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There have been conflicting papers on the usefulness of online patient reviews as a proxy for quality, and NYS Health Foundation just released a paper in its favor. Previous studies looked at the correlation between online patient reviews and results of a survey known as HCAHPS, while this study assessed the correlation between online reviews and a New York state data set known as SPARCS.

There have been conflicting papers on the usefulness of online patient reviews as a proxy for quality, and NYS Health Foundation just released a paper in its favor. Previous studies looked at the correlation between online patient reviews and results of a survey known as HCAHPS, while this study assessed the correlation between online reviews and a New York state data set known as SPARCS. SPARCS, or Statewide Planning and Research Cooperative System, collects outcomes data and publishes risk-adjusted mortality rates for certain cardiothoracic procedures. This data represents something closer to what we typically think of as quality than the HCAHPS survey.

New York's decision to collect and publish this data was initially controversial, with some affected providers threatening to leave the state. Hopefully, New York will expand the data collection to cover other specialties. Even better would be for other states to follow suit.

Kaiser Health News published a brief follow-up to last year's news that Alaska's legislature stepped in to prevent the collapse of its individual market. Last year, the state was down to just one insurer who was sustaining losses. The state's individual market might have been an example of a death spiral: once premiums are high enough, some healthy individuals stop buying insurance, gambling that they won't incur significant health care costs in the next year. Since those who remain tended to have more healthcare costs on average, insurers would need to raise premiums on everyone who remains to cover costs. As a result, some more healthy individuals decide to stop buying insurance, intensifying the cycle. Seeing the imminent collapse of the individual market, the legislature of Alaska stepped in with a broad-based tax (taxing all insurance companies in the state) to offset the high costs associated with the individual market.

Kaiser Health News published a brief follow-up to last year's news that Alaska's legislature stepped in to prevent the collapse of its individual market. Last year, the state was down to just one insurer who was sustaining losses. The state's individual market might have been an example of a death spiral: once premiums are high enough, some healthy individuals stop buying insurance, gambling that they won't incur significant health care costs in the next year. Since those who remain tended to have more healthcare costs on average, insurers would need to raise premiums on everyone who remains to cover costs. As a result, some more healthy individuals decide to stop buying insurance, intensifying the cycle. Seeing the imminent collapse of the individual market, the legislature of Alaska stepped in with a broad-based tax (taxing all insurance companies in the state) to offset the high costs associated with the individual market.

The hope is that the subsidy (which comes from a much larger pool of people and cannot be avoided, rather than simply those who buy individual insurance) is enough to reverse the spiral by keeping premiums at a more palatable level. The results from the first year seem positive. Likely, the architects of the Affordable Care Act likely wanted to do something similar, but thought that it would have been politically infeasible to pass the legislation with an explicit tax. Instead, they settled on the concept of an individual mandate, a penalty that may have been reduced too much for its original purpose of keeping healthy people in the insurance pool.

Historically, the medical community has been reluctant to measure and publish physician performance data, making it difficult for consumers to compare one provider to another. In this age of sophisticated consumerism, the medical community may be feeling pressure to change, especially as healthcare institutions figure out how to compete with one another in a era of limited reimbursement growth. In an article about Leapfrog's efforts to establish minimum procedure volumes for certain procedures, the chief medical officer of Virginia Hospital Center, Dr. Jeffrey DiLisi, argued for the disclosure of outcomes data so that patients can make informed choices. While such voices may be rare in the medical community, it is encouraging to see at least someone in such a position push for transparency.

Historically, the medical community has been reluctant to measure and publish physician performance data, making it difficult for consumers to compare one provider to another. In this age of sophisticated consumerism, the medical community may be feeling pressure to change, especially as healthcare institutions figure out how to compete with one another in a era of limited reimbursement growth. In an article about Leapfrog's efforts to establish minimum procedure volumes for certain procedures, the chief medical officer of Virginia Hospital Center, Dr. Jeffrey DiLisi, argued for the disclosure of outcomes data so that patients can make informed choices. While such voices may be rare in the medical community, it is encouraging to see at least someone in such a position push for transparency.

One would expect that institutions that perform well to push for the disclosure of quality data. In the long run, one might imagine some institutions highlighting their risk-adjusted outcomes, while other institutions highlight their low prices.

Kaiser Health News reports that congressmen have introduced legislation to allow US citizens to import medications from other countries (starting with Canada). A bill like this will certainly find resonance among many who are already importing medications and also among some of those who struggle with the high prices of medications. PhRMA, a trade group representing the pharmaceutical industry, objected to the legislation, claiming insufficient safety measures. As described, the bill seems to take a sensible approach towards safety, with foreign pharmacies paying for licenses and inspections from the FDA.

Kaiser Health News reports that congressmen have introduced legislation to allow US citizens to import medications from other countries (starting with Canada). A bill like this will certainly find resonance among many who are already importing medications and also among some of those who struggle with the high prices of medications. PhRMA, a trade group representing the pharmaceutical industry, objected to the legislation, claiming insufficient safety measures. As described, the bill seems to take a sensible approach towards safety, with foreign pharmacies paying for licenses and inspections from the FDA.

Pharmaceutical companies have long charged Americans higher prices, in large part because the regulatory environment allows it. Pharmaceutical companies have less leverage in other countries, which may cap the prices that can be charged. The bulk of the companies' revenues may be from the US, and the companies can charge what they can get in other countries. This arrangement essentially means that US subsidizes drug development (and operations) for the rest of the world. Understandably, pharmaceutical companies are hesitant to see the current arrangement change.

Recently, we've made a flurry of changes to our website to make it more accessible to users who might have visual impairment or difficulty using the keyboard. There's a standard for this called WCAG, and we've been reviewing its guidelines and looking at various examples. If you find any consumer-facing functionality that doesn't seem to work, please let us know.

Recently, we've made a flurry of changes to our website to make it more accessible to users who might have visual impairment or difficulty using the keyboard. There's a standard for this called WCAG, and we've been reviewing its guidelines and looking at various examples. If you find any consumer-facing functionality that doesn't seem to work, please let us know.

This is just one milestone in a bigger project of updating the entire website. There will be more news to come on that front as we make additional progress.