Research Results I Wish I Hadn’t Seen
- Female mortality rates increased in 42.8 percent of counties in the United States during 1992–2006.
- The average physician will lose $43,743 over five years after adopting electronic health records.
- Cost savings from workplace wellness incentives reflect cost shifting to unhealthy workers.
More on these issues in the Health Affairs blog.
“The most common financial change was a reduction in the cost of paper medical records (seen by 55 percent of respondents), yet almost half of practices did not realize these savings because they continued to keep records on paper,”
Wow, guys. Just wow.
“Savings to employers may come from cost shifting, with the most vulnerable employees — those from lower socioeconomic strata with the most health risks — probably bearing greater costs that in effect subsidize their healthier colleagues,”
Hmmm. What a minefield. You want to save money by giving incentives for your employees to be healthier, but can you really tell them what to do outside of work? Even if they’re good at their jobs?
“In a related article, Jessica Ho of the University of Pennsylvania reports on her analysis that mortality under age 50 accounts for much of the fact that US life expectancy lags that of other high-income countries. She recommends focusing on prevention of the major causes of death in younger populations, such as unintentional injuries, including drug overdose; noncommunicable diseases; perinatal conditions; and homicide.”
We need a major paradigm shift in our culture to practice real prevention for some of these issues.
“The researchers found reductions in inpatient costs but similar increases in non-inpatient costs, resulting in no savings for the employer in the short term and underscoring that the ACA’s wellness program incentives are unlikely to greatly reduce health care spending over the short run.”
Yeah, I don’t see how this effectively reduces costs. Wellness is more of a cultural association than an acquired incentive provided by an employer. Therefore, I do see a big caveat in regards to the inability for such incentive to yield away from discriminatory outcomes.
Those were from EHR pilots in Massachusetts(sp?) Not all EHRs are created equal, how about some data from Stage 7 hospitals with inhouse IT support infrastructure. If we’re going fee-for-service, EHRs will do nothing but streamline quantitative care provision which should increase revenue.
Here’s an NBER working paper discussing EHRs:
http://www.nber.org/papers/w18281
Under the right conditions there can be a 2 to 3.4 percent increase in profits through the use of EHRs. In an integrated network like the VA, that amounts to a couple of billion dollars annually.
But like Jack said.. in MA, under those specific conditions, with a randon EHR pilot, with lots of unknown variables… sure poor physicians for allowing the hospital to actually green light that sort of a program.
That’s the thing about machines! Way too much potential for human error. Under the right conditions, computers make things better. Under poor management, they almost always make things more complicated.
Cost savings from workplace wellness incentives reflect cost shifting to unhealthy workers.
There’s nothing wrong with that!
Thanks Jack and Kyle. You are absolutely right. These are very poor representations of the potential revolutionary quality that a good EHR can have.