At DocSpot, our mission is to connect people with the right health care by helping them navigate publicly available information. We believe the first step of that mission is to help connect people with an appropriate medical provider, and we look forward to helping people navigate other aspects of their care as the opportunities arise. We are just at the start of that mission, so we hope you will come back often to see how things are developing.
An underlying philosophy of our work is that right care means different things to different people. We also recognize that doctors are multidimensional people. So, instead of trying to determine which doctors are "better" than others, we offer a variety of filter options that individuals can apply to more quickly discover providers that fit their needs.Got questions?
NPR published a piece showing that women with high-deductible plans often delayed screenings and treatment. The effect was true, regardless of whether the women or low-income or high-income (although high-income participants tended to delay less). There is no particular reason to think that this effect is limited to only women.
I did not read the study itself (payment required), but one question is what benchmark the authors measured the delay from (e.g. from the control group or from a triggering event or diagnosis). Regardless, the study highlights one of the challenges of high-deductible health plans, which is that people may delay appropriate medical care because of the high deductible. Ideally, people would be more cost-sensitive (e.g. comparison shop for non-emergency procedures) without compromising their health. Unfortunately, there is not an inexpensive and reliable way for everyone to know whether they really need to seek treatment.
STAT published an opinion piece highlighting the lack of clinical quality information available to patients. With all of the talk about high-value medicine, we need to be cognizant that value involves both price and quality. While it is true that information on both fronts is lacking within the practice of medicine in the US, there is at least some more pricing information that is available. Except for the few small pockets of information outlined in the piece, there is very little clinical quality information that is available to consumers.
While there have been large efforts to define clinical quality metrics (e.g. the National Quality Forum), actual physician performance data on those metrics is rarely disseminated publicly. Organizations outside of the medical establishment (such as Propublica and Consumers' Checkbook) have tried to rate surgeons, drawing criticism from the medical community. It is possible that the most successful measures will come from large self-insured employers who mandate disclosure of some information.
We are pleased to announce the launch of a new feature that gives insight into providers' Medicare patients. Medicare released information about their beneficiaries (patients), aggregated at the provider level. For example, you can see how many Medicare patients a provider treated who are African-American or Asian-American. Or, what percentage of the Medicare patients treated by a particular provider have asthma. The information can be helpful for patients who are looking for providers who treat patients like themselves.
Medicare released the information by year. There are still many finishing touches that we would like to implement. In the meantime, please visit the "Patients" tab to see the data. If you have any suggestions on how to present the data more intuitively or helpfully, please let us know.
This week's top headline in US health policy appears to be that the current White House administration has announced that it backs the court's ruling to nullify the entirety of the Affordable Care Act (ACA), whereas previously, it suggested that some parts could be left intact, even while it challenges certain core pieces. Some are taking this announcement to mean that the administration wishes to roll back protection for patients who have pre-existing conditions, although the president has since indicated support for those protections. The New York Times reported on some of the politics of the decision. Notably, Democrats are seizing upon the moment to further amplify the importance of protecting the Affordable Care Act. Perhaps not surprisingly (given the popularity of covering patients with pre-existing conditions and how narrow some of last year's midterm elections were), some Republican politicians have dissented with the White House's announcement.
The same article noted some interesting legislation approved by a House subcommittee: prohibiting "pay for delay" (where name-brand pharmaceutical manufacturers pay a generic manufacturer for delaying selling a competitive product) and requiring that pharmaceutical manufacturers supply samples to generic manufacturers so the generic manufacturers have an easier time running clinical trials to demonstrate therapeutic equivalence. If passed, such legislation could have a meaningful impact on people's ability to afford medications.
Following a survey of the political landscape from last month, the New York Times published a follow-up, detailing the progress of the "Medicare for all" movement. In particular, the article highlighted that "Medicare for all" would prevent private insurance companies from offering primary insurance. Such a drastic measure would have wide-reaching implications for the industry. Humorously,
"Gerald Friedman, a labor economist at the University of Massachusetts Amherst, who was close to Mr. Sanders's 2016 campaign, estimated then that it could reduce the nation's health care spending by $6 trillion over a decade, while the left-leaning Urban Institute said it might increase the overall bill by nearly $7 trillion."
Supporters of the sweeping policy change believe that removing private health insurance companies is key to reducing the administrative load of each provider group negotiating with several insurance companies. At the same time, many provider groups also favor patients with private insurance over Medicare. Regardless, it seems that as long as the Republicans have more than forty senators in Congress, Medicare for all is unlikely to be passed any time soon.