By Jason Gillikin | February 19, 2014
Tidbits for you to enjoy over your morning coffee:
Health Care Quality
- The Centers for Continuous Regulatory Rescheduling — oops, I mean, the Centers for Medicare and Medicaid Services — pushed the EHR meaningful-use reporting by a month. Data are now due by 11:59 p.m. on March 31, instead of February 28.
- Dr. Lisa Bielamowicz, writing in The Advsiory Board’s Care Transformation Center Blog, suggested (last October) that patient-centered medical homes may be “a blind alley on the way toward a more highly evolved form of population health management.” Interesting perspective.
- In the current issue of Diabetes Care, Wei, Zheng and Nathan offer blood glucose targets to achieve HbA1c goals. The implication is that glucose and A1c targets haven’t been in sync to date.
- The American College of Physicians has decried the narrow networks in ACA plans. ACP suggests that, according to Medscape, “health plans should not select providers solely on the basis of cost, and the criteria used should reflect national quality standards, and be made public.” Which makes sense. Except for one thing: The ACA’s dollar targets require cost-containment measures to meet the standards imposed by the law while remaining relatively cost-efficient. If all the salient characteristics of a health plan should be price-insensitive, then the final bill to the consumer will be very high — “sticker shock.” Quality, access and cost are three legs of a stool: Maximize one, the others have to follow, or the whole stool becomes unbalanced.
- Have you heard of MIPS? The Merit-Based Incentive Payment System is intended to shift Medicare reimbursement from fee-for-service to pay-for-performance, with three current Medicare bonus/penalty programs rolled into it (including Meaningful Use). The bill to propose MIPS also would repeal the sustainable growth rate formula for physician reimbursement. The package was introduced into various Congressional committees last week. Stay tuned.
- A study released in BMJ suggests there’s no material benefit to annual mammograms for women aged 40 to 59, with the usual caveats, and that the rate of over-diagnosis of breast cancer from mammography screenings was 22 percent.
- Most folks aren’t fully ready for ICD-10. But on the bright side, ICD-11 was kicked down the road a few more years by the World Health Organization. The newest version is now due in 2017.
Statistics & Methodology
- Kaiser Fung raises a good point in a recent blog post. The short version: “Doing data analysis is a good first step. The bigger challenge is pushing people with preconceptions to believe the analysis (with all its imperfections and assumptions) and to change their minds.”
- I’ve recently linked to stories that are somewhat critical of p-values — including, right now, Regina Nuzzo’s piece in Nature about statistical errors in the scientific method. Jeff Leek of the Simply Statistics blog counters that “the problem is not p-values, it is a fundamental shortage of data analytic skill.”
- The R for Public Health blog offers a nice cheat sheet for using ggplot2 for visualizing distributions.
- More links/resources on the Feb. 16 issue of the Data Science Association newsletter.
- Cost estimation in health care isn’t advanced by tying price levels to various metals.
Notes from Jason
- Remember last week’s Icicle of Doom? Be glad you didn’t pay me a visit at 6:45 this morning. The two-story ice behemoth finally broke free … and crashed into my living-room window. One of my feline overlords was sleeping on my chest, so when gravity prevailed, I ended up thiiiiiis close to being America’s first recipient of a cat-administered tracheotomy.
Have a safe and happy week!