The abuse of government programs and misappropriation of limited healthcare resources contribute significantly to, and further complicate, the growing burden of healthcare expenditures and utilization in the United States. Government bodies have demonstrated a paradigm shift, embracing collaborations and implementing evolved strategies, to more effectively combat Medicare fraud.
Farzad Mostashari, MD, ScM, National Coordinator for Health Information Technology, US Department of Health and Human Services, says that meaningful use sets a foundation for new models to deliver care to an entire population.
As the search continues for effective cost-containment strategies in a landscape of substantial healthcare expenditures, policy authorities are looking at Medicare reform and the Part D model for opportunities and direction. In this discussion, 2 policy experts share their insights on the progress, trends, and possibilities of Medicare Part D.
Mark McClellan, MD, PhD, Director, Engelberg Center for Health Care Reform, Leonard D. Schaeffer Chair in Health Policy Studies, Brookings Institution, talks about how to better inform providers regarding regulations and quality measures that are part of new delivery care models.
Although delivery systems are seemingly designed with beneficial intentions and streamlined utilization, a number of current practices and policies have been the subject of criticism and controversy. Two leaders in health policy shared their insights regarding these concerns and discussed the necessary steps to further improve an antiquated delivery system during changing times.
Karen Ignagni, President and Chief Executive Officer, AHIP, feels Medicare is right to take on the challenge of hospital readmissions. Ms. Ignagni also discusses how the Medicare Advantage plans have done a better job with traditional fee-for-services programs and tackling high hospital readmission rates.
The hotly debated proposition of premium support comes during a time of healthcare improvements through the Affordable Care Act and Medicare reform, which aim to combat the rising costs and substantial budget deficits resulting from an aging population and increased healthcare utilization.
Innovation in healthcare is becoming more important as the environment continues to evolve. There are a couple key components to increasing the adoption rate of new technologies and ideas in healthcare, according to Burns.
Many organizations would like to get consumers more engaged in their health. However, many programs miss the mark by lacking key features that have the potential to improve participation rates.
Barry Kinzbrunner, MD, Executive Vice President, Chief Medical Officer, VITAS Corporation, states that hospice and palliative care programs are important in the coordination of care for patients.
Much of the focus at AHIP Institute 2012 has naturally been on the issues that affect health plans and payers. However, one session in particular focused on some of the barriers and issues that providers face in today's complex healthcare environment.
"The problem is that incentives are still not aligned. Health plans need to align incentives so that hospitals are not losing and not being counterproductive of the goals they are striving for, says Jan Berger, MD, MJ, President & CEO, Health Intelligence Partners and Editor-in-Chief, The American Journal of Pharmacy Benefits.
The lunchtime general session at AHIP Institute 2012 on Thursday featured a couple of big name speakers: Paul Begala and Ari Fleischer, both of whom are political analysts for CNN. They spoke to a packed ballroom about the hot topics in healthcare reform and how they see the 2012 Presidential election shaping up.
In a heavily regulated market, it is becoming increasingly important for health plans to rely on innovative ideas. In order to do so, health insurers must create an organizational culture that places emphasis on flexibility and new ideas. In this session, presenters discuss some of the ways their organizations continue to break the mold in order to stay ahead of the curve.
Robert Margolis, MD, Managing Partner and CEO, HealthCare Partners, states that physicians and hospitals need to understand how to assess health and insurance risks in order to provide better care.
Karen Ignagni, President and CEO, America's Health Insurance Plans, spoke on Wednesday about the looming Supreme Court decision and how it will impact insurers.
One of the featured workshops at the America's Health Insurance Plans Institute 2012 on Wednesday was the Health Reform Advanced Studies Workshop, which was an interactive session that touched on a number of healthcare issues. Here are some of the highlights.
A focus at the America's Health Insurance Plans Institute 2012 is health insurance exchanges (HIX). With 30 million newly insured lives entering HIX in 2014, insurers face considerable risk. To assist insurers with managing this risk, the Centers for Medicare & Medicaid Services have developed 3 methods-reinsurance, risk adjustment, and risk corridors.
Sarah Thomas, Vice President, Public Policy and Communications, NCQA, states that there are 3 significant pieces of quality improvement strategies for health insurance exchanges.
In this video, Margaret Powers, PhD, talks about obesity's impact on the management of chronic illnesses. Dr. Powers also talks about the benefits of obese patients losing 5% to 7% of body weight and working out 150 minutes a week to lower their risk of developing diabetes and other chronic conditions.
Some studies have found that individuals with diabetes have a heightened risk of morbidity and premature death associated with macrovascular complications among smokers. In this study, researchers tested an educational, interventional program led by non-doctor health professionals in order to assist adult male diabetes patients to quit smoking.
In this video, Felicia Hill-Briggs, PhD, speaks about the importance of patient-reported outcomes in improving the effectiveness of specific interventions and treatments. Hill-Briggs also talks about the role of comparative effectiveness in patient-reported outcomes.
Chandra Osborn, PhD, MPH, addresses the technologies available that impact behavioral outcomes in diabetes, such as mobile devices, PDAs, and the Internet. These technologies can be leveraged to improve self-management behaviors and outcomes in diabetes.
The following are highlights of late-breaking abstracts that were on display at the ADA's 72nd Scientific Sessions in Philadelphia, PA. The abstracts were submitted after April 2012.
Diabetes is a condition that has many variables. Researchers are finding more and more about how genetics and patient behavior play a role; however, it turns out that socioeconomic status, education, and ethnic background all play a role as well.
Allison Rosen, MD, ScD, talks about using value-based insurance design as an incentive to improve type 2 diabetes outcomes.
Simon Heller, MB, DM, discusses the various ways hypoglycemia can affect the cardiovascular system. Examples of these consequences are thrombosis, heart disease, and myocardial infarction.
Monday morning at the ADA's 72nd Scientific Sessions featured the National Scientific & Health Care Achievement Awards Presentation and Outstanding Scientific Achievement Award Lecture. This year's recipient of the Outstanding Scientific Achievement Award was David Altshuler, MD, PhD, Professor of Medicine and Genetics at Harvard Medical School and Massachusetts General Hospital, Boston, for his work on genetic-based research regarding the inherited basis of type 2 diabetes, cholesterol levels, myocardial infarction, and a number of other conditions.
Roman Hovorka, PhD, talks about the prohibitive costs in continuous glucose monitoring. He states that if these costs can be reduced there will be wider acceptance and therefore a benefit to diabetes care.
View some of the photos from the American Diabetes Association's 72nd Scientific Sessions.