Using data to treat the sickest and most expensive patients – “super-utilizers”
by JONATHAN M. METSCH, DR.P.H., LLC
Nov 27, 2014 | 276 views | 0 0 comments | 1 1 recommendations | email to a friend | print
Recently an article in Marketplace http://www.marketplace.org * noted: "We can actually take the sickest and most complicated patients, go to their bedside, go to their home, go with them to their appointments and help them for about 90 days and dramatically improve outcomes and reduce cost…" “That’s the theory anyway. Like many ideas when it comes to treating the sickest patients, there’s little data to back up that it works.” “Helping lower costs and improve care for the super-utilizers is one of the most pressing policy questions in healthcare today. And given its importance, there is a striking lack of data in the field.” People like to call randomized controlled trials (RCTs) the gold standard of scientific testing because two groups are randomly assigned – one gets the treatment, while the other doesn’t – and researchers closely monitor differences. But a 2012 British Medical Journal article found over the last 25 years, a total of six RCTs have focused on care delivery for super-utilizers.” “Every major health insurance company – Medicare and Medicaid, too – has spent billions on programs for super-utilizers. The absence of rigorous evidence raises the question: Is all this effort built on health policy quicksand?” “Healthcare has benefitted from the fact that you don’t understand it. It’s a bit of an art, and it hasn’t been a science….You made money in healthcare by putting a banner outside your building saying you are a top something without having to justify whether you really are top at whatever you do.” “....it’s too easy – and frankly, wrong – to say the main reason doctors avoid these rigorous studies is because they’re afraid to lose money and status. He said doctors aren’t immune from the very human trap of being sure their own ideas are right. …. psychologists call it confirmation bias. …“Everything you see is filtered through your hopes, your expectations and your pre-existing beliefs…” “Providers have a lot more incentive now than they use to,” she said. “They have much more skin in the game.” * to read the full Marketplace article “Using data to treat the sickest and most expensive patients” by Jessica Kourkounis , highlight and click on open hyperlinkhttp://www.marketplace.org/topics/health-care/diagnosis-camden/using-data-treat-sickest-and-most-expensive-patients?utm_campaign=KHN%3A+Daily+Health+Policy+Report&utm_source=hs_email&utm_medium=email&utm_content=12602330&_hsenc=p2ANqtz-80fSnkOFukvy4pilVWU-S1rioNrPvot0RSmbytq_m0-gljXSPA423gUuTJsbTSUQ8apjvM6ahCTKz_F12HMoTmuJoZbcrT1OhTBuwFuanexZJ2M6U&_hsmi=12602330 Doctor, Did You Wash Your Hands? ™ provides information to consumers on understanding, managing and navigating health care options. Jonathan M. Metsch, Dr.P.H., is Clinical Professor, Preventive Medicine, Icahn School of Medicine at Mount Sinai; and Adjunct Professor, Baruch College ( C.U.N.Y.), Rutgers School of Public Health, and Rutgers School of Public Affairs and Administration. This blog shares general information about understanding and navigating the health care system. For specific medical advice about your own problems, issues and options talk to your personal physician.
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Zimmer backs down on 'rolling reassessment'; proposes revals every six years
Nov 26, 2014 | 422 views | 0 0 comments | 8 8 recommendations | email to a friend | print
HOBOKEN — The administration of Mayor Dawn Zimmer is backing off of its plans for a rolling annual revaluation of property values for the next four years. In a letter to the Hoboken City Council released Nov. 26, Zimmer announced that she placed an ordinance on the agenda of the council’s upcoming Dec. 3 meeting requiring a revaluation only every six years. Zimmer said she changed her mind after “many members of the community expressed strong reservations about the impact that the rolling revaluation might have on their taxes going forward” in letters and at a Nov. 12 community meeting. After the news about the reval was broken in the Reporter two weeks ago, the newspaper received several letters as well. However, Zimmer still argues that revaluations must be done regularly, and that property value assessments cannot be allow to lapse for 25 years, as the city did before its 2013 revaluation. All nine City Council members voted in favor of the contract with Appraisal Systems to undergo the rolling reassessment in September. Since then, however, the four Council members unaffiliated with Zimmer have come out publicly against the contract, arguing that it will raise taxes and had been misrepresented when it was presented to the council. If the council passes Zimmer’s new proposal, she said, “there will be no rolling reassessment” of property values over the next four years, meaning that the contract with Appraisal Systems will have to be terminated. However, it was not totally clear as of press time whether the work Appraisal Systems has already completed for this year’s revaluation will be used to alter property values. The city has already paid out some money to the company. Zimmer said that rescinding the approval for the Appraisal Systems contract, as the four Zimmer opponents on the council have proposed, is technically not possible, so it has to be done by passing her new proposal.. The city’s contract with Appraisal Systems, she wrote, “has already been executed…[and] the authorization to enter into it can no longer be rescinded by the City Council.”
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Bayonne Bridge to be open for Thanksgiving
Nov 26, 2014 | 468 views | 0 0 comments | 8 8 recommendations | email to a friend | print
BAYONNE – The Bayonne Bridge will be open for Thanksgiving and the days following the holiday, according to information received from the Port Authority of New York & New Jersey. The Port Authority announced that the bridge will be open from Nov. 26 through Nov. 29. It also announced that there would be no weekend closures until after the new year. For more information on bridge closures, call the authority’s hotline number (855) 265-5482 and press 1. For bridge alerts and advisories, go to http://www.paalerts.com and click on “Register for Port Authority Alerts.”
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