Notes & Linkes: August 8, 2013

“Validity of Web-Based Self-Reported Weight and Height: Results of the Nutrinet-Sante Study”

Lassale, Peneau, et. al. have published an article in JMIR examining the trending in healthcare of e-pidemiology and the validity and reliability of self-reported data. 

Compared with the clinical data validity was high. Intraclass correlation coefficient ranged from 0.94 for height and 0.99 for weight. They reported a slight underreporting of weight and over reporting of height which lead to underreporting of BMI (p<.05) for both men and women. I guess we all lie about our weight and height a little

Conclusions: Web-based self-reported weight and height data from the NutriNet-Santé study can be considered as valid enough to be used when studying associations of nutritional factors with anthropometrics and health outcomes. Although self-reported anthropometrics are inherently prone to biases, the magnitude of such biases can be considered comparable to face-to-face interview. Web-based self-reported data appear to be an accurate and useful tool to assess anthropometric data.

This study supports web-based self reporting and for my two cents it is another tool to aid outcomes that resides outside the office visit. But for my money it strikes me as an important step in demonstrating to providers a way to lower utilizations costs while improving physician patient engagement. 

Glad to see more studies like this every month. We need to know what is happening from a data .

“What’s CBS worth? How About Just the Programs”

If you live in NYC or LA TWC shut down CBS and Showtime (Dexter!!!!!) over money.

Doc Searls examines this issue and what may happen going forward. I know I am looking to find a way to cut the cable cord myself. Most of the tech heads I follow have done it to some degree but tend to return. There is a real opportunity for change in pricing and access to TV shows and networks. I wonder about Apple and their iTV. Networks will not roll over like the cheap suits of music due to the impeccable logic of one Steve Jobs. But with Netflicks and others producing high quality content we may just be at the cross roads. I sure hope so.

“Top 5 Reasons Hospitals Are Losing Money”

Only 5? Each one of us can identify three more. 

Danyell Jones posting in HealthWorks Collective presents the follow sobering data

With such a high cost of care, many assume that hospitals in America are turning a healthy profit; however this just isn’t the case.  In fact recent estimates indicate that nearly 67% of US hospitals are losing money, particularly when it comes to the treatment of Medicaid/Medicare patients. 

The five are:

  • Denials and Coding Issues
  • Service Level Discrepancies
  • Front Desk Processes
  • Look at your Patient Mix
  • Evaluate Your Contracts and Negotiate to Win

 Color me surprised a post on an industry supported site first blames Medicaid/Medicare patients. Gee that was easy. Listen to the Terry Gross on Fresh Air interviewed Elisabeth Rosenthal, MD from the New York Times about her series on cost of healthcare in the US. 

It costs $13,660 for an American to have a hip replacement in Belgium; in the U.S., it’s closer to $100,000.

Rosenthal examination of the issue from an investigative journalist does not lay the blame (i.e. reasons) on Medicare/Medicaid. Our system drives the need to price healthcare at an al la carte basis with layer upon layer of costs for each procedure. 

We may never change our system but all of us will be looking at costs going forward and that may help to put pressure on lowering prices while delivering care, not excess. To that point a friend just delivered a baby at a major NYC hospital and said for the two days she was there every time there was a service delivered (i.e. cleaning the room, coaching breast feeding, etc.) there was a survey immediately following. Gotta love a corporation humping outcomes. In fact my friend said for the breast feeding coaching session there were no less then four people in the room. It takes a village of al a carte services.

PS: Why does a class money filled operation like NPR hang its graphic hat on crappy stock art of the lowest order. Gee show me pills spilled on $20 bills. Nothing says cost in medicine like that. NOT! 

“Why Reports of the Death of Physician Participation in Medicare May be Greatly Exaggerated”

Dan Diamond writing in The Health Care Blog quotes the usual suspects on the demise of care for Medicare patients 

 “Half of primary care physicians in survey would leave medicine … if they had an alternative.” — CNN, November 2008

“Doctors are increasingly leaving the Medicare program given its unpredictable funding.” – ForbesJanuary 2013

And least we forget our favorite healthcare resource for evidence based knowledge 

The Wall Street Journal last month portrayed physician unhappiness with Medicare as a burning issue, with a cover story that detailed why many more doctors are opting out of the program.

And yes, the number of doctors saying no to Medicare has proportionately risen quite a bit — from 3,700 doctors in 2009 to 9,539 in 2012. (And in some cases, Obamacare has been a convenient scapegoat.)

Oh no Mr. Bill the WSJ didn’t report on some data? I am shocked. 

What the Journal didn’t report is that, per CMS, the number of physicians who agreed to accept Medicare patients continues to grow year-over-year, from 705,568 in 2012 to 735,041 in 2013.

And other providers aren’t turning down Medicare, either. The number of nurse practitioners participating in the program has only gone up, Jan Towers of the American Academy of Nurse Practitioners says. 

Yes there is frustration and HCP are pissed at low revenue and more work. My hope is as the system lowers cost overall dollars can be shifted to the HCP to care for the elderly who suck down a lot of dollars. Outcomes measures will do much to drive that balance. 

Leave a Reply

Your email address will not be published.