Defusing Health Care's Ratings Bomb?

Back in September I posted an item, linking to a question from consultant Dan Beckham, about whether health care is the next big "ratings bomb."

The November 20-21 Wall Street Journal announced that Meredith Whitney, a prominent banking analyst, plans to set up her own credit-rating firm and is in the process of applying for a license to be a "nationally recognized statistical rating organization," or NSRO.

The article doesn't say whether Whitney's new firm will rate tax-exempt health care debt, though it'd be nice to see the Big 3 credit raters (Moody's, S&P, Fitch) facing some independent, intelligent competition.

I think Beckham is right - there is a timer ticking in the health care debt market. Too many hospitals adding too much debt chasing demand that even the dumbest politician now recognizes as unaffordable and unsustainable. Anybody else worried?

If history is any guide, the usual suspects will announce a crisis nine months after the bomb detonates.

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Michael Porter On Health Care Reform

Michael Porter, writing in the New England Journal of Medicine, proposes "A Strategy For Health Care Reform - Toward A Value-Based System." His proposals are fundamental, lucid and right-on, meaning they're sure to be opposed by some parties to the debate, the so-called "Yes, but..." crowd. Most important, in my opinion, is this: "... electronic medical records will enable value improvement, but only if they support integrated care and outcome measurement. Simply automating current delivery practices will be a hugely expensive exercise in futility. Among our highest near-term priorities is to finalize and then continuously update health information technology (HIT) standards that include precise data definitions (for diagnoses and treatments, for example), an architecture for aggregating data for each patient over time and across providers, and protocols for seamless communication among systems. "Finally, consumers must become much mor...

gapingvoid cartoon #378

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"An Affordable Fix For Modernizing Medical Records"

...from the Veterans Health Administration and Midland (TX) Memorial Hospital. I know enough about my own strengths and weaknesses to know that I'm no IT expert. But I am acutely interested in examples of people and teams thinking differently to solve long-standing, intractable problems and, for better or worse, there are lots of those to be found in the IT realm. Yesterday, it was a story about a team adding iPhone portability to MEDITECH functionality, delivering to harried physicians better access to clinical data and more productive hours in every work day. (Wow. Apple in the boardroom AND the physician lounge. Has to be an IT traditionalist's worst nightmare. But I digress...) Today, the Wall Street Journal features a story about Midland (TX) Memorial Hospital finding an affordable, open-source alternative to proprietary EMR systems : "In the push to digitize America's hospitals, Midland Memorial faced an all-too-common dilemma: a crying need for information ...

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