Summer Bean Tacos

Quick, easy and satisfying meals are the name of the game this time of year. And those meals are best when you have minimal cooking or turning on of the oven or stove. And these Summer Bean Tacos are the perfect fit for your summer eating mood. Whipped these up today using my leftover baked beans...Read more »

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* This article was originally published here

Partners HealthCare. Too big to succeed?

Too big to nail?

Question: How do you know when a non-profit healthcare organization is getting too big?

Answer: When it’s considering spending over $100 million to change its name.

Partners HealthCare was founded in 1994 when Massachusetts General Hospital and the Brigham and Women’s Hospital decided to team up (“partner”) to defend themselves against Blue Cross and Harvard Pilgrim, which for a brief moment had gained the upper hand as managed care caught on. As a new MBA at the Boston Consulting Group, I remember seeing the projections: MGH and the Brigham were going to be in trouble as Massachusetts copied California and drove down hospital utilization.

Insurance companies didn’t need to include both MGH and the Brigham in their networks–so they tried to play them off against one another to get better rates. That’s why Partners was created.

The two hospitals never wanted to merge and in the end they didn’t have to. The healthcare economy boomed, no one could exclude Partners from their network, and Partners was able to use its muscle to do very well in managed care contracting.

Partners got its act together and executed well, especially compared to its local academic and community-based competitors.

A quarter century later, the original partners have acquired several other hospitals and physician organizations. It’s the biggest private employer in Massachusetts by far, and rivals the state government itself in terms of workforce size.

Lately the company has had to deal with its success. Healthcare costs are a big issue in Massachusetts –as they are elsewhere– and Partners is in the crosshairs. The company is built for market power and clinical excellence, which does not lead to the lowest cost approach. And leaders within the Partners hospitals have been reluctant to cede authority to the central organization.

Something has to change. In particular Partners has to do a better job of integrating its various components –or so goes the conventional wisdom.

New CEO, Dr. Anne Klibanski was mostly recently the head of research for Partners.  She’s touted as a great listener, and good at getting people to collaborate. But as I told the Boston Globe (New Partners Chief no stranger to role of uniter)

As a good listener, Klibanski could successfully unite the various factions at Partners. “On the other hand,” [Williams] said, “listening might not be the issue. Partners might need someone to bang people’s heads together.”

Now comes word that Partners is thinking of investing $100 million in changing its name to something more alluring like Mass General Brigham Health. It could be worth it to Partners by bringing the different factions together and for marketing and fundraising purposes. (For sure it will be great for branding and marketing agencies!)  But what does that say about the state of healthcare in Massachusetts?

An expert quoted in the Globe (As Partners HealthCare rethinks its strategy, it’s considering whether to change its name) said it best:

“I don’t think those names matter to ordinary human beings who get health care in our state,” said Alan Sager, a professor at the Boston University School of Public Health. “The underlying fights about decentralized versus centralized power are internal matters for Partners. I don’t think they should plague the public with their own organizational anxieties.”

Partners has great hospitals and great people that make it the pride of Massachusetts. It does make business sense for Partners to consider rebranding. But that doesn’t mean it’s good news for the finances of those footing the bill.

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By healthcare business consultant David E. Williams, president of Health Business Group.

 

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* This article was originally published here

Superhydrophobic 'nanoflower' for biomedical applications

Plant leaves have a natural superpower -- they're designed with water repelling characteristics. Called a superhydrophobic surface, this trait allows leaves to cleanse themselves from dust particles. Inspired by such natural designs, a team of researchers at Texas A&M University has developed an innovative way to control the hydrophobicity of a surface to benefit to the biomedical field.

* This article was originally published here

The United Provinces of Canada (at least on healthcare)

Happy and Healthy?

Happy Canada Day!

We usually think of Canada as a divided nation, with the province of Quebec perennially at odds with the rest of the county and threatening to secede. I was in Montreal over the weekend and it’s fair to say there wasn’t much evidence of enthusiasm for the upcoming Canada Day (the rough equivalent of our 4th of July).

And yet, at least when it comes to healthcare policy, Quebec is very much at peace with the rest of the country.  From the Montreal Gazette (Quebecers united with Canadians on health, divided on language, hockey):

When it comes to stoking national pride, Canadians and Quebecers are united in their appreciation for universal health care and the Canadian passport. They also see eye-to-eye on the importance of the monarchy, Air Canada and Tim Hortons as national symbols, in that they don’t find them particularly important.

A national survey asked the question, “How important are each of the following as a source of personal or collective pride in Canada?”

Universal healthcare scored highest. Seventy three percent of Canadians and 70 percent of those from Quebec ranked it as very important. Anglophones and Francophones responded the same way.

We usually think of the United States of America, but when it comes to healthcare that is certainly not the case. If anything, Americans might be united against the idea of a Canadian-style system.

Kind of odd, then that the people living under that regime are so proud of it.

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By healthcare business consultant David E. Williams, president of Health Business Group.

The post The United Provinces of Canada (at least on healthcare) appeared first on Health Business Group.

* This article was originally published here

8 Life Lessons That Screenwriting Has Taught Me

(Wrote this yesterday....) Tonight I graduate! Wow, I haven't said that in well over ten years, but it's true! I am headed to the certificate ceremony for a program I have been in for the past year at UCLA. This past year I participated in UCLA's TFT Professional Program for TV Screenwriting, one-hour drama being my chosen track. And besides learning how to write a script, the art of screenwriting has taught me some very universal life lessons that I wanted to share with you...Read more »

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* This article was originally published here

Should ICER be NICER? The case for analyzing the value of drugs

It’s a tree of ICE, for those who hold fast to it

The headline in today’s Boston Globe —Price watchdog’s influence on drug makers expands; As nonprofit assesses treatments, some fear it inhibits key options— could have been written by a drug industry lobbyist. [And maybe it was, since the online headline instead uses the squeaky phrase ‘mouse that roared.’]

The article itself is more balanced. Of course it quotes the parents of a couple of kids who take expensive meds, objecting to anyone putting a price tag on their lives. But it also quotes health economics experts pointing out that the price can’t be infinity.

The Institute for Clinical and Economic Review (ICER) follows a data-based approach to assessing the value of drugs, utilizing Quality Adjusted Life Years (QALY) and other well developed metrics. It provides guidance on what a drug could be worth, both on an absolute basis and relative to other treatment options. It doesn’t set prices or prevent a drug from being made available by a public or private health plan. At most, it helps contain the prices of drugs that enter the market and points out cases of outright rip-offs.

Elsewhere in the world (pretty much everywhere) there are real forces limiting drug prices and impacting access. In the UK for example, the National Institute for Health and Clinical Excellence (NICE) decides which drugs and treatments will be provided to patients in the National Health Service. Sometimes drugs are rejected or their use is heavily restricted. On the flip side, patients don’t pay for the drugs that are approved.

In the US the drug pricing forces are heavily weighted in favor of higher prices. We shouldn’t fret about an entity like ICER.

Many drug companies have decided to play ball with ICER by providing data to help justify the value of their products. Some, like Vertex and Serepta have pulled back, saying ICER is biased against drugs for rare diseases. I don’t read ICER’s analyses that way.

The quality of ICER’s research is high, but of course the reports are limited by the data and analytical techniques that are available to the organization. The correct response is to build up the availability of real world evidence (RWE), especially from clinical registries that demonstrate how a drug actually improves (or doesn’t improve) the lives of patients. Patient-generated data and information from claims and electronic medical records can be helpful as well.

With better data we can have answers we are more confident in, and we can accumulate evidence on how drugs perform after they are launched, which can offer a refined understanding of their value.

Thanks to the 21st Century Cures Act, enacted in 2016, there is an increased demand for the generation of RWE. The industry is ramping up its spending on RWE for drug approval, safety monitoring, and reimbursement. New analytical techniques and enhanced data availability from wearable devices and other electronic sources are ushering in a heyday for RWE.

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By healthcare business consultant David E. Williams, president of Health Business Group.

 

 

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* This article was originally published here

Moments of clarity in dementia patients at end of life: Glimmers of hope?

It happens unexpectedly: a person long thought lost to the ravages of dementia, unable to recall the events of their lives or even recognize those closest to them, will suddenly wake up and exhibit surprisingly normal behavior, only to pass away shortly thereafter. This phenomenon, which experts refer to as terminal or paradoxical lucidity, has been reported since antiquity, yet there have been very few scientific studies of it. That may be about to change.

* This article was originally published here

Chocolate Milkshake

updated post, orig pub: 4/26/09 This recipe is for a straight up, dessert-tasting, vegan Chocolate Milkshake. But I promise, this tall, frosty, creamy concoction is absolutely good for you.....Read more »

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Zero Waste Homemade Oat Milk

This Homemade Oat Milk requires only 2 ingredients and about 5 minutes of your time to prepare. Incredibly easy, it costs nearly nothing to make, on top of generating absolutely zero waste. It’s a no fuss, no mess and no straining needed recipe. Simply put: there’s nothing not to love about it! I don’t know […]

The post Zero Waste Homemade Oat Milk appeared first on The Healthy Foodie.

* This article was originally published here

Sometimes, a non-invasive procedure will suffice

When a patient complains about chest pain, diagnosis will usually involve catheter angiography to evaluate the adequacy of blood supply to the heart. Researchers have now established that, in certain cases, the diagnostic reliability of non-invasive coronary computed tomography (CT) angiography is as good as that of coronary angiography - thereby dispensing with the need for invasive procedures.

* This article was originally published here