Health Wonk Review - T.G.I.R. Edition

by Billy Wynne

Source: Health Wonk Review

Welcome to this “Thank God It’s Recess” edition of Health Wonk Review. With Congress adjourned for the 2014 midterm elections, the wonkophile class has some time to think about the upcoming open enrollment period and broader health system changes. This week we’ve got some insightful gems to get your heads churning for the fall.

Remember all the talk about rationing? Prof. Brad Wright at Wright on Health reviews a recent study that found Massachusetts coverage expansions did not lead to limitations on provider access.

In the “BAM!” file, Louise Norris at Colorado Health Insurance Insider reports Colorado’s individual market rates are only increasing by 0.71 percent for 2015, but says 2016′s rates will be more informative regarding the long term trajectory of plan prices.

In the “not-so-BAM!” corner, John. R. Graham at the National Center for Policy Analysis gives us his preview of the 2015 open enrollment period and suggests it ain’t going to be pretty.

Adding even more nuance to the 2015 outlook, Joanne Boyer at reports that PreferredOne is pulling out of the Minnesota market but says that’s not such a big deal, there are plenty of other options.

On the role of insurers in our evolving healthcare system, David Williams at Health Business Blog suggests they can deliver value by keeping prices and utilization in check, but ultimately concludes that a single payer approach would be preferable to the status quo.

Digging deeper into the role of insurers, Ari Friedman and Siyabonga Ndwandwe take to the boards at Health Affairs to compare different reform initiatives, including a comparison of relative value health insurance and pay-for-performance. They conclude that these approaches aren’t mutually exclusive; an amalgam of multiple models may work best.

At our own Healthcare Lighthouse, Les DelPizzo asserts that sound population health management techniques should be the cornerstone of efforts to implement bundled payments and other advanced reimbursement models.

In a counter-Nietzschien turn, Roy Poses at Health Care Renewal criticizes the rise of “super-managers” – those who “extract value” from their organizations for personal benefit – and says a different class of leaders is needed to drive our healthcare system forward.

Turning to the workplace, Julie Ferguson at Workers Comp Insider reports that job-based fatalities are declining but still amount to more than 4400 per year.

When it comes to diagnosis, false positives can often be as problematic as missing something. Joe Paduda at Managed Care Matters describes how early use of MRIs can do more harm than good.

On the treatment side, when trying to demonstrate value of investment in pharmaceutical development, a question is whether to invest limited funds in longer trials or broadening their sample size. Jason Shafrin at Healthcare Economist investigates.

Meanwhile, with all the strutting and fretting around meaningful use standards, Peggy Salvatore at Health System Ed says Apple’s introduction of the latest iPhone and its pre-loaded personal healthcare app reminds us that true innovators are more likely to define patient-centered healthcare than a centralized control model.

Another story of innovation is unfolding in the medical malpractice space, where – according to Tinker Ready at Health Leaders – the second generation of reforms is coming not from state legislatures but via a proliferation of medical injury dispute resolution programs at hospitals.

Hope you enjoy some of this in-depth analysis amid the changing leaves and tailgating…

Billy Wynne is the Founder and CEO of Healthcare Lighthouse, a low-cost one-stop shop for comprehensive policy information for healthcare organizations and businesses. He is also a Partner at the Washington policy and lobbying firm Thorn Run Partners. Previously, he served as Health Policy Counsel to the Senate Finance Committee. If you are interested in discussing how Thorn Run can assist your organization in understanding and influencing Federal health policy, contact Billy at You can also follow him on Twitter at @billywynne77.