Tag Archives: healthcare costs

How Facebook — yes, Facebook — might make MRIs faster

Facebook’s artificial intelligence lab is working with New York University’s medical school to make MRI exams 10 times faster, which, if successful, would allow radiologists to complete a test in minutes.

  @mattmcfarlandAugust 20, 2018: 11:14 AM ET

Doctors use MRI — shorthand for magnetic resonance imaging — to get a closer look at organs, tissues and bones without exposing patients to harmful radiation. The image quality makes them especially helpful in spotting soft tissue damage, too. The problem is, tests can take as long as an hour. Anyone with even a hint of claustrophobia can struggle to remain perfectly still in the tube-like machine that long. Tying up a machine for that long also drives up costs by limiting the number of exams a hospital can perform each day.

photo of high speed MRI machine for article, How Facebook -- yes, Facebook -- might make MRIs fasterComputer scientists at Facebook (FB) think they can use machine learning to make things a lot faster. To that end, NYU is providing an anonymous dataset of 10,000 MRI exams, a trove that will include as many as three million images of knees, brains and livers.

Researchers will use the data to train an algorithm, using a method called deep learning, to recognize the arrangement of bones, muscles, ligaments, and other things that make up the human body. Building this knowledge into the software that powers an MRI machine will allow the AI to create a portion of the image, saving time.

“You could be in and out in five minutes. It would be a real game-changer.” Daniel Sodickson, vice chair for research in radiology at NYU School of Medicine, told CNNMoney.


Fresh Food By Prescription: This Health Care Firm Is Trimming Costs — And Waistlines

Heard on Morning Edition

But as a society, we’ve got a long way to go. About 1 out of every 2 deaths from heart disease, stroke and Type 2 diabetes in the U.S. is linked to a poor diet. That’s about 1,000 deaths a day.

There are lots of places to lay the blame. Calories are cheap, and indulgent foods full of salt, sugar and fat are usually within our reach 24/7.

So, how best to turn this around? Consider Tom Shicowich’s story. It begins with a toe. His left pinky toe.

“One day I looked down and it was a different color … kind of blue,” Shicowich says. And he began to feel sick. “I thought I was coming down with the flu.”

The next day he was on the operating table. A surgeon amputated his toe, and it took two weeks of intravenous antibiotics to fend off the infection.

Registered dietitian Anna Ziegler counsels Tom Shicowich, who has Type 2 diabetes. Since enrolling in the Fresh Food Pharmacy program, Shicowich has lost about 45 pounds. His hemoglobin A1C level has dropped significantly.

All told, he spent a month in the hospital and a rehab facility.
“Oh, I tell you, it was a bad year,” Shicowich recalls.

But this wasn’t just bad luck. His toe emergency was somewhat predictable. Foot infections are a common complication of Type 2 diabetes — often due to nerve damage and poor blood flow, especially when the disease isn’t well-controlled.


Diabetes Deaths Exploding in California’s Under-55 Population

By Phillip Reese

Chart of diabetes deaths in California for people under 55 years of ageDeaths from Type II diabetes in California among people under age 55 were practically unheard of 15 years ago. Just 24 people in that age group died from the disease in California in 1999.

Times have changed. In 2015, 390 Californians under age 55 died from the disease, according to new figures from the U.S. Centers for Disease Control and Prevention.

Deaths from Type II diabetes have risen across all age groups. About 4,900 Californians died from the disease last year, for a rate of 12.5 deaths per 100,000 people, up from 2 deaths per 100,000 people in 1999.

But the death rate among the under-55 group has grown exponentially. About 3.6 out of every 100,000 Californians between ages 35 and 54 died from the disease last year, roughly 18 times the death rate in 1999, CDC figures show.

The trend is mirrored in the Sacramento region. Almost 130 area residents under age 55 died from Type II diabetes between 2011 and 2015, up from 15 deaths between 1999 and 2004. Continue reading Diabetes Deaths Exploding in California’s Under-55 Population

Pop Quiz; Are Soda Taxes Changing America?

By Judge David Langham 12/06/2016

illustration of soda equal to eathing 22 packs of sugarA few years back, I introduced the sugary soda debate in Get Me a Huge Soda Please. There is co-morbidity in workers’ compensation. One that has attracted discussion and attention is obesity.

It turns out that those of us with a few extra pounds can be more challenging to treat following an injury. Months later, New York encountered legal issues with its effort to tax soft drinks, noted in Can I get a Team Gulp with that Please.

In the last election, voters in four cities were confronted with whether to impose a tax on soft drinks and other “sugar-sweetened beverages. According to CNN, in early November, ballot initiatives were proposed in “San Francisco, Oakland and Albany, California; and Boulder, Colorado.”

The purported drive behind the taxation effort is to discourage consumption. If the cost of the soft drink is increased sufficiently by the taxation, then people will consume less of the soft drink. CNN says that “soda beverages have been associated with an increased risk of obesity, type 2 diabetes, heart disease and possibly heart failure.” Proponents claim that their efforts are not directed at revenue from taxes, but at improved health. There are claims that such taxation detriment works in that regard.
Continue reading Pop Quiz; Are Soda Taxes Changing America?

CA & NH Look to Help Consumers Get Healthcare Pricing Information

March 11, 2016 | Jordan Rao – Kaiser Health News

California healthcare cost comparisonTwo states are making inroads into revealing some of the biggest secrets of health care by publishing price information to help consumers comparison shop for doctors, dentists and prescription drugs.

New Hampshire, which already had the nation’s most advanced website allowing people to compare the cost of specific medical procedures, last week added prices for 16 dental procedures and 65 prescription drugs. The website, NHHealthCost.org, is run by the state insurance department and lets consumers see how much they would have to pay based on the price their insurer negotiated with each provider, rather than the sticker price that is charged. The site also shows the price uninsured people must pay.

California on Wednesday released an expanded version of its quality report cards on 154 large physician groups. Those cards, which already assess clinical quality and patient experiences, take a different tack than New Hampshire. Instead of drilling down on specific procedures, the report cards summarize the total cost of medical services run up by the average patient of each group. The medical groups care in total for more than 9 million people.

Elizabeth Abbott, the director of California’s patient advocate office, which put together the report cards, said that by coupling the cost rating with similar star ratings for quality, consumers and those who decide which medical groups to include in insurance networks will see that the most expensive medical groups may not be the ones that provide the best care.

“We want to have human resources departments and executives for health providers look at this to guide their decisions,” Abbott said.


Can You Heal Me Now? Telemedicine’s Momentum.

Momentum for telehealth is accelerating


Doctor of the future as envisioned in 1925The nation’s ongoing battle to strike a delicate balance between increasing access to quality health care for all Americans and reducing overall health care spending just scored one of its most substantial victories.  In late April, after several months of thoughtful and robust collaboration, the Federation of State Medical Boards (FSMB) ratified a new model national policy: the Appropriate Use of Telemedicine in the Practice of Medicine.

This marks the first time the medical community has unilaterally acknowledged the impact technology has had on the practice of medicine, and the ability telemedicine — or connected health — has to facilitate and improve the delivery of health care.

Let us first put this in perspective.  We all know health care is at a critical juncture.  The implementation of the Affordable Care Act means millions of newly eligible Americans will seek access to an already overburdened health care system.  The nation faces a serious shortage of primary care providers, specialty care is becoming more diversified, and access to care in rural areas is an ongoing challenge.  All of these issues are on the rise.

Technology-enabled care

Enter technology-enabled care.  Real-time video encounters between patients and providers reverse the burden on patients to seek care in a hospital or doctor’s office by bringing health care directly to them, in their home.  At the same time, remote monitoring, sensors, mobile health and other technologies are helping to reduce hospital readmissions, and improving adherence to care plans and clinical outcomes, as well as patient satisfaction.  Connected health tools also support preventative care efforts for chronic care patients and can empower individuals to make positive lifestyle changes to improve their overall health and wellness.

Momentum for telehealth is accelerating at an undeniable rate.  As of March, twenty states and the District of Columbia have passed mandates for coverage of commercially provided telehealth services; 46 states offer some type of Medicaid reimbursement for services provided via telehealth.  A study by Deloitte predicts that this year alone, there will be 100 million eVisits globally, potentially saving over $5 billion when compared to the cost of face-to-face doctor visits.  This represents a growth of 400 percent in video-based virtual visits from 2012 levels, and the greatest usage is predicted to occur in North America, where there could be up to 75 million visits in 2014.  This would represent 25 percent of the addressable market.

Continue reading Can You Heal Me Now? Telemedicine’s Momentum.

Doc-in-the-Box Meets Docs-Outside-the Box

Fortunately, the doctors and staff of Central Coast UrgentCare and IndustrialCare, have great relationships with other healthcare professionals in the Santa Maria Valley.

masthead for Dr. Fred Pelzman's blogBy Fred N. Pelzman, MD


We have all seen patients coming out of urgent care centers and emergency departments with prescriptions for antibiotics that were probably not necessary, and with opiate pain medicines which we are then left to sort out whether they are needed. We have also seen extensive scans and lab tests that we now need to take care of and follow up on, that likely are not clinically relevant.

I’m not saying that in the primary care setting our care is always perfect, efficient, always evidence-based. We have all given antibiotics for a cold (admit it, you know you have), and ordered too many labs and scans because we could.

But these other settings, these alternatives to the primary care office, serve an incredibly important and useful purpose, and can become critical cogs in the healthcare team that we’re trying to build in the patient-centered medical home model.

We know that ideal care requires 24/7/365 access but, as we know, none of us want to be on call 24 hours a day, 7 days a week, 365 days a year.

I recently had a nearly perfect interaction with an urgent care center and the staff who provided care. My patient was seen there urgently late on a Friday night, and they actually followed up with her 2 days later (then Sunday morning) and provided ongoing, and appropriate, care for this clinical situation. Monday morning I arrived in my office and received an email communication from the provider at the center, detailing what had happened, explaining their thought process, and recommending follow-up with me.

For most of us busy primary care providers, after-hours care is usually telephone care. It’s hard for us to come into the office at 12:30 at night when a patient is sick and wants to be seen. There certainly are exceptions to this, where we may come into the emergency department to see a sick patient, but for many things it is nice for patients have an option for walk-in care that is safe, clinically rational, and available.

Wouldn’t it be nice if the urgent care centers and emergency departments became an integrated part of our team, rather than us continuing the sometimes somewhat adversarial relationships that currently exist between these different settings?

Urgent Care Centers Divert Patients From PCPs, EDs Alike

Signs: Emergency Dept. $500, Urgent Care $50by Robert Lowes

Urgent care centers (UCCs) save money by treating patients who otherwise may land in a more costly hospital emergency department (ED), but they also boost healthcare spending by diverting patients from primary care practices (PCPs), according to a new study published online today by the Center for Studying Health System Change (HSC).

Given these findings, UCC executives, ED directors, and health plan network managers interviewed in the study are uncertain about the overall effect of UCCs on cost, write lead author Tracy Yee, PhD, and coauthors. On a more positive note, these healthcare industry figures generally perceive UCCs as improving access to some services for privately insured patients “without significantly disrupting continuity of care,” according to the study, which focused on 6 metropolitan areas.

The number of UCCs has grown rapidly during the last 20 years, giving patients an alternative to crowded EDs as well as booked-up PCPs. UCCs are not designed to handle car accidents or resuscitate patients at death’s door, but they do treat minor injuries such as cuts and minor fractures, as well as the ear infections and strep throats of primary care. The Urgent Care Association of America puts the number of UCCs at 9000, with physicians or physician groups owning 35% of them. In addition, corporations own 30%, hospitals own 25%, and nonphysician individuals or franchisors own 7%.

The authors of the HSC study found that UCCs mostly treat patients covered by Medicare and private insurance and tend to avoid Medicaid patients. Lately, private insurers have tried to steer patients from EDs to UCCs by making co-pays for the latter less than ED co-pays. At the same time, however, insurers have begun to price UCC co-pays higher than those for primary care office visits.

Continue reading Urgent Care Centers Divert Patients From PCPs, EDs Alike

The $21 Advil Debate in California

Golden pills
Thar's gold in them thar pills!

This could be the “golden toilet seat” of the health care debate in California. And guaranteed to be a conversation starter around your favorite water cooler or coffee machine!

Should California voters cap hospital costs?

 Download/Play Audio

A single Advil tablet costs around 8¢ at your local pharmacy, so would you be willing to pay $21 for one at a hospital? You might not have a choice if you’re in the hospital and $21 is the going-rate. Such extreme price mark-ups are evidence of “hospital price gouging,” according to union health care workers who are trying to stop it.
“We’ve learned that they charge 21 dollars for a single Advil – not the bottle, but a single Advil,” said Elizabeth Brennan, spokeswoman for the Service Employees International Union (SEIU.) Brennan maintains that such lofty prices are why health care costs are as high as they are. In order to stop the alleged unfair practices, union health care workers in Southern California are collecting signatures for two initiatives they hope to get on this Fall’s ballot.
The first initiative would prohibit hospitals from charging patients more than 25 percent above the actual cost of services and the second initiative would require non-profit hospitals to provide a pre-determined minimum amount of “charity care” for needy patients. Jim Lott, spokesman for the Hospital Association of Southern California, said the SEIU has identified a very real problem, but that limiting hospitals’ ability to charge is the wrong solution. Lott maintains that hospital costs are raised because of low payments received from customers who use Medicare and
Medi-CAL and that the situation could be resolved if the government covered more.


Are hospitals only out for profit or are they simply doing what’s necessary to spread the costs of California’s underinsured? How restricted, if at all, should hospitals be when it comes setting prices for services?


Dave Regan, president, Service Employees International Union, United Healthcare Workers WestJames Lott, spokesman, Hospital Association of Southern California

“Hot” New App from OSHA!

graphic with iPhone and flames on words "Hot Apps" OSHA Releases Mobile App To Help Protect Workers From Heat-Related Illnesses

As part of continuing educational efforts by the U.S. Department of Labor’s Occupational Safety and Health Administration about the dangers of extreme heat, Secretary of Labor Hilda L. Solis today announced a free application for mobile devices that will enable workers and supervisors to monitor the heat index at their work sites in order to prevent heat-related illnesses.

“Summer heat presents a serious issue that affects some of the most vulnerable workers in our country, and education is crucial to keeping them safe,” said Secretary of Labor Hilda L. Solis. “Heat-related illnesses are preventable. This new app is just one way the Labor Department is getting that message out.”

The app, available in English and Spanish, combines heat index data from the U.S. National Oceanic and Atmospheric Administration with the user’s location to determine necessary protective measures. Based on the risk level of the heat index, the app provides users with information about precautions they make take such as drinking fluids, taking rest breaks and adjusting work operations. Users also can review the signs and symptoms of heat stroke, heat exhaustion and other heat-related illnesses, and learn about first aid steps to take in an emergency. Information for supervisors is also available through the app on how to gradually build up the workload for new workers as well as how to train employees on heat illness signs and symptoms. Additionally, users can contact OSHA directly through the app.

The app is designed for devices using an Android platform, and versions for BlackBerry and iPhone users will be released shortly. To download it, visit http://go.usa.gov/KFE

More than 30 workers died from heat stroke in 2010. Thousands become ill from heat exhaustion and other heat illnesses every year. Some of the highest illness rates occur among construction workers, farmworkers, roofers, landscapers, baggage handlers and other air transportation workers.

Effective heat illness prevention requires simple planning. Employers are responsible for protecting workers by providing plenty of water, scheduling rest breaks in the shade or air-conditioned spaces, planning heavy work early in the day, preparing for medical emergencies, training workers about heat and other job hazards, taking steps to help workers – especially those who are new to working outdoors or who have been away from work for a period of time – acclimatize to the heat, and gradually increasing workloads or allowing more frequent breaks during the first week of an outdoor project.

Information for employers about using the heat index to calculate and address risks posed to workers also is available through OSHA’s new Web-based tool “Using the Heat Index: Employer Guidance,” which is accessible at http://www.osha.gov/SLTC/heatillness/heat_index/index.html. OSHA’s other educational and training tools about heat illnesses prevention, available in English and Spanish, can be found at http://www.osha.gov/SLTC/heatillness/index.html .

“OSHA’s prevention message is clear: Water. Rest. Shade. These are three little words that make a big difference for outdoor workers during the hot summer months,” said Assistant Secretary of Labor for OSHA Dr. David Michaels.