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Getting more from “community benefit,” Mark Cuban is getting too many blood tests, and dying in America is still painful

April 2, 2015

In order to bring you more of the news you want to read, RightCare Weekly summarizes and interprets three important articles and provides headlines linking to the many other articles and editorials you’ll find interesting. As always, RightCare Weekly presents articles related to moving our healthcare system toward the right care for all patients.

Join the conversation: Post your comments in our new section at the bottom of this page.

 

Features:

  • In JAMA, Elliott Fisher and colleagues write that the ACA presents some new opportunities for rethinking hospital community benefit programs. Non-profit hospitals required to offer “community benefits” as part of receiving tax-exempt status have long been able to show that contribution by accepting low reimbursements from Medicaid, offering uncompensated care to the indigent or uninsured. Many hospitals have also claimed they are satisfying the requirement  through offering free cancer screening, a practice that strikes some as more of a loss leader intended to drum up business that a real benefit to their communities. Under the ACA, hospitals should have more opportunities to partner with each other at a regional level, and collaborate with their local communities to fund projects that address fundamental social needs, like prevention. This idea could allow communities to take the lead in designing their healthcare system.

 

  • Investor and Dallas Mavericks’ owner Mark Cuban took to Twitter Wednesday night to promote his aggressive personal regimen of regular blood tests, saying “If you can afford to have your blood tested for everything available, do it quarterly so you have a baseline of your own personal health.” His comments have been widely criticized. As Dan Diamond reports in Forbes, healthcare experts including journalists and physicians turned out on Twitter to inform Cuban that his plan is unnecessary, unsupported by evidence, and far more likely to lead to harm from false positives and over-diagnosis than to offer any meaningful information. Like Cuban, many people believe that having more information about one’s health can only be helpful. Countering that narrative will require the medical community to be upfront with the public about the risks of unnecessary tests, and the follow-up treatments they lead to.

 

  • Why is dying in America still accompanied by pain? In a Kaiser Health News piece, author Jenny Gold cites a recent study, involving more than 7,000 individuals, that shows the number of Americans experiencing pain in the last year of life actually increased by 12 percent between 1998 and 2010.  In the study, pain, depression and periodic confusion at the end of life were considered. Said one physician quoted in the piece, “…We fail to empower patients with the truth…it’s easier to continue to do procedures and diagnostics rather than having that conversation, which is very honest and very difficult.” In a Health Affairs blog this week, author Rebecca Kirch, calls for a national movement to integrate palliative care in the U.S. health system, citing that “our sick care system has not yet adapted to effectively manage the needs of patients with complex chronic illness across all populations and care settings to help preserve their quality of life at every age and disease stage.” Lastly, supporting the dying can take many forms, as Alina Tugend writes in a New York Times piece. Death “doulas” are emerging to help the dying and/or their loved ones prepare for the end of life. They organize paperwork, assist with funeral arrangements or simply hold someone’s hand.

 

 

Announcements:

  • Save the Date! Thursday, April 16, 1-2 pm ET. Join us for a webinar on the Do No Harm Project, a special session for clinicians and trainees to learn how to implement this program in your institution. Presenters are the program founders, Brandon Combs, MD, FACP, University of Colorado School of Medicine and Tanner Caverly, MD, MPH, University of Michigan. The DNH Project inspired the Teachable Moments series in JAMA Internal Medicine. Register now.

 

  • Looking for Spanish-Speaking Health Professional: ACP Decisions is looking for a native Spanish-speaking health professional who feels comfortable discussing goals of care and end-of-life issues with Spanish-speaking patients and families to serve as a narrator for several new videos.  Filming will take place in the Boston area.  If interested, please contact Aretha Delight Davis at aretha@acpdecisions.org.

 

 

Headlines: 

More coverage of the Road to RightCare Conference

 

Medicaid

 

End-of-life care

 

Race in medicine

 

Medical education

 

Patient-centeredness

 

Shared decision making

 

Social determinants of health

 

Politicizing medicine

 

Payment system

 

Overuse

 

Primary care

 

Health reporting

 

Patient safety

 

Hepatitis C treatment

 

Medical evidence

 

Guns and public health

 

Healthcare delivery system

 

RightCare Weekly is made possible through the generous support of the Robert Wood Johnson Foundation.  

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