Tag Archives: @fsgoldstein

Saving on Employee Health Benefits: Would you Hire this Consultant?

Over the years as an HMO executive and later founding a disease management and Healthcare IT company, I have analyzed a lot of medical claims and quality data. One of the largest was an analysis of a State Medicaid program with about 675,000 beneficiary lives with two years of inpatient, outpatient and pharmacy claims. The pharmacy file alone contained about 15 million prescription fills.

More recently I became certified as a Professional by the Care Innovations Validation Institute and sit on their Advisory Board. This certification tested my ability to look at data and decide whether the outcomes reported were likely to be valid or not.  As you look for vendors or consultants I would suggest you start with the Validation Institute. The following example is a good reason why.

Cruising around the web looking at various healthcare consulting firms and company websites I came across  a company that is targeting employers and claims they  have vetted and can bring in vendors to lower the costs for a company’s self funded health plan. Their website says they can identify, evaluate, oversee, manage and report on the vendors they propose.

On their home page is a chart used to show the savings an employer can expect to see by implementing their various cost saving approaches.  Can you spot the flaw(s)?

 

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Let’s start with the first and most glaring error and its on the first line. Continue reading

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Mindfulness: Is This the Way to Improve our Eating Habits and Reduce Smoking?

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This week we had Judson “Jud” Brewer, MD, PhD from Claritas Mind join us on PopHealth Week. I have recently gotten into Mindfulness and have used HeadSpace (which has been very good) daily for over a month. I’ll discuss Headspace in another post. More recently I started Eat Right Now developed by Claritas Mind and have used it daily as well. Eat Right Now states it’s “a program that utilizes a proven scientific approach to help you control your food cravings.”

It has surprised me how much of an impact mindfulness can have on my thinking and behavior. Continue reading

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Casino Healthcare – An Interview with Dan Munro

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I recently interviewed Dan Munro on PopHealth Week and we discussed his book Casino Healthcare. dan-munro-picWe all know about the high costs and poorer outcomes associated with American Healthcare.  In Casino Healthcare Dan explains his view of how our system, one built with Selective Health Coverage is like a casino; or really three casino’s, the insurer casino, provider casino and pharmaceutical casino.

Dan explores each of these areas and explains how they work to maximize revenue through a system of complex transactions and systems.

As an example, on the Provider side Dan explains a little known group called the AMA/Relative Value Scale Update Committee  or “RUC” as its more affectionately known.   Continue reading

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PopHealth Week – This week we discussed Theranos, Healthways, ACOs and Precision Medicine

Listen to Doug Goldstein (@efuturist) Gregg Masters (@2healthguru) and me (@fsgoldstein) discuss the continuing Theranos Saga, The Healthways acquisition by Sharecare, Precision Medicine and the Cancer Moonshot and ACO results on PopHealth Week:

 

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Tom Chamberlain, CEO of EdLogics on PopHealth Week

In attempting to control healthcare costs, improve health and seek better utilization of healthcare services by their employees,  one key area of focus by employers needs to be health literacy. It’s clear that poor health literacy is a strong indicator of health care costs. Here are some statistics:

Health Literacy Stats

 

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Tom Chamberlain, PharmD, the Founder and CEO of EdLogics joined Gregg Masters  and me on PopHealth Week  to discuss their platform and how it works to improve Health Literacy and engagement.

 

From their marketing materials:

EdLogics is an education-based consumer engagement company that provides innovative health education and learning management solutions to employers, health plans, healthcare providers, and government entities. Through interactive game-based learning, multimedia educational programs, innovative gamification strategies, and rewards for educational achievement, EdLogics is transforming the way consumers learn about health. The EdLogics Platform makes learning fun and engaging, measures learning comprehension, improves health literacy, and empowers consumers to take greater responsibility for managing their health.

You can learn more about their platform via this video (http://www.edlogics.com/overview/)and listen to the interview on PopHealth Week below:

 

 

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For full disclosure, I am an advisor to EdLogics.

PopHealth Week is Produced by Health Innovation Media

 

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