Random charts - hospital costs

 

Source: Prices Paid to Hospitals by Private Health Plans Are High Relative to Medicare and Vary Widely

"... Large price discrepancies exist between what private health plans pay for hospital services and what Medicare pays. RAND Corporation researchers used data from three sources — self-insured employers, state-based all-payer claims databases, and health plans — to assess $13 billion in hospital spending in terms of hospital price levels, variation, and trends from 2015 through 2017 in 25 states. In this report, prices reflect the negotiated allowed amount paid per service, including amounts from both the health plan and the patient, with adjustments for the intensity of services provided. These negotiated prices are then compared with Medicare reimbursement rates for the same procedures and facilities to determine relative prices…” 

Relative prices, including all hospitals and states in the analysis, rose from 236 percent of Medicare rates in 2015 to 241 percent of Medicare rates in 2017 

• Relative prices varied twofold among states. Some states (Michigan, Pennsylvania, New York, and Kentucky) had relative prices in the range of 150 to 200 percent of Medicare rates; other states (Colorado, Montana, Wisconsin, Maine, Wyoming, and Indiana) had relative prices in the range of 250 to 300-plus percent of Medicare rates. 
• Relative prices increased rapidly from 2015 to 2017 in Colorado and Indiana, but they fell over the same period in Michigan. 
• Among hospital systems, prices varied nearly threefold, ranging from 150 percent of Medicare rates at the low end to 350 to 400-plus percent at the high end. 

Relative prices for hospital outpatient services were 293 percent of Medicare rates on average, far higher than the average relative price for inpatient care (204 percent of Medicare rates) 

• However, eight states — Michigan, New York, Tennessee, Massachusetts, Louisiana, New Hampshire, Montana, and Maine — stand out as exceptions to this general finding, with relative prices that are roughly equal for inpatient and outpatient services.."

Random charts - med devices

Source: Medical Device Cybersecurity Regional Incident Preparedness and Response Playbook 1.0 (32-page PDF)

Random chart - healthcare

Source: How Alphabet, Amazon, Apple, and Microsoft are shaking up healthcare — and what it means for the future of the industry

Random charts - Medicare spend

 

Source: Improving Care for High-Need, High-Cost Medicare Patients (32-page PDF)

Random chart - healthcare costs

Source: National Health Expenditure Projections, 2016–25: Price Increases, Aging Push Sector To 20 Percent Of Economy (12-pg PDF)

Abstract: "Under current law, national health expenditures are projected to grow at an average annual rate of 5.6 percent for 2016–25 and represent 19.9 percent of gross domestic product by 2025. For 2016, national health expenditure growth is anticipated to have slowed 1.1 percentage points to 4.8 percent, as a result of slower Medicaid and prescription drug spending growth. For the rest of the projection period, faster projected growth in medical prices is partly offset by slower projected growth in the use and intensity of medical goods and services, relative to that observed in 2014–16 associated with the Affordable Care Act coverage expansions. The insured share of the population is projected to increase from 90.9 percent in 2015 to 91.5 percent by 2025."

Random charts - quality & safety

 Source: As a critical behavior to improve quality and patient safety in health care: speaking up!

Random charts - medical devices

 

Source: Better Evidence on Medical Devices: A Coordinating Center for a 21st Century National Medical Device Evaluation System (23-pg PDF)

Random charts - CPOE med errors

 

Source: (BMJ) Computerised physician order entry-related medication errors: analysis of reported errors and vulnerability testing of current systems

Random charts - child health

 

 

 

 

 

Source: Time to Act: Investing in the Health of Our Children and Communities. Recommendations From the Robert Wood Johnson Foundation Commission to Build a Healthier America (120-pg PDF)

"In 2008, the Robert Wood Johnson Foundation (RWJF) convened the Commission to Build a Healthier Americato help us find better ways to improve the health of our nation. In their search for solutions, the Commissioners found that there is much more to health than health care and that where we live, learn, work, and play profoundly influence our health..."

Their recommendations? 

"Recommendation 1: Make investing in America’s youngest children a high priority. This will require a significant shift in spending priorities and major new initiatives to ensure that families and communities build a strong foundation in the early years for a lifetime of good health. 

Recommendation 2: Fundamentally change how we revitalize neighborhoods, fully integrating health into community development. 

Recommendation 3: The nation must take a much more health-focused approach to health care financing and delivery. Broaden the mindset, mission, and incentives for health professionals and health care institutions beyond treating illness to helping people lead healthy lives."

Read it!

Random charts - personalized medicine

 

 

 

Source: Paving the Way for Personalized Medicine (62-pg FDA PDF)

Random charts - med device cybersecurity

Source: Networked medical device cybersecurity and patient safety

Random charts - guideline panels

Source: Expanding Disease Definitions in Guidelines and Expert Panel Ties to Industry: A Cross-sectional Study of Common Conditions in the United States 

Its conclusion? "For the common conditions studied, a majority of panels proposed changes to disease definitions that increased the number of individuals considered to have the disease, none reported rigorous assessment of potential harms of that widening, and most had a majority of members disclosing financial ties to pharmaceutical companies." Note that "... these findings do not establish a causal link between industry ties and proposals to change disease definitions"

Random animation - flu pandemic

The National Institute of Allergy and Infectious Diseases has a YouTube animation to demonstrate the emergence and potential spread of new influenza viruses...

McCain and Obama on health

Health Affairs has analyzed the two candidates' respective health care plans, and the verdict is in: each plan has major flaws, best would be a combination of selected features of the two!

McCain:
Cost and coverage implications of the McCain plan to restructure health insurance

Abstract: "Senator John McCain's (R-AZ) health plan would eliminate the current tax exclusion of employer payments for health coverage, replace the exclusion with a refundable tax credit for those who purchase coverage, and encourage Americans to move to a national market for nongroup insurance. Middle-range estimates suggest that initially this change will have little impact on the number of uninsured people, although within five years this number will likely grow as the value of the tax credit falls relative to rising health care costs. Moving toward a relatively unregulated nongroup market will tend to raise costs, reduce the generosity of benefits, and leave people with fewer consumer protections."

Obama:
The Obama Plan: More Regulation, Unsustainable Spending

Abstract: "The health reform plan put forth by Sen. Barack Obama (D-IL) focuses on expanding insurance coverage and provides new subsidies to individuals, small businesses, and businesses experiencing catastrophic expenses. It greatly increases the federal regulation of private insurance but does not address the core economic incentives that drive health care spending. This omission along with the very substantial short-term savings claimed raise serious questions about its fiscal sustainability. Heavy regulation coupled with a fallback National Health Plan and a play-or-pay financing choice also raise questions about the future of the employer insurance market."

... and the winner is:
Blending Better Ingredients For Health Reform

Abstract: "This paper argues that a desirable health reform plan should accept some features that the Obama and McCain plans have in common, and combine other features from each of the plans. Useful combinations include the presence of both public and private options and a system of credits that are more generous for lower-income households (Obama) and creation of a system of public subsidies that is incentive-neutral across individual and group insurance, curtailment of the current tax subsidy to high levels of coverage for high-income households, and the use of targeted high-risk pools and guaranteed renewability rather than community rating(McCain)."

Not all bad

It turns out that the bacterium Helicobacter pylori which is present in the human stomach and gut (and can cause ulcers) might have some positive effects and not be all bad. A study has shown that there is an inverse relationship between the disappearance of H. pylori in children in the U.S. and the increase in childhood asthma, GERD (gastric reflux), hay fever, and allergies. OK, so this is correlation and not necessarily causation, but it opens up possible avenues for further research.

It also shows that the complexity of the interactions between our bodies and the host of bacteria we carry around with us. Colonization of our bodies begins immediately at birth, and an estimated ninety percent of the cells in an average person’s body are bacteria (an estimated 90-100 trillion cells, and perhaps two to nine pounds of body weight). These bacteria have positive as well as negative effects - positive effects include the synthesis of vitamins, stimulation of the production of natural antibodies, and by their presence protection from other pathogens, while negative effects include disease, etc. The interactions are complex and not that well understood. Amazing stuff!


Ulcer bacteria may protect from asthma
Stomach Bug May Ward Off Asthma
Of microbes and men
Helicobacter Pylori - Wikipedia

Your Body Is a Planet
The Bacterial Flora of Humans
Bacteria and Human Body Weight