On The Record (with daily recap)

  • FDA: Proposed guidelines for incl of more women in clinical device trials via RWJF New Public Health Blog

Today in TIE: Reflex, Austin on Supply and Demand side cost control, Aaron points out that access is more than health insurance, and Don is not sure we have reached the tipping point for caregiving policy

On The Record (with daily recap)

  • RWJF: Federally-Facilitated Exchanges and the continuum of state options

Today in TIE: Reflex, Austin looks at pricing CABG, Don updates the Center for Health Care Research and Transformation’s ACA flow chart, Aaron provides more context for why the Plan B decision matters, and TIE wishes readers Happy Hanukkah.

DT

On The Record (with daily recap)

  • RWJF: Policy Brief on Independent Payment Advisory Board (IPAB)

Today in TIE: Reflex, Austin concludes his premium support series, Don looks at a piece saying quality improvements are not likely to reduce costs, while Aaron covers Paul Starr wondering if the individual mandate was a miscalculation?

DT

On The Record (with daily recap)

  • CBO: Report on federal budget deficit during first months of FY 2012
  • Mathematica: MPR launches new working paper series
  • RWJF: Do students who are more active do better in school?

Today in TIE: Reflex, Austin intros a series on premium support, and notes that Gov. Romney is keeping his options open on that issue, Don updates on teaching about the individual mandate, Aaron looks for Plan C on the FDA over-the-counter-morning-after pill controversy, and he is having trouble finding the words a lot this week, this time per Sen. Santorum’s take on the individual mandate, while Kevin rocks it out in the NEJM on the First Amendment and smoking

DT

On The Record (with daily recap)

  •  GAO: Fraud Detection Systems: Centers for CMS…
  • CMS: Health Spending by State of Residence, 1991-2009

Today in TIE: Reflex, Austin tries to explain the Medicare cost slow down, and wants you to vote for the most influential health policy paper of the year, Don is not ready to take the genome pledge but thinks we shouldn’t overreact, while Aaron has more on parental (mis)perception of child obesity, and how campaigning in Iowa is not making it better

On The Record (with daily recap)

  • BPC: Is Premium Support the Answer? Dec 16, 10-11:30am @Brookings Inst.
  • RWJF: vote for the most influential health research publication of 2011

Today in TIE: Reflex, Austin wonders why more educated people live longer, and shows us how to blog better and worse, Don provides evidence that Medicare is complicated, Aaron concludes that retail clinics are good for some things, and talks about Harold’s single payer post and the TIE way, while Kevin looks at the international market for generics.

Bundled payments and nursing

Interesting post by Gail Wilensky in the Robert Wood Johnson Foundation Human Capital blog. Her discussion of the impact of bundling on the role of nurses stood out:

The move to more inclusive bundles, particularly those that differentiate according to the quality of care provided, should increase the role of nursing in providing care to patients. Since nurses have not traditionally been able to bill Medicare independently, except under limited circumstances, the value they bring is easier to capture the larger the payment unit. In capitated systems, such as HMOs, where a single payment covers all services provided over the course of the year, the incentive is greatest to use the mix of health care personnel that can provide the health services needed at the lowest cost.

Not surprisingly, the role of nurses has tended to be greater at organizations such as Kaiser and Geisinger, as well as in the military relative to the care provided by more traditionally reimbursed physician groups. As the scope of services that is included in the bundled payment expand, some of the same incentives that have affected decision-making in the capitated systems will begin to dominate decision-making elsewhere. The repeated studies that have shown high quality associated with primary care services provided by nurse practitioners should only increase their attractiveness whenever payments are differentiated for quality.

More on the potential impact of bundling on nurses from Ellen Kurtzman.