Archive for Tom Emerick

Most expensive cities for primary care

An article Becker’s shows the cities with the most expensive primary care.

The three most expensive cities for a primary care visit are on the West Coast:

  1. San Francisco     $251
  2. Sacramento        $219
  3. Portland             $216

Hmm. Curious. What gives on the West Coast? Those prices are outrageous.

Despite the best efforts of an active coalition, Minneapolis comes in number four at an average cost for a primary care visit of $209.

According to the article, “In Dallas, a patient can pay up to 23 times more than necessary for a lipid panel….”  Does Dallas have the powerful Baylor system to thank for that?

It’s not cost of living. According to a Forbes article, the five highest priced cities are:

  1. Honolulu
  2. New York
  3. Bridgeport-Stamford-Norwalk, CT
  4. Boston
  5. San Jose

Except for Boston, none of those cities made the top 15 most expensive primary care list.

These kinds of telling statistics have been around for decades, but no one does anything about it. We’ve tried just about everything to fix these exorbitant prices, except one thing…narrow networks.

The time for serious action is now.

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Tom Emerick

Cracking Health Costs, the book, an Amazon best seller, is available on Amazon at a deeply discounted price.  Click here:  Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care by Tom Emerick and Al Lewis.

Tom Emerick is the President of Emerick Consulting and co-founder of Edison Health. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare in the US for his work on medical ethics. Prior to consulting, Tom spent a number of years working for large corporations: Walmart Stores, Burger King, and British Petroleum.

 

 

Are Workplace Wellness Programs Legal?

That is the headline in a recent Forbes online article by Dan Munro.

Writes Dan, “On the one hand, workplace wellness programs are openly endorsed by the Affordable Care Act. On the other, how they’re constructed and implemented is critical in determining any potential benefit or legal risk.”

Further, [Wellness is] a potentially toxic combination that’s ripe for abuse. Employers eager to control exploding healthcare costs and vendors eager to sell programs claiming big ROI with little scientific evidence and no legal review. What could possibly go wrong?”

The short answer is plenty has gone wrong and we can expect much more to go wrong. Just look at the messes created at CVS and Penn State for examples.

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Tom Emerick

Cracking Health Costs, the book, an Amazon best seller, is available on Amazon at a deeply discounted price.  Click here:  Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care by Tom Emerick and Al Lewis.

Tom Emerick is the President of Emerick Consulting and co-founder of Edison Health. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare in the US for his work on medical ethics. Prior to consulting, Tom spent a number of years working for large corporations: Walmart Stores, Burger King, and British Petroleum.

 

 

 

 

American Heart Association silliness

Al Lewis and Vik Khanna wrote a terrific piece on this topic on The Healthcare Blog.

Write Vik and Al, “Last year, we soundly criticized the American Heart Association (AHA) on this blog for its proposal to lower the thresholds for treating cholesterol and getting larger numbers of Americans to swallow statins. We also exposed wellness vendor StayWell, for its mathematically impossible claims of success in British Petroleum’s wellness program” 

The AHA invited the CEO of StayWell, Paul Terry,…“to help write its workplace wellness policy statement, sort of like Enron inviting Bernie Madoff to help design its financial plan.”  When Terry wrote a statement professing an ROI for wellness, he cited a paper HE HIMSELF WROTE.

In short Terry said wellness has an ROI. How does he prove it? He proves it by citing himself saying it gets an ROI. That’s a humdinger of a citation…a real show stopper, that one is.  While my ninth grade English teacher would never have bought that one, this is the kind of sloppiness we’ve come expect from wellness vendors…and now the American Heart Association too.

Well it seems the AHA is up to it’s old song and dance.  They seems to want to statinize the planet.  But why?

Please read the full article.  It’ll be worth your time.

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Tom Emerick

Cracking Health Costs, the book, an Amazon best seller, is available on Amazon at a deeply discounted price.  Click here:  Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care by Tom Emerick and Al Lewis.

Tom Emerick is the President of Emerick Consulting and co-founder of Edison Health. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare in the US for his work on medical ethics. Prior to consulting, Tom spent a number of years working for large corporations: Walmart Stores, Burger King, and British Petroleum.

Annals of Internal Medicine | Screening for Carotid Artery Stenosis… by Vik Khanna

Writes Vik:

Once again, screening, which is highly profitable for many healthcare providers, proves pointless for patients. If you do not have any symptoms, don’t get suckered into having a ultrasound screen done in a search for disease in your carotid arteries. The US Preventive Services Task Forces (USPSTF) concludes that such screenings are worthless.

Annals of Internal Medicine | Screening for Carotid Artery Stenosis: U.S. Preventive Services Task Force Recommendation Statement.

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Tom Emerick

Cracking Health Costs, the book, an Amazon best seller, is available on Amazon at a deeply discounted price.  Click here:  Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care by Tom Emerick and Al Lewis.

Tom Emerick is the President of Emerick Consulting and co-founder of Edison Health. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare in the US for his work on medical ethics. Prior to consulting, Tom spent a number of years working for large corporations: Walmart Stores, Burger King, and British Petroleum.

 

 

Arianna Huffington Embarrasses Herself

According to an article by Al Lewis in Insurance Thought Leadership, Arianna Huffington made major gaffs in a recent post on wellness,  Al writes, “She drank the Kool-Aid on wellness programs and may have gotten more wrong in a single post than any I’ve ever seen.”

Further, “Yesterday, the highest-profile person ever to address the topic of wellness – Arianna Huffington — posted this. I don’t think I’ve ever seen anyone get a story more wrong when a few simple mouse-clicks could have cleared up any misconceptions. (Note: Unlike probably everyone else who attacks Ms. Huffington, I have no political agenda, because she is in the same party as I am — or at least as I was, until this commentary came out)”

More…“Finally, she conflated doing wellness to your employees (like Penn State did and most organizations stlll do) with doing wellness for your employees. She cites examples of caring for employees, an exemplary message with which I wholeheartedly agree. (My book Cracking Health Costs, written with Tom Emerick, was the first to distinguish the “to employees” from “for employees” wellness program strategies)”

The Hufffington article is a good example of blindly defending wellness when more and more facts are coming out, e.g. the recent Rand study, that workplace wellness is just not delivering on its promises.

__________________________________________________________________________

Tom Emerick

Cracking Health Costs, the book, an Amazon best seller, is available on Amazon at a deeply discounted price.  Click here:  Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care by Tom Emerick and Al Lewis.

Tom Emerick is the President of Emerick Consulting and co-founder of Edison Health. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare in the US for his work on medical ethics. Prior to consulting, Tom spent a number of years working for large corporations: Walmart Stores, Burger King, and British Petroleum.

 

 

 

Medical experts disagree on the worthiness of annual pelvic exam

According to a report in the Annals of Internal Medicine, doctor organizations are in sharp disagreement on the worthiness of the annual pelvic exam. When groups like that disagree, follow the money.

The “ACP [American College of Physicians] recommends against performing screening pelvic examination in asymptomatic, nonpregnant, adult women….”

Predictably, the doctors who make the most profit from giving women this examination, The American College of Obstetricians and Gynecologists, sharply disagrees. Get it? They make the money from these.

Problem is, one is right and one is wrong.

Pelvic exams are not risk free. Further I’ve been told they are a miserable experience. I imagine this exam is a thousand times more miserable than the annual digital rectal prostate exam which lasts only a few seconds.

Lesson? Do not trust the various medical specialist associations, sometimes loftily called “colleges”, to provide objective, ethical, and honest recommendations. Period.  Only fools and wellness vendors do so.

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Tom Emerick

Cracking Health Costs, the book, an Amazon best seller, is available on Amazon at a deeply discounted price.  Click here:  Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care by Tom Emerick and Al Lewis.

Tom Emerick is the President of Emerick Consulting and co-founder of Edison Health. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare in the US for his work on medical ethics. Prior to consulting, Tom spent a number of years working for large corporations: Walmart Stores, Burger King, and British Petroleum.

 

One-third of knee replacements in the U.S. may be inappropriate (OUCH!!)

A Reuters report by Will Boggs had the headline above. (Parentheses are mine.) By today’s surgery standards this should come as a surprise to no one.

“Judging by the symptoms of people with knee arthritis, one-third of knee replacement surgeries may be inappropriate, according to a new study.”  The lead author of that study, Daniel L. Riddle from Virginia Commonwealth University, said ‘ “We found that some patients undergo total knee replacement when they have very low grade symptoms or minor knee arthritis…” ‘

That is the point I’ve been making all along. The ethics around surgery in the US are declining rapidly.  EdisonHealth surgeons at places like Mercy in Springfield, MO, and Virginia Mason, don’t do unnecessary and potentially harmful knee surgery.

It’s time for HR and benefit mangers to wake up. Bad surgeons will get worse and worse until you take their patients away.

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Tom Emerick

Cracking Health Costs, the book, an Amazon best seller, is available on Amazon at a deeply discounted price.  Click here:  Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care by Tom Emerick and Al Lewis.

Tom Emerick is the President of Emerick Consulting and co-founder of Edison Health. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare in the US for his work on medical ethics. Prior to consulting, Tom spent a number of years working for large corporations: Walmart Stores, Burger King, and British Petroleum.

 

 

A scary story: Big brother is watching what you eat and buy

This is a scary story about massive invasions of privacy in the US. This is a travesty in my opinion and one that needs exposure.

According to a story in Bloomberg, doctors and hospitals are watching what you eat, buy, wear, and more. Why? To better manage your health, of course. If you buy a donut somewhere, whether for yourself or as a treat for a grandchild, a company like Acxiom or LexisNexis may be recording that buy and selling that information to your insurer but only for “marketing.” 

The Carolinas HealthCare System for one…”is placing its data, which include purchases a patient has made using a credit card or store loyalty card, into predictive models that give a risk score to patients.”

“University of Pittsburgh, which operates more than 20 hospitals in Pennsylvania and a health insurance plan, is using demographic and household information to try to improve patients’ health.”  Remember the Penn State wellness scandal? Is there something bad in the water in Pennsylvania?

Okay let me get this straight.  If you buy one of the following, your doctor and your health system really should know about it and it should become a part of your medical record?

  • a dozen donuts
  • a cigar for your grandfather
  • a pack of condoms
  • a burger at McDonalds
  • a half pound of deli salami
  • a steak dinner
  • a milk shake
  • a martini after work
  • a case of diet soda

How about too many/much:

  • pounds of coffee (even if it is for your club)?
  • packages of hot dogs (they won’t know your feeding your kids entire soccer team)?
  • popcorn?

Or not enough:

  • fresh fruit?
  • veggies (even if your grow your own)?
  • skim milk?

How about if your teenage son buys a package of condoms? That needs to be in his medical record for your health system/insurer to peruse?

This is nuts…plain nuts, but, alas, the predicable result of the nation’s and employers’ obsession with collecting your personal heath information. I guess if your want privacy you’d best pay cash. But maybe face recognition tools will thwart that too.

For the record, I can’t think of anything I buy that should be keep secret but the idea that my health systems can access my purchase is utterly repugnant to me.

Here is the understatement of the week, says “Jorjanne Murry, an accountant in Charlotte, North Carolina, who has Type 1 diabetes. ‘I think it is intrusive.’ “

BTW:  I’m not a privacy nut, but these kinds of data will create an abundance of “false positives” and rabbit trails (def, an exercises in futility).  I see no real value in this nonsense.

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Tom Emerick

Cracking Health Costs, the book, an Amazon best seller, is available on Amazon at a deeply discounted price.  Click here:  Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care by Tom Emerick and Al Lewis.

Tom Emerick is the President of Emerick Consulting and co-founder of Edison Health. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare in the US for his work on medical ethics. Prior to consulting, Tom spent a number of years working for large corporations: Walmart Stores, Burger King, and British Petroleum.

The Wizardry of Dr. Oz’s Own Words – General Healthy—by Vik Khanna

Vik Khanna has posted a piece about the shaky nutrition advice you hear from Dr. Oz.

When confronted about a “miracle” weight loss pill Dr. Oz has promoted, he came clean with the truth about how to lose weight. It’s really pretty simple and there really are no “miracle” pills.

Says an imbedded link written by General Healthy: “For the most part, getting weight loss fraud advice from Dr. Oz is like the 3 Pigs getting construction tips from the Wolf.”

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Tom Emerick

Cracking Health Costs, the book, an Amazon best seller, is available on Amazon at a deeply discounted price.  Click here:  Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care by Tom Emerick and Al Lewis.

Tom Emerick is the President of Emerick Consulting and co-founder of Edison Health. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare in the US for his work on medical ethics. Prior to consulting, Tom spent a number of years working for large corporations: Walmart Stores, Burger King, and British Petroleum.

 

Overuse of cancer drug Procrit…caveat emptor

The WSJ carried a story of how some oncologists are still overusing a discredited cancer drug, Procrit.

According to the article, Procrit “... was approved in 1989 for anemia and became a popular treatment for that side effect of chemotherapy. But regulators later learned Procrit can speed tumor growth and hasten death in cancer patients.”  Let’s repeat that, Procrit can speed tumor growth and hasten death.

Further, Medicare data shows that one-sixth of the money Medicare paid for this drug went to one clinic in Florida, Florida Cancer Specialists. “Of the 20 oncologists whom Medicare paid most for Procrit, 11 belonged to the Florida group.”

What do you do? Go to your PPO or TPA or network provider and demand that Florida Cancer Specialist be deleted immediately. If you do not, you’re possibly subjecting your employees to serious harm.

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Tom Emerick

Cracking Health Costs, the book, an Amazon best seller, is available on Amazon at a deeply discounted price.  Click here:  Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care by Tom Emerick and Al Lewis.

Tom Emerick is the President of Emerick Consulting and co-founder of Edison Health. In December 2012, Tom was listed in Forbes.com as one of 13 unsung heroes changing healthcare forever. In 2009, Tom was named by Healthspottr as one of the top 100 innovators in healthcare in the US for his work on medical ethics. Prior to consulting, Tom spent a number of years working for large corporations: Walmart Stores, Burger King, and British Petroleum.