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Health Management Technology News
  April 22, 2014
In this issue:

 The most misused word in healthcare

 Avoiding healthcare cost with pricing transparency hype

 Cause for concern: Healthcare costs are rising and the experts aren't sure why

 Imagining a U.S. healthcare system without insurance

 Health Management Technology’s Resource Guide sign-up

 Asian stocks fall, led by healthcare, technology shares

 e-Integrate recognized as Leading Healthcare Technology Integration Provider with IPAK

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The most misused word in healthcare

Let's ban the word "rationing" from the health care debate.

It's everywhere. Sen. Pat Roberts (R-Kan.) earlier this month introduced the "Repeal Rationing in Support of Life Act," which would remove four provisions of the Affordable Care Act (a.k.a. Obamacare) that restrict spending. A recent front-page article in the New York Times, headed "Treatment Cost Could Influence Doctors' Advice," noted that some critics call such a practice rationing. Accusations and denials of rationing have filled discussions of the ACA since before its enactment four years ago.

So let's be clear on two big facts about rationing. First, as the term has long been used, we don't have rationing of health care under the ACA. Rationing is what we had in World War II. The government imposed strict limits on how much sugar, gasoline, rubber, and other goods you could buy, and you could not legally buy more than that, no matter how much you were willing to pay. We don't have that with respect to health care. So long as you're willing to pay the doctor or hospital directly with your own money, you can buy all the health care you want.

Remember that fact when you read statements like this one from Sen. Roberts: "Under Obamacare, Washington bureaucrats can dictate one uniform standard of health care that is designed to limit what private citizens are allowed to spend, with our own money, to save our own lives." Obviously that isn't correct. Sen. Roberts is actually criticizing­ -- quite rightly, in my view -- a provision of the ACA that restricts how much people can spend on health insurance. But you don't need health insurance to get as much health care as you want. You just need money.

The second big fact about "rationing" concerns what people really mean when they misuse the word. They mean that in some patients' cases some procedures or products or medications won't get paid for because they cost too much. Those people are absolutely right. We've had that situation for years with private insurance, and we'll have it much more under the ACA. It's just that in every other area of our lives, we don't call it rationing, we call it budgeting. Who will do it is the great question, because a ton of it will need doing.

Read the full Fortune post here  

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Avoiding healthcare cost with pricing transparency hype

No less than two reports were published last week which fall loosely under the banner of healthcare pricing transparency.

The first was Medscape’s Physician Compensation Report for 2014. The annual Medscape report is based on a survey of over 24,000 physicians in 25 specialties around a broad range of compensation issues – including satisfaction.

Medscape’s findings (with data from 2013) is marginally more insightful than the Medicare Data dump from 2 weeks ago. One of glaring inadequacies of the Medicare data (for 2012) is the simple fact that revenue isn’t compensation. Seeing an annual summary of what Medicare paid to individual providers has almost no patient use.

According to the Medscape report there weren’t many big swings in compensation (there rarely are), but there’s always a few noteworthy shifts. No less than 19 of the 25 different practice areas saw an increase in compensation from the previous year, 1 was neutral and 5 saw a decrease. Of the decreases, only 1 (nephrology) saw an 8% decline in compensation. Three of the remaining 4 saw a 2% decline.

Overall satisfaction was near or above 50% for most of the specialties across 4 categories (Overall, Income, Career and Specialty). The two noteworthy exceptions were Family & Internal Medicine with 32% and 27% (respectively for choice of specialty) even though they appeared to be relatively satisfied (50% & 46%) with their income. Other findings as quoted from the slide notes:

  • Those who perform procedures have the highest incomes compared with those who manage chronic illnesses. Earnings are for full-time work only. They include salary, bonus, and profit-sharing contributions. They do not include non-patient-related earnings.

Read the full article from Forbes here  

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Cause for concern: Healthcare costs are rising and the experts aren't sure why

Last week's news about Obamacare enrollment was great. But health care policy wonks have something else on their mind now: the cost of health care. It’s starting to rise more quickly than before. That could be a problem.

For the last four years or so, national health care expenditures—that is, all the money that Americans spend on medical services and supplies—has been growing at historically low rates. It’s gone up every year, as it almost always does, but only by 3 or 4 percent. That’s just a little bit more than inflation. Typically health care spending has risen more quickly. Sometimes, in the 1980s and again in the early 2000s, it's risen much more quickly. Keep in mind that when national health care spending rises much more quickly than the economy is growing, you feel the impact—as relatively higher insurance premiums, higher out-of-pocket costs, and higher taxes to support government insurance programs. You may not have noticed it, but the recent slowdown has been good for your finances.

Now the respite may be ending. You can see it in the latest monthly reports from the Altarum Institute, an Ann Arbor-based think-tank that monitors national health care spending. These reports, based on government data, are the equivalent of an early warning system for medical costs. They are one of the first places a spending spike would show up. According to Altarum, expenditures started to rise more quickly in the middle of 2013. Since then, the rate has gone up even more. Reports of rising costs have already gotten the attention of savvy health care observers in the media, like Philip Klein and Sarah Kliff. The question now is how long the trend will continue, how quickly spending will accelerate, what should be done about it—and, of course, what it means for Obamacare.

Read the full article from The New Republic

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Imagining a U.S. healthcare system without insurance

Dr. Michael Park, a specialist in allergies who has a practice in Portage, says the secret to reforming U.S. health care is cutting insurance companies out of the equation.

Park, 46, outlined his vision in response to a column I wrote last week.

"You need to look at the big picture," he wrote in an email.  "We're talking a totally different paradigm. A totally different system."

In his vision, the United States would reform its health-care system by enacting dramatic tort reform; making people pay more out-of-pocket if they wanted access to the latest and most expensive technology, and rethinking our approach to end-of-life care.

But the key to his vision is deep-sixing insurance.

"Quite frankly, the only way I can think of to restore true market forces in health-care costs is to eliminate health insurance as we know it," he writes.

"Then the price would more closely reflect supply and demand. .... If all health insurance were eliminated, I submit that all healthcare prices would rapidly plummet by 25-50% With the middle man out and physicians and patients dealing with each other directly, prices would fall."

His idea: Instead of subsidizing insurance premiums, employers would put that money into a pre-tax medical fund that people would use to pay their medical bills.

"Obviously the very poor would still require the charity of others for the more expensive aspects of healthcare," he added.  "That has always been the case and that always will be the case."

"It could work," he wrote about his no-insurance idea. "It would reduce the cost of healthcare to the lowest it could possibly be."

He added: "Of course, I realize this will NEVER happen. It's too radical a change. Most people wouldn't be able to wrap their minds around it and there would be too much fear."

Read the full article from here  

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Health Management Technology’s Resource Guide sign-up

Register your company in Health Management Technology’s Resource Guide (July 2014 issue) and be listed within 3 categories for free!

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Asian stocks fall, led by healthcare, technology shares

Asian stocks fell, with the regional gauge heading for its first drop in four days, led by health-care stocks and information technology shares. Several markets across the region are shut today for a holiday.

Ono Pharmaceutical Co. fell 2.9 percent in Tokyo to lead losses among health-care stocks. Wipro Ltd. declined 5.6 percent in Mumbai after Goldman Sachs Group Inc. said the Indian software maker’s first-quarter sales forecast is the weakest in the past four quarters. Japanese consumer-loan providers Acom Co. (8572) and Aiful Corp. each jumped at least 7.7 percent after the Nikkei newspaper reported that the ruling party is considering loosening lending restrictions in the sector.

The MSCI Asia Pacific Index fell 0.2 percent to 138.85 as of 5:36 p.m. in Tokyo. U.S. President Barack Obama meets with Japanese Prime Minister Shinzo Abe this week and HSBC Holdings Plc’s and Markit Economics Ltd.’s release their preliminary gauge of China factory activity on April 23. About 160 companies on the Topix are due to post earnings this week.

“We are awaiting many events such as the Obama-Abe meeting, Chinese data and earnings this week,” said Hideyuki Ookoshi, general manager at Chibagin Securities Co. “Investors are thinking the market won’t move much, so they’re holding off on making trades.”

Read the full article from Bloomberg here  

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e-Integrate recognized as Leading Healthcare Technology Integration Provider with IPAK

e-Integrate's Industry Process Application Kits (IPAK) were among the first to market with integration points to fully comply with the CMS and State specific 834 & 820 EDI transaction sets, and now have advanced the simplicity of integration with the release if IPAK 7.2 with out-of-box views for 834 EDI Enrollment and 820 EDI Financial transactions.

Because regulations, such as Health Insurance Portability and Accountability Act (HIPAA) and the Affordable Care Act (ACA), require trading partners to connect with the Health Exchanges to transmit and receive specific transaction formats - interoperability connection points, such as IPAKs are required to connect data to specific Carrier business processes.

Rahul Deosthale, President of e-Integrate, said, "IPAKs help Exchanges and Carriers connect in a way that easily optimizes operational processes and data integrations, with greater agility than ever before. We see this as the new baseline best-practice for accelerating interoperability."

Read the full press release here  

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