by Winifred S. Hayes, PhD, President and CEO, Hayes, Inc.

If the Affordable Care Act (ACA), also known as the Patient Protection and Affordable Care Act (PPACA), remains as is, beginning in 2014 consumers without employer-sponsored health insurance will be able to purchase health insurance through health insurance exchanges (HIX is the approved acronym for these entities). The intent of implementing state-based HIXs is to create a more competitive marketplace through which the uninsured can purchase health insurance. HIXs would offer consumers a choice of private health insurance plans (and perhaps a public option, as well), and these plans will be required to follow standardized rules with regard to the services covered and cost sharing (deductibles, copayments, and out-of-pocket expenses) so that consumers can easily compare plans.

Like any good intention, in theory HIXs sound like an ideal way to provide health insurance coverage to the many Americans without health insurance. But what will the effect be on the healthcare marketplace in general? And in this period of declining federal funding, how will states fiscally plan for and implement HIXs?

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by Karen Matthias, MBA, RN, Vice President, Sales and Marketing

In the United States, approximately 8 of 100 people suffer from neuropathic pain, the type of pain that often seems to have no obvious cause. Symptoms may include shooting and burning pain or numbness and tingling.

Unfortunately, neuropathic pain responds poorly to standard pain therapies and often causes severe disability and poor quality of life (QOL). In fact, health-related QOL in patients with chronic neuropathic pain is similar to that reported by those with cancer and chronic heart failure.

Spinal cord stimulation (SCS), which involves the electrical stimulation of spinal nerves using electrodes implanted into the spinal cord, has been proposed as a possible treatment for neuropathic pain. We recently completed a health technology assessment on the use of SCS for the relief of neuropathic pain and examined these relevant questions:

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by Karen Matthias, MBA, RN, Vice President, Sales and Marketing, Hayes, Inc.

As I mentioned in yesterday’s blog, the WBL Summit in Las Vegas is all about change. Thursday’s focus was on how we can lead change. One thing we know for sure, although many things in the United States remain uncertain, perpetual change in the healthcare system is a given. Most of the attendees I’ve met agree that adjusting to the tenets of healthcare reform are key issues for their companies and their clients.

The first session I attended was led by Linda Ireland, Chris Majai, and Paula Morgan, all partners in AVEUS. They discussed the importance of distinguishing change readiness from change management. Do you know the difference?

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by Karen Matthias, MBA, RN, Vice President, Sales and Marketing, Hayes, Inc.

I’m having a great time at the 11th Annual WBL Summit. The energy here is contagious! The healthcare leaders I’ve met are quite impressive; all bring unbelievable expertise to the meeting and to the industry. Of the 160 women executive leaders in attendance this year, about 50% are first-time attendees, representing many areas of healthcare.

Three themes emerged yesterday, the opening day of the Summit:

• Networking.
• Managing change.
• Identifying and promoting women leaders to serve as members of executive boards, with the goal of having women serving on at least 30% of boards of directors in the future.

Tags: women's business leaders
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by Karen Matthias, MBA, RN, Vice President, Sales and Marketing, Hayes, Inc.

Physicians often have preferences with regard to the contrast media they prefer. However, without an evidence-based comparison of the safety, utility, and diagnostic performance of competing products, the contrast agent used may not be the best product from a clinical performance perspective. Using an evidence-based approach can balance the marketing hype and physician preference that sometimes drives the selection of contrast media.

We’d like to commend our colleagues, Pamela Johnson, RN, MHA, Administrator, Imaging & Cardiology Resource Management, from Dignity Health, and Nancy Cahill, PharmD, from Cardinal Health Pharmacy Solutions, for leading the development of an evidence-based methodology for contrast media selection in the Dignity Health system. They will be sharing this process and the clinical and operational outcomes achieved at a complimentary webinar on Tuesday, March 27, 2012, from 2:00 PM to 3:00 PM EDT.

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By Karen Matthias, MBA, RN, Vice President, Sales and Marketing, Hayes, Inc.

Each year the Women Business Leaders of the U.S. Health Care Industry Foundation™, WBL for short, sponsors great opportunities for women serving in a senior executive capacity in the U.S. healthcare industry. This month, I’ll be racking up more frequent flyer miles as I head to Las Vegas for the 2012 WBL Summit on March 14 to 16. This year’s theme is “Ahead of the Curve: Leading Industry Change.” You can learn more about the conference agenda here.

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by Karen Matthias, MBA, RN, Vice President, Sales and Marketing

We all have family members or know others who suffer from some degree of coronary artery disease (CAD). Did you know that this is the most common type of heart disease and is the leading cause of death in the United States for both men and women?

Treating CAD involves improving blood flow to the heart by opening up blocked arteries or replacing diseased arteries with healthy vessels from another part of the body in a procedure known as coronary artery bypass grafting (CABG), commonly referred to as open heart surgery. Minimally invasive coronary artery bypass grafting (MI-CABG) techniques have been introduced as alternatives in order to improve patient outcomes.

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by Diane Allingham-Hawkins, PhD, FCCMG, FACMG, Director, Genetic Test Evaluation Services (follow on Twitter)

If you encounter CPT codes at all in your work, you should be aware that the first series of new CPT codes for molecular testing went into effect on January 1, 2012. In our opinion, that’s a good thing, since the new CPT codes provide payers and providers with clarity regarding the type of testing being requested and/or performed.

So that our clients can make informed decisions about managing and paying for these molecular tests, we’ve posted initial reviews of the evidence for the diseases and tests associated with all of the 193 newly implemented codes. We’ve also created a new section on our website that lists all available GTE topics that correspond with these new CPT codes. If you’re already a Hayes’ GTE client, you can access all of our evidence reviews through the Knowledge Center. If you’re not a Hayes’ GTE client, you can download a sample GTE report here after completing a short registration form. You can also purchase any of our reports individually. Contact us for more information.

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by Jill Shuman, MS, ELS, Managing Editor, News Service

According to a study published in the January 2012 issue of Health Affairs, the United States could improve clinical outcomes and save money by adopting the use of more disease registries. Disease registries are online databases that incorporate clinical information on a specific condition from many different physicians and patient populations.

Researchers from the Boston Consulting Group and 3 Swedish hospitals analyzed data from 13 disease registries in 5 countries (Sweden, Australia, Denmark, United Kingdom, United States) and across 6 major medical conditions or procedures—cataracts, rheumatology, cancer, joint replacement, cystic fibrosis, and ischemia/heart disease. In addition, a number of healthcare professionals were interviewed to learn more about how registries work in various countries and to identify how they might influence clinical practice.

Compared with the other four countries, the complexity of the U.S. healthcare system has hindered the widespread development and use of such registries. This is unfortunate, as the researchers were able to calculate specific examples of how U.S. registries might improve clinical outcomes and lower healthcare costs.
For example, if the United States was to implement a hip replacement registry such as the one maintained in Sweden, we could lower the revision rate by 10% in 2015 and save $2 billion of the expected $24 billion in costs for revisions in that same year. In another case study, the researchers calculated that a national cataract registry could decrease the incidence of postoperative endophthalmitis—a complication of cataract removal—by 8500 cases. This translates to savings of approximately $25 million per year in direct medical costs and $125 million in medical and social costs.

Tags: disease registries
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by Winifred S. Hayes, PhD, President and CEO, Hayes, Inc.

If you read this blog on a regular basis, you’ve heard me say before that one driver of the skyrocketing healthcare costs in the United States is our penchant for more of everything—more tests, more medications, and more treatments. Another contributor is the misperception that if a technology is new, high tech, and costs more, it must be better than an existing, cheaper one.

Nothing illustrates this better than the current rush to build expensive proton beam treatment facilities.

Tags: health technologies, proton beam treatment
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