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5 Technologies Shaping the Future of Healthcare

From implants to self-diagnosis, innovation is growing in the medical industry, and can soon transform healthcare all together. Although technology has already evolved since the development of the microscope back in the 17th century, the health industry is still welcoming more advances to medical and surgical tools, as well as new ways to make effective medicines and vaccines.

In this article, we’ll take a look at the five ways that technology is pushing the medical industry to another level, and shaping the future of healthcare.

1. 3D-Printed Prosthetics

“Prosthetics are one of the most requested products in the medical industry, especially with amputee patients,” says Michael Keener, a business writer at Boom Essays and Academized. “And with 3D printing, it’s now easier to create prosthetic limbs, and make these products more accessible to people worldwide. Ever since the success of the 3D-printed mini heart, now 3D printers are a must-have.” 

2. Biosensing Contact Lens

Recently introduced by UNIST’s team of researchers, biosensing contact lens will be able to detect glucose levels in diabetic patients, whenever there are tears in the eye. Having built-in transparent electronics, the lens, fortunately, won’t bother people who wear them. Sounds amazing, right?

And although the lenses aren’t in the market yet, UNIST is hopeful that they’ll soon be available in the near future. 

3. Virtual Reality (VR)

VR is no longer reserved for video games. In fact, both patients and doctors can use VR to see what’s going on – whether surgeons are using it for noninvasive procedures, or patients want a virtual escape while they’re recovering from surgery in a hospital bed. 

In addition, VR software like Osso VR and ImmersiveTouch help future surgeons train for the real deal, and lets experienced surgeons and physicians perfect their operations and methods. According to a recent study from Harvard Business Review, VR-trained surgeons did around 230% better in their overall performance – faster and more accurate in performing surgeries – than traditionally-trained surgeons.

VR also makes surgery and post-operation less painful for patients. With VR being as noninvasive as possible, patients suffering from things like gastrointestinal, cardiac, and neurological problems find them less painful when using VR to visualize soothing images and scenarios to distract them from what’s going on. Even women in labor can use VR to distract them from labor pains. With VR, the hospital experience is less stressful for patients.

4. Wearable Trackers And Sensors

With wearable trackers like Fitbit, it has never been easier for people to track their steps and heart rate. But pretty soon, these types of trackers and sensors will be able to detect one’s health status, so that people can take better control of their lives. Whether you’re looking to manage your weight, have lower stress levels, check on your body cognitively, or find a good level to be fit and active, wearable trackers and sensors will soon be able to do those things.

Here are some of the technological advances to date:

  • Fitbit Ionic – Lets you monitor your sleep, and even tracks your workout.
  • Polar H10 – Helps you find the best exercises for you, and fine-tune your current practices. (Wear this with the Fitbit Ionic, if you desire.)
  • The Muse Headband – Helps you focus on the major things that make your meditation session successful.

Now more than ever, it’s easier for people to track their health, and get a better hold of what they would need to do to stay healthy and active. 

5. Nanotech

“Nanomedicine will soon be a reality, if not now,” says Hollie Kelly, a project manager at Bestbritishessays and Academ advisor. “People are already seeing nanoparticles and nanodevices as our drug delivery systems, tiny surgeons, and cancer treatment tools.”

For example, there is already talk about smart pills like the PillCam, which is a noninvasive, electronic pill that can relay diagnostic information about the patient and or release necessary medication via smartphone. The medical industry is hoping that these smart pills can take biopsy samples for further analysis, or take the place of traditional, invasive surgeries.

Conclusion

With technology already changing our world at a rapid pace, healthcare will surely benefit from innovations from technological advances. Although these technological advances may not show up overnight, you can rest assured that doctors, physicians, surgeons, and developers are working towards these solutions, and promising a brighter future in healthcare.


Molly Crockett writes for Ukservicesreviews.com and Big Assignments. She also writes articles about writing and editing on Best Coursework Services. As a marketing writer, she shares her unique lifestyle tips and personal development advice with her audience.

Steps to Improve Patient Access to Online Services

The telehealth market is expected to experience an 80% year on year growth in 2020 as a result of the pandemic, with telehealth services easing the burden on traditional healthcare systems by urging patients with mild or moderate ailments to use web-based applications for treatment or management. Telemedicine also takes the lead in the cancer care strategy during the coronavirus outbreak and will continue to play a role in the future to support symptom management, lifestyle changes, and medication protocols. Therefore, access to online services to support patients with cancer is crucial to coordinate care from availing of financial aid and medical services to legal and psychological support. Empowering the patient to take control of their overall care using internet-based technologies can improve care coordination with medical and legal professionals and may also reduce the burden on the health care system.

Learn to Navigate the Web

Of vital importance to accessing online services is knowing how to use the internet to search for resources that you may need. In addition to the basics of having an email that you use to communicate, you must familiarize yourself with the main features of browsers such as clearing cache, bookmarking, and viewing history as well as the practicality of tabbed browsing.

Another important aspect of being internet savvy is to learn to use search engines such as Google, Bing, or Duck Duck Go effectively that will enable you to find answers to queries on all types of subjects. Know that you can also filter and refine your search to yield results that are suitable to your queries. Hence, if you are looking for lawyers that can help you find financial assistance for your cancer treatment, it will save you time since most professional websites are optimized for search engines nowadays. Professional sites do this by providing relevant and authoritative content that are useful to website visitors ranking them high whenever a query is typed in the search engine and results are displayed. Keywords that are often used by surfers are also incorporated in the text and articles of sites, making these portals easy to find by search engines.

Retrieve Information and Benefit From Online Access

Now that you are confident about using internet technology, there are many things that you can do online to assist in your cancer care management. One of the constraints in cancer care is health insurance. Access to government portals and organization websites such as the Social Security Administration (SSA) for disability insurance benefits or the Cancer Financial Assistance Coalition (CFAC) which offers a data base of financial resources can already give you leads on where to get financial aid.

Although many people are benefiting from treatment outside of hospitals due to mounting medical costs, declining number of doctors, and an older cohort of patients who are living longer, outpatient care can lead to a decrease in support delivered by health care staff. The good news is internet-based tech including patient portals, websites, and apps can tip the scale to balance the perceived support deficiency.

The ability to access health records, choose health providers and place of treatment, book and cancel appointments online, find psychological support, and order prescription refills virtually are major steps in cancer care management. Telephony is also another feature of the internet offering free phone calls if a patient needs to talk to a healthcare provider or specialist urgently. Other forms of communication with doctors and hospitals include forums such as message boards and instant messaging. Mobile applications to track and fight cancer also make it easy for patients to sign up for trials and access research results and other information on the go.

Improved access to online services by learning to navigate the web efficiently and effectively can open up an entire virtual world to a person with cancer. It also empowers a patient by managing the coordination of their condition with different actors such as oncologists, lawyers, therapists, and psychologists.

Health Fraud Scam – Be Aware and Careful

Avoiding health care scams can be as simple as not signing blank forms, not providing personal information to unknown parties, and not agreeing to schemes to make money by falsifying paperwork.

Unfortunately, there is a scammer for every medical condition or concern. People who are suffering from conditions like cancer and its harsh treatment regimen may be confused and belittled by persistent phone calls or emails but there are ways to fight back.

How it Works

Healthcare fraud is a way of billing health insurers or government programs like Medicaid out of money through a system of fake, unnecessary, or inflated bills. An unscrupulous doctor may offer you cash in exchange for your signature on a permission form that will allow him to bill for fake services.

Others, including people who show up at retirement homes or senior activity centers, may offer to provide  a medical “test” of some kind, whether eyesight or hearing, etc. The individual then bills your insurer or Medicaid an exorbitant amount for the useless service – or gets added to your monthly regimen of providers despite the service or monitoring not being necessary. A new wrinkle in this phishing scam are people who offer to provide a “genetic test” using a cheek swab at a healthcare fair, senior center, or other forum, and who have you fill out medical insurance information at the same time. They will then try to bill your insurance for the unnecessary “test” and may pursue you for the cost if your insurance refuses to pay.

Medical equipment, from oxygen tanks to catheters to shower chairs, may be provided by scammers who bill your healthcare insurance despite the item being either unnecessary or absurdly high-price. If you accept medical equipment, be sure it’s recommended by your regular doctor, that it’s necessary, and that you shop around for the best price rather than just signing an authorization that allows the provider to bill any amount.

Home health aides may be assigned to your home and billed to your insurance but never show up to provide a service. Keep an eye on your billing statements to be sure this sort of fraud is not showing up on your account, and call your provider if you see anything suspicious.

How to Avoid Healthcare Scams

To protect yourself from such scams use tools at your disposal, such as reverse email lookup, confirm website addresses and compare them to actual government websites you find on your own, or call your health insurance provider if you’re suspicious about a bill, a caller, or an unwanted package of medical equipment. Here are other tips to follow:

  • Never sign a blank healthcare or medical form that authorizes payment in exchange for a treatment (such as that described above) that was not planned and authorized by your usual medical team.
  • Do not accept unnecessary equipment that you did not order and do not use, like braces, apnea devices, or orthotics.
  • Watch your billing statements for any unauthorized charges, and report any that are unusual.
  • If you think a doctor is doing unnecessary tests or surgeries, get a second opinion. This can be a way to bill for services that you don’t need.
  • Check your billing statements to ensure that the procedures noted are exactly what you received because some scammers are able to change the name of a procedure, such as a biopsy, to collect more money.
  • Providers may also try to “unbundle” procedures and charge more for each step rather than a “package” price. Watch for this more expensive billing practice on your statements.


Related issues

Healthcare can be a confusing part of life to navigate, as many of us have multiple doctors, copayments, coverage issues, deductibles, drug coverage, and more to learn about. Unfortunately there is a scammer looking to work every angle and take advantage of anyone, so beware of the following healthcare related scams:

  • Anyone who calls to tell you it’s necessary to buy a new health insurance card or pay over the phone for a new Medicare card immediately and wants your credit card and/or social security number and personal information (you can call 1-800-MEDICARE to check the person’s identity and validity of their call before providing any information);
  • Confusing medical discount plans with medical insurance – discount plans are “club” like groups that claim to offer discounts on doctor visits, drugs, and medical devices but they are not the same as insurance;
  • If you receive Medicare you do not need additional insurance provided through the Healthcare Marketplace, and anyone who wants to charge you a fee for helping to make a decision about coverage offered through the Healthcare Marketplace is a scammer and should not be given a credit card number, bank transfer, or paid with gift cards, and
  • Anyone who claims to be “from the government” and threatens you with a financial penalty for not being up to date on insurance is a scammer and should not be told any personal information such as social security number (you can call the Federal Trade Commission at 1-877-382-4357 to ask about or report fraudulent schemes).

Artificial Intelligence in Healthcare

Ready for its closeup, or not ready for primetime?

Headlines about the advent of artificial intelligence, AI, in pretty much every sector of human life or enterprise seem to be a daily occurrence. Other phrases that get thrown around in stories about AI are machine learning, deep learning, neural networks, and natural language processing.

Here’s a handy list, from the transcription company Sonix, which uses some of these AI tools to drive their service:

  • Artificial Intelligence (AI) –the broad discipline of creating intelligent machines
  • Machine Learning (ML) –refers to systems that can learn from experience
  • Deep Learning (DL) –refers to systems that learn from experience on large data sets
  • Artificial Neural Networks (ANN) –refers to models of human neural networks that are designed to help computers learn
  • Natural Language Processing (NLP) –refers to systems that can understand language
  • Automated Speech Recognition (ASR) –refers to the use of computer hardware and software-based techniques to identify and process human voice

A lot of the stories I see about AI are focused on how it might impact, improve, or otherwise influence healthcare. Depending on who you listen to, it sounds like AI is already diagnosing cancer successfully – here are two pieces, from science savvy sources, on how that’s working, “AI is already changing how cancer is diagnosed” from The Next Web, and “AI matches humans at diagnosing brain cancer from tumour biopsy images” from New Scientist, for your reading pleasure.

As aspirational as the idea of AI in healthcare is, and despite the fact that it’s showing some promise in cancer diagnosis, I’m not thinking that it’s time for the champagne, balloons, and glitter … yet.

One of the biggest barriers to AI is the same barrier everyone – on both sides of the stethoscope, and all the way up to the c-suite – in healthcare confronts daily: data access and liquidity. Data fragmentation is rife across the entire healthcare landscape, with EHR systems that don’t talk to each other well (if at all), and insurers unwilling to open their datasets to anyone under cover of “trade secrets.” In “The ‘inconvenient truth’ about AI in healthcare” in the journal Nature, the authors (British, so this is not just an American problem) point out that, “Simply adding AI applications to a fragmented system will not create sustainable change.” Healthcare systems may be drowning in data (they are), but tools to parse all those data lakes into actionable insights aren’t able to bust the dams holding in that data.

Access is one barrier. Another is the ethics of using AI in healthcare. The American Medical Association’s Journal of Ethics devoted an entire edition to that issue in February 2019, with AMA J Ethics editor Michael J. Rigby calling for deeper discussions about preserving patient preferences, privacy, and safety before implementing AI technology widely in healthcare settings. He particularly notes the impact AI could have in medical education, with medical education being shifted from a focus on absorbing and recalling medical knowledge to a focus on training students to interact with and manage AI-driven machines; this shifting would also require attention to the ethical and clinical complexities that arise when humans interact with machines in medical settings.

AI, across all uses, but particularly in healthcare, has to take a long, hard look at how bias can spread algorithmically, once it’s baked into the code that’s running the machines. There are data scientists doing bias detective work, but will the detectives be able to prevent bias, or just bust perpetrators once the biased outcomes appear?  Stay tuned on that one.

Is there an upside to AI in healthcare? Absolutely, *if* the ethical issues on privacy and error prevention, and the practical issues on data access, are addressed. AI could pave the way to fully democratizing information, both for patients and front-line clinicians. It could liberate all clinicians from data-input drudgery, or “death by a thousand clicks.” The Brookings Institution has a solid report, “Risks and remedies for artificial intelligence in health care,” as part of its AI Governance series, that breaks down the pros and cons.

Circling back to the question in the headline, is AI in healthcare ready for primetime? This person’s answer: it depends. I think that rigorous study, in the development of AI in medicine and its use in the healthcare system, is required as an ongoing feature of AI tech used in human health. Upside there? A whole new job classification: AI oversight and management.

How Healthcare May Be Improved With Artificial Intelligence

If you have not been up to date with healthcare news, or do not work in any healthcare related field, you may be unaware of the gradual increase how reliant the sector is on technology. Every facet of society has been on an upward climb with how digitized it is, and healthcare is no exception. From breakthroughs as interesting as robotic surgery to standardizing electronic patient notes, both primary and secondary care have grown accustomed to the benefits of how artificial intelligence can benefit them.

In healthcare, introducing new treatment whether based in technology or pharmaceuticals is highly expensive, though great efforts are being taken to increase efficiency, reduce human errors and improve healthcare overall. In the long running of things, this would save the healthcare economy billions in coming decades.

Genomics

There has been a public declaration made by IBM Watson Health to incorporate artificial intelligence to the ongoing battle against cancer. The focus currently lies with later stage cancer patients who are at their most critical points. This is because it is likely current treatments have failed for them, or aren’t strong enough. New treatments could offer them the best chances when facing their life or death situations.

Specific genetic factors involved in cancer can be identified and targeted with idealized therapies. This offers hope to many Veterans in the US, and cancer patients worldwide.

Drug Discovery

It has been about three whole decades since a new effective antibiotic has been discovered. This has led to a seemingly losing battle with the emergence of more superbugs (antibiotic resistant pathogens) significantly often. The journey to discovering new drugs is very expensive, meaning many drug companies have slowed down the process of discovery. However, Pfizer’s use of IBM Watson (technology that utilizes machine-based learning) is pioneering the path to finding new drugs that are active for cancer and immune therapies.

Other drug companies such as Sanofi are using artificial intelligence to find new therapies for metabolic disease; Genentech are also leading the way in cancer research with artificial intelligence from Cambridge, Massachusetts.

Robotic Surgery

The correct term for this is robot-assisted surgery, because though it looks like a robot is handling the surgery from the operating theatre, there is actually a surgeon (or multiple surgeons) that are controlling the robotic tools remotely. This has been rolled out successfully in multiple countries so far. These include the United Kingdom and Dubai. The major benefits of robot-assisted surgery is increased precision and accuracy. There is less room for human error, and more room for improved patient care.

Secondary Prevention

One of three or sometimes four main branches of prevention, secondary prevention relates mostly to medical imaging. There has been a huge surge of technological advances in this area in the past century. The simple ultrasound has become 3D imaging and the simple radiograph has become detailed computerised tomography. New approaches can now be taken, that reveals more information about patients. This leads to clearer imaging, faster diagnosing and better results.

Personalized Medicine

Genetic screening has been more incorporated into healthcare since the sequencing of the human genome in recent decades. With genetic information and associations readily available, more accessible means of accessing patient DNA have been developed. There are now easy methods of reaching a patient’s genetic code and assessing their risk for certain health issues that carry genetic risks.

“Polygenic scoring weighs the linear combination of multiple small genetic variations and are used in predisposition assessment,” says Mary Crawford, tech blogger at Australia2Write and Write Myx.

Visual Assisting

Nursing is investing in the development of virtual assistants, which can take over the role of healthcare assistants and push the healthcare staff population to higher fields of work. Healthcare providers will then be able to maintain continuous contact with patients.

Better Data Security

A major leap in healthcare is digitizing patient records, and rolling out a singular way of standardizing them across the country. Though this is extremely useful for transferring patients from healthcare provider to healthcare provider, it creates room for a cyber-attacks that will steal sensitive data.

“As artificial intelligence increases with patient data storage, it also increases with cybersecurity. Extra security is essential to patient protection,” says Erick Schmid, data analyst for Brit Student and Next Course Work.

Discussing how healthcare may become revolutionized by artificial intelligence may conjure up images of the 1985 movie Daryl. However, the movements are very much real and non-fictional. Productivity is on the rise and medicine has become more business-minded.

Due to its benefits, artificial intelligence is certainly gaining popularity in the healthcare industry and there are developments every year. There are predictions that the involvement of artificial intelligence will grow by 1000% by 2015, pushing it to become a 13 billion dollar industry.

Michael Dehoyos is a medical Blogger at Phd Kingdom and Academic brits. He assists companies in their marketing strategy concepts, and contributes to numerous sites and publications. Also, he is a writer at Case Study Help, academic service.

Bias in Medicine – An Untreated Epidemic

Bias – noun – prejudice in favor of or against one thing, person, or group compared with another, usually in a way considered to be unfair.

Humans are, by nature, biased in favor of their own group – village, country, race, social status – over “others” from outside that group. This tendency toward bias against those different from us is rooted in how humans process the information they get from their surroundings – “is that friend or foe?” is a pretty basic processing form. If someone looks, talks, or smells “different,” the most basic parts of the human brain can start firing warnings about stranger danger. That’s called a cognitive filter, or cognitive distortion [1].

How does this impact medicine? Since medicine is a human endeavor, everyone involved is bringing their own implicit biases [2] into the room with them. It’s human to feel a little uncomfortable with someone who looks, or acts differently than you. However, in a medical setting, what happens when a clinician “others” a patient? Or when a patient does the same thing to a clinician? My educated guess is that this drives down positive health outcomes, creating burnout in clinical staff and hampering recovery in patients.

I’m not the only one asking questions about bias in medicine. My fellow funny person (I am, after all, the “comedy health analyst [3]”) John Oliver devoted most of a recent episode of his HBO series “Last Week Tonight” to the topic [4], which I’d say is required viewing for anyone interested in this segment of health policy. In the piece, Oliver and his crew stack up some serious evidence of racial and gender bias in medicine, particularly in the cases of women having heart attacks [5], and women of color giving birth [6].

How should we – all of us, patients and the clinicians who prove our medical care – address this issue? A good first step would be to recognize that we’re all a bit racist [7] (link is to a Psychology Today article with that very title), which would at least put us in a frame of mind to question our assumptions about the person in front of us in the clinic, or the exam room, or the hospital bed – whichever side of the stethoscope we’re on.

If you’re willing to take that first step, your next step could include taking any of the Teaching Tolerance Project Implicit [8] self-tests on bias with regard to gender or race.

“I wouldn’t have seen it if I hadn’t believed it” is a quote often attributed to Canadian philosopher Marshall McLuhan [9] – a perceptive twist on the “seeing is believing” aphorism, one that asks us to challenge our assumptions about the people we encounter in our daily lives, in medicine and beyond.

Self-awareness leads to a better understanding of others. Better understanding of others leads to less distrust, and more cooperation between individual humans, and among the groups we gather in. Which just might improve human health overall. Let’s test that theory, shall we?


Resource Links

[1] cognitive filter, or cognitive distortion

[2] implicit biases

[3] comedy health analyst

[4] devoted most of a recent episode of his HBO series “Last Week Tonight” to the topic

[5] women having heart attacks

[6] women of color giving birth

[7] we’re all a bit racist

[8] Teaching Tolerance Project Implicit

[9] Canadian philosopher Marshall McLuhan

Access To Healthcare As A Human Right

One of the keys to health literacy is understanding your role, as a patient, in the care delivery process chain: learning what you need to know to ask questions that can help clarify decisions with your clinical team; how to assess the information you’re given to understand what you need to do, or to consider, as next steps in your treatment journey; who to consult for expert input and guidance to fact-check, and gut-check, the information you’re processing and the decisions you’re making.

It’s a lot, particularly when you’re dealing with the impact of what I (and Firesign Theater) like to call “a really big disease.” It’s even more – way beyond “a lot” – if you have to also fight for the right to access treatment for your diagnosis.

This may seem like a problem that belongs to someone in a developing country, not one that happens in the USA, but that’s not the case, far too often. In America, a person given a diagnosis of cancer, or of Parkinson’s disease, or any other “really big” condition, not only has to navigate learning all about that condition, but also has to figure out how to pay for the treatment for it.

In a recent survey from West Health and Gallup, some alarming stats surfaced about Americans and access to medical care:

  • 45% of people surveyed feared bankruptcy if they had a major health event (“really big disease” or accident)
  • 77% feared that rising costs will significantly damage the U.S. economy
  • More than 3 million people borrowed more than $10,000 to cover medical expenses in the past year

Which brings me to my main point here – access to medical care is, I believe, a basic human right. If the system that’s providing your care has been priced out of your reach, and you wind up bankrupting yourself, and your family, to access care, is that really “care,” or a symptom of a broken system?

Sure, the doctors and nurses, as well as the hospitals and clinics where they work, deserve to be compensated for their work. I’m not suggesting that medical care be free. What I am suggesting is that, in the US at least, the goal of the “system” has been to protect the status quo – the revenue stream, which at last official count (2017, from the US Centers for Medicare and Medicaid Services) was $3.5 trillion, of which about $1 trillion is estimated to be waste. Does that sound like a healthcare system, or a RICO scheme? Asking for millions of friends.

Until we, as a nation, confront this issue of access to medical care, and the inequity of access caused by the “chaos behind a veil of secrecy” that marks the pricing of that access, we’ll be stuck in the loop we’ve been in since the end of WWII, when Harry Truman tried to initiate a national healthcare program and got beaten up on the White House lawn by Congress, and the American Medical Association.

America is founded on the idea that every person has a right to “life, liberty, and the pursuit of happiness.” It’s hard to have life, or liberty, or happiness without access to healthcare. Let’s live up to our founding principles, and guarantee healthcare access to all. Anything less, and we’re betraying the American promise.

The Biggest Question No One Is Asking in Healthcare

There is a really big question in healthcare, one that could shift the entire industry toward more patient-focused care while simultaneously driving down healthcare costs. Very few people even think about this question. In my experience even fewer, if any, of those who do ask it are involved in developing healthcare policy at the federal or state level.

This one question, if deployed, would start to solve the issues facing patients, clinicians, payers, hospitals – everyone involved in getting or receiving medical care.

What’s the question?

“How much is that?”

There are two things in play in the healthcare industry that fly in the face of marketplace sense. First is the lack of price transparency. Imagine going to the grocery store and seeing aisles upon aisles of food … without any prices posted.

“How much is that package of chicken breasts?” “That depends. How are you paying for it?”

My guess is that you wouldn’t shop in that store again. Healthcare is the only consumer-facing industry in the US that doesn’t have price transparency. Worse, if you ask for pricing, you’re often met with blank stares and “I have no idea” or, worse, “we can’t tell you because [insert name of health insurer here] considers that to be proprietary business information.”

Second is how the prices are set. You’ve heard of the medical billing codes – the Holy Codes that outline Medicaid, Medicare, and health insurance reimbursement payments for everything from lab tests to joint replacement. The price values for each of those billing codes is set by an American Medical Association (AMA) committee called the RUC: the Specialty Society Relative Value Scale Update Committee (for my personal take on the RUC, see this piece). The RUC meets behind closed doors, creates the pricing list for every single medical procedure and billing code, and then publishes it. This is not price fixing, since they hand the list to the Centers for Medicare and Medicaid Services (CMS) for publication, the AMA does not publish the list on its own.

Here’s a critical health policy issue: creating price transparency. One starting point could be requiring providers to know, and share, the cost of the services they provide to the customers they serve: THE PATIENTS. On the employer sponsored insurance (ESI) front, employers are starting to push for this with reference-based pricing in their benefits packages. On the state and federal policy front, there are a rising number of discussions about all-payer claims databases (APCDs) – for a really good explainer on that, I’ll point you toward this piece from July 2018 on the Health Affairs blog, “Transparency In Health Care: Where We Stand And What Policy Makers Can Do Now.” Both of these, either in tandem or singly, might accomplish what all the healthcare blue-ribbon committees and working groups in DC haven’t been able to pull off since the 1960s: downward pressure on healthcare costs.

In 2003, the late Princeton economist Uwe Reinhardt published an article in Health Affairs titled, “It’s The Prices, Stupid: Why The United States Is So Different From Other Countries.” Fifteen years later (on March 13, 2018 to be exact), WBUR in Boston published “Why Are U.S. Health Costs The World’s Highest? Study Affirms ‘It’s The Prices, Stupid’” – we haven’t made much progress since 2003.

Think about that as you evaluate your choices in the voting booth on November 6, and hold your representatives at the state and federal level to account after they take office. Whether you love the Affordable Care Act or not, you know that the healthcare system in the US must change, for the health of our families and communities as well as the financial health of our national economy.

And the next time you’re buying healthcare services, ask that really important question: “How much is that?” If you don’t get an answer, consider shopping in another healthcare store.

That could start bending the cost curve.

Facts About Medicare You Didn’t Know

If you or a loved one are approaching the 65-year-old mark, it’s time to get serious about Medicare. There are a lot of things to look forward to as you get older (and wiser), and Medicare can be one of them if you take the time to understand the program and how you can benefit from it.

Unfortunately, a lot of confusing misconceptions surround Medicare. This leaves people unsure of how to make the best choice for them. Luckily, we have all the best facts you didn’t know about Medicare from a licensed HealthMarkets agent who knows the program inside and out. Keep reading to make sure you have the right coverage when you reach Medicare years.

Image via Pexels

Medicare is Not Free Insurance

The most common misunderstanding about Medicare is that it is free insurance sponsored by the government. Like all health insurance in the United States, you have to pay premiums for Medicare Part B, Medicare Advantage, and supplemental coverage. The good news is that the government secures costs for Medicare Part B based on your income. The standard premium for Part B in 2018 is $134 assuming your income is under $85,000 as a single taxpayer or $170,000 for joint returns.

If you receive social security benefits, this can help cover the costs of Medicare premiums. For those who opt for Medicare Parts C and D or any supplemental coverage, you have more freedom in the price depending on the plan you choose.

Medicare Will Not Cover All Treatment

Once again, like most traditional health insurance, Medicare will not 100% cover all health costs. Inpatient services involve a deductible over $1300, and you’ll need to pay a fee per day for any coverage in a facility for over 60 days. With Medicare Part B, you’ll need to still pay 20% of the Medicare-approved amount for care, and this is in addition to your annual deductible.

The best way to prepare for the costs of treatment is to do your research. If you know there are certain prescription drugs you’ll need or special doctors you’d prefer to visit, consider a Medicare Part C plan which gives you more freedom in coverage.

Image via Pexels

There is a Deadline to Sign Up

The best time to sign up for Medicare is when you turn 65. This is called the Initial Enrollment Period, and it begins 3 months before you turn 65. It continues for another 3 months after your birthday. If you miss this initial period, you’ll face deadlines if you choose to join later. You’ll also be limited to enrolling during the specific open enrollment times during the year, which could lead to limited coverage.

There are a few exceptions to this rule. First, if you already receive social security benefits, you are automatically enrolled in Medicare on your 65th birthday. Also, if you’re still working and covered by your employer, there are different options. When in doubt, speak to an advisor at your local Social Security office for the specifics of your situation.

You Might Need Supplemental Coverage

Medicare is a great program, but there’s a list of things the program does not cover. Things like long-term care, hearing aids, dental care, or even eye exams are often not covered under Medicare. This is why many seniors opt for a Medigap policy to include extra coverage for these gaps in treatment. Talk to your doctor about what you’ll likely need coverage for in the upcoming years, and prepare yourself with the right additional policy, as needed.

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You Have Access to Preventative Care

While you’ll likely need to pay for treatment and complex health services, you receive a wide array of preventative care for free. It’s always a good idea to take advantage of these services to stay on top of your health as you age.

The most comprehensive option is the annual wellness visit which includes a personalized prevention plan. Every 5 years you’ll have access to a free cardiovascular screening, and annually you can get a flu shot and routine cancer screenings. The sooner you’re able to catch a potential problem, the less expensive and complicated it will be to treat.

It’s vital you take your health seriously as you age. It’s important to understand that while Medicare covers much of your health care, it does not cover everything. You’ll also need to follow the enrollment rules to take advantage of the program’s benefits. Knowing what Medicare is and is not will help you decide on the right coverage when it matters most.

The best way to prepare for the costs of treatment is to do your research. If you know there are certain prescription drugs you’ll need or special doctors you’d prefer to visit, consider a Medicare Part C plan which gives you more freedom in coverage

Health Insurance and Cancer: Your Mileage (and Coverage) May Vary

Financial toxicity is the phrase used to describe the impact of the cost of treatment on patients. The NIH describes financial toxicity as “problems a patient has related to the cost of treatment.” No matter what kind of health coverage plan you have, if you get a cancer diagnosis you’ll quickly discover all the things you’ll have to pay for, from co-pays on chemotherapy infusion drugs to the intricacies of “co-insurance,” where an insurer will pay a percentage, usually 70-80%, of the cost, with the patient responsible for the remaining percentage.

Financial toxicity isn’t limited to cancer – ask any person with diabetes who relies on insulin to stay alive about that – but the cost of cancer treatments is high, and rising higher. Cancer patients are put in the position of having to decide whether they’ll get the treatment their oncology team prescribes, or if they’ll put it off until they have the money for it. Patient assistance programs at pharmaceutical companies can offer some help, but there is no guarantee that a patient assistance program for a specific cancer drug will help everyone who can’t afford the drug.

An NPR piece covered this last year, framing the story around a man with advanced lung cancer whose oncologist prescribed a new drug, Alecensa, for his treatment. Alecensa’s annual list-price cost is $159,000, with Medicare patients like the man in the NPR piece paying $3,200 per calendar year. The patient in the story was prescribed the drug in late 2016, but decided to forego filling the prescription until January 2017, to avoid having to pay $6,400 within 60 days for the treatment.

This is part of a pattern of cost shifting across the health payment landscape. Premiums for private insurance rose 170% from 1999 to 2011, far higher than the average increase in wages in the same time frame. Prescription co-pays also rose dramatically with the introduction of tiered drug coverage plans that passed more cost to the patient. For example, from 2000 to 2012, the proportion of individuals with a drug plan that had three tiers increased from 27% to 63%.

Exacerbating the immediate financial anxiety of negotiating for a treatment that could mean the difference between life and death, there’s the impact of medical bills on a patient’s long-term financial health. A Consumer Financial Protection Bureau report in 2014 revealed that almost 20% of credit reports had medical debt reported on them. In 2016, the Commonweath Fund noted that, “As of late 2016, 28 percent of U.S. adults ages 19 to 64 who were insured all year were underinsured — or an estimated 41 million people. […] Half (52%) of underinsured adults reported problems with medical bills or debt and more than two of five (45%) reported not getting needed care because of cost.”

I’ll put a face on this issue by introducing you to a friend of mine, Linnea Olson, who has been successfully beating Stage IV lung cancer for over a decade. Linnea has insurance coverage under COBRA, which is costly, but helps keep her alive by covering the costs of treatment that aren’t covered by the clinical trials she’s been part of over the years. She recently got a notice that her insurance had been terminated – the story on that is here, on her blog – which put her in the “high anxiety” zone, to say the least. That post is a very clear example of how financial toxicity impacts someone with cancer. Her situation lit fires across the cancer patient activist community, launching a campaign to get her coverage back. Four days later, she received word that her coverage had been reinstated. She shared that news publicly on her blog, too.

My point here is that this should not be way Americans are expected to deal with a cancer diagnosis – by facing the fight of their life while their financial lives are laid waste. The costs of treatment shouldn’t be the first thing someone has to think of when facing a life-threatening illness. The patient community is in sync on that. The oncology clinical community agrees that treatment costs, and financial toxicity, are in need of clearer discussion. The American Society of Clinical Oncology published a report in 2017 that included a recommendation that discussion of treatment cost and coverage “would […] facilitate rational discussions of efforts to use more cost-efficient regimens, use less expensive alternatives, or perhaps forego extremely expensive and toxic options that have little chance to provide meaningful benefit.”

I recommend that we keep advocating for more transparency in insurance coverage, and in the in-clinic discussion of the costs and benefits of cancer treatments. It also couldn’t hurt to advocate that our elected representatives craft legislation that makes that transparency a requirement, not an option.

Why Health Systems and Hospitals Should be Transparent to Earn Trust

Editor’s Note: This post was written by Craig Mullen for HealthSparq and originally published on February 6, 2018


Would you buy a new car and drive it off the lot without knowing the cost? Or purchase a house without comparing prices of other properties in the neighborhood? Silly questions, right?

So, why do we as consumers/patients continue to buy treatments and services from health care providers without knowing the estimated costs and if we’ve selected the best venue of care?

When it comes to health care, I think a lot of the issue is related to our conditioning – we think to ourselves, ‘I’ve never known the cost of my treatments and visits, so it must just be how it is.’

However, in the past couple of years, consumers have become vastly more engaged in all aspects of their health care and expectations are increasing related to accessing cost estimates and quality scores. According to Accenture, 91 percent of health care consumers are looking to price information, but many providers don’t offer it—or it isn’t easily found.

RELATED: READ WHAT HEALTH SYSTEM LEADERS SHARE ABOUT CONSUMERISM IN NEW WHITE PAPER

Health systems have been hesitant to share pricing information with consumers, but are starting to become more strategic by empowering people with cost information and personalized recommendations of care. Many realize that being transparent is a critical component of building trust within their communities. With this trust, consumers are more likely to look to their health care provider for recommendations for the right venue of care (physician, telehealth, urgent care facility, etc.) and other decisions.

Recently, we commissioned research, asking health system leaders to define an optimal solution to address consumer demands and expectations. Most agreed the solution would need to be web-based and incorporate some type of mobile app capability. Various features and benefits were on their wish lists, including:

Robust, Interactive Tools

These include doctor and hospital ratings, price comparison calculators, assistance in understanding insurance benefits, online scheduling and translation/multi-language capabilities.

Bi-directional communication

According to one participant, “We need patients to feel like this is not the health system bothering them, sending unwanted texts or spam. We need this to become a way that they engage with us so that they can’t be passive recipients,” he said.

Seamless integration

Another executive summarized this aspect best, detailing, “We can order an Uber through an app. It should be as seamless as we’ve seen with everything else in our lives.”

Comprehensive platforms

In general, all participants worry that current digital solutions to patient engagement and cost transparency are too fragmented and not collaborative enough.

HealthSparq is focused on understanding and addressing consumers evolving health care needs and what’s important to them, such as – cost, convenience, provider and/or services. This insight can help them get the care they need by booking an appointment with the right provider or guiding the consumer to a location for immediate service (telehealth, urgent care, etc.).

Driving behavior change that delivers business outcomes for providers requires trust from patients. Sharing cost information is a win-win. If you’re giving patients guidance on care options and cost information in the process, they can make smarter choices – for their health and finances – and you gain their trust, loyalty and an educated patient who is engaged in their own health care.

To learn more, download “Defining Success in the Era of Health Care Consumerism: How Health Systems Can Build Loyalty, Preference and Trust Through Transparency and Guidance.”

Health Cost Literacy: “How much is that?”

The title of this post asks the $3.5 trillion-with-a-T question in American healthcare: how much is that? It often feels like healthcare is split into two camps, with one side working away feverishly to find more cures for life-threatening conditions like cancer and ALS, while the other side is working at an equally feverish pace to figure out just how many millions of dollars they can make of the latest breakthrough.

A recent example of this Tale of Two Healthcares was the roaring headlines about the first FDA-approved gene therapy, Kymriah (tisagenlecleucel), for leukemia. The business side of healthcare was ecstatic, pricing the drug at $475,000, which made Wall St. happy, and Novartis (the drug’s maker) ecstatic. The patient side of healthcare? Not so much.

Kymriah is an extreme example of healthcare pricing, but even trying to get a CT scan can turn into a trip down the rabbit hole, if you try to find out before the scan how much it will cost you. Asking “how much?” can seem like shouting down a well the first time you do it – you’ll hear an echo, because the person you’re asking will likely say “how much?” right back, in total shock at the question. However, asking questions is how we get answers, right?

Here are tips for asking “how much is that?” and getting meaningful answers:

  • Find out if your insurer has a cost-estimator tool. If so, use it. For everything required for your care. You’ll need the insurance billing code for the test, scan, or procedure (called the CPT code), so get that from your doctor’s billing office.
  • Use online price-check tools like Clear Health Costs or Fair Health Consumer to reality-check the pricing information you get from your insurer’s cost-estimator tool.
  • When your doctor refers you to a lab for testing, or an imaging center for scans, ask if they know what the cost is. They likely won’t at first, but the more of us who ask the question the more they’ll want to know the answer.
  • Call around to labs and imaging centers in your insurer’s network to ask about their cash price for the test or scan that’s been ordered for you. Depending on the cash price, you might be better off not using your insurance, and actually paying cash for the test or scan. If you have a high-deductible plan, you’ll need to assess which medical services are worth going off-the-books for if you haven’t yet met your annual deductible.

I know a lot about “how much is that?” because I was uninsured for five years after my own cancer treatment ended. I discovered that asking the question got me the answers I needed, and I could choose the providers that could give me a cash price for the mammograms and follow-up oncology services I needed. I’ve continued to use the simple question “how much is that?” every time a doctor has ordered tests or scans, because even with insurance, you’ll wind up with a bill for some part of the service.

If we all work together, asking “how much is that?” before receiving any medical service, we’ll start to shift the system, and the culture of healthcare. It takes a village, not just to raise a child, but also to change a status quo.

It’s your turn. Start asking.

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