Senior Housing Options Compared

Senior Housing Options from HelpGuide.orgarticle by Perry Hua with edits by Wayne Caswell

The goal when choosing housing is to pick an option that best matches your financial, physical, medical, and social needs. The earlier you assess your current and future needs, and the more you know about the options available, the easier it is to make a decision. Here’s a list of options showing their advantages and costs, starting with the most expensive first. Read More …

MiniTrends affecting Telehealth

Skype TranslatorOverlapping MiniTrends affecting Telehealth include

  1. health reform,
  2. the Internet of Things,
  3. speech recognition & synthesis, and
  4. real-time language translation.

I’ve written a lot here about health reform, telehealthmedical tourism, the Internet of Things, and the overlap of healthcare MiniTrends, but today I saw a video that evolves my thinking further. It’s about Microsoft’s Skype and their newest Skype Translator Preview.

The Skype Translator video below gave me a glimpse of what telehealth might be like in 5 years or so. This vision includes the Internet, video consultations, smart sensors, and the trend of medical devices becoming smaller, cheaper, easier to use, and widely used among consumers for telemedicine. But the video consultation may be done from anywhere, in any language, and that could dramatically increase competition and result in much better outcomes at lower prices.

As you watch, imagine that it’s a conversation between you and a doctor in Costa Rica, where you went for your knee surgery and recovered on the beach in a 4-star hotel, paid for by your insurer because the outcomes were better than most any U.S. provider. It’s the sheer volume of procedures they do that led to their world-class expertise and efficiency.  Read More …

About Operating Room Safety

 Make Sure You’re in the Safest Possible Operating Room

Operating Room

The Hazards of Hospitals

We all think of the hospital as a place we go to get better, but hospitals in the United States are making people sicker at alarming rates. Between overtired interns, germ-covered doctors,  haphazard record keeping, and equipment failures, you might find yourself in more trouble than you were when you checked in. Here are some alarming statistics, followed by some patient recommendations.

  • 1.7 million infections are contracted in hospitals each year.
  • 1 in 5 patients suffer harm from medical errors, and 99,000 die from them.
  • You’re 30,000 times more likely to die from a hospital visit than a plane crash.
  • And more die from infections each year than from car accidents, breast cancer or aids.

High Anxiety

The simple mention of having a medical procedure brings out anxiety in most people. It’s human nature to become fearful when preparing to undergo a surgical procedure that requires in-patient treatment, sedation and operating rooms, as it is associated with pain and mortality. Read More …

Why doctors are so afraid of apples

Old Rotten AppleAs implied in An Apple a Day… the fruit and the smartphone can both keep doctors away, and that has many of them terrified for good reason.

Those at the top of the healthcare mountain especially fear the Healthcare MiniTrends, because they know 429 of the original Fortune 500 companies (1955) are no longer in business today. And they’re looking down at a new class of hungry competitors who are already exploiting these minitrends.

Let’s look at just two of the trends: (1) the new focus on wellness, and (2) new smartphone uses. Read More …

HealthSpot visits reimbursed by Medicaid!

HealthSpot and CareSource Team to Improve Access to Healthcare
Managed Care company creates value for Medicaid members, increasing access to care through HealthSpot telehealth platform.

Telehealth KioskDUBLIN, Ohio–(BUSINESS WIRE, 8/20/2014)–HealthSpot®, a pioneer in patient and provider driven healthcare technology, and CareSource, an Ohio nonprofit managed care company dedicated to meeting the needs of healthcare consumers for more than 25 years, announced an agreement to increase access to quality healthcare for CareSource Medicaid, CareSource Just4Me and MyCare Ohio members.

HealthSpot has built a comprehensive healthcare delivery platform that combines cloud-based software with the award-winning HealthSpot station. The stations connect patients to medical providers from a variety of Ohio’s health systems including Cleveland Clinic, MetroHealth and University Hospitals. For the past 18 months, these providers and others have been using the stations for diagnosis of high frequency illnesses, such as the flu and upper respiratory issues.

“HealthSpot is the first open platform that enables community providers to see patients outside their facility and truly create value for everyone in the healthcare ecosystem.”

Read More …

Doctored, about Physician Disillusionment

Doctored - The Disillusionment of an American Physician

Click to buy on Amazon.com

Doctors are just as frustrated with our fee-for-service “sick care” system as patients are. Following on the heels of a related article from a few days ago by Dr. Stephen Schimpff, today’s post introduces an NPR article featuring an in-depth interview with cardiologist Sandeep Jauhar, MD, who wrote the book, Doctored: The Disillusionment of an American Physician. It begins…

“As a young doctor working at a teaching hospital, Sandeep Jauhar was having trouble making ends meet. So, like other academic physicians, he took a job moonlighting at a private practice, the offices of a cardiologist. He noticed that the offices were quick to order expensive tests for their patients — even when they seemed unnecessary. It was ‘made very clear from the beginning’ that seeing patients alone was not financially rewarding for the business.”

Read the rest at NPR, listen to the full interview below,
or watch the Wall Street Journal interview below that. Read More …

101 MiniTrends in Health Care

Watch for Trends Ahead

This image is from MiniTrends, a book by John Vanston that I strongly endorse. I’ve known John for years and did consulting work for his company, Technology Futures. His book inspired the vision of Modern Health Talk, because it helped me see unfulfilled opportunity at the intersection of trends. (Click image to see book)

“What the Hell is happening to health care?”

“And is it an Opportunity or a Threat?”

Insights by Wayne Caswell, Founder of Modern Health Talk.

An awful lot has changed in just the last few years and even more will change in the near future, with the aim of reducing (or at least containing) our health care costs. What’s behind these MiniTrends, and what is their implication for providers, payers and consumers? That’s the $1.5 trillion question. Here I talk about many, many MiniTrends–surely you can find 101 of them if you look! 

“It is not the strongest or the most intelligent who will survive but those who can best manage change.” – Charles Darwin

That quote is important, because 429 of the original Fortune 500 companies [1955] are no longer in business today. That’s a scary thought for those sitting at the top of the healthcare mountain, because they know they must adapt to the megatrend of health reform and Obamacare (the Patient Protection and Affordable Care Act) or die. And they are looking down with fear at the hungry competitors who are already exploiting the many related minitrends, because for them these are times of great opportunity.

Read More …

Reframing the Question of Doctor Frustration

Frustrated DoctorBy Dr. Stephen Schimpff

Editor: I just love this doctor’s thinking and have published several of his articles here. I’m happy to feature another one from HealthWorksCollective.

There has been a lot of interest in the Daily Beast article written by Dr Daniela Drake, about very frustrated primary care physicians (PCP.) She quoted both Dr Kevin Pho and myself. Dr Drake noted that nine of 10 doctors would not recommend medicine to their children as a career and that 300 physicians commit suicide each year. “Simply put, being a doctor has become a miserable and humiliating undertaking.”  Dr Pho offered his own commentary here pointing out that “it is important to have the discussion on physician dissatisfaction….demoralized doctors are in no position to care for patients…To be sure many people with good intentions are working toward solving the healthcare crisis. But the answers they’ve come up with are driving up costs and driving out doctors.” Read More …

Telehealth is Shaping Healthcare for the Better

Game ChangerBy Karen R. Thomas, President of Advanced TeleHealth Solutions

As incredibly innovative and efficient as telehealth is at providing greater access to care for consumers, lowering healthcare costs for both patients and healthcare systems, and improving outcomes, barriers have always existed that hinder the widespread adoption of telehealth. Yet recently, issues such as state requirement hurdles, reimbursement limitations, and a general resistance from physicians to learn and integrate new technologies into their care routines are quickly evaporating in the wake of the overwhelming proof of telemedicine’s many benefits. Read More …

Managing My Costs of Care [ESSAY]

MedicaidDollarsManaging My Costs of Care is a well-written essay by Jay Warner.

I recommend it, because this one example shows just how easy it “should” be to cut healthcare costs in half to get down to what the rest of the world pays — for better care and outcomes — and save $1.5 trillion/year. It all comes down to getting the incentives right, because with employer-provided health insurance, Jay had no incentive (or ability) to comparison shop. Now he does.

The healthcare landscape is changing as payers pressure providers for more price transparency and seek other ways to contain costs and maintain profitability now that they can no longer cherry-pick the healthiest customers or cut them off when care gets too expensive.

Other disruptive changes include remote sensor monitoring (telemedicine) that can follow trends and identify problems earlier, remote consultations (telehealth) that can replace in-person office visits, medical tourism when it’s less expensive and has better outcomes than local surgeries, and an overall shift away from the fee-for-service insurance model. That model once served as pre-paid medical care, but now payers are starting to view insurance as protection against catastrophic illness and injury with consumers paying for the small stuff out of pocket. With that trend comes two others: (1) increased competition and (2) an increased focus on overall health and wellness, including nutrition, exercise, and sleep as it’s pillars.

A side benefit of wellness, beyond dramatic reductions in health care costs, is improved safety and performance. Restorative sleep, for example, is associated with improved alertness, attention, creativity, decision-making, focus, learning ability, mood, reaction & recovery times, and working memory, all of which contribute to better grades at school, better productivity at work and in sports, and fewer motor vehicle accidents and deaths.

Hyper Growth of Private Insurance Exchanges

Shared with permission from MEDCITY News, by Dan Verel, 7/25/2015

Accenture Figure 1

While much attention has been heaped on the public health insurance exchanges over the year, private health insurance exchanges “are experiencing hyper-growth” and enrollment could exceed that of public exchanges by 2017, “if not sooner,” according to Accenture. Read More …

Meaning And Depth of the Primary Care Crisis

photo image of Stephen C. Schimpff, MDThis is Part 1 of a Series on The Crisis in Primary Care by Stephen C Schimpff, MD

The primary care physician (PCP) should be the backbone of the American healthcare system. But primary care is in crisis – a very serious crisis.

The first statement is my considered opinion and I will attempt to convince you of its truth. The second sentence is a simple fact.

Accounting for only 5% of all health care expenses, the PCP can largely control the “if and when” of the other 95% and hence can be the one to best affect quality of care and the totality of costs. This crisis limits the effectiveness of the primary care physician such that care quality is nowhere near what it could be or should be and the costs of care have skyrocketed. Read More …

Early-Stage Obamacare – How’s it Going?

Is your glass Half Empty, or Half Ful?EDITOR: Opinions of Obamacare, and whether it’s a glass half empty or half full, depend largely on one’s political viewpoint and sources of your information. Opponents of the law, including many in the medical industrial complex with lots to lose if health reform cuts costs, often cite articles hinting that it’s a failure, while proponents cite articles highlighting successes and progress. The mainstream media, in efforts to generate buzz and attention, seem to stoke the fires of controversy by avoiding the hard task of investigative journalism and simply publishing inflammatory stories fed to them by either political party without checking the facts. Then again, the official government numbers, which you can believe or not based on your politics, present a moving target. So, I’m more interested in the trends and the long-term implications and publish today’s byline article with some editorial comments added.

Early-Stage Obamacare:
A Checkup on the Health of the Affordable Care Act Thus Far

By Paisley Hansen

What will be the ultimate impact–for good or bad–of the Affordable Care Act on Americans? Although it’s still too early to tell, a January 13 article by the Associated Press posted on AOL sheds some light on the health status of Obamacare thus far [2.2M through December, 2013]. Read More …

We Endorse Telehealth Across State Lines

Medicine Unplugged: Your phone, your DNA, your data

By Wayne Caswell

Modern Health Talk strongly endorses telehealth and efforts to break down barriers to wider adoption nationwide. The TELE-MED Act of 2013 (HR 3077) is still not out of committee but is intended to start breaking down barriers related to licensure and payment when medical care is given online across state lines, starting with Medicare providers. Hopefully Congress will pass this bill and then start extending telehealth to all insurance carriers. Read More …

Fee-For-Service is Pervasive yet Perverse

The FFS payment model was created long ago, during a time when physicians treated less-complex problems and offered only a few inexpensive therapeutic interventions. It worked back then but a significant percentage of patients today have multiple chronic conditions. Meanwhile, the number of complex and very expensive tests, medications and interventions available are practically unlimited.

Economics 101 teaches that as supply goes up, costs should come down. But this tenant doesn’t hold true in medical care – not when the supplier also controls demand.

In health care, doctors can stimulate demand because (a) health insurance blinds most patients to the costs of services and (b) patients often don’t know whether a complex procedure is as necessary as a non-invasive one.

As a result, we have seen a major increase in utilization of complex services over the past 20 years.

That’s a short extract from an important FORBES article, The High Cost Of American Health Care: You Asked For It. Everything in the article is consistent with my understanding of economics and long-held view that the problem with our healthcare system is perverse incentives in the payment model. I highly recommend it. Read More …

Regulations Not Keeping Up with Technology

Health ReformBy Wayne Caswell

The rapid and accelerating pace of tech innovation has profound implications for healthcare delivery & payment, aging, and disability employment, but regulations that support that are spotty or nonexistent.

The good news

“Durable medical equipment” is a class of assistive technology that can be paid for by Medicare, Medicaid and many private insurance plans. Motorized wheel chairs most often fall into this category. Read More …

Saving while Helping your Kids & Parents

Click to view original photo

Flickr photo credit: geoffreyrockwell

By Lucy Stewart, a financial counselor
for families looking to get out of debt

Forty-eight percent of middle-age adults provided support to their adult children in 2012, which is up from 42 percent in 2005, according to PewSocialTrends.org. Also up is the financial support they provide their aging parents: 21 percent said they provided some financial support to a parent age 65 or older in 2012, up from 19 percent seven years earlier.

Offering financial support to your adult children and 65+ parents does not mean that you give up your own financial plans and dreams. Family is family, but sacrificing your personal well-being won’t benefit anyone. Look for ways to cut expenses and create streams of income, and don’t assume you have to do this alone. Read More …

Can Insurers Force Better Care at Lower Cost?

InsuranceFierceHealthPayer.com recently published an article that looked at successful strategies to improve health care and lower costs. It mentioned

  • bundled payments,
  • global payments, and
  • accountable care organizations.

But that’s as far as it went, so I added the following response to show other ways that the ACA and changes to the healthcare Payment system can disrupt the Deliver system. Read More …

The Elephant in the Room – Retirement Planning

The Elephant In The Room When It Comes To Family And Retirement

Elephant in the RoomThis is the first of a two-part series by Ken Dychtwald Ph.D. (Gerontologist, psychologist, author, entrepreneur and public speaker)

For most of us, our families make our lives — and life in retirement — richer and far more enjoyable. However, retirement planning has traditionally centered on just dollars and cents — and largely on the financial needs of an individual or a couple. With more and more of our lives impacted by family ties as well as family tensions, perhaps it’s time to rethink retirement planning from a more holistic perspective.

You may have already begun to notice in your own life that the hopes and dreams of today’s pre-retirees and retirees are increasingly complicated by three converging family-related trends: Read More …

Telehealth Enhancement Act takes Important Step

Telehealth KioskAs a member of the American Telehealth Association (Austin chapter), I too support the Telehealth Enhancement Act, however I see it as just a baby step and think much more is needed. Still, it’s a step in the right direction.

The proposed bill would modernize the Medicare program by allowing Medicare patients to be cared for remotely by a licensed healthcare provider from any state. That way, if you need medical help while on vacation, you could connect online or by phone with your own doctor back home without requiring that they be licensed in the state you traveled to. I urge Congress to adopt this bill and expand it beyond Medicare, to other federal agencies and health benefit programs.

Read More …