Health Wonk Review: Baby New Year Edition

With 2012 and the fiscal cliff now behind us, it’s time to turn an eye to the year ahead. What will 2013 hold? More fights in Congress over the debt ceiling, entitlement reform, and other spending cuts seem inevitable. The Affordable Care Act will continue to move towards full implementation, but what new wrinkles will that process encounter? Will gun control and mental health reform finally get some much-needed attention? It promises to be an interesting–if not exciting–year for health policy. AND it promises to be an interesting year for me personally, as my wife and I are expecting our first child this summer. There is great potential all around as we start this new year, and in that spirit I bring you the “Baby New Year” edition of the Health Wonk Review. This edition features some really fantastic posts from the best health policy bloggers out there, along with a selection of cover art from some vintage issues of The Saturday Evening Post, depicting Baby New Year. Enjoy!

First up is Joe Paduda’s interesting post on the Florida Medical Association. At the Managed Care Matters blog, Joe examines the issue of the FMA supporting physicians’ dispensing of medications to worker’s comp patients, despite the fact that there is no demonstrable benefit for patients. In fact, the practice is likely to increase the risk of drug-to-drug interactions. Why the strong push then? Well, it does greatly fatten physicians’ wallets.

Similarly, at Health Care Renewal, Roy Poses draws our attention to a key opinion leader who was paid by a pharmaceutical company to help liberalize the use of narcotics for chronic, but non malignant pain. Said opinion leader is now saying he based his comments on weak evidence from studies that were too small to be meaningful, and that narcotics aren’t actually as safe as he once claimed. But, hey, at least the drug companies are a bit richer for it.

Then, while we’re talking about money, there’s the fiscal cliff, which John Goodman of the National Center for Policy Analysis writes about here. Thanks to some last-minute Congressional action, a crisis was averted, but some things still went over the cliff. One of those was the CLASS Act, writes Harold Pollack at the Medicare Resource Center Blog. CLASS was designed to complement private long-term care insurance, Medicare, Medicaid, and public disability programs. For Medicare recipients living in their own homes, CLASS would cover important services no one else would cover. But, Tuesday night, in the fiscal cliff vote, the CLASS Act was killed by Congress.

The rest of health reform marches forward, however. Maggie Mahar makes a splash with her post from healthinsurance.org that provides an overview of the ObamaCare health insurance subsidies. Beginning in 2014, millions of Americans will discover that they qualify for subsidies designed to help them purchase their own health insurance. The aid will come in the form of tax credits, and blogger Maggie Mahar says many will be surprised by how generous they are. Included in the post is an “infograph” which tells you whether you will be eligible, a “subsidy calculator” which lets you estimate the size of your subsidy, and a table explaining how the government calculates the subsidy.

And speaking of government subsidies, over at the Health Affairs blog, Richard Frank and Jack Hoadley endorse a proposal to require manufacturers to pay a minimum rebate on drugs covered under Medicare Part D for those beneficiaries who receive the program’s Low-Income Subsidy (LIS). They defend the idea against criticisms in a letter organized by the Council on Affordable Health Coverage and based on analysis by Douglas Holtz-Eakin and colleagues.

Health reform is also leading us towards models of high-quality, patient-centered care. As we begin a New Year, David Wilson of Innovative Health Media says now is the time to look at a new paradigm shift occurring in health care. High costs and new research have prompted this shift toward a system more focused on patient education and prevention than ever before. Meanwhile, David Harlow of the HealthBlawg writes about a recent study that suggests that patient-centered care, including improved communication, can improve outcomes, reduce readmissions and thereby improve hospital finances, and Dr. Jaan Sidorov of the Disease Management Care Blog reviews a recently published article that tackles an underestimated challenge for accountable care organizations: the need for an organized approach to communication, including educating docs to give up on their informal ways of doing things. Bringing it back to money for just a moment, Brad Flansbaum explains what parity in Medicaid and Medicare payment rates means for hospitalists at the Hospitalist Leader.

Anthony Wright of the Health Access WeBlog provides a review of how California is leading in implementing the Affordable Care Act–and the significant work to do in this new year, even in such a leading state, to be ready to start enrollment in October 2013–just nine short months away. And, even with all the Affordable Care Act promises to do, there will be unmet needs. That is why, as Louise at the Colorado Health Insurance Insider writes, Colorado State Senator Irene Aguilar is pushing for the state to implement its own universal coverage program.

As we head into the future, we also have new and better ways of tracking personal health data. But for all the potential good that represents, it is not without certain risks. At the InsureBlog, jovial regular Hank Stern writes about “Watching Figures.” From pedometers to GPS, we are facing a new frontier in personal health data, and questions are emerging about who really owns it.

Also with an eye on technology and innovation in health care, is an interview with American Well CEO Dr. Roy Schoenberg. Conducted by David Williams of the Health Business Blog the interview addresses how changes in technology, physician practice and health reform are contributing to the growth of the field. The interview is also available as a podcast.

A couple of entries in this “best of” collection, present their own “best of” posts. Wing of Zock has a blog carnival all its own entitled “Chart Review.” In this monthly feature, the editors highlight their top posts from the previous month. They focus on academic medicine from a variety of perspectives, and welcome your contributions, which you may submit by email. Julie Ferguson of the Workers Comp Insider posts a retrospective of their 20 most popular posts of 2012 – including many occupational health & safety issues, from compensability related to heart attacks and carpal tunnel to policy issues put forth by OSHA and NCCI.

Finally, not everything interesting in health policy happens in the United States. The Healthcare Economist’s Jason Shafrin investigates how the single-payer National Health Service in the United Kingdom may be less centralized than it appears.

Well, that’s it for this edition of the Health Wonk Review. Here’s wishing everyone a healthy and happy 2013! It looks like the next edition on January 17 is still in need of a host at this point……and then it’s Steve Anderson of healthinsurance.org on January 31st!