RCAW wrap-up, challenging workplace wellness, and misaligned health quality measures

October 27, 2016

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.

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Right Care Alliance members all over the country were hard at work this month organizing and participating in events focused on the theme of listening for Right Care Action Week, and that hard work paid off! This year we organized nearly 100 events, with thousands of participants in 25 states (plus DC), which included 32 listening booths, 16 story slams, 39 “What Worries You” activities, and many other listening-related events. We partnered with 20 organizations, posted 550 tweets with the #RCAW hashtag, and reached more than a million people on Twitter. Several events also piqued the attention of news media. Maia Dorsett, MD, an Emergency Medicine council member, was featured in STAT’s On Call newsletter for her “What Worries You” activity. WTNH in New Haven, C.T. covered two listening booths at the New Haven Public Library, one of which was manned by Lown Institute President Vikas Saini, MD. And New England Cable News interviewed Lown Institute Senior Organizing Fellow Francisco Irby, MD, about his Boston-area listening tours. Thanks to all the RCAW organizers and participants for listening and sharing! Stay tuned for more stories from RCAW coming soon.

Workplace wellness programs are supposed to encourage employees to quit smoking, get fit, or better manage illnesses like diabetes—and keep health care costs down in the process. Many employers use wellness programs as a carrot or a stick, offering financial incentives to join programs or penalties for abstaining. While these programs are growing in number, some employees are resisting sharing personal medical information with their employers. This week, the The New York Times reports that the AARP filed suit against the agency that issues rules for the programs, citing the rules violate anti-discrimination laws protecting worker’s health records, and it questioned whether the programs are, in fact, voluntary, given the consequences of non-participation. In May, the Equal Employment Opportunity Commission ruled that employers could set incentives as high as 30 percent of the annual cost of an individual employee’s health insurance coverage. The AARP contends that its members face “imminent harm” from the rules, which allow “employers to pressure employees to divulge their own confidential health information and confidential genetic information of their spouses as part of an employee ‘wellness’ program.” It is seeking a preliminary injunction to stop the rules, which go into effect next year. The real question is, do these programs actually help workers improve their health? They might, according to STAT, but there’s still no proof.

With all the policies and promises around improving health care quality, one would think that there must be standardized measures used to evaluate it. It turns out, only a small proportion of quality measures are similarly defined and used by various health care payers, the Government Accountability Office (GAO) reported this week. For example, a 2013 study found more than 500 different measures used across 48 health plans, only 20% of which were used by more than one program. This plethora of measures wastes time, money, and energy. One study found that doctors spend 785 hours per year on documenting quality measurements overall—that’s a full month! Compiling different information for different payers contributes to administrative burden. Additionally, doctors receive conflicting information from different payers on their performance, making it difficult to identify what changes are needed to improve quality. Meanwhile, many quality metrics have no bearing on patient outcomes, say several organizations, including Care That Matters, a group affiliated with the Right Care Alliance. It’s high time for the Department of Health and Human Services to develop and implement meaningful quality measures that matter, and for payers to quit haranguing doctors and nurses with metrics that don’t.






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