June 22, 2000
SOLUTIONS CHANGING THE PARADIGMS OF HEALTH"
Senior Analyst James Ackerman of
Friedman, Billings, Ramsey & Co. has authored an excellent analysis
emerging e-care opportunities, a full 34 page report (dated June
1, 2000) and a 2 page summary.
The analysis includes discussion of
(1) wireless, handheld physician automation tools, (2) home-based
patient monitoring/disease management and (3) medical risk
management by payors. A few highlights from the summary:
There are four key factors driving
the widespread penetration of the Internet in healthcare. These
1) Spiraling costs and the imperative
to find operating efficiencies.
2) Growth of healthcare consumerism
3) Introduction of wireless
technologies as a means of accessing and communicating patient
4) The necessity to utilize
technology to reduce the prevalence of medical errors.
The onset of the e-care age promises
to alter the landscape of the healthcare industry -- patients will
be enabled to better monitor their health, physicians will have more
resources at their disposal when practicing medicine and payors will
finally have a credible means for "managing care." The benefits to
the healthcare industry will be two-fold: 1) improved care outcomes
and 2) reduced costs.
MEDICARE+CHOICE PROGRAM: IS IT CODE BLUE?"
In 1997 Congress created the
Medicare+Choice (M+C) program. M+C was an attempt to bring expanded
managed care and care management options to Medicare beneficiaries.
Three years later, however, the
program is struggling. Many private plans have withdrawn from
Medicare or reduced the geographic areas in which they offer
The Health Insurance Association of
America sponsored a
white paper examining the M+C program. The paper was authored by
Bruce Merlin Fried and Janice Ziegler.
The white paper identifies three
fundamental changes as the cause of the program's decline:
Change in payment formula
Increases in regulatory costs and
burdens under M+C
Increased risks associated with
serving as a government contractor
The authors recommendations include a
series of measures to stabilize the program:
Increase payments to Medicare HMOs
to keep up with medical inflation.
Reduce the administrative burden
and expense of M+C.
Require HCFA to implement risk
adjustment in a budget neutral manner and direct HCFA to explore
alternative mechanisms of assessing health risk status.
10 HEALTH CARE WEB
SITES RANKED BASED ON USABILITY
WebCriteria develops and presents
industry indices of websites based on an
"objective comparison of the user experience and accessibility".
...and the envelope please....rankings among health care provider
web sites are:
2. Mayo Clinic
6. Bristol-Myers Squibb
7. Columbia HCA
9. Johnson and Johnson
And just how did WebCriteria
STUDIES OF PATIENT
SATISFACTION WITH TELEMEDICINE
the British Medical Journal reviewed 32 studies on patient
satisfaction with interactive video telemedicine applications (p.
365). "Firm conclusions are limited by methodological difficulties,
but it would seem that the patients found teleconsultations
acceptable; noted definite advantages, particularly increased
accessibility of specialist expertise, less travel required, and
reduced waiting times; but also had some disquiet about this mode of
healthcare delivery, particularly relating to communication between
provider and client via this medium."
Another study published in the
April, 2000 issue of the Mayo Clinic Proceedings explored
telemedicine applications in primary care for geriatric patients.
Participants in this small pilot study were pleased with the
experience they had with telemedicine.
The emergence of the Internet as a
tool in disease management has created a sense of both opportunity
and confusion among management teams. Recently, several clients have
asked BHT to develop and present a customized, 1 day workshop --
"State of the Art in eDM Strategy and Applications". Please call or
write if we can assist you in seizing opportunities or clarifying
MEDICAID CARE COORDINATION APPROACHES
Mathematica Policy Research has
Coordination and Medicaid Managed Care: Emerging Issues for States
and Managed Care Organizations" (Adobe Acrobat required).
The study presents several key
Care coordination programs take
time to develop but can be put in place even after a state has
implemented Medicaid managed care.
For the Medicaid managed care
population, care coordination must be broader than simply
expanding case management to include referrals for social
Creative problem-solving, through
advocacy, is emerging as an important new role for care
2000 issue of Internet World features five articles relating to
various aspects of e-health.
E-CareManagement News is an
e-newsletter that tracks a major change in health care and managed
care—the paradigm shift from “managing cost” to “managing care”.
This e-newsletter is brought to you by Better Health Technologies,
LLC (http://www.bhtinfo.com). BHT provides consulting and
business development services relating to disease management, demand
management, and patient health information technologies.
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