Grab a cup of coffee (the good stuff, not the institutional brew many employers inflict upon us) and relax in your office chair, because it’s time for another exciting installment of “Industry News of the Week.”
Health Care Quality
- CMS announced a delay of the two-midnight rule until after September 30. Small victories.
- Medical Group Management Association finds that fewer than 10 percent of physician practices are, at this point, ready for ICD-10 deployment. This low level of preparedness constitutes a significant red flag: ICD-10 transition is tough work, even for small practices, and the clock is ticking ever closer to midnight.
- Could it be? There appears to be bipartisan support for a permanent solution to the doc fix.
- Sarah Kliff of WaPo’s Wonkblog argues that expensive hospitals aren’t better hospitals.
- Some California hospitals are perfecting “hot-spotting” — identifying their highest-volume users of inefficient services (e.g., ER frequent flyers) for interventions intended to reduce costs and improve health. The Affordable Care Act’s financial incentives for avoiding hospitalization make this kind of intervention more attractive for facilities with unbalanced utilization patterns.
- … and related to hot-spotting, some hospitals are trying to affect the various social determinants of health, but the strategy may be risky in a fee-for-service system.
- Insurers are facing more pressure to widen physician networks in Exchange plans, in light of outcry about people losing their doctors.
- The American College of Emergency Physicians has released an emergency dashboard with state-by-state rankings (spoiler: we’re doomed) and various calls to action. The website is interesting, in its way, but it relies on questionable assumptions to advance a specific policy position. For example, 15 percent of a state’s grade relate to “public health and injury prevention” behaviors with a host of metrics that have absolutely nothing to do with E/R or hospital performance (e.g., “gun-purchasing legislation,” “unintentional fall-related fatal injuries per 100,000 population”). Reliance on scare tactics means this dashboard is best understood as an advocacy strategy, not a quality-improvement tool.
- Earlier this week we learned that Medtronic, Boston Scientific and St. Jude Medical were hacked sometime last year. Cybersecurity isn’t just about the government; increasingly, hackers are looking to steal consumer data, intellectual property and other electronic assets. Although hospitals and insurers are strengthening their defenses, there are many vectors of infection — including, alas, network-connected medical devices that may have no security protocols whatsoever. Remain vigilant and press for security assessments as part of any RFP evaluation.
- The ACA’s employer mandate is getting delayed yet again.
Statistics & Methodology
- For a quick foray into learning R — with an emphasis on linear modeling and logistic regression — check out Introducing R by German Rodriguez of Princeton University. The tutorial is available online or as a PDF.
- Rick Haynes offers some interesting perspective on whether minimum sample sizes are truly relevant.
- Bayesian alternatives to classical hypothesis tests can help when you can’t or shouldn’t assume normality.
- The Revolution Analytics January blog round-up can help fill you in on the latest and greatest about R.
- Hate coding in the console? R offers several different graphical user interfaces worth checking out.
- Read the latest e-newsletter (Feb. 2) from the Data Science Association, filled with articles, videos and resources. (Click here for Feb. 9.)
- Heretical though it may be for some hard-core data folks to accept, Microsoft has a fairly powerful “Power BI” module for Excel that includes natural language querying. May be worth a look, especially for shops with lots of people who can think clearly with data but may not have the expertise to use full-fledged statistical or visualization tools.
- A new blog to help readers gain data literacy looks promising so far. Check out Statsguys for their three-part “data analytics for beginners.”
- The data/statistics weekly round-up by Jeff Leek remains an invaluable resource. Check it out.
- Bonnie Dixon offers a great tutorial about using dates and times in R. The R Trader blog offers a “million” ways to connect R and Excel.
- For your daily dose of creative data-viz: Try mixing your metaphors a bit.
- The February issue of the News from the World of Statistics newsletter is now available.
Notes from Jason
- Stay warm, and stay safe. If you pay an unexpected visit to my house, beware the Icicle of Doom.