The Atlantic and Planning Accountable Care

CAL/AAEM News Service calaaem.news.service1 at gmail.com
Tue Nov 9 08:05:04 PST 2010


November 2010
Lies, Damned Lies, and Medical Science

The Atlantic

Much of what medical researchers conclude in their studies is  
misleading, exaggerated, or flat-out wrong. So why are doctors—to a  
striking extent—still drawing upon misinformation in their everyday  
practice? Dr. John Ioannidis has spent his career challenging his  
peers by exposing their bad science.

IN 2001, rumors were circulating in Greek hospitals that surgery  
residents, eager to rack up scalpel time, were falsely diagnosing  
hapless Albanian immigrants with appendicitis. At the University of  
Ioannina medical school’s teaching hospital, a newly minted doctor  
named Athina Tatsioni was discussing the rumors with colleagues when a  
professor who had overheard asked her if she’d like to try to prove  
whether they were true—he seemed to be almost daring her. She accepted  
the challenge and, with the professor’s and other colleagues’ help,  
eventually produced a formal study showing that, for whatever reason,  
the appendices removed from patients with Albanian names in six Greek  
hospitals were more than three times as likely to be perfectly healthy  
as those removed from patients with Greek names. “It was hard to find  
a journal willing to publish it, but we did,” recalls Tatsioni. “I  
also discovered that I really liked research.” Good thing, because the  
study had actually been a sort of audition. The professor, it turned  
out, had been putting together a team of exceptionally brash and  
curious young clinicians and Ph.D.s to join him in tackling an unusual  
and controversial agenda.

For the rest of the article, go to: http://www.theatlantic.com/magazine/archive/2010/11/lies-damned-lies-and-medical-science/8269
November 1, 2010
Planning Accountable Care Organizations

Kaiser Health News

American Medical News: "The National Committee for Quality Assurance  
is seeking input from the public on draft accountable care  
organization standards," which "were drafted by the organization's  
Accountable Care Organization Task Force comprising representatives  
from large integrated health care systems, academia and the insurance  
industry. ... Establishing ACOs for Medicare and Medicaid  
beneficiaries is a key part of health system reform legislation" (11/1).

Modern Healthcare: California's experience with ACOs may help predict  
whether accountable care organizations, which "bring together  
providers and then reward them for taking responsibility for the  
quality of care for their patients while controlling costs," will work  
under the Affordable Care Act. "In California, many providers have  
been working in ACOs for decades, and they say they can work well-- 
although there are pitfalls and limitations." Currently, around "half  
of insured Californians receive their care through some type of ACO."  
According to one expert, California's experience demonstrates that  
"[a]ligning incentives and strong leadership are more important than  
the actual institutions;" that "varied payment mechanisms, instead of  
a one-size-fits-all approach, such as capitation" are important; and  
that "ACOs must not be fixed to only one insurance type." A pressing  
question is whether care coordination can "work in a PPO environment  
where consumer choice reigns. ... Pilot projects are under way in  
California that seek to collaborate among providers and payers across  
business lines" (Vesely, 11/1).

Anna Parks &
Brian Potts MD, MBA
Managing Editors, CAL/AAEM News Service
University of California, Irvine


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