The Plausibility Factor
Morning Consult’s Mary Ellen McIntire writes on an idea to curb overbilling of Medicare beneficiaries.
University of Pennsylvania researchers suggest that the best way to stop overbilling is to consider “the number of hours physicians can plausibly work in a certain time period compared to what patients are billed for.”
“We construct the implied hours worked at the individual physician level based on service codes submitted to Medicare,” the researchers write. “We flag physicians as potentially overbilling based on whether the implied hours worked are implausibly long. Our method for detecting potential overbilling has at least three advantages relative to the existing methods.”
As McIntire notes, the model’s most promising aspect is that it imposes “minimal data requirements.”
Patient Blog Spotlight: Gray Connections
Today, as part of our ongoing effort to spotlight great patient blogs, we shine the spotlight on Gray Connections, which offers perspectives on lung cancer, brain science, and other stuff. The blog is the product of Janet Freeman-Daily, who was diagnosed with non-small cell lung cancer in May 2011.
“Since I know you’re going to ask: no, I never smoked anything (except a salmon),” she explains in her bio page. “The cancer became metastatic in October 2011. After two different chemo-radiation combinations, each followed by a cancer progression, I have had No Evidence of Disease since January 2013 thanks to precision medicine, clinical trials, and other patients.”
We share a post from her blog highlighting the recent news that the anticancer pill Xalkori (generic name crizotinib) has received FDA approval for ROS1-positive non-small cell lung cancer. She was one of the 50 patients whose results were included in the clinical trial data.
“I feel proud to be part of the research that is making new cancer treatments available for more patients,” she says. “Precision medicine, targeted therapies, and clinical trials are awesome.”
Gut Bacteria 1, Cancer 0
Bloomberg’s Makiko Kitamura reports that top scientists at Roche Holding AG and AstraZeneca Plc are optimistic that the trillions of bacteria that live in our bodies could be deployed in the fight against some cancers.
According to a study published in the journal Science, University of Chicago researchers found evidence that bacteria found in the gastrointestinal tract in mice was as effective as an immunotherapy in combatting skin cancer. Meanwhile, French scientists found that some bacterial species activated a response to immunotherapy.
“Five years ago, if you had asked me about bacteria in your gut playing an important role in your systemic immune response, I probably would have laughed it off,” Daniel Chen, head of cancer immunotherapy research at Roche’s Genentech division, told Bloomberg. “Most of us immunologists now believe that there really is an important interaction there.”
Ban Drug Ads on TV? Some Positive Outcomes Would Be Lost
Austin Frakt writing at the New York Times’ Upshot blog believes that there are positives to all those drug ads we see on TV. So, what’s the upside to as many as 80 drug ads per hour?
“One-third of adults said that drug advertising prompted a discussion with their physician. Collectively, every $28 spent by drug companies per year on ads resulted in one more visit to a doctor that led to a prescription. One more person making one more doctor visit doesn’t sound like much, but drug companies spend billions on advertising.”
A great point. While it’s easy to laugh at the ad disclaimers – and their spoofs on Saturday Night Live — they also break the ice and remind us to talk about our symptoms. The ads also provide that helpful nudge to complete our treatments.
“Another way drug ads can help patients is by encouraging them to continue with medication they’ve already been prescribed. According to one study, for every 10 percent increase in viewership of drug ads, between 1 and 2.5 percent more people adhere to their prescribed drug regimen.”
At the end of the day, drug ads provide patients with more information. That’s a good thing.