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Highlights of the important and the interesting from the world of health care:
Why critics say the AMA supports health overhaul: Some eyebrows were lifted skyward when the traditionally conservative American Medical Association, which opposed the creation of Medicare in the 1960s, came out in favor of Democrats’ plans to overhaul the U.S. health system. What’s more, the health overhaul bill in the Senate doesn’t even address what’s traditionally been an extremely important issue to the AMA: a permanent fix to the annual cuts in the rates that Medicare pays to doctors. So what gives?
With the Rise of AI, What IP Disputes in Healthcare Are Likely to Emerge?
Munck Wilson Mandala Partner Greg Howison shared his perspective on some of the legal ramifications around AI, IP, connected devices and the data they generate, in response to emailed questions.
According to the Chicago Tribune, critics argue that the answer lies in a set of medical billing codes describing every medical procedure that doctors are required to use when they submit bills to insurance plans, called current procedural terminology or CPT codes. The AMA holds exclusive rights to the codes, and maintains and updates them at no cost to the government, but generates millions (it won’t say exactly how much) each year selling the code books and software licenses to doctors and insurers. “Critics question whether the AMA can represent the interests of doctors while it relies on revenue that comes from a government-sanctioned monopoly,” the Tribune reports.
“There’s an inherent conflict of interest,” said Kathryn Serkes, director of policy at the Association of American Physicians and Surgeons, a competing doctors’ group that has been challenging the code monopoly for years. “The AMA has a vested interest in keeping those codes going and keeping that system going because they’re making money from those, tens of millions of dollars every single year.”
Health care VCs optimistic for 2010: Health care venture capitalists are feeling good about the prospects for exits next year, the Wall Street Journal’s venture capital blog reports. While a few companies are looking towards the IPO market, mergers and acquisitions remain the best and most realistic option. Recent examples cited in the article include Johnson & Johnson’s purchase of Acclarent Inc., Cubist Pharmaceuticals Inc. acquiring Calixa Therapeutics Inc., and Celgene Corp.’s agreement to buy Gloucester Pharmaceuticals Inc. The main reason? “Corporations have plenty of cash, and they are finally willing to spend it,” the Journal says.
“I can think of big companies that wouldn’t let people get on a plane to go to a conference or visit a small company that [could] be acquired,” said John Steuart, managing director of Claremont Creek Ventures. But in 2010, corporations “will look increasingly to small companies as an off balance-sheet source of R&D,” he said. “They’re going to go on a shopping spree.”
A Personalized Approach to Medication Nonadherence
At the Abarca Forward conference earlier this year, George Van Antwerp, managing director at Deloitte, discussed how social determinants of health and a personalized member experience can improve medication adherence and health outcomes.
The biggest obstacle to cutting health spending? It’s you and me, writes Kevin Pho of KevinMD, and he’s probably right. Despite data showing that more care isn’t necessarily better care, much of the American public refuses to buy into that notion. The result is excessive and wasteful spending that doesn’t lead to better outcomes. Afraid of telling people what they don’t want to hear (and correctly guessing that there’s no votes in doing so), Congress merely acts as our enabler. As Pho says, “This does not bode well for reformers who want to control costs by encouraging medical practices to adhere to the best available data.” No, it doesn’t.
The poverty of poverty: What’s worse for your health than being obese, uneducated or smoking? Poverty, which can cause a loss of up to 8.2 years of perfect health, according to a new study published in the American Journal of Public Health. “The average person whose income level is below 200 percent of the federal poverty line (the bottom third of the country’s population) would lose an estimated 8.2 years of perfect health, smokers 6.6 years, high school dropouts 5.1 years and the obese 4.2 years,” the Chicago Tribune reports. So it seems that saving a little more of your paychecks each month may be a better New Year’s resolution than vowing to hit the gym.
