This Week in Managed Care: September 26, 2015

Top managed care stories this week include the follow up to the National Academy of Medicine's groundbreaking "To Err Is Human" report, findings on the sharp increase in deductibles, and discussing costs in cancer care.

Transcript (slightly modified for readability)

Hello, I’m Justin Gallagher, Associate Publisher of The American Journal of Managed Care.

Welcome to This Week in Managed Care, from the Managed Markets News Network.

More Accurate, Timely Diagnosis

This week, the National Academy of Medicine said the next phase of healthcare reform must cover how patients are diagnosed—too often doctors make the wrong call, or it takes too long to reach a decision.

In a 300-page report, the Academy called for changing the way doctors are trained, for creating a workplace culture that encourages feedback instead of punishment, and for getting patients involved so they are encouraged to share information.

Other recommendations include changing the legal environment, which today discourages sharing information about errors or near misses. The report said the movement toward payment reform, which will reward doctors for spending more time with patients, is a step in the right direction.

Deductibles Up Sharply

The slowdown in healthcare spending isn’t reaching the average consumer. That’s what the 17th annual Kaiser Family Foundation Employer Health Benefits Survey found this week.

Results showed that deductibles have gone up 6 times faster than wages since 2010, while premiums are growing modestly. The effect is greater at smaller firms, where workers face an average deductible of $1836 , compared with an average of $1105 paid by workers at large firms.

Said Kaiser Family Foundation President and CEO Drew Altman: “With deductibles rising so much faster than premiums and wages, it's no surprise that consumers have not felt the slowdown in health spending.”

Hiring Nonphysician Providers

One of the top stories this week at AJMC comes from contributor Andria Jacobs, who writes about the growth of nurse practitioners and physician assistants in primary care practices. These healthcare professionals can help busy practices overcome the shortage of primary care doctors, but Jacobs warns that it’s important to take steps in hiring and supervision to avoid pitfalls, including lawsuits.

Among the steps she recommends: Take time to write complete job description, conduct a thorough background check, and correct patients if they refer to the nurse practitioner as a “doctor.” Read Jacobs’ essay.

Mitzi Wasik, PharmD, the director of Pharmacy Medicare Programs at Aetna, also spoke to AJMC recently about the importance of teamwork in a practice and how it contributes to accountability under new pay-for-performance models. View the video.

Costs of Cancer Care

Finally, the current issue of The American Journal of Managed Care features an important new study from S. Yousuf Zafar, MD, MHS, and his team at Duke Cancer Center. The team found that about half of all cancer patients want to talk to their oncologist about the cost of their care, but only 19% do.

Patients were more likely to want a discussion about costs if they were in financial distress, and their willingness to discuss treatment costs increased over the duration of their care. About a third of patients said they wanted the best possible care no matter the price, which researchers said suggests some may fear that bringing up cost could lead to a lower quality of care. But when patients did raise cost concerns, the study found that adjustments did not affect their care.

Patient-Centered Oncology Care

Dr Zafar will be one of the speakers at our upcoming conference, Patient-Centered Oncology Care, which will take place November 19-20 in Baltimore. Learn more and register.

For the Managed Markets News Network, I’m Justin Gallagher. Thanks for joining us.