National News

Data: The secret ingredient in hospital cooperation

Marketplace - American Public Media - Wed, 2014-05-28 07:53
Thursday, June 5, 2014 - 11:51 Jessica Kourkounis

Our Lady of Lourdes Medical Center and Hospital in Camden, New Jersey.

If you’ve got to go to the hospital   – one that’s near your home or very far from it – you’d want your prescriptions, past procedures, and all the rest at your doctor’s finger tips.

And while sharing that kind of data could reassure consumers and save perhaps as much as $80 billion a year, it remains a fantasy for most patients.

“Everybody in the medical field knows there are economies to be gained there if we would just work together and share the information,” says former Beth Israel Deaconess Medical Center CEO Paul Levy. “And yet the industry, for the most part, is dead set against doing that.”

After nearly ten years running one of the premiere institutions, Levy says he came to see that hospital executives don’t trust each other enough to work together. But what is out of reach for most patients in America is becoming a reality in one of America’s poorest and most troubled cities, Camden, New Jersey.

It’s a potential blueprint, say executives involved in the program.

“You get three health systems to come together who are competitors who on Monday, Wednesday and Friday want to kill each other in the marketplace, but on Tuesday and Thursday are putting together a coalition that is taking better care of patients at lower costs,” says Dr. Anthony Mazzarelli, a Senior Vice President at Cooper University Health System in Camden.

Cooper, Our Lady of Lourdes Hospital and the Virtua health system have all agreed to share patient data on the city’s 30,000 residents enrolled in Medicaid. They’re doing that through what’s called a health information exchange – or HIE.

The Virtua Health Systems building. (Photo: Jessica Kourkounis)

The value, says Virtua attorney Deborah Mitchell, is that doctors and hospitals can track who is where, when they are there, all in real time.

“Now a doctor will know, 'This patient was at Cooper yesterday, now why are they are Virtua’s ER today? What’s happening with this patient?'” she says.

To put Camden in context, there are only 119 HIEs around the country and they’re generally more limited. University of Michigan health policy professor Julia Adler-Milstein explains for most of us our information may be shared with some doctors and hospitals.

For Medicaid patients in Camden the HIE involves virtually every health provider.

“Is what is happening in Camden in the best interest of their patients?” Adler-Milstein says. “You would say yes. You go to most other places, you would say no.”

Adler-Milstein says it’s hard to criticize hospitals and physicians. After all, she says, they’re just following the economic incentives they see.

In that way, Camden’s hospital executives are no different.

“The common denominator is we all can kind of win,” says Cooper’s Mazzarelli.

What’s different in Camden is data.

Long before the HIE, Dr. Jeff Brenner began tracking some of the city’s sickest and most expensive patients, the patients hospitals had lost money on for decades. And he told docs and executives often mesmerizing and horrific stories -- like one guy who had 300 emergency room visits in a year.

“I mean there’s only 365 days,” says Mazzarelli. “I think before this every health system thought they were carrying the burden and now you realize, ‘Wait, wait, we are all carrying this unbelievable burden on the same patients.’”

Those stories cracked opened the door to modest data sharing in the city. And that helped the hospitals get their arms around the problem.

Pretty soon, Kim Barnes, with Our Lady of Lourdes, says everybody could see it was in their economic best interest to share patient data, at least on their Medicaid patients.

“You realize that problem is going to be solved by partnering, by developing better transitions and handoffs among providers,” she says. “Those pictures are painted very clearly when you see the data.”

What took Camden so long to do might be quicker in San Diego, Kansas City and Miami as incentives move and more and more providers get paid to keep costs down.

Mazzarelli predicts that’ll be enough to get hospital executives over the hump to break bread with their competitors.

“Executives, I think – and I can say this, being one myself – I think we look at where our incentives lie,“ he says. “I wish that shifting the incentives of how people get paid didn’t change things in our healthcare system, but it’s becoming pretty clear it probably will make a difference.”

Executives at all three Camden hospitals say they imagine a day soon when they’ll exchange data for all their patients. Mazzarelli says the incentive undertow is so strong that the patients the hospitals have gone to war over for decades – gold-plated privately insured patients – are now more valuable as something shared than something guarded.

Cooper University hospital. (Photo: Jessica Kourkounis)

Marketplace for Thursday June 5, 2014by Dan GorensteinPodcast Title Data: The secret ingredient in hospital cooperationStory Type FeatureSyndication SlackerSoundcloudStitcherSwellPMPApp Respond No

Obama Emphasizes Importance Of Alliances In Foreign Policy Address

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Speaking at West Point, Obama suggested the nation's "long season of war" was drawing to a close. Although the U.S. will continue to lead, it will seek partners when not under direct military threat.

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NPR News - Wed, 2014-05-28 07:06

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Could Diet Soda Really Be Better Than Water For Weight Loss?

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A new study funded by the beverage industry suggests that diet drinks might be more effective than water alone in helping dieters shed pounds. Researchers speculate that soda made people less hungry.

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Son Of Late Snake-Handling Pastor Is Bitten By Rattlesnake

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Can Employers Dump Workers On Health Exchanges? Yes, For A Price

NPR News - Wed, 2014-05-28 06:20

A recent IRS rule bars employers from offering workers tax-free subsidies to buy policies. But a company could still cancel its plan and leave workers to buy individual policies on the marketplaces.

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PODCAST: Is it smart for employers to dump workers onto the ACA exchanges?

Marketplace - American Public Media - Wed, 2014-05-28 05:41

If companies stop offering health insurance they must treat the stipends as taxable income…or else face fines of more than $30,000 a year per worker.

The Learning Curve story: How the digital revolution is transforming learning and the business of the classroom.

Maya Angelou, Poet, Activist And Singular Storyteller, Dies At 86

NPR News - Wed, 2014-05-28 05:41

Angelou refused to speak for much of her childhood and revealed the scars of her past in her groundbreaking memoir, I Know Why the Caged Bird Sings. She opened doors for black and female writers.

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Snowden Says He Was 'Trained As A Spy' In NBC Interview

NPR News - Wed, 2014-05-28 05:08

Targeting what he calls "misleading" statements about his work for the U.S., former NSA contractor Edward Snowden tells NBC's Brian Williams he "was trained as a spy" and lived under a false name.

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Google's New Car Lacks A Steering Wheel (And Brakes)

NPR News - Wed, 2014-05-28 03:58

The tech company built three prototypes from scratch, creating compact cars that look like they're on an extreme no-options diet. For now, their top speed is 25 mph.

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When College Isn't Worth It

NPR News - Wed, 2014-05-28 03:49

Higher education always pays off. Except if you do these three things.

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Ukraine Promises To Crush Insurgency; Chechnya Denies Sending Troops

NPR News - Wed, 2014-05-28 03:22

Chechnya's leader says the country hasn't sent fighters to join rebels in eastern Ukraine, denying a charge that gained substance when Chechens were reportedly found after recent fighting.

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Employers must treat ACA stipends as taxable income

Marketplace - American Public Media - Wed, 2014-05-28 03:01

A recent IRS ruling underscores how serious the Obama Administration is about encouraging employers to keep providing health insurance to their workers.

If businesses stop offering the benefit and give employees a stipend to help cover costs on the health exchanges they must treat that as taxable income, or face fines of more than $30,000 dollars a year per worker.

There’s some concern that as the Affordable Care Act picks up steam, employers will get out of the healthcare business. But PricewaterhouseCooper’s Ceci Connolly says that overstates what she’s hearing from company executives.

"They’re saying we want to know what our options particularly for saving some money," she says. You’d think dropping employee health insurance might do that, but Connolly says the math is pretty clear.

As long as companies can write off contributions, employers and employees make out better than if worker’s got a stipend for an exchange because everyone would pay taxes on those stipends.

On top of that, Brian Marcotte with the National Business Group on Health says many employers question these exchanges.

"What’s different in terms of how care is delivered, how care is managed? Is it any better than what’s being done today," he says.

Remember many of the country’s largest employers are self-insured. Marcotte says businesses continue to believe they can do a better job controlling costs, but would be happy for the exchanges to prove them wrong.

When is hummus really hummus?

Marketplace - American Public Media - Wed, 2014-05-28 02:56

Sabra has spent millions of dollars making hummus mainstream in the U.S. Now, it wants the Food and Drug Administration to rule on what is and is not hummus.

The word "hummus" means chickpea, and Sabra wants the FDA to rule that new, chickpea-free dips like black bean hummus and edamame hummus should not get to use the name.

Instead, the company wants the FDA to define hummus this way: "The semisolid food prepared from mixing cooked, dehydrated, or dried chickpeas and tahini with one or more optional ingredients," says Greg Greene, Sabra's director of marketing.

If it succeeds, the FDA will issue what's called a Standard of Identity. Lots of foods have these, determining what can be labeled juice, or mayonaise, or this one for milk: "The lacteal secretion of an animal."

The National Milk Producers Federation has been fighting names like soymilk and almond milk for years now. To milk producers and Sabra, these FDA definitions help avoid customer confusion.

It's also, of course, about money: If you've invested a lot marketing milk or hummus, you don't want some newcomer stealing your identity.

Everybody's talking about Cuba

Marketplace - American Public Media - Wed, 2014-05-28 02:06

The U.S. Chamber of Commerce is leading a delegation to Cuba this week to, in its words, "develop a better understanding of the country’s current economic environment."    

“One thing it will do is open people’s eyes to some of the opportunities that may be down there, ” says former Deputy Secretary of State and National Intelligence Director John Negroponte. Negroponte, who is not on the trip, now heads the Americas Society/Council of the Americas and recently signed a public letter the Society sent to President Barack Obama, asking him to ease U.S. sanctions on Cuba while continuing to push for human rights reforms. 

Why all this attention to Havana now? It’s partly because the administration has already eased up a bit.

“We should broaden out what is in our national interest to do with Cuba,” says Ted Piccone, acting vice president of the Brookings Institution’s foreign policy program. “It’s in our interest to have better relations with the country.”

Texas A&M study says if the U.S. ended travel and financial restrictions on Cuba, the U.S. would be $1.1 billion richer. 

New trade venue is in talks to become a full-fledged financial exchange

Marketplace - American Public Media - Wed, 2014-05-28 01:36

Driven in part by Michael Lewis' recent book, regulators are taking hard looks at the widespread practice of ultra-high frequency trading in financial markets.  

Lewis' book argues that regular investors lose out when technology gives some traders the ability to jump in and out of trades with lightening speed. The fast folk say there's nothing wrong with what they do. At the center of Lewis' book is an upstart financial trading system out of New York City called IEX that looks for ways to use technology to insulate clients from high speed traders nibbling on the edges of their prices. Now the Wall Street Journal says IEX is in talks to raise several hundred million dollars in cash to turn itself into a full-fledged financial exchange with all the necessary regulatory permissions and safeguards. IEX isn't commenting about this, but the head of Market Operations at this maverick out was willing to talk about his efforts to thwart the fast boys, as he sees it.

Don Bollerman, Head of Market Operations at IEX, joins Marketplace Morning Report host David Brancaccio to discuss. 

A digital night at the museum

Marketplace - American Public Media - Wed, 2014-05-28 01:00

The Metropolitan Museum of Art recently announced that it would make over 400,000 pieces of art from its collection available online through high quality digitzation. It's part of a commitment by the museum to provide high resolution images for those who want to study the art work more closely. 

Sree Sreenivasan, digital officer at The Metropolitan Museum of Art, points out that it's also a means by which people around the world can enjoy the collection:

"Everybody in the world has part of their history here over the 5,000 years of art that we've collected, and so they will find something that connects with them and their culture."

The Learning Curve story

Marketplace - American Public Media - Wed, 2014-05-28 00:38

Technology is transforming education.

It’s a big statement, and we’ve heard big statements before. Remember the early predictions about Apple computers? Or how educational television would be the future of learning?

But this time, things look different. Technology really may change the way teachers teach and children learn. The digital revolution, fueled by billions in private and public investment, is full of promise. The promise of making kids better learners by letting them direct their own learning, of making teachers better teachers by giving them more and better information about their students, of bringing down costs, and of getting more kids across the college finish line with less student debt.

Simply put, educational technology is the New Right Answer.

Or so its proponents would have us believe.

But for all the promise of online courses, flipped classrooms, personalized learning, tablets, laptops, apps, MOOCs and the rest of it, there’s an equal amount of peril. The peril of having kids, who already spend seven hours a day with electronic media, spend even more time in front of a screen. The peril of taking teachers out of the center of the class, and into the role of technology advisors directing kids to the best app. The peril of letting the feedback loop created by collecting data on everything students do, determine their futures.

This will be our territory.  Over the next year, the LearningCurve team will explore the expanding role of educational technology from preschool through college. We will take you into the digital classroom, and the hotbeds of EdTech innovation. We will ask the big questions about whether all this technology is actually making kids any smarter, or better prepared for the workforce of the 21st century. We will follow the money as it pours into the classroom.

We will bring these stories to you over the air and online. We will get behind the numbers that tell the deeper story . We will keep you up to date with a podcast and newsletter. We will let you test your knowledge with our daily quiz.

And we want to hear from you as we do it. Parents. Teachers. Students. Comment on our stories. Follow us on Twitter and Facebook. Humor us with your Tumblr posts. Join us in Google chats with experts. Tell us what you like and what drives you nuts about learning and teaching today. Join us in an ongoing conversation about one of the most important issues of the day. The education of the next generation.

About Learning Curve

Marketplace - American Public Media - Wed, 2014-05-28 00:38

Technology is transforming education.

It’s a big statement, and we’ve heard big statements before. Remember Apple computers? Or how educational television would be the future of learning?

But this time, things look different. Technology really may change the way teachers teach and children learn. The digital revolution, fueled by billions in private and public investment, is full of promise. The promise of making kids better learners by letting them direct their own learning, of making teachers better teachers by giving them more and better information about their students, of bringing down costs, and of getting more kids across the college finish line with less student debt.

Simply put, educational technology is the New Right Answer.

Or so its proponents would have us believe.

But for all the promise of online courses, flipped classrooms, personalized learning, tablets, laptops, apps, MOOCs and the rest of it, there’s an equal amount of peril. The peril of having kids, who already spend seven hours a day with electronic media, spend even more time in front of a screen. The peril of taking teachers out of the center of the class, and into the role of technology advisors directing kids to the best app. The peril of letting the feedback loop created by collecting data on everything students do, determine their futures.

This will be our territory. All of it and more. Over the next year, the LearningCurve team will explore the expanding role of educational technology from preschool through college. We will take you into the digital classroom, and the hotbeds of EdTech innovation. We will ask the big questions about whether all this technology is actually making kids any smarter, or better prepared for the workforce of the 21st century. We will follow the money as it pours into the classroom.

We will bring these stories to you over the air and online. We will get behind the numbers that tell the deeper story . We will keep you up to date with a podcast and newsletter. We will let you test your knowledge with our daily quiz.

And we want to hear from you as we do it. Parents. Teachers. Students. Comment on our stories. Follow us on Twitter and Facebook. Humor us with your Tumblr posts. Join us in Google chats with experts. Tell us what you like and what drives you nuts about learning and teaching today. Join us in an ongoing conversation about one of the most important issues of the day. The education of the next generation.

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