By Emily Warner
Greetings, Palliative in Practice readers, and happy Valentine’s day! This week Obama is celebrating V-day by cuddling up to the fact that 3.3 million people have enrolled in private health insurance through the exchanges, a considerably better figure than the 12 or so who managed to sign up in the first week. Though, this hasn’t detracted from the sniggers Obama is getting for once again delaying a provision of the health law, this time the health insurance mandate for medium-sized employers. News: it has it’s ups and downs.
- The February issue of Health Affairs came out last week. I failed to notice the email in my inbox, and also the fact that the month had changed, so I’m bringing you my top pick a week late. This issue is all about “connected health,” the phrase I guess we’re using now to describe healthcare delivered through and facilitated by information technologies. My top pick: Use of Telemedicine Can Reduce Hospitalizations of Nursing Home Residents and Generate Savings for Medicare. The piece starts out with the daring hypothesis that the lack of a physician presence at many nursing homes during off hours might contribute to inappropriate hospitalizations. The tested intervention: telemedicine (real-time medical consultation via two-way video conferencing). The results were a bit tepid, but indicated that those facilities that utilized the telemedicine service the most saw a reduction in hospitalizations. Unnecessary hospitalizations of nursing home residents is a very important issue, so hopefully this study will be the first of many that test telemedicine for this population.
- And if you’re a doc, this probably is no surprise, ditto if you speak to docs, or are a patient who goes to a doc and happens to mention that you work in health policy, but it looks like uncertainty in the healthcare business is driving more docs to seek salaried employment with larger organizations like hospitals. In the short run, the article reports, this may lead to an increase in healthcare costs as docs employed by hospitals may have tests performed in-house, which will add a “facility fee.” And though it might make sense that the salary factor would reduce perverse FFS incentives, many contracts include bonuses for higher billing. Sigh.
- And finally, congratulations to Senator Ron Wyden, who on Thursday became the chair of the Senate Finance Committee. We mentioned Senator Wyden’s Medicare reform bill in the January 17 edition of This Week in Health Refom. Wyden is known for his big ideas and progressive policies, and his support for palliative care has been longstanding. We look forward to seeing how his leadership unfolds on this important Committee.
And honorable mention this Valentine’s day goes to Twitter, for being a breeding ground for HPV. That is, for #HealthPolicyValentines. Your dutiful Wonkblogger, Sarah Kliff, pulled together a roundup of some of her favorites. Not noted: mine. Must have been an oversight…