Payer+Provider in the News – June 2012
BOSTON– July 1, 2012: June 2012 was a month marked by numerous media appearances for Payer+Provider Syndicate. Payer+Provider experts provided commentary in a broad variety of forums over the course of the month.
Becker’s Hospital Review featured Payer+Provider commentary in the articles “6 Valuable Outcomes Cloud Technologies Offer Hospitals” and “6 Trends in an Era of Consumer-Driven Healthcare“. The commentary on cloud technologies was subsequently featured in an article by Paragon Development Systems, while the commentary on consumer-driven healthcare was cited by the Georgia Public Policy Foundation.
dailyRx appointed Dr. Adam Powell as official contributing expert. Dr. Powell began working in this capacity by providing commentary on a health economics article that was published in Medical Care.
In addition to providing commentary, Dr. Powell authored some original articles over the course of the month. KevinMD featured his discussion of the negative impact of workload on hospital reimbursement. Fair Observer printed his comparison of the role of pharmaceuticals in China and the United States. Dr. Powell’s remarks on pharmaceuticals were based on the speech that he delivered in May at the 2012 BIO-FORUM in Shanghai, China.
TraumaQi Featured on KevinMD.com
NASHUA – June 6, 2012: An essay on the influence of fatigue on claim quality written by Dr. Adam Powell was featured on KevinMD.com, the site of social media’s leading physician voice. In the essay, Dr. Powell described the problem behind Payer+Provider’s TraumaQi service:
While there is an extensive literature on how tired, overworked physicians provide lower quality medical care, one thing that has been ignored by advocates of quality improvement is that overwork financially harms hospitals as well. Just as tired physicians sometimes fail to attend to certain clinical details, they are also more likely to commit errors when writing the notes which ultimately are used during the coding process. If hospitals consider the fact that lower quality clinical documentation negatively impacts their revenue, documentation quality improvement will become a financial imperative in addition to being a medical one.
After noting that “physicians discharging three patients on a day produced about 33% less revenue per patient than they would have on a single discharge day,” Dr. Powell concluded by recommending that hospitals put into place a system for mitigating the impact of workload consisting of selectively double-checking work “to make sure that it is of the highest quality from a medical and financial perspective.”
Payer+Provider’s TraumaQi service solves the problem that Dr. Powell described in his essay. Using predictive modeling, TraumaQi identifies the claims most likely to be incompletely reimbursed due to issues related to workload. The financial benefit of reviewing each flagged claim is estimated before the flagged claims are returned to providers so that providers only undertake a review when it is likely to be financially impactful.
Dr. Powell discusses working in the Chinese healthcare industry
BANGKOK – May 7, 2012: Dr. Adam Powell was recently interviewed by the site Emerging Market Careers on both his career in healthcare economics and his interest in the Chinese healthcare market. Dr. Powell was asked a series of questions in the article, including, “You’ve mentioned that you admire some of the contrasts between the Chinese healthcare system and that of the United States. How do these differences result in business opportunities in China for enterprising entrepreneurs and professionals looking for jobs in China’s healthcare system?” He replied:
Perhaps the greatest difference between the two nations is that the average Chinese family income is less than the cost of the average American family health insurance policy. As a result, China has developed a three-tiered system of care which uses practitioners with a wider range of training than is seen in the U.S. in order to achieve greater affordability. A great opportunity exists for entrepreneurs willing to redevelop existing technologies to better serve the needs of lower income customers. As C.K. Prahalad discussed in The Fortune at the Bottom of the Pyramid, low cost technologies created for the developing world have the potential to eventually better serve the needs of the higher income world. However, as incomes grow in China, there will also be an increasing demand for complex care. The number of specialty hospitals in China doubled over the past decade, and I predict that the trend towards the use of more skilled providers will continue. Thus, there may be opportunities surrounding care delivery. Finally, due to family planning policies, seniors will have fewer descendants to provide care for them than have historically been available. As grown children increasingly live remotely from their parents, there is an expanding need for senior services.
While Payer+Provider Syndicate is headquartered in Boston, Massachusetts, it is a global company with a team of experts that has experience working and living around the world. Half of Payer+Provider Syndicate’s experts are from a developing country. Payer+Provider Syndicate is committed to bringing about improvements in healthcare in both the developed and developing world.
Dr. Concannon recognized for his research on comparative effectiveness
BOSTON – April 24, 2012: The American Heart Association’s journal, Circulation: Cardiovascular Quality and Outcomes, recently released a review of the most important papers on health costs, cost-effectiveness, and resource utilization. The list featured one of Dr. Thomas Concannon’s papers, and cited two of them. The paper featured on the list, “Comparative effectiveness of ST-segment-elevation myocardial infarction regionalization strategies,” compared several scenarios for increasing access to percutaneous coronary intervention (PCI) for patients with ST-elevation myocardial infarction (STEMI). Dr. Concannon and colleagues found that an emergency medical service systems-based strategy of detection and diversion of patients with STEMI to PCI-capable hospitals is more effective and less costly than any strategy involving the construction and staffing of new PCI facilities. In conducting this research, Dr. Concannon has developed a patient- and region-sensitive methodology for comparing strategies to increase access to PCI.
In a subsequent paper also cited in the Circulation review, Dr. Concannon found that robust expansion in the number of PCI programs at U.S. hospitals has only modestly increased access to the procedure, as many of the new facilities are proximate to existing facilities. State of the art methodologies used in Dr. Concannon’s studies on PCI can be applied to many contexts beyond PCI, and outside of academia. Methods from Dr. Concannon’s research on access to care can be used by providers applying for Certificates of Need or developing service line strategies, and by payers working on designing provider networks that provide adequate in-network access.
For more information on the list of important papers, please see Dharmarajan, et al. 2012. “Most Important Papers in Health Costs, Cost-Effectiveness, and Resource Utilization,” Circulation: Cardiovascular Quality and Outcomes. 5: e9-e15.
Dr. Powell featured in Reuters article
NEW YORK – April 19, 2012: One of the responsibilities of Payer+Provider Syndicate experts is to provide insights through interviews with representatives from other organizations and the media. To fulfill this, our experts regularly discuss healthcare-related topics with the media. Last week, Dr. Adam Powell spoke to a reporter from Reuters in order to provide key insights into how consumers can best utilize health savings accounts (HSAs).
