“The expansion of the direct-to-consumer (DTC) medical imaging market elicits several safety and ethical concerns. Discounted DTC imaging may lead to unnecessary testing and subsequent incidental findings, false-positive results, radiation exposure, and downstream interventions. Groupon, Inc, a global e-commerce marketplace, has garnered media attention for its vouchers for discounted DTC medical imaging services. In this study, we evaluated the scope, pricing, customer feedback, and claims of medical imaging services offered through Groupon vouchers. We performed a cross-sectional analysis of Groupon offerings in the US on February 6, 2020. On the Groupon home page, in the Imaging and Scans section [..], … Read More
All posts by Anupam
“On October 29, 2020, the Departments of Health and Human Services (HHS), Treasury, and Labor issued the “transparency in coverage” final rule. The rule imposes new transparency requirements on group health plans and health insurers in the individual and group markets. [..] plans and insurers must disclose cost-sharing estimates at the request of an enrollee and publicly release negotiated rates for in-network providers, historical out-of-network allowed amounts and billed charges, and drug pricing information. The rule’s goal is to enable enrollees to estimate their cost-sharing before receiving health care to encourage shopping and price competition amongst providers. HHS also amends … Read More
“[Oak Street, ChenMed, Partners in Primary Care (owned by Humana), Iora Health, Geisinger] contract with Medicare Advantage plans to provide primary care “on steroids” to older patients with multiple chronic illnesses, as one executive put it. Because they typically take full financial risk from the Advantage plans, which pay them fixed monthly fees for each patient, the clinics make money by keeping patients out of the hospital. They do that by providing preventive and behavioral health care along with managing chronic diseases and addressing social needs. Working with a team of clinicians and coordinators, doctors see about a fifth as … Read More
This week’s refresh of the excess mortality count from the CDC (last updated October 28 [I think]). The federal agency identified over 294,000 excess deaths across the country since the start of this year (about 5,000 more than last week’s estimate). The overall excess mortality rate decreased from 11.4% last week to 11.3% this week. Data from CDC’s National Center for Health Statistics, updated October 28, 2020
“In recent years, a worldwide increase in the incidence of thyroid cancer has been acknowledged and has primarily been attributed to overdiagnosis of small, low-risk papillary thyroid cancers. Observational evidence suggests that active surveillance is a safe and effective management option for carefully selected patients with low-risk papillary thyroid cancers. In light of this contemporary data, guidelines now include more conservative treatment options for patients diagnosed with papillary thyroid cancer. Ultimately, these guidelines help to avoid potential overtreatment and improve quality-of-life outcomes. Yet despite all this, the willingness to accept less invasive management options, specifically the uptake and acceptability of … Read More
“Concerns about hotspots flaring in schools of all types, sports teams, and workplaces lend special urgency to answering how best to limit the spread of COVID-19, and specifically how to test for and track the SARS-CoV-2 virus in the general population. An ongoing public health debate centers on whether we should use sub-optimal tests on a massive scale, testing frequently to overcome their analytical shortcomings. The basic argument was encapsulated in the 9/11 Health Affairs post by Paltiel and Walensky and has two parts. First, that widespread screening will dramatically expand testing capacity and ease ongoing strain on critical supply … Read More
“Surgeons were recruited from the Illinois Surgical Quality Improvement Collaborative in 2016 for a video-based technical skills assessment program.4 Each surgeon submitted 1 representative video of a laparoscopic right hemicolectomy that they performed. Videos were reviewed by 12 or more surgeons, including 2 colorectal surgeons with video evaluation experience. Skill scores were assigned using the American Society of Colon & Rectal Surgeons Video Assessment Tool, and the mean score from all raters was used. Skill score was analyzed separately by terciles and as a continuous variable. Patients who underwent any minimally invasive colectomy for stage I to III epithelial-origin colon … Read More
“For evidence-based, prescribed digital therapeutics to reach the most vulnerable populations, they need to be reimbursable by Medicaid. [..] One example is WellDoc, an FDA-cleared digital therapeutic that has been shown to improve outcomes for patients with Type 2 Diabetes, leading to cost savings for employers and health plans. Another example is the FDA-cleared digital health platform Propeller Health, an evidence-based platform for asthma and chronic obstructive pulmonary disease (COPD). There are also digital therapeutics earlier in the FDA-clearance pipeline with growing literature demonstrating reproducible clinical effect. One example is Cognoa, an evidence-based FDA breakthrough-designated company that focuses on diagnosis … Read More
“Improving our understanding of clinician-level perceptions regarding e-consultation is important for informing program implementation and adoption, and ensuring that e-consults facilitate delivery of high-quality care. Prior evaluations demonstrated that primary care clinicians and specialists believe that e-consults may improve communication between clinicians. Primary care clinicians and specialists across several health care systems have reported that use of e-consultations increases the efficiency of care and reduces appointment burden for patients. [..] In a 2018 study, primary care clinicians working in safety-net clinics described e-consultations as “increased administrative burden, broadened clinical responsibility, and restructuring of specialty care delivery.” A perception among primary … Read More
“[Question] What are you working on right now that you’re excited about? [Steinberg] Our team is developing a behavioral intervention focused on improving intuitive eating and diet quality using digital health tools (apps, video coaching, APIs) to improve blood pressure. Most notably, we were purposeful in not focusing on calories or changing one’s weight in this project. I am excited to offer people something that can improve health independent of changing body size or weight. Reducing weight stigma is something I aim to work on more in future projects. [Question] Who’s doing something that you admire in healthcare today, and … Read More