In a big surprise in Washington, Karen Ignagni, the longtime head of America’s Health Insurance Plans, the industry’s main lobbying force, is leaving to become president and chief executive of EmblemHealth, a New York-based financially troubled insurer.
She will replace Frank Branchini, effective Sept. 1. Mr. Branchini has been with EmblemHealth and its predecessor companies for 30 years and will stay on as chairman.
Vitals.com reviews its reviews of patient experiences in dealing with hospitals and physicians.
Vitals, in text and infographics available in this link, says: “A word analysis of 5,000 recent patient reviews by Vitals to mark its six millionth review drew attention to the fact that ‘diagnosis’ and ‘answers’ are not nearly as important as ‘time,’staff’ and ‘office.’
“Time is an issue that startups providing concierge care service from telemedicine to house calls have used to win over customers and make a case for their businesses. Of course medical professionals should be encouraged by the fact that ‘professional,’ ‘great’ and ‘caring’ get mentioned frequently, although ‘rude’ isn’t far behind.”
But a JAMA article last year showed that the biggest factors impacting a person’s choice of physician were insurance coverage and location.
Fred N. Pelzman, M.D., the New York writer and internist, writes in MedPage Today:
“The Institute of Medicine’s report ‘Vital Signs: Core Metrics for Health and Healthcare Progress’ from the Committee on Core Metrics for Better Health at Lower Cost, attempts to define such a set of metrics we need to measure to ensure that we are taking the best care of each individual patient, each group of patients, and each population that we are providing care for.”
But, he warns, “All of these checkboxes, audits, database reviews, lead, in more cases than not, to us paying lip service, checking a box, testifying that we have reconciled meds or counseled a patient on healthy lifestyles, come up with a plan for weight loss, ensured that they will definitely take their medicines. Quality is more than audit results and patient satisfaction scores.
“We risk catering our care to the measured outcome, rather than to true quality and what is best for patients….
“As we build up patient-centered medical homes, Accountable Care Organizations, and other models of care, we need to continuously ensure that we are not being overwhelmed with mindless tasks that add no benefit to our patients, that by default cause us to click a box to get through our day’s work….”
Ruth M. Kelley is joining Cambridge Management Group as a senior adviser.
She has decades of leadership in behavioral health. Her management experience and clinical knowledge from serving Federally Qualified Health Center (FQHC) clients are of increasing value as the importance and number of FQHC’s swells and as the role of behavioral health becomes better understood by patients, clinicians, payers and policymakers. She has extensive knowledge of community health centers’ role in integrating primary care and behavioral health.
Ms. Kelley, a seasoned executive and a registered nurse, has wide experience with a panoply of behavioral-health issues, particularly in serving populations suffering from substance use and co-occurring disorders. Her work at The Dimock Center, which runs a large FQHC in Boston, where she was chief of behavioral health, received national attention.
In 2014, she received The Lifetime Achievement Award from the Association of Behavioral Healthcare, the largest Massachusetts advocacy organization for mental-health and substance-abuse issues.
She has worked in substance-abuse matters for more than 30 years, during which time she has gained extensive experience in general administration, contract negotiations, grant procurement, program and policy development for women, men and their families. She has sat on multiple professional committees at the local, state and national level.
Before her career at Dimock, Ms. Kelley served as nurse, counselor and coordinator for patients with substance-use disorders at the Massachusetts Osteopathic Hospital and at New England Memorial Hospital. Before then, she worked at Sancta Maria Hospital, in Cambridge, Mass., where, among other achievements, she designed and implemented a substance-abuse awareness program .
Ruth Kelley has a master’s degree in management from The Heller School of Social Policy at Brandeis University and a bachelor of science degree in nursing from Northeastern University.
“Urgent care should be part of an integrated delivery network,” said Dr. Schwamm, who is also the director of telestroke services at Massachusetts Massachusetts General Hospital, at the iHT2 Health IT summit in Boston.
MedCity News paraphrased that he said that “telemedicine companies risk creating their own information silos because they don’t do an adequate job of ensuring these patient-physician interactions get passed along to patients primary care physicians and aren’t designed with follow-up care in mind. They are also attracting dissatisfied physicians who want to set their own work hours rather than the long hours they currently work.”
“It destroys the profession,” he said, adding, MedCity News reported, that it is attracting wealthier patients who can pay out of pocket for these services.
“It’s pulling dollars out of the healthcare system that are desperately needed to care for poorer patients.”
“In-house {of hospitals}, these facilities can generate thousands in additional revenue, improve outcomes post-discharge in reducing readmissions and reduce hospital employee benefit drug costs. In the community, they provide the pharmacist with the opportunity to perform some healthcare functions such as immunizations, smoking cessation and chronic disease state management, and do so while capturing [prescription] volume that would have gone to other pharmacy retailers.”
Examining about 3,000 adults ages 19 to 64, the fund found 23 percent of to be underinsured. Most were covered by an employer-sponsored plan or a privately purchased plan.
In other words, we have a lot further to go in American health-insurance reform.
The hearing Tuesday, chaired by U.S. Rep. Kevin Brady (R.-Texas), was entitled “Improving Competition in Medicare: Removing Moratoria and Expanding Access,” participants. It discussed a rule under the Affordable Care Act that keeps physician-owned hospitals from expanding and keeps new physician-owned hospitals from treating Medicare and Medicaid patients.
“It is our responsibility to protect Medicare for today’s seniors and for future generations — increasing competition in the marketplace can help achieve that. We will continue to hold hearings on improving the payment system for hospitals and other healthcare providers over the course of this year and develop reforms that will help save Medicare for the long term,” Mr. Brady told the session.
The CMA said its change to neutral on the issue was the first by a state medical association.
But CMA’s national parent, the American Medical Association, remains opposed to doctors participating in assisted suicide, that the practice would violate physicians’ roles as a healer, would be difficult to control and would pose “serious societal risks.”
It’s unclear how a California law allowing physician-assisted suicide might affect legal liability and other issues for hospitals employing physicians who help patients kill themselves.
