April 19, 2019 | Trust your patients!


Health care again tops breach list

Who had the most security breaches in 2018? Health care did. It led all industries in cybersecurity breaches, making up a quarter of the roughly 750 U.S. data breaches included in BakerHostetler's 2019 Data Security Incident Response Report. Health information was the second-most at-risk type of data in cyber incidents. Across all industries, employees—mostly as victims, not perps—were responsible for 55% of breaches. (Healthcare Dive; Data Security Incident Response Report)

Secrecy good, transparency bad, say PBMs

Members of the House Energy and Commerce Committee’s Oversight and Investigations panel expressed frustration with the explanations for high insulin prices during a hearing last week. For example, pharmacy benefit managers testified that secrecy in negotiations ultimately helps lower drug prices, and transparency would mean higher prices, Medscapereports. Rep. John Sarbanes was having none of it. “I don't buy it. […] I think a system has been built that allows for gaming to go on," he told the witnesses from pharma and PBMs. “The system is working for both of you at the expense of the patient.” (Medscape)

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CMS toolkit highlights ACO care coordination

CMS has released a public ACO Care Coordination Toolkit showing the work of ACOs and End-Stage Renal Disease Care (ESRD) Seamless Care Organizations (ESCOs). The toolkit aims to educate the public about strategies used by ACOs and ESCOs to provide value-based care while also providing actionable ideas to current and prospective ACOs to help them improve or begin operations. CMS has also released seven case studies to describe innovative initiatives from ACOs and ESRD ESCOs. (CMS announcementACO Care Coordination Toolkit)

If you can’t beat them…

Blue Cross and Blue Shield of Texas—the state’s largest insurer—announced plans to open 10 medical centers in January 2020. The centers will be co-owned and run by Sanitas USA, which has similar facilities in Connecticut, Florida and New Jersey. The centers, based in the Dallas and Houston areas, will offer primary and urgent care, lab and diagnostic imaging services and wellness and disease management programs. (Dallas Morning News)


Synchronizing medical care to tax refund

It appears Americans are putting off health care until they receive their refund. Out-of-pocket spending on health care jumps about 60 percent in the week after people get their refunds, according to an analysis of data from the JPMorgan Chase Institute. “It was surprising, and I’d go so far as to say alarming,” the Institutes’ Fiona Greig tells Bloomberg. “Those are visits that would have taken place three weeks earlier, had the tax refund arrived three weeks earlier.” (Bloomberg; JPMorgan Chase Institute analysis)

Trust your patients

Physicians need to trust their patients, according to a Viewpoint piece in JAMA Network Open. Maintaining health and addressing illness are inherently collaborative. Mere adherence is not nearly enough, the authors argue. “[T]he principles underlying the patient-physician relationship must shift from simply emphasizing patients’ adherence to cultivating patients’ ability to contribute to the development of care plans that reflect their own values and preferences.” (JAMA Network Open)


Giving patients credit: Some physicians may scoff, but Dr. Google has become the second opinion for many patients, writes Susannah Fox, former chief technology officer at U.S. Department of Health and Human Services. She’s soliciting stories from “fans of Dr. Google” who, like her, have found the internet helpful in understanding their or a loved one’s health care. (LinkedIn Pulse)

Housing as health: CMS has approved a waiver for a Florida pilot program that provides behavioral health services and housing to adult Medicaid beneficiaries with serious mental illness and/or substance abuse disorders. (HealthLeaders Media)

End rebates, say employers: A plurality (42%) of employers support ending all rebates negotiated by pharmacy benefit managers, according to a new survey from Mercer, while 17% of respondents want to maintain the status quo. Five percent support eliminating them for government plans only. (FierceHealthcare; Mercer)


Don’t stress out about it, but….

New research—a sibling study from Sweden—confirms what earlier studies have shown: Chronic stress hurts your heart. Literally. “Stress related disorders are robustly associated with multiple types of cardiovascular disease, independently of familial background, history of somatic/psychiatric diseases, and psychiatric comorbidity,” the authors of the BMJ study conclude. The NPR piece explores this and other studies and addresses how to counteract stress (NPRBMJ)


“Don’t confuse the 1-hour lecture you had on my condition with my 20 years of living with it.”—a Twitter reply to the ubiquitous “Don’t confuse your Google search with my medical degree,” posted by Trisha Greenhaigh and quoted in LinkedIn Pulse

Jorden Gunessever