Big news: Future Pulse will publish five days a week starting Monday, September 26. Our mission is expanding to cover all ideas that reshape healthcare. You’ll find analysis that drives you forward, interviews with innovators, and data-driven stories that reveal what’s to come.
In July, after months of delay, a Trump-era rule from the Centers for Medicare and Medicaid Services took effect, requiring health insurers to publish what they pay for care.
It promises to introduce better competition to benefit consumers. But much still needs to happen for this goal to become a reality.
A similar rule requiring health systems to publish their prices went into effect last year and has done little so far to curb cost increases, according to consumer advocates. In an August report, the group PatientRightsAdvocate.org found that only 16 percent of hospitals were in compliance. The available data, released in voluminous form, is not easy for patients to use.
And prices alone are not enough to increase value unless they are accompanied by information about the quality of the services people are buying.
CMS hopes that third parties can make sense of the data to help patients find the best quality for the right price.
The pulse of the future sat down with former US tech boss Aneesh Chopra, who talked about trying to answer that call with his new company, CareJourney. The interview has been edited for length and clarity:
Who do you think is likely to see the most benefit from these rules?
In the short term, it is likely that insurers will now see what their peers are getting in terms of discounts. There is likely to be a convergence to the mean. In general, this can be a good thing.
We can see providers getting more of a “come to me, I’m a better value story”.
I believe that risk-based primary care networks—physicians paid under Medicare for the value of care provided rather than per service—will be the ultimate beneficiary.
Tell me about it…
It’s about me trusting my doctor, not just for better primary care, but referrals for specialized imaging and other services.
If you ask your primary care physician, “Hey, which specialist should I see for back pain?” “Well,” they’ll say, “you can go to all these people on the net, but it’s going to be a little less expensive and of higher value.” And it would be a win for the primary care network, because the total cost of care is what they care about.
Who will make this price information available to doctors who are not paid this way?
Big tech can do something, although it’s less likely we’ll see a big tech play and more likely big tech will be the end of a trusted advisor. I already trust TurboTax for my taxes. I trust banking institutions. And so someone will create, in the spirit of those other areas, a custom unit that is not sponsored by my insurance company. It may not even be an extension of my doctor’s office; may be a separate entity.
Welcome back to The pulse of the future, where we explore the convergence of healthcare and technology. Ricky Gervais got us thinking: If you had to keep three of the following, which would you get? “Makeup, driving, bread, cell phone, alcohol, pets, television, dancing, novels, haircuts, passport, sick pay.” Pets definitely do the cutting for me.
Share yours three picks, news, tips and reviews with Ben in [email protected] or Ruth in [email protected] and follow us on Twitter for the latest @_BenLeonard_ AND @RuthReader. Send tips securely SecureDrop, Signal, Telegram or WhatsApp.
THE SMALL OFFICE THAT RESPONDS TO CYBER ATTACKS — Hackers breach the health records of millions of people each year, a growing number that threatens lives, causing losses for healthcare organizations and exposing patients to identity theft.
The HHS Office for Civil Rights is tasked with investigating violations, but it’s buckling under the pressure, Ben reports. The office has thin resources and a dual—and perhaps conflicting—mission: fining health care organizations for lax security while trying to help them increase their protections.
“They are a fish out of water. … They were given the role of enforcement under HIPAA, but not given the resources to support that role,” said Mac McMillan, CEO of cybersecurity firm CynergisTek.
Melanie Fontes Rainer, the office’s acting director, said her investigators have to be careful what cases they pursue because they are “under tremendous resource constraints and incredibly overworked.”
WATCHDOG: ORGAN TRANSPLANT NETWORK NEEDS CYBER GROWTH — HHS should strengthen oversight of the Organ Procurement and Transplantation Network’s cybersecurity measures, the HHS Inspector General found in a report last week.
The watchdog said the HHS Health Resources and Services Administration, which oversees the network that distributes organs to people waiting for transplants, has taken some measures to protect its data, but not enough.
HRSA “has no policies or procedures” instead of monitoring network systems, the watchdog wrote, warning that “a security breach could have significant consequences for vulnerable patients.”
The agency says it has taken steps to improve.
DEMOCRATS PRESS ZUCKERBERG ON ABORTION DATA – House Energy and Commerce Chairman Frank Pallone (D-N.J.) led top Democrats on the committee in writing to Meta CEO Mark Zuckerberg to demand a briefing by Sept. 21 on how the Facebook-owned company is handling data that could used in abortion prosecutions.
Democrats fear Meta could be required to turn over clients’ Internet chats about obtaining abortions now that the Supreme Court has allowed states to ban the procedure.
“The possibilities are endless and are endlessly troubling,” the lawmakers wrote. “Safeguarding personal information and communications on your platform is paramount.”
TELEHEALTH FLEXIBILITIES RELATED TO LOW OVERDOSES – Pandemic-era rule changes that allowed providers to prescribe opioid addiction medications via telehealth may have contributed to lower overdose rates and more adherence to care among Medicare beneficiaries, a study published in JAMA Psychiatry found. .
The researchers aren’t saying that the improved outcomes were directly due to telehealth, but Ben reports that the findings showing the link are still a victory for advocates of expanding access to virtual prescribing for opioid addiction.
The HHS waiver that allows doctors to prescribe controlled substances like buprenorphine without an in-person visit will expire with the Covid emergency, which HHS could end as early as January.
FTC MEDICAL PROBING AMAZON-ONE – The Federal Trade Commission is investigating Amazon’s July move to buy primary care provider One Medical, POLITICO’s Josh Sisco reports.
1Life Healthcare, which runs One Medical, disclosed the investigation in a filing on Friday.
The FTC is raising questions about the data Amazon would have access to, asking insurance companies and others how One Medical’s patient data could give Amazon a leg up on competitors.
Amazon declined to comment directly on the investigation, but said it will protect customer data.
EU BLOCKS EASY AGREEMENTS — The European Commission has blocked Grail’s acquisition of gene sequencing company Illumina for cancer testing, POLITICO Europe’s Pietro Lomardi reports.
The commission was concerned that Illumina might “have an incentive to cut off Grail’s rivals from access to its technology, or otherwise harm them,” according to a statement from European Commission Executive Vice President Margrethe Vestager.
The genetic sequencing machines produced by Illumina are critical to bringing to market the type of tests produced by Grail.
Illumina said it will appeal the decision. But Reuters reported on Monday that the company was also in talks with the European Commission about leaving Grail.
THE WORLD BANK ISSUES THE GLOBAL PANDEMIC FUND – The World Bank will commit at least $1.2 billion to help low- and middle-income countries prepare for future disease outbreaks.
The bank’s board approved the fund in June. The board will meet on Thursday and Friday to determine how it will secure the funding and who will have a say in the fund’s governance, apart from major donors such as the US and the European Union.
Activists and global health experts want low-income countries and civil society organizations to have a voice in deciding how to spend the money, with the aim of reducing disparities between rich and poor.
The fund is expected to channel money towards improving disease surveillance and laboratory networks; communication, coordination and emergency management; critical health workforce capacities; and community engagement.
Who’s giving: The US, a big advocate for the fund, pledged $450 million and the EU matched it. Italy has pledged 101 million dollars and Germany 50.5 million dollars. China and Indonesia have each pledged $50 million. But these promises pale in comparison to the need, estimated at $10 billion a year.
VIDEO GAME TO INCREASE ATTENTION? – A motion-detection video game was associated with improved attention levels in adults compared to 20-year-olds who didn’t play the game, and also lowered blood pressure and improved balance, a study published this week found. passed in npj Aging. found.
The game presented mental challenges to the participants and required them to respond with physical movements.
Profiting from America’s health care bloat – David Wainer, opinion piece in The Wall Street Journal
Preparing for the Burst of Hipsterism’s Psychedelic Bubble – David Yaden, James Potash, and Roland Griffiths, op-ed in JAMA Psychiatry
Google debuts new AI tool in global fight against tuberculosis – Casey Ross, STAT
