Friday, June 20, 2014


Tomorrow is the official first day of summer so today kicks off our first real summer weekend.

So change is in the air. Fierce Health Payer reports from the ACO Summit that
As many as 50 percent of [healthcare] delivery systems say they will be in the insurance business in the coming years.  Despite these new entrants into the market, WellPoint Chief Medical Officer Samuel Nussbaum, M.D., said payers will continue to exist, but in a different form due to the transformation of the healthcare industry. They won't go off the map completely as there's still a gap in providers' ability to manage population health, have the necessary data analytics and coordinate comprehensive care, he said.  So what could payers look like in the blurred future? Aetna pointed to its strategy of virtual integration. "You won't see Aetna buying groups or hospital systems," said Joseph Zubretsky, senior executive vice president of national businesses at Aetna. Instead, the insurer will partner with providers in collaborations.
ABC News reports on a new type of FDA authorized cancer research technique that is akin to speed dating. According to that report
A bold new way to test cancer drugs started Monday in hundreds of hospitals around the U.S. In a medical version of speed dating, doctors will sort through multiple experimental drugs and match patients to the one most likely to succeed based on each person's unique tumor gene profile.
It's a first-of-a-kind experiment that brings together five drug companies, the government, private foundations and advocacy groups. The idea came from the federal Food and Drug Administration, which has agreed to consider approving new medicines based on results from the study.
Its goal is to speed new treatments to market and give seriously ill patients more chances to find something that will help. Instead of being tested for individual genes and trying to qualify for separate clinical trials testing single drugs, patients can enroll in this umbrella study, get full gene testing and have access to many options at once.
The study, called Lung-MAP, is for advanced cases of a common, hard-to-treat form of lung cancer — squamous cell. Plans for similar studies for breast and colon cancer are in the works.
In a man bites dog story (at least from the FEHBlog's perspective), Kaiser Health News is reporting that the Public Citizen consumer advocacy group is urging hospitals to stop promoting "low-cost screenings for heart disease and stroke risk, saying the promotions are “unethical” and the exams are more likely to do harm than good." The article explains
The programs are advertised on websites, in newspapers or through direct mail. Screenings — often performed in specially equipped buses — include  ultrasound tests for blockages of the carotid artery and weak spots in the abdominal aorta, a resting electrocardiogram, or EKG, a test of elasticity of the arteries and another for blockages in arteries serving the legs, a condition called peripheral arterial disease.
What the promotions don’t say, generally, is that most of the tests are not recommended for people without risk factors or symptoms.  Widespread screening of people without the risk factors could lead to misleading results and potentially even unnecessary surgery. Other medical experts warn that the tests could needlessly raise health-care spending.
If health plans must align their benefits with US Preventive Health Task Force Services recommendations, why shouldn't providers similarly align their service offerings?

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