Health Care Innovations Exchange features three profiles about innovative programs that increase patients’ involvement in health care. Two programs provide patient access to online medical records via secure patient portals, and one program offers patients access to routine laboratory tests between visits, enhancing engagement and satisfaction.  One profile describes an initiative known as OpenNotes®, in which doctors invite patients to access their notes detailing medical office visits via secure patient portal linked with their electronic medical record system.  Patients may read a note to develop a better understanding of their care; to discuss aspects of the visit with the doctor at the next office visit; to act on self-management, treatment, and other recommendations included in the note; or to share the note with others, including family members and other providers.  More than 1,000 primary care doctors and 20,000 of their patients at Beth Israel Deaconess Medical Center in Boston, Geisinger Health System in Pennsylvania, and Harborview Medical Center in Seattle participated in a 12-month demonstration project of OpenNotes®.  Early feedback from this project suggests that the program generated high levels of satisfaction among patients and the doctors who volunteered to participate. Select to read more innovation profiles related to patient involvement in health care on AHRQ’s Health Care Innovations Exchange Web site, which contains more than 725 searchable innovations and 1,500 QualityTools.

Cost and Quality concerns are common across the globe

As much as we think our cost and quality issues are unique to our country, we see this from the Commonwealth Fund that reinforces that there are common issues across the globe that have yet to be solved.

Transatlantic Lessons on Health Reform

Despite significant differences in their health care systems, the United States and England face similar imperatives: reduce the cost of delivering care to aging populations and address deficiencies in quality and safety. A new article in the Lancet by Jennifer Dixon, MBchB, of the Nuffield Trust in London and Harvard Medical School’s David Blumenthal, M.D., chief health information and innovation officer at Partners Healthcare System in Boston, identifies major areas of reform where the two countries have common aims and may be able to learn from each other. These include:

  • payment reforms, such as experiments with bundled payments to encourage better coordination of health services across providers and sites of care
  • encouraging innovation through the creation of accountable care organizations in the U.S. and clinical commissioning groups in the U.K.
  • using electronic health records to improve clinical decision-making and patient engagement.

“Policymakers and health care managers in both countries should miss no opportunity to make progress by learning from one another, and from other international examples,” the authors conclude.

Since 1999, the Commonwealth Fund and Nuffield Trust have sponsored an annual meeting bringing together government officials, health researchers, and practitioners from the U.S. and U.K. for an exchange of ideas on quality improvement policies and strategies.

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