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February 2019

Receiving healthcare in alternative settings

This HND piece examines the move to delivering healthcare in non-traditional settings. Walk-in clinics, aka urgent care centers have been around for years, and when CVS purchased MinuteClinics in 2006, another milestone was reached. Now, in light of the CVS/Aetna merger, the new company wants to build these out into offering full-on primary care.

Before you can say "anti-trust," consider that a sizable number of people do not have a primary care physician, and their entry point to healthcare is either via the ER, or a walk-in clinic. Rational public health policy should always favor getting more care to more people.

Read the complete article.


What's behind the increase in healthcare costs?

This HND piece examines a few major causes of the rapid increase in the cost of healthcare. We spend $3.5 trillion every year in this space. For starters, fraud is estimated to be as high as ten percent. But there's also the inexplicably large charges coming out of the hospitals—as opposed to the physician's fees.

And, let's not forget about Pharmacy Benefit Managers, whose sketchy rebate system often favors them, rather than the patient, or even their clients, the insurance companies.

How many things besides healthcare carry a price tag that cannot be quoted in advance? Really, what could possibly go wrong with such an arrangement? Read the complete article.


Population health and conventional demographics: both in need of an overhaul

This HND article examines some of the problems with population health and conventional demographics, and then highlights valuegraphics as a way of fixing them.

In many cases, since population health is often used to evaluate the performance of accountable care organizations. As such, improvements seen in the aggregate are not reflected in quite the same way in individual patients. In fact, these ACOs, highly touted within Obamacare to lower Medicare costs, have actually done just the opposite.

Likewise, conventional demographics, whereby cohorts are simplistically arranged by age group, are not at all predictive of behavior within these groups. Instead, valuegraphics, in which value-based profiles are included within these age cohorts is far more predictive of behavior.

Read the complete article.


CDC, Coca-Cola, sugary drinks, and obesity

This HND piece examines the connection between sugary drinks and the obesity epidemic, while putting things in a historical context. Simply put, diets in the 1950s were high in what we would today call "junk food," yet, almost no one was fat. Of course, there was no body positivity movement either, and fat people were shamed.

We then segue into the matter of "collusion" between the Coca-Cola Company and the CDC, as demonstrated via e-mails, secured using the Freedom of Information Act—in a recently published study. However, the authors of the study come off a bit unhinged, as we explain.

Read the complete article.