Using Publicly Available Health Plan Pricing Data For Research And App Development

“We used Elevance Health’s in-network pricing data and medical claims data. We focused on in-network prices because these are the prices negotiated by the payer, and out-of-network providers represent a small percentage of use for planned procedures. The formatting of the released data files follows the specifications provided by CMS. We limited our analysis to one state, Colorado, and one month, August 2022, to illustrate the concepts. [..] We split the prices into two components, the professional price and the facility price. Notably, these two components may not be the only costs associated with a procedure as there are often other … Read More

The Only Career Advice You’ll Ever Need

“When we are stuck on a hard problem, it usually isn’t because we can’t find the answer; it’s that we don’t even know the right question. Imagine that you are trying to figure out how fast food can make you healthier: You are overlooking the right first question—which is whether fast food can do this. That is precisely the problem with agonizing over finding the right job and career. “What am I supposed to do to find a career that makes me happy?” is not the right first question. The right first question is “Who am I?” Only after we answer that can we understand … Read More

Michael Milken Wants to Speed Up Cures

Excerpt – Driven by a family history of disease and his own experience with prostate cancer, [Michael] Milken, the onetime junk-bond wizard whose spectacular downfall on securities charges led to a 22-month prison term in the 1990s, has spent the last three decades trying to advance medical science so that people “can find cures to life-threatening diseases within their own lifetimes.” [..] [KFF] Is the U.S. too slow in reaching cures? [Milken] A train today in Europe or Asia can travel at 200 miles an hour, but the average train in the U.S. travels at the same speed as 100 years ago because you … Read More

An AI Chatbot May Be Your Next Therapist. Will It Actually Help Your Mental Health?

“At the South by Southwest conference in March, where health startups displayed their products, there was a near-religious conviction that AI could rebuild health care, offering apps and machines that could diagnose and treat all kinds of illnesses, replacing doctors and nurses. Unfortunately, in the mental health space, evidence of effectiveness is lacking. Few of the many apps on the market have independent outcomes research showing they help; most haven’t been scrutinized at all by the FDA. Though marketed to treat conditions such as anxiety, attention-deficit/hyperactivity disorder, and depression, or to predict suicidal tendencies, many warn users (in small print) that they … Read More

Estimated Rates of Incident and Persistent Chronic Pain Among US Adults, 2019-2020

“Introduction Epidemiological research on chronic pain (pain lasting ≥3 months) and high-impact chronic pain (HICP) (chronic pain associated with substantial restrictions in life activities, including work, social, and self-care activities) in the US has increased substantially since the release of the Institute of Medicine (currently the National Academy of Medicine) report on pain in 2011 and the Department of Health and Human Services National Pain Strategy (NPS) in 2016. [..] we used data from the 2019-2020 National Health Interview Survey (NHIS) Longitudinal Cohort (NHIS-LC) to determine the IRs [incidence rates] of chronic pain across demographic groups to refine our understanding of … Read More

The Economic Burden of Racial, Ethnic, and Educational Health Inequities in the US

“Introduction During the last half of the 2010s, life expectancy for college-educated persons continued to increase, while life expectancy for adults without a college education decreased. This crisis in the health of adults who do not have a college degree rose to national attention due largely to the opioid crisis. Initially, the opioid crisis devastated predominantly White communities in the midwestern and north-central states of the US, but eventually spread to other communities and currently disproportionately affects Black and Latino populations. However, a closer analysis reveals that mortality rates for adults who were not college-educated increased for many causes of … Read More

Excess Mortality and Years of Potential Life Lost Among the Black Population in the US, 1999-2020

“Introduction In 1985, the US Department of Health and Human Services (HHS) Secretary Margaret M. Heckler issued the Report of the Secretary’s Task Force on Black and Minority Health, also known as the Heckler Report. The landmark report found that the Black population had strikingly higher mortality rates than the White population, resulting in almost 60 000 excess deaths a year relative to the White population. Race offers no intrinsic biological reason for those categorized as Black individuals to have worse outcomes than White individuals, indicating therefore that these disparities are driven by the burden of acquired risk factors, influence of … Read More

Different Types of Patient Health Information Associated With Physician Decision-making Regarding Cancer Screening Cessation for Older Adults

“Introduction Although cancer screening has been shown to reduce cancer-related mortality and morbidity, there is increasing recognition that it can also be harmful and burdensome, especially for older adults. The benefits of cancer screening typically lag by 10 or more years for breast, colorectal, and prostate cancer screenings, whereas the harms and burdens of these screenings—which include complications from screening and follow-up tests, overdiagnosis and overtreatment of clinically unimportant cancers, psychological stress from false-positive results, diverted attention away from other health conditions—occur in the short term. Guidelines recommend against routine cancer screening for older adults for whom the harms outweigh the benefits, … Read More

Your job is (probably) safe from artificial intelligence

Why predictions of an imminent economic revolution are overstated Excerpt – [..] in the 1960s Robert Fogel published work about America’s railways that would later win him a Nobel Prize in economics. Many thought that rail transformed America’s prospects, turning an agricultural society into an industrial powerhouse. In fact, it had a very modest impact, Fogel found, because it replaced technology—such as canals—that would have done just about as good a job. The level of per-person income that America achieved by January 1st 1890 would have been reached by March 31st 1890 if railways had never been invented. Of course, … Read More

CMS’s Universal Foundation Measures Are Not Universally Good For Primary Care

“Primary care is where most people have relationships with a health professional, where more than one-third of all health care visits happen, and the only part of the health system that demonstrably produces longer lives and more equity. However, primary care is experiencing widespread and longstanding shortages and skyrocketing rates of burnout and moral injury. Primary care physician turnover, often associated with burnout, is estimated to cost CMS nearly one billion dollars annually. Before the COVID-19 pandemic, more than one-third of family physicians reported frequent burnout. Since the pandemic, primary care physicians are stepping up to meet patient needs even … Read More