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Often times, when medical providers weigh in about quality metrics in medicine, they complain that the metrics are generally invalid and shouldn't be used. Those responses tend to be less helpful since patients think that selecting a provider can have a meaningful impact on outcomes and that there must be a way of comparing providers. Simply asking patients to select providers based on advertising or reputation seems to ring hollow. The CEO of Mayo Clinic, Dr. John Noseworthy, wrote an editorial expressing specific criticisms around the current methods of rating hospitals regarding patient attribution and categorization. Rather than broadly dismissing quality metrics, Dr. Noseworthy identifies two areas that can be improved, allowing the discussion to move forward.

Often times, when medical providers weigh in about quality metrics in medicine, they complain that the metrics are generally invalid and shouldn't be used. Those responses tend to be less helpful since patients think that selecting a provider can have a meaningful impact on outcomes and that there must be a way of comparing providers. Simply asking patients to select providers based on advertising or reputation seems to ring hollow. The CEO of Mayo Clinic, Dr. John Noseworthy, wrote an editorial expressing specific criticisms around the current methods of rating hospitals regarding patient attribution and categorization. Rather than broadly dismissing quality metrics, Dr. Noseworthy identifies two areas that can be improved, allowing the discussion to move forward.

As Dr. Noseworthy pointed out, Mayo Clinic was among the small number of hospitals to receive a five-star rating from CMS. It would have been easy for Mayo to simply ride its reputation and current rating, so it's commendable that they are taking this public stance to improve industry metrics.

HealthCare.gov has tried to make it easier for consumers to compare insurance plans. At the time of launch, HealthCare.gov tried something that I hadn't seen before: standardize insurance plans into various metallic tiers. Consumers could quickly look at a plan and understand which other options were comparable without wading through the details. Kaiser Health News

HealthCare.gov has tried to make it easier for consumers to compare insurance plans. At the time of launch, HealthCare.gov tried something that I hadn't seen before: standardize insurance plans into various metallic tiers. Consumers could quickly look at a plan and understand which other options were comparable without wading through the details. Kaiser Health News Read more

The world of prescription drug distribution can be complicated and confusing. Bloomberg reported on an interesting angle: the world of large manufacturer rebates may be coming up against the world of high deductibles. For historical reasons, many pharmaceutical manufacturers end up pricing their product expensively, but offering a significant rebate to offset some of that cost. As long as the insurer was paying for the medications, it made sense that the insurers would also receive the rebates. However, as deductibles have risen, more patients are paying full-price for their prescriptions, and the distribution system is not set up to send the rebates to the people who actually paid, but rather the traditional recipients, the insurers. The result certainly seems incorrect, but I can also see how the solution would be non-trivial.

The world of prescription drug distribution can be complicated and confusing. Bloomberg reported on an interesting angle: the world of large manufacturer rebates may be coming up against the world of high deductibles. For historical reasons, many pharmaceutical manufacturers end up pricing their product expensively, but offering a significant rebate to offset some of that cost. As long as the insurer was paying for the medications, it made sense that the insurers would also receive the rebates. However, as deductibles have risen, more patients are paying full-price for their prescriptions, and the distribution system is not set up to send the rebates to the people who actually paid, but rather the traditional recipients, the insurers. The result certainly seems incorrect, but I can also see how the solution would be non-trivial.

The healthcare industry has had decades of assuming a third-party payer, and now that patients are increasingly responsible for a significant portion of their own costs, the industry finds itself needing to course-correct.

Earlier this year, Kaiser Health News reported on a study conducted on provider directories. People posing as patients called provider offices to try to make appointments with providers using information listed in the directories of some large insurers. The study found that the callers could only schedule an appointment with a primary care doctor less than 30 percent of the time.

Earlier this year, Kaiser Health News reported on a study conducted on provider directories. People posing as patients called provider offices to try to make appointments with providers using information listed in the directories of some large insurers. The study found that the callers could only schedule an appointment with a primary care doctor less than 30 percent of the time.

Somewhat alarming is that about a third of the time, callers were told that the doctors' specialty information was listed incorrectly. A reasonable case can be made for how difficult it can be to update changing information such as whether a doctor is accepting new patients and even phone numbers, but doctors' specialties do not change that frequently.

The insurers were fined what seemed like relatively small fines for the size of their operations. This summer, a new law in California took effect, requiring insurers to update their directories more frequently. It'll be interesting to see whether such the government will effectively enforce such regulation.

Earlier this year, we participated in a contest sponsored by Robert Wood Johnson Foundation (RWJF) and ProPublica to leverage data from Medicare to help patients select physicians. Health 2.0 announced today that we won first place. We're grateful to the sponsors and organizer, and we're delighted at the result. This was a fun contest to participate in, and we hope to incorporate our work from the contest into our publicly available service.

Earlier this year, we participated in a contest sponsored by Robert Wood Johnson Foundation (RWJF) and ProPublica to leverage data from Medicare to help patients select physicians. Health 2.0 announced today that we won first place. We're grateful to the sponsors and organizer, and we're delighted at the result. This was a fun contest to participate in, and we hope to incorporate our work from the contest into our publicly available service.

The key data set that we have not yet integrated into our public website yet is the demographics and conditions data set that Medicare recently released. This data set includes information about the patients that specific physicians treat, aggregated at the physician level (e.g. 15% of Dr. Smith's Medicare patients are Hispanic or 5% have asthma). This detailed information gives patients a powerful tool to help them find physicians that have treated other patients like themselves.

In this context, we were also able to experiment with some innovative ways of visually representing data. We look forward to integrating those displays in the coming months.

Thanks to Ningning for spearheading this effort, and thanks to Robert Wood Johnson Foundation and ProPublica for their sponsorship!