Healthcare Roundup: Enthoven's Take on Reform, Help For Small Practices, Docs Drop Credit Cards, and More

Eminent Economist Speaks - Alain Enthoven, a professor emeritus of management at Stanford University, has weighed in against the public option that many Democrats espouse. In a New York Times op-ed piece cowritten with David Riemer, director of the Community Advocates Public Policy Institute in Milwaukee, Enthoven, who supplied much of the intellectual firepower for the Clinton reform plan, said that the proposed public plan would not lower costs and “would misuse the government’s power to set prices without getting at the underlying errors, waste and inefficiency in America’s overpriced health care system.” [Source: New York Times]

Supporting Small Practices - While small medical practices still provide nearly 75 percent of ambulatory care, many of them lack the resources to improve quality, implement EMRs, or address the disparities in care given to minorities, says a new report from the National Committee for Quality Assurance (NCQA). Physicians need training and support in all of these areas, the report argues. Meanwhile, a New England Journal of Medicine article by Thomas Bodenheimer, MD, Kevin Grumbach, MD, and Robert Berenson, MD—all leading health policy experts—maintains that primary-care physicians will need outside support to reorganize their practices into medical homes. The authors express hope that the government will do this through its proposed technology extension centers. [Sources: HealthLeaders, NEJM]

Dog Chasing Tail Dept. -  Just as the percentage of patients paying out of pocket has taken a big jump, fewer physician practices are accepting credit cards. A large-scale survey by SK&A Information Services shows that 33 percent of practices did not take credit cards in April, compared to 28 percent a year earlier. The apparent reason is that they don’t want to pay the high transaction fees of credit card companies and banks, which now average 3 to 4 percent of charges. Ironically, the credit merchants say that they need to levy these fees to insure against the risk of consumer nonpayment. But practices that don’t take credit cards have a higher risk of not getting paid when they try to collect later on. [Source: American Medical News]

Quality Data From EHRs - The National Quality Forum (NQF), a multi-stakeholder organization that vets quality measures, is seeking comments on a draft data set that would enable EHRs to generate quality data. This is considered important because most current information on healthcare quality is drawn from claims data and lab reports. The NQF committee that drew up the data set noted that the clinical data needed for accurate quality measurement is often not available in EHRs. [Source: Government Health IT]

Computer Talk - The Certification Commission for Health Information Technology (CCHIT), a private, nonprofit group that certifies EHRs, has formed an “advanced interoperability” workgroup that will begin work next month. Its goal will be to recommend optional criteria and testing for advanced EHRs that have capabilities for data exchange that go beyond the current interoperability standards. The new co-chairs of this volunteer workgroup are Brian Levy, MD, chief medical officer and senior vice president of Health Language Inc., and Alan Zukerman, director of primary-care informatics at Georgetown University Medical Center. Levy’s appointment is especially interesting, since Health Language specializes in “semantic interoperability.” This is a method of exchanging data between disparate systems that relies on mapping medical terms to a single lexicon. [Sources: Health IT Strategist, CCHIT]

Health Wonk Review: Get your eyeful of the latest healthcare blogs at Jason Shafrin’s Health Economist site. The next HWR will appear right here on July 9.