Real World Health Care Blog

Tag Archives: medicine

Why We Give to HealthWell Foundation – and Why You Should Too

As the head of a communications strategy shop that helps clients in science, technology, and health care, I encounter a seemingly endless number of organizations that want to do good for society and the planet.  Why then have the WHITECOAT Strategies employees – who serve as editors of Real World Health Care (RWHC) Blog – decided that the HealthWell Foundation should be one of our two charter charities, as our firm becomes a social enterprise in 2014?

David Sheon

David Sheon

Before I answer that, just what is a social enterprise?

A social enterprise is an organization that applies business strategies to maximize improvements in human and environmental well-being, rather than maximizing profits for shareholders.

Social enterprises can be structured as for-profit or non-profit organizations, but their focus is using their proceeds to do good.

We decided that organizations seeking communications firms would like to know that revenue from their work is going to help society.  And our employees like to know that too.

When we made the decision to become a social enterprise, we thought about the impact of our work globally and locally.  And that’s how we arrived at helping CA Bikes, as well as the HealthWell Foundation.

CA Bikes is a nonprofit organization founded by Chris Ategeka, a native of Uganda. The oldest of five children, Chris became an orphan and head of his household at an early age after losing both his parents to HIV/AIDS. After years of poverty and laboring in the fields, a miracle happened, as Chris says, when a woman from the United States started an organization called Y.E.S. Uganda near his village, took him in, and supported him through school. Now, Chris holds a BS and an MS in Mechanical Engineering from the University of California, Berkeley.

Many people living in rural Africa have no access to emergency medical services, and given that the nearest health clinic or hospital is often miles away, this results in needless suffering and deaths. CA Bikes builds and distributes bicycle and motorcycle ambulances to rural African villages and trains partners in their maintenance and use to provide access to life-saving care during medical emergencies. For more information about CA Bikes and to help support their work, click here.

The WHITECOAT team is honored to help Chris fulfill the mission of CA Bikes.

WHITECOAT’s history with the HealthWell Foundation dates to a discussion one of my staff members and I had over three years ago.  She told me that her best friend from college had been diagnosed with a brain tumor. He had insurance through his job, which stuck with him through the medical emergency.  His wife had been laid off of her job a month before the diagnosis.  The emotional toll of the diagnosis was awful.  I knew the couple and their children would find their own way to deal with that and there was nothing we could do. But I felt that perhaps we could do something more to find them financial support.

One call to the HealthWell Foundation was all that was needed.  After reviewing financial records and evaluating the situation, the Foundation tapped a fund reserved for medical emergencies that reimbursed not only for the co-pays associated with medication, but also for the cost of the monthly health insurance premium and related medical expenses.  This program has now transformed into the Emergency Cancer Relief Fund, which WHITECOAT is proud to help launch for HealthWell.

HealthWell has awarded more than 265,000 grants to patients in over 40 disease categories, making a profound difference to over 165,000 people faced with difficult medical circumstances in the U.S.

I hope that at this time of giving, you’ll join me and the WHITECOAT staff by donating to the HealthWell Foundation.

Categories: Cost-Savings

Experts Say More Med Students Good News for U.S. Health Care

Fresh data released just last week demonstrates that new student enrollment at medical schools is on the rise nationwide.

Paul DeMiglio

Paul DeMiglio

The Association of American Medical Colleges (AAMC) announced Thursday that the total number of those who applied to and were accepted into medical school grew by 6.1 percent this year to a record 48,014. This figure beats out
— by 1,049 students — the previous all-time high set in 1996. The AAMC, which represents U.S. hospitals, health systems, Department of Veterans Affairs medical centers, academic societies and 141 accredited U.S. and 17 accredited Canadian medical schools, also found that:

  • The number of first-time applicants climbed to 35,727 (5.5 percent increase).
  • The number of students enrolled in their first year of medical school went past 20,000 for the first time. 

“At a time when the nation faces a shortage of more than 90,000 doctors by the end of the decade and millions are gaining access to health insurance, we are very glad that more students than ever want to become physicians. However, unless Congress lifts the 16-year-old cap on federal support for residency training, we will still face a shortfall of physicians across dozens of specialties,” AAMC President and CEO Darrell G. Kirch, M.D. said in a statement. “Students are doing their part by applying to medical school in record numbers. Medical schools are doing their part by expanding enrollment. Now Congress needs to do its part and act without delay to expand residency training to ensure that everyone who needs a doctor has access to one.”

Record-breaking enrollment is also being seen at colleges of osteopathic medicine, where 20% of medical students are enrolled. Although they make up a smaller number of students, their growth rates increased even faster. In an announcement released Wednesday by the American Association of Colleges of Osteopathic Medicine (AACOM), experts say this trend will help offset the looming primary care crisis that will result from a growing shortfall in the number of doctors.

Enrollment at colleges of osteopathic medicine has almost doubled over the past decade, with the number of students who applied this year hitting 16,454. Other key findings, according to AACOM, show that:

  • Osteopathic medical colleges saw an 11.1 percent increase in first-year student enrollment for 2013, bringing total enrollment to 22,054.
  • 4,726 new osteopathic physicians graduated this past spring, representing an increase of more than 50% over the number of such graduates 10 years ago.

“Because large numbers of new osteopathic physicians become primary care physicians, often in rural and underserved areas, I’m hopeful that the osteopathic medical profession can help the nation avoid a primary care crisis and help alleviate growing physician shortages,” Stephen C. Shannon, DO, MPH, President and CEO of AACOM, said in a statement. “Interest in osteopathic medical education is at an all-time high.”

Primary care physicians are expected to be hit harder than any other specialty, with a projected shortage of about 50,000 by 2025. 

So what exactly is osteopathic medicine and osteopathic physicians (DOs)? According to AACOM, which represents the nation’s 30 colleges of osteopathic medicine at 40 locations in 28 states, DOs offer a comprehensive, holistic approach to medical care.

One in five medical students are now enrolled in osteopathic medical schools, and this percentage will grow even more as new campuses open and colleges continue to expand to keep pace with more students.

Now it’s your turn. What are potential advantages and disadvantages of more medical school graduates – to cost, care and access? Will the rise in new enrollment be enough to offset expected physician shortages? Tell us what you think.

Kaiser Permanente Gives Providers Evidence-Based Tools to Increase Adherence

At an industry conference years ago, I met an HIV-positive patient. We spoke about her treatment as well as her adherence program. “Who takes care of you?” I asked. “Kaiser Permanente,” she responded. Afterward, I did a little research and discovered this was one of the first HMOs created in the United States that takes care of millions of patients. Based in Oakland, California, their goal is “supporting preventative medicine and attempting to educate its members about maintaining their own health.”

Joel L. Zive

Joel L. Zive

Adherence remains a capstone in caring for patients after medications are dispensed and is an especially important issue for indigent populations. But now with implementation of health care reform fast approaching, patients will be required to take even more responsibility for their health, including adherence to medication regimens. Although no integrated health care structure is perfect, Kaiser’s integrative model fascinates me and allows its health care teams to implement successful adherence strategies.

For example, a Kaiser physician at the South San Francisco Medical Center conducted a hypertension study (“Improved Blood Pressure Control Associated With a Large-Scale Hypertension Program”) that compared their program’s results to those at the state and national level. The outcomes are startling:

  • The Kaiser Hypertension control rate nearly doubled, skyrocketing from 43.6 percent in 2001 to 80.4 percent in 2009.  
  • In contrast, the national mean of hypertensive control went from 55.4 to only 64.1 percent during the same time period.

One aspect of this program included using single pill combination therapy, which has been shown to boost adherence. In a slightly different approach to adherence in hypertension, Kaiser Permanente Northern California and UC San Francisco were recently awarded an $11 million grant to fund a stroke prevention program by targeting and treating hypertension among African Americans and young adults.

By Googling “Kaiser Permanente adherence” the Kaiser Permanente Division of Research appears. Their published research draws from Kaiser Permanente units throughout their network, collaborations with academic institutions nationwide, and the HMO Research Network – a consortium of 18 health care delivery organizations with both defined patient populations and formal, recognized research capabilities. These resources provide clinicians and pharmacists with a plethora of study designs and disease states from which to choose and evaluate.

In the study “Determination of optimized multidisciplinary care team for maximal antiretroviral therapy adherence,” for example, a multidisciplinary care team was assigned to patients with new antiretroviral drug regimens. Because this model translated to improved adherence rates, clinical teams around the country now use some variation of a multidisciplinary approach, enabling each discipline’s area of expertise to benefit the patient.

Another article from Kaiser — “Health Literacy and Antidepressant Medication Adherence Among Adults with Diabetes: The Diabetes Study of Northern California (DISTANCE)” – demonstrates that adherence is multifactorial.  This study’s conclusions underscore the importance of health care literacy components, simplifying health communications for treatment options, executing an enhanced public relations campaign around depression and monitoring refill rates.

In my experience, if someone with mental health issues does not take his or her medications, then regardless of disease state, the patient’s treatment falls off the track. I approach these difficult situations by drawing on the conclusions of the above studies:

  • First, is there a different message I could give the patient? Or am I reaching the patient at a level of health care literacy he could understand? For example, I had a deaf patient who found it tiresome writing messages back and forth to me. When I realized he “speaks” to people via a teletype machine, I began communicating with him via word processing software. This made our communications less cumbersome. And this improved adherence to his regime because he was less frustrated.
  • Next, the multidisciplinary approach is quite powerful. When I served HIV-positive patients in the South Bronx, if anything occurred that affected adherence, the prescriber, nurse, social worker or case manager immediately were made aware. Sometimes we would discontinue the regimen and other times we would tweak the regimen and get the patient back on treatment.

The real adherence tragedy for indigent patients is not whether they receive medication, but whether they have access to the tools, education and knowledge they need to take their meds as prescribed. Leveraging articles from resources like Kaiser’s Division of Research may be the solution to reversing the trend of low adherence.

Now we want to hear from you. If you’re a patient, has your doctor or pharmacist worked with you to improve med adherence? If you’re a provider, what resources have you found to be useful when helping patients understand why they should take meds as prescribed? Share your stories in the comments.

Categories: Access to Care

The President and His Stent: How the Patient-Physician Relationship Represents What Works Best in U.S. Health Care

BassTed_jpg

Dr. Ted A. Bass

The decision by former President George W. Bush and his doctors to treat a blockage in one of his heart arteries with angioplasty and stenting has become the newest chapter in the intense debate over appropriateness in stenting.

Bush’s physical examination revealed irregularities that led to tests that revealed a blockage in his coronary artery, which Bush and his doctors decided to treat with a stent, according to his statement. That he was not having a heart attack and apparently had not felt any symptoms, such as chest pain, brought objections from those who would place sharp limits on the use of stents.

Only President Bush’s physicians and family know what alternative therapy choices were presented to Bush, but we do know medical advances allowed him to choose from several therapeutic courses. Bush, in consultation with his doctors, chose the one that was right for him and the quality of life he wished to maintain.

High quality medical care is patient-centered. We strongly value the right of patients, with their doctors, to make informed choices in line with their health and quality of life goals. This right is threatened by critics who would “reform” the health care system by ignoring the complex nature of medicine, cardiovascular disease and the individual needs of each patient.

For those who are quick to dismiss the benefit of stents, I would encourage them to speak to our patients. As a practicing interventional cardiologist, I see first-hand the benefits of interventional cardiology procedures. I see it when a patient’s life is saved during a heart attack, in infants born with a serious heart defect whose hearts beat strong because of advances of interventional care and in seniors who enjoy productive lives again after a minimally invasive heart procedure. In patients with stable coronary artery disease, stenting reduces chest pain from poor circulation of the heart arteries, decreases the need for repeat procedures, and improves the overall circulation of the heart.

And this is what the President Bush case demonstrates:  Health care decisions must be made between the patient and his or her doctor. As outsiders in the Bush case, we do not presume to make that decision for him – nor should others. While it is important to review patient cases to continually improve, learn from and advance the science of medicine, we must not judge the appropriateness of a medical decision on the basis of limited information. To do so is to rush to a judgment that is short sighted, uninformed and, ultimately, emphasizes attention-seeking soundbites over patient care.

In our quest to reduce costs and ensure that appropriate and optimal treatment is provided to each patient and is in step with the guidelines, let us not forget the doctor-patient relationship at the heart of all we do as physicians. It is a fundamental trust that must not be jeopardized.

Now tell us what you think. Do you agree that stents are beneficial to patients? Why or why not? What does the case of President Bush illustrate in terms of the doctor-patient relationship?

Juvenile Arthritis Awareness Month Underscores Efforts to Identify Causes and Develop Treatments

That’s right. Children get arthritis too. In fact, according to the Arthritis National Research Foundation (ANRF), nearly 300,000 children in the U.S. have been diagnosed with juvenile arthritis (JA) – one of the most common childhood diseases in the country.

Linda Barlow

Linda Barlow 

When Juvenile Rheumatoid Arthritis (JRA) first shows its symptoms in a child’s body, many parents write off swollen joints and fever as the flu, or think a sudden rash might have occurred from an allergic reaction. The symptoms might even recede slightly before showing up again, sometimes delaying diagnosis. 

Because a child’s immune system is not fully formed until about age 18, JRA can be especially virulent, compromising the body’s ability to fight normal diseases and leaving children open to complications that can adversely affect their eyes, bone growth and more.

Both the Arthritis Foundation and the ANRF are on the forefront of combatting this disease by supporting research into causes and treatments.

The ANRF’s Kelly Award is one example of how the organization dedicates part of its research effort toward treatment of JRA. The $75,000 grant is given annually to a researcher focused solely on JRA treatment and cures. For the past two years, the award went to Dr. Altan Ercan at Brigham & Women’s Hospital in Boston, whose work has the potential to provide novel targets for new therapies.

Another example is the Arthritis Foundation’s partnership with the Childhood Arthritis and Rheumatology Research Alliance (CARRA). Through the partnership, the Foundation is working to create a network of pediatric rheumatologists and a registry of children with the disease, allowing researchers to identify and analyze differences and similarities between patients and their responses to treatment. Ultimately, the registry will help researchers cultivate personalized medicine, the ultimate weapon in battling the disease. The CARRA Registry has been launched at 60 clinical research sites and has enrolled 8,000 patients.

The Arthritis Foundation has also committed to providing more than $1.1 million in funding this year to researchers investigating a wide range of topics, including: 

  • Exploring how environmental and genomic factors might play a role in triggering juvenile arthritis; 
  • Collecting data and evaluating the efficacy of standardized treatment plans; and 
  • Developing and testing a smart phone app to help children cope with pain.

According to the Arthritis Foundation, there is no single test to diagnose JA. A diagnosis is based on a complete medical history and careful medical examination. Evaluation by a specialist and laboratory studies, including blood and urine tests, are often required. Imaging studies including X-rays or MRIs may also be needed to check for signs of joint or organ involvement.

“When joint pain, swelling or stiffness occurs in one or more of your child’s joints for at least six weeks, it’s important not to assume these symptoms are temporary, and to get a proper diagnosis from a pediatric arthritis specialist,” says Arthritis Foundation Vice President of Public Health Policy and Advocacy, Dr. Patience White. “Early medical treatment of juvenile arthritis can prevent serious, permanent damage to your child’s joints and enable her to live an active, full childhood.”  

Management of JA depends on the specific form of the disease but can include:

  • Care by a pediatric rheumatologist.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) to control pain and swelling.
  • Corticosteroids such as prednisone to relieve inflammation, taken either orally or injected into inflamed joints.
  • Biologic Response Modifiers (BRMs), such as anti-TNF drugs to inhibit proteins called cytokines, which promote an inflammatory response. These are injected under the skin or given as an infusion into the vein.
  • Disease-modifying anti-rheumatic drugs such as methotrexate, often used in conjunction with NSAIDs to treat joint inflammation and reduce the risk of bone and cartilage damage.

One promising therapy in the fight against juvenile arthritis has been recently approved by the Food and Drug Administration – Actemra (tocilizumab) – from Roche. Used to treat polyarticular juvenile idiopathic arthritis (PJIA), the medicine can be used in children ages 2 and older. It is also approved for the treatment of active systemic juvenile idiopathic arthritis (SJIA).

How can organizations like the Arthritis Foundation and the ANRF increase awareness that arthritis happens to children, and build support to advance development of research and therapies?

Keeping Boston Strong: How Disaster Training at Osteopathic Medical School Helped Save Lives

VCOM Image 2

The Bioterrorism and Disaster Response Program equips students at VCOM with critical skills through field exercises and more (photo courtesy of VCOM).

When Danielle Deines crossed the finish line of the Boston Marathon on April 15, she had no idea her unique medical training as Doctor of Osteopathic Medicine would make a real difference in the life-and-death events that would soon unfold.

A 2012 graduate of the Edward Via College of Osteopathic Medicine – Virginia Campus (VCOM), Dr. Deines immediately sprang into action after the explosions violently rocked the most prestigious race in the country. Triaging people in the medical tent to ensure they received the care they needed, she helped make room for victims on a moment’s notice:

“They asked all of the runners to move to the back of the tent,” Dr. Deines said. “Once there as the volunteer physicians headed to the explosion sites, I made an effort to get to my feet and informed the nurse near me that I wanted to help. I was asked to discharge runners who were able and interested in leaving to help make room for the victims who were starting to be brought in from the street. I cleared those wishing to leave and signed off on their discharge paperwork, then helped to get them out of an entrance that had been made in the side of the tent.  We then moved the freed up cots to form triage areas. The back corner became the most severe triage area, nearest the entrance where the ambulances were arriving. I saw victims with traumatic amputations of the lower extremities, legs that had partially severed or had shrapnel embedded, and clothing and shoes literally blown off of victims’ bodies.”

Dr. Deines’ ability to help at the time of urgent need did not come coincidentally. Her education at VCOM equipped her — and all other graduates of the Blacksburg, Virginia school — with the critical life-saving skills that are needed when attacks or other emergencies strike.

The Bioterrorism and Disaster Response Program, a two-day, mandatory training curriculum for all second-year osteopathic students at VCOM, has immersed students in real-life disaster training, field exercises and specialized courses since its inception in 2003. This comprehensive approach gives participants expertise in areas including terrorist and major disaster response, hospital planning, behavioral risk factors, psychological response to trauma, and media relations.

Students who have completed the program now serve as lifelines, having the ability to respond to catastrophes locally, nationally and internationally – from Hurricane Katrina to the Virginia Tech shootings, tsunamis and tornado damage in Virginia.

Now more than ever, a working knowledge of disaster response issues is central to providing quality patient care.

“All medical students and practicing physicians need to be able to respond to natural and manmade disasters.  With changing global weather patterns such as global warming and changing political climates, disasters are now a part of the framework,” said Dr. James Palmieri, Associate Professor and Dept. Chair at VCOM. “I always teach the students that no matter what kind of disaster takes place, both natural and manmade, it will always begin in someone’s neighborhood and the local medical community will be part of the initial response.  In light of today’s instant communication, if and when you respond, the world will see you as the local expert.  You had better know how to respond properly for both your benefit and that of your patients.”

How can VCOM’s leadership role in disaster response training be replicated by other medical training programs?  In what ways can more medical schools develop and leverage their curricula to prepare students for disaster response?

Today, more than one in five medical students in the United States are training to be osteopathic physicians, who can pursue any specialty, prescribe drugs, perform surgeries and practice medicine anywhere in the U.S. Osteopathic physicians bring the additional benefits of osteopathic manipulative techniques to diagnose and treat patients, helping patients achieve a high level of wellness by focusing on health education, injury prevention, and disease prevention.

For students who are interested in going into osteopathic medicine, visit the American Association of Colleges of Osteopathic Medicine, www.AACOM.org; and VCOM at http://www.vcom.vt.edu/.

Filling the Financial Gap When Health Insurance Isn’t Enough

You can’t escape the headlines: rising expenses and high unemployment. And even for the employed, a sharp reduction in health benefits – coupled with a steep increase in out-of-pocket costs, including deductibles, copayments and coinsurance – is making access to life-saving and life-sustaining therapies out of reach for many Americans.

For some individuals and families, these out-of-pocket expenses can total thousands of dollars each month – much more than many folks earn.

When people in these circumstances need help, many turn to Patient Assistance Programs (PAPs), while others apply for financial assistance through independent non-profits such as The HealthWell Foundation. PAPs – which are offered by state governments or drug makers – are designed for those who cannot afford the cost of medication. Groups like Partnership for Prescription Assistance, NeedyMeds, RxAssistRxOutreach, and the National Center for Benefits (provided by the National Council on Aging), empower individuals to sort out their options and get connected to the PAP that’s right for them, sometimes even helping applicants fill out their paperwork.

What do all these organizations have in common? They focus on addressing the financial strains confronting individuals with health insurance who need important medical treatments but cannot cover their associated out-of-pocket costs and premiums.

Individuals like Marianne of Tarpon Springs, Florida, for example. For Marianne, living frugally her whole life didn’t help. Even though she had health insurance, paid all her bills on time, and once earned a good living as a librarian, the 70-year-old breast cancer survivor could not afford the medicine she needed to keep the cancer from coming back.

With no other alternatives to the $500-a-month life-saving medicine, the fixed-income senior citizen didn’t know where to turn. Until her doctors pointed her to the HealthWell Foundation.

Two years later, and thanks to the financial assistance she received from HealthWell, the still-healthy Marianne travels, cycles, and enjoys the life that continues to “delight and amaze” her.

“I am so fortunate,” she says. “I’ve always been glad to give back to others, and now that I’ve needed the help, I know just how precious it is to receive the kindness and compassion of others.”

Marianne is one of many Americans who benefit from organizations like HealthWell, which has provided copayment assistance to more than 164,000 patients since 2004. Without these critical funds, many of those living with chronic and life-altering illnesses would not have the treatments they need in order to live healthier lives.

No child or adult in the U.S. should go without health care because he or she cannot afford it.

How can charitable copayment assistance organizations partner with businesses, government and other stakeholders to achieve lower costs for health care treatment?

The HealthWell Foundation sponsors this blog.

Get the conversation going in the comments section.

Categories: Cost-Savings

Walgreens Unveils Solutions to Boost Medication Adherence

How can health professionals enable their patients to take medications more consistently as prescribed?

Personalized counseling from pharmacists and prescription refill reminders are two effective ways now shown to fuel better drug adherence, according to research from Walgreens presented March 15 at the World Congress Summit in Philadelphia.

Walgreens’ community pharmacy programs – in addition to successful intervention models – are equipping patients with powerful tools to self-manage their health.

One finding, for example, revealed that individuals receiving in-person counseling from their pharmacist saw 7.2 percent higher adherence than those with more conventional pharmacy care. Meanwhile, one of Walgreens’ pilot programs demonstrated that patients who receive prescription refill reminders (also called automated refill reminders or ARR) are more likely to consistently take medications for chronic conditions.

“In order to improve medication adherence among patients, providers need to understand the key challenges and contributors to non-adherence, and how to address them,” said Jim Cohn, Walgreen Co. spokesperson. “The research findings demonstrate how programs at the community pharmacy level designed to target common barriers to adherence, such as the challenge of learning a new medication therapy or simple forgetfulness, can significantly improve patient health and outcomes.  Ultimately, these types of pharmacy initiatives can help providers do their part to ensure more people get, stay and live well.”

Walgreens isn’t alone in recommending evidence-based approaches to enhance adherence outcomes. The Medication Adherence Project’s (MAP) 2010 Training Package also offers strategies for both providers and pharmacists that stress individualized patient engagement, with solutions that include writing 90-day instead of 30-day prescriptions, prescribing generics, communicating directly with providers, and more.

Securing increased medication adherence will not only go far in helping patients live longer and healthier, but will deliver considerable savings for the health care system too.

How do we know? Underscoring the benefits of adherence, MAP cites “lower disease-related medical costs” for diabetes and hypercholesterolemia in addition to related “reductions in health care costs.”

The New England Health Institute (NEHI) also provides compelling evidence in its October 2012 Issue Brief that reducing medication non-adherence, which contributes to hospital readmissions, helps lower hospitalizations and saves on associated expenses, noting: “One study found that one-third of adverse drug events resulting in a hospital admission were related to non-adherence. The aggregate cost of hospital admissions related to medication adherence has been estimated to be roughly $100 billion per year and estimates of the share of hospital admissions related to non-adherence are as high as 10 percent.”

Successful strategies generating increased medication adherence are clearly worth pursuing and replicating, both to strengthen the quality of health services and to lower the cost of care.

Now we want to hear from you. As a medical professional, what approaches do you incorporate to encourage patients to properly take their meds? If you’re a patient, what has worked for you?

Will Consolidation Change Health Care for the Better?

The Cleveland Clinic believes it will, especially when it produces better patient outcomes and improves care across a spectrum of services.

As part of the recent wave of hospital mergers and acquisitions designed to improve quality and lower costs, Cleveland Clinic recently entered a long-term strategic alliance with Community Health Systems (CHS), a for-profit provider that operates 135 hospitals nationwide. While the two organizations will remain independent, they will “both [remain] committed to discovering novel strategies to improve care, reduce costs, enhance access to health care services and develop new approaches to care delivery.”

In discussing the alliance, CEO and President of Cleveland Clinic, Delos M. Cosgrove, MD, notes that thriving in today’s health care environment will require new ways of doing things. He calls medicine a “team sport.”

We couldn’t agree more. All effective strategies that successfully remove obstacles to quality, affordable care should be on the table in today’s health care environment. The Cleveland Clinic’s consolidation with CHS will lower expenses and improve the quality of care by:

  • Improving patient outcomes and reducing costs by creating a framework that enables physicians to share best practices while capturing, reporting and comparing data.
  • Enhancing quality and data infrastructure by assessing CHS-affiliated hospitals and applying the expertise of the Cleveland Clinic’s Heart and Vascular Institute to related programs.
  • Sharing best practices and creating synergies that encompass telemedicine initiatives, second opinion services for physicians and patients, complex care coordination and other areas in care and cost containment.

We look forward to watching the alliance between Cleveland Clinic and Community Health Systems as they continue to reframe health care.

Have you seen examples of successful collaborations that are improving access to care and/or reducing health care costs? Share them with us.

Why Aren’t Patients Taking Their Medication?

It’s a question with which many in the health care community grapple. In some cases, it’s a matter of affordability, as the high cost of certain therapies makes it difficult to pay for needed drugs AND to pay for essentials like rent or the mortgage, utilities and food. Even with medical insurance, the copays for these expensive therapies put them well out of reach for many Americans.

In other cases, it’s a matter of easy access to refills – a problem being solved, in part, by mail-order pharmacies. This was especially the case among 44,000 hypertension patients recently studied by Kaiser Permanente. Research found that making prescription refills more affordable and easier to access might reduce disparities in medicine-taking behaviors among racial and ethnic groups.

The study authors noted that as early as the first refill, some patients are forgoing their hypertension medication. The result? According to the CDC, hypertension can lead to heart attacks, strokes and deaths related to cardiovascular disease. The impact is devastating to communities of color, particularly among African Americans, where males have the highest hypertension death rates of any other racial, ethnic or gender group.

The research found that both mail-order pharmacy enrollment and lower copayments were associated with a significantly lower likelihood of being non-adherent.

Said the study authors, “Our findings suggest that while racial and ethnic differences in medication adherence persist – even in settings with high-quality care – interventions such as targeted copay reductions and mail order pharmacy incentives have the potential to reduce disparities in blood pressure.”

If you’re in the health care field, what ideas have you seen put in action that work to improve treatment compliance? As a patient, have you ever stopped taking your medication due to high cost or hassles getting refills? And have you turned to mail-order pharmacies or copay assistance programs for help?

Categories: Cost-Savings