2011 Potpourri XVII

A new white paper discusses the use of electronic and digital data gathering, sharing and analysis techniques to increase the speed and lower the cost of drug trials.  Sponsored by the National Cancer Institute, the work focused on digital identities, digital signatures and cloud computing.  In pilot trials, these helped to accelerate completion of otherwise time-consuming tasks related to the security and accuracy of documents which need to be shared among parties.  It sometimes get lost in the cost discussion, but new drugs can be a big improvement in patient care and development cost is one reason not many innovative products are making it to market.   (Clinical Trial Paper)

The Atlanta Journal Constitution carried a story on hospital pricing to uninsured patients, just the latest piece of evidence in the key role hospital charge increases play in overall rising health spending.  One instance related how a hospital charged a patient over $23,000 for an appendix removal, four times what Medicare pays.  The hospitals claim that inadequate payments from Medicaid and Medicare require them to charge self-pay more, but that is nonsense.  At most, hospitals lose a small amount on those government programs.  And the article indicates that hospitals which provide the most government and charity care tend to have the lowest markups.  (AJC Article)

CMS has released 2009 numbers on payouts in the PQRS quality improvement and eprescribing incentive programs.  About 120,000 doctors got $23 million in the PQRS program or about $1950 per physician.  The eprescribing program paid out $148 million to 48,000 professionals, or about $3000 each.  It is not clear whether the programs are actually improving health outcomes, such as fewer medication errors or actual better patient health, but they do seem to be increasing adherence to the things they measure.  (CMS Release)

Thomson Reuters’ health care unit has put together a new Workforce Wellness Index which it says measures six behavioral health risk factors that account for as much as 14% of the total cost of privately insured employees.  These unhealthy behaviors cost employers $670 per employee per year.  The index has declined in the period 2005-2009 from 86.4 to 84.4.  The biggest driver is employee weight issues, which account for about $400 of additional cost.   (Thomson Release)

There is evidence that some health information technology can help improve care.  A recent example is reported in the journal Pediatrics, involving the use of electronic clinical decision support systems with alerts to help guide the use of blood transfusions in children.  The cohort study looked at almost 7,000 cases and found that those cases in which the electronic CDS was used had more appropriate and less use of transfusions, with no change in ultimate outcomes.  Cost savings also likely occurred.   (Pediatrics Study)

A report looks at health care merger and acquisition activity in recent months, finding it to be quite healthy!!  In the first quarter of 2011, almost $55 billion in deals were done, up 65% from the same period in the prior year, although a slight decrease from 4th quarter 2010.  Pharmaceuticals led the way with $13.5 billion in deals, followed closely by long-term care with $12.6 billion and medical devices with $11.7 billion.  Overall, products and technology have more deals than does the service sector.   (Irving Levin Report)