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Kevin Roche

The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry through Roche Consulting, LLC. Mr. Roche is available to assist health care companies through consulting arrangements and may be reached at khroche@healthy-skeptic.com.

Oct 18 2016

For the most significant outcomes, a recent study in NEJM finds no difference between bare metal and drug-eluting stents.  Drug and device companies are really good at selling expensive products with no or marginal outcome improvements.

http://www.nejm.org/doi/full/10.1056/NEJMoa1607991
Oct 18 2016

A study in NEJM finds that while ten-year mortality was similar for treatment or surveillance for prostate cancer, failure to treat led to more metastases and disease progression.  Proponents of ending PSA screening and what they view as excessive diagnoses of prostate cancer may be happy, but for a few men, late diagnosis and/or surveillance just means worse disease and outcomes.  The same approach is coming on mammograms.

http://www.nejm.org/doi/full/10.1056/NEJMoa1606220
Oct 17 2016

A study published in the British Medical Journal finds that physicians' recommendations given closer to when a decision must be made are more likely to influence a patient to choose a course of action against the patient's own preferences.  To ensure respect for patient preferences this suggests that doctors should give any recommendations early in the process.

http://bmjopen.bmj.com/content/6/9/e011282.abstract
Oct 17 2016

Primary care clinic operator Iora Health has raised $75 million in new capital for expansion purposes.

http://medcitynews.com/2016/10/iora-health-raises-75m-series-d/?utm_source=hs_email&utm_medium=email&utm_content=35900867&_hsenc=p2ANqtz-95twCnxR7anLRoUaDSh-CL_hbGyS2e-GQdOLHpck3ASWy4VfbQr0Xcl6CDqoWRiC-QR546mkYK9FJ_BynmgkQYjjx07OobyrgNyUIWIP0e6hYooag&_hsmi=35900867
Oct 14 2016

Contessa Health, a vendor of home hospitalization and risk payment services, has received $7 million in new funding.

https://www.pehub.com/2016/10/contessa-health-snags-7-mln/
Oct 12 2016

2016 Kaiser Employer Health Benefits Survey

http://kff.org/health-costs/report/2016-employer-health-benefits-survey/
Oct 12 2016

Evidation Health has evidently grabbed $15 million in fresh funding for its "machine learning" "behavioral analytics" tools.  If you built it, they might come, but they sure won't understand it.

https://www.pehub.com/2016/10/evidation-health-scores-15-mln/
Oct 11 2016

Another study finds that live human doctors do much, much better at diagnosing than do symptom checker apps.

http://www.fiercehealthcare.com/it/face-off-human-doctors-more-accurate-than-symptom-checker-apps?mkt_tok=eyJpIjoiTnpNMk1UQXlaakpqTmpRdyIsInQiOiJRSXZVZ0JTcDd3U3N0RUppR0UrRTlKNGRNTFozQWNNNEMyRzNRU0VyNHYwM3F2Z3BNTVlOclQ0VDR0QWhnc1VPdGhlXC9CS2Z1UFg5cFBQVE9obzZSWnBkamlKMFRvRG5raEZuVHFDVEhYcFU9In0%3D&mrkid=635530&utm_medium=nl&utm_source=internal
Oct 11 2016

The 2017 final Medicare hospital reimbursement rule.

https://www.federalregister.gov/documents/2016/08/22/2016-18476/medicare-program-hospital-inpatient-prospective-payment-systems-for-acute-care-hospitals-and-the
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