Monday, January 30, 2012

Price Transparency of Contact Lenses and Consumer Empowerment

Got my contacts in the mail. 

This post is about a personal experience as a patient. It's about how I saved 40% on my contact lenses.

My experience reflects one snapshot of the level of price transparency within the contacts lens market. The intent of this post is not to argue for either more or less amount of price transparency in healthcare.

I ordered my contacts all by myself last week. By that I mean I went on, put in my contact's specs from my doctor's prescription slip, and paid for it --- all in one process.

I'm not an educated contacts consumer, but a typical one. I've been wearing contacts for the last 7 years and last week, I ordered and paid for my contacts by myself for the first time. Here's what I've done before that: I call my ophthalmologist and ask him order it for me, pick up from his office and pay him. The average price was $50 per box (6 lenses) per eye, or about $100 for both eyes.

My ophthalmologist controlled the supplier and the price, so I was a powerless consumer who accepted whatever price he selected for me. However, I didn't know how much prices varied and hence I did not care.

Sunday, April 24, 2011

Amazon Server Outage Raise Questions for Cloud in Health IT

Amazon's much-touted server service called EC2 provide storage space for many business and personal websites, including well known names like Foursquare, Quora, Hootsuite, and Reddit. Last week, Amazon's EC2 servers went down and many websites, including those above, were rendered unusable for as long as two days.

Many in the consumer technology as well as the health IT space have predicted that "cloud computing" (where information is stored and accessed from online servers) is the future. In addition to services named above, other prominent cloud products include Facebook, Gmail, Google Docs, and Mint. 

I use Quora and Hootsuite everyday. While it was annoying to not being able to explore questions on Quora or send scheduled tweets on Hootsuite, the server outage did not affect my job or my academics, things that matter. The Amazon server issue has caused an uproar in the social media consumer community, but I believe the problem will pass. 

However, if cloud computing were to be the future of health IT, what would happen when a server went down and EMRs cannot access medical information? All medical data would be inaccessible. Can hospitals afford to lose data access for all of its patients for anymore than 48 hours? Or six hours? Or minute? 

To learn about EMRs, my ONC-sponsored health IT course is using PracticeFusion, a 100% online cloud EMR. It'll be interesting to see if they come up with any solutions to problems like Amazon's. 

Monday, April 18, 2011

Does Every Hospital Commit Medicare Fraud? (Tenet, Community)

That was the question in my mind when Tenet Healthcare (NYSE:THC) sued Community Health Systems (NYSE:CYH) for illegally overbilling Medicare.

Estimates put the effect of Medicare fraud at 3% to 9% of the total $431B in Medicare costs, implying that it's a systematic problem within the US healthcare system. Popular methods range from billing for services not rendered to upcoding procedures to more expensive ones. Many kinds of Medicare fraud is difficult to identify and hence quantify. It's even possible for hospitals to unintentionally commit Medicare fraud.

So does this mean every hospital is potentially contributing to Medicare fraud? For hospital managers, is it possible to build a solid defense against fraud accusations if the problem itself is so hard to gauge?