Obama gives GOP 6-week deadline to get on board with healthcare package

WASHINGTON – At a White House healthcare summit held Thursday, President Barack Obama urged Republican congressional leaders to consider working on several areas of common interest in the healthcare reform package, giving them a rough 6-week deadline before Democrats may consider using alternative measures to pass the plan.

Obama named health insurance reform, the purchase of health insurance across state lines and medical liability reform among the top three areas where agreement could possibly be reached.

Republicans argued they wanted to scrap all proposals on the table and rework a set of smaller steps to reform healthcare.

For Democrats, starting over is not an option they said, because of the dire situation many Americans face.

According to Sen. Chris Dodd (D-Conn.), 14,000 Americans lose their healthcare daily, while six to eight Americans die per day because of no health insurance.

Democrats said healthcare reform is interconnected and cannot be tackled one step at a time. "We can't handle healthcare incrementally," Dodd said. "It has to be dealt with holistically. You can't get to quality and affordability, if you don't deal with coverage."

Much of the day's debate focused on coverage and whether or not it could be expanded without including more people in the insurance pool.

Sen. Tom Harkin (D-Iowa) said, "If you don't bring more people in together, the only people who get a break are the people who are healthy. People who are sick pay more. Is that what we want in this country?"

Republicans at the summit backed a health reform plan proposed by House Minority Leader John Beohner of Ohio, which would expand healthcare to some 3 million uninsured Americans.

The Democrat House and Senate bills, passed last year, would extend coverage to 30 million.

Sen. John McCain (R-Ariz.) said the unspoken issue overriding the entire summit was the threat of Democrats using an alternative measure to pass a bill with a simple majority, rather than the 60 that would be normally required in the Senate.

The special mechanism, called "reconciliation," was never meant to be used for issues that involve 17 percent of the Gross Domestic Product, as healthcare does, McCain said.

President Obama and Speaker of the House Nancy Pelosi (D-Calif.) would not guarantee that they would not use the method to pass a healthcare reform bill, when asked directly by several Republicans during the summit.

Obama said, "We cannot have another year-long debate about this."

"So the question that I'm going to ask myself and I ask of all of you is, is there enough serious effort that in a month's time or a few weeks' time or six weeks' time, we could actually resolve something," Obama said. "And if we can't, then I think we've got to go ahead and make some decisions and then that's what elections are for."

"We have honest disagreements about the vision for the country and we'll go ahead and test those out over the next several months till November," he said.

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Obama releases his own plan for healthcare reform

WASHINGTON – As Congressional leaders prepare for Thursday's White House summit on healthcare reform, President Barack Obama has released his own version of a healthcare reform plan.

Obama said his plan would put American families and small business owners in control of their own healthcare and build on legislation passed by the House and Senate last year, with a focus on providing health insurance reform "that lowers costs, guarantees choices and enhances quality healthcare for all Americans."

A White House statement on Monday said, "The president has long said he is open to any good ideas for reforming our healthcare system, and he looks forward to discussing ideas for further improvements from Republicans and Democrats at an open, bipartisan meeting on Thursday."

According to the White House, the Obama proposal would make healthcare more affordable, make health insurers more accountable, expand health coverage to all Americans and make the health system sustainable, stabilizing family budgets, the Federal budget and the economy.

"It makes insurance more affordable by providing the largest middle class tax cut for healthcare in history, reducing premium costs for tens of millions of families and small business owners who are priced out of coverage today," according to the White House. "This helps over 31 million Americans afford healthcare who do not get it today – and makes coverage more affordable for many more."

The White House said the Obama plan would also:

• set up a new competitive health insurance market, giving tens of millions of Americans the same insurance choices that members of Congress will have;


• bring greater accountability to healthcare by laying out so-called "rules of the road" to keep premiums down and prevent insurance industry abuses and denial of care;


• end discrimination against Americans with pre-existing conditions; and


• put the budget and economy on a more stable path by reducing the deficit by $100 billion over the next 10 years – and about $1 trillion over the second decade – by cutting government overspending and reining in waste, fraud and abuse.

The plan would also provide significant additional financing to all states for the expansion of Medicaid, eliminating any promised favoritism in bills proposed by Congress.

Data warehousing in healthcare: what is it and why do it?

In its 1996 Data Warehouse Roadmap, the Data Warehouse Institute outlines a number factors which help justify investment in a data warehouse. The Institute envisions these factors as only a starting block and maintains, logically, that every organization needs to review, at greater depth, the benefits of such an investment in its own unique business environment. With this in mind, following is a look at the benefits of data warehousing, using these factors as a framework. But first, what is a data warehouse and how does it differ from a transactional database.?Data Warehouse Defined

A data warehouse is essentially a large-scale central database loaded with information from multiple operating databases, for the express purpose of easy end-user access and decision support. It consolidates disparate data sources, making available the resources to support information generation critical to making strategic business decisions.

A data warehouse differs from a transactional system in that the data it contains is static and updated in a scheduled manner in massive loads. Data from multiple and disparate operational systems is brought into a data warehouse and "normalized." In this new environment, previously prohibitive data formats are stripped away, leaving a virtually limitless, user-friendly, uniform data format. In other words, a data warehouse readies inaccessible, disparate data for transformation into usable business information. This fact alone spawns the majority of the benefits of data warehousing. These benefits include, but are not limited to, the following:

Newly Enabled Workers
Historically, employees in need of strategic information have chosen from a limited number of reports available through MIS, submitted a request, and waited for as long as 30 days to get results. In addition, most healthcare organizations have been burdened by a multitude of disjointed sources of information. With a data warehouse, all of this disparate data can be pulled together and put into the hands of users. A data warehouse is specifically developed to give users the ability to explore data in an unlimited number of ways, accommodating essentially any query a manager could dream up, and providing access to the data sources which are behind the results. A data warehouse affords this ability to an increased number of employees, reduces the MIS report load and provides improved response time.

The user-driven nature of a data warehouse allows for exploration by users with a wide range of computer literacy, providing ready views for less experienced users and drill down and open query capabilities for those with more advanced skills. This benefit is particularly relevant considering the widespread decrease in the numbers of middle managers, who historically played the role of preparing and summarizing data for upper management.

Exposure to New Business Opportunities/Improved Cost Control
There are endless ways management can utilize a data warehouse for business gain. One is user-defined investigative querying. A manager, for example, can investigate resource utilization by a particular group of doctors or for a healthplan's different lines of business. In addition, a data warehouse performs a second, and very valuable, function by examining data for trends and abnormalities which users may not know to look for. In this way, the system can lead users toward hidden business opportunities and cost centers. For example, a data warehouse could assist healthcare organizations in detecting erroneous or fraudulent billing, identify patient or provider trends or uncover seemingly insignificant pockets of loss which, over extended periods, could become significant.

Improved Customer Bond
In addition to the constant pressure to reduce costs, healthcare organizations are increasingly confronted with demands to improve the quality, of care. As is often the case, knowledge is one key to improving the quality of care and thereby improving customer satisfaction. A data warehouse can help healthcare organizations watch trends in patient care and physician practices, utilize quality care measurements, and apply this knowledge for improved customer satisfaction.
For a healthcare organization, however, the patient is only one of many customers. Others include employers, providers, and the government. A data warehouse can help an organization meet the needs of these customers as well through decreased response time and improved reporting. Whether "customers" means patients, providers or whomever, an organization stands to benefit greatly by knowing its customers better.
Precise Marketing Tools
In addition to serving customers better, the knowledge gleaned through a data warehouse can improve a healthcare organization's reach to potential customers. Data warehouse reports can provide solid proof of the benefits the plan can offer, including indications of quality and efficiency of care. These "bragging rights" can help a healthcare organization differentiate itself from its competition. A data warehouse can aid in detecting geographic or demographic segments of the marketplace which remain untapped and help show the best way to reach out to these potential members. In addition, a data warehouse can help managers anticipate changes on the business horizon and assist them in altering their marketing plan accordingly. Finally, managers can utilize a data warehouse to measure the effectiveness of a particular marketing campaign, helping further maximize marketing dollars.

The obvious result of effective marketing and improved customer satisfaction is increased revenue. By engaging in more precise marketing tactics and more effectively meeting the needs of existing customers, an organization can increase its awareness and draw in business, thereby increasing its revenue intake. Also affecting revenue is the decision to enter new markets or offer new products or services.

A data warehouse can bolster revenue in more subtle ways as well. For example, information gleaned from a data warehouse can assist a managed care plan in deciding which type of contract to offer a potential member group. After simulating costs and profitability with different contract options, a healthplan can develop a more targeted proposal for a potential client, not to mention delivering a convincing sales presentation, complete with solid evidence of the plan's merits.

Ability to Respond More Rapidly to Key Business Events
It is important to think of a data warehouse as a strategic business tool. While the warehouse system itself may fall under the heading of information technology, the purpose of, benefits of, and responsibility for a data warehouse fall to management. A data warehouse is only as good as its ability to guide management in making strategic business decisions for the organization. Rapid reporting response and unlimited access to information translate into improved ability to anticipate, guide and respond to changes in a dynamic business atmosphere.

Ability to Respond More Rapially to Market and Technology Trends
By being aware of the marketplace and future trends, a healthcare organization can take advantage of the "first mover" principle, creating ownership of new offerings in the minds of consumers by coming to market first. A data warehouse can also help a healthcare organization forecast the potential profitability of new products and services and extend the life cycles of existing ones by adapting them appropriately. This is, once again, a result of knowing the customer and the marketplace.

Conclusion
While data warehousing is a significant task to undertake, the potential benefits are tremendous. The bottom line, however, is that it can help an organization succeed financially.

Ideally, warehousing should be viewed as an ongoing activity, wherein it is essential for managers to be intricately involved in planning, to reprogram the way they do business, and to make the warehouse an indispensible advisor. By incoporating the technology fully into business practices and by seeking to further apply the information available, a healthcare organization can assure that it is realizing maximum return on its investment in data warehousing.

Data Warehousing:
What's In It For You?
* Newly Enabled Workers
* Exposure to New Business Opportunities/Improved Cost Control
* Improved Customer Bond
* Precise Marketing Tools
* Increased Revenue
* Ability to Respond More Rapidly to Key Business Events
* Ability to Respond More Rapidly to Market and Technology Trends

New Jersey announces multi-payer portal to connect doctors with insurers

TRENTON, NJ – In a development that was compared for its convenience and usefulness to banks' establishment of ATM networks, NaviNet, the country's largest real-time healthcare communications network, announced Thursday it would partner with major health insurers in New Jersey to build a multi-payer portal as a "one-stop shop" for physicians to communicate directly with an array of health plans.

Developed in concert with two insurance trade groups – America’s Health Insurance Plans and the Blue Cross Blue Shield Association – NaviNet's Insurer Connect will offer providers easy communication with five of New Jersey's largest insurers: Aetna, AmeriHealth New Jersey, Cigna, Horizon Blue Cross Blue Shield of New Jersey, and United Healthcare.

"We absolutely believe that our coming together to use the NaviNet provider portal will be making better use of doctors' times and their staffs' times, will streamline services to our members and ultimately will improve quality and reduce costs," said Christy Bell, senior vice president of healthcare management for Horizon Blue Cross Blue Shield of New Jersey, on a conference call.

Doctors in New Jersey spend an average of $68,000 annually simply checking referrals and benefit eligibility, and ensuring their patients are enrolled in the correct plans, it was noted. Such expensive, "time-intensive, redundant administrative tasks add no value to the healthcare system, and [are of] no direct benefit to patients," said Sal Bernardo, MD, of the New Jersey Academy of Family Physicians, who uses the portal. "It's an "excessive amount of time on paperwork that could otherwise be spent on direct patient care."

Working to obviate that administrative burden of all those phone calls and faxes is the aim, said NaviNet president and CEO Brad Waugh. "We’ve seen positive feedback and results from the more than 50,000 New Jersey providers that already use NaviNet on behalf of 95 percent of the state’s commercially insured population, so we’re confident that this initiative will improve efficiencies as well as deliver a foundation for a comprehensive national health information exchange.”

"Over the years," noted Bell, "healthcare has become very complex, with inherent tensions built into the system, and that's eroded trust between the parties that really do need to work together. [There are] many different carriers doctors have to deal with, different coverages they have to deal with, and these different coverages may have different rules….  This collaboration will reduce that complexity and improve interactions and relationships."

“In order to ensure our patients receive the best possible care in a timely manner, family physicians are always eager to find a more uniform, efficient and cost effective manner in which to exchange patient information with health plans," said Stephen Nurkiewicz, MD, president, New Jersey Academy of Family Physicians. "In this current healthcare delivery system, family medicine and other primary care practices must make a significant investment in their front desk staff time managing these types of communications with multiple health plans in New Jersey.  We are hopeful that the NaviNet Web-based portal will provide a uniform means to interact with health plans and access a broad range of information for our patients from a single Web site in real time."

iPhone app to keep track of alcohol units

The NHS has launched a free iPhone app to let people keep track of how much alcohol they are drinking.

By Rebecca Smith, Medical Editor
Published: 6:45AM GMT 01 Dec 2009

Drinkers will be able to keep track of their units with a new iphone app launched by the Department of Health Photo: PAUL GROVER

The new application was launched by Gillian Merron, public health minister, as the festive party season gets under way to help people keep track of their alcohol consumption.

The device which can be downloaded onto smart phones like the iPhone, will allow users to see how many units of alcohol there are in their drink, keep a running total of their consumption and get personalised feedback on their drinking habits.

Studies have shown that people underestimate how much alcohol they have drunk on a night out and may exceed the safe limits without realizing it.

Recommended limits are two to three units a day for women - the equivalent of a medium to a large glass of wine - and three to four a day for men - a large glass to a glass and a half, or two pints - with at least two alcohol-free days a week.

Because of the increasing strength of alcoholic drinks and the trend for larger measures, one large glass of wine now counts as three units, a medium glass as two and a small glass as one-and-a-half.

Research earlier this year by Government statisticians showed more than 7 million middle-class drinkers are putting their health at risk by enjoying evenings at home with a bottle of wine.

Public Health Minister, Gillian Merron said: “It is all too easy to lose track of how much you drink. So as the festive parties start to build up, this innovative tool will help people keep tabs on their drinking – wherever they are.

“It’s one of many ways the Government is helping people to understand how much they are drinking. Sticking within the NHS recommended limits means you reduce the risk of serious conditions such as mouth cancer and strokes.”

Chris Sorek, Chief Executive of Drinkaware, said: “Efforts to help people keep track of how much they’re drinking over the festive season and throughout the year are a good idea. Trying to stick within the daily unit guidelines will help people avoid the January slump and the long term health implications associated with drinking too much alcohol.”

The app is available from iTunes and www.nhs.uk and people who do not have a smart phone can text the word UNIT to 64746 and receive information on the NHS Choices alcohol unit calculator.

The application can be found at:http://www.nhs.uk/Tools/Pages/NHSAlcoholtracker.aspx