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admin | Category: Herpes Treatment Options | 28.04.2015
A pair of massive data breaches is making many health care providers across the country reconsider their security policies.
In an attempt to prevent such situations, the government has laws in place protecting patients and guiding providers on how to safeguard medical data. According to Stephen Cobb, a senior security researcher at information technology (IT) firm ESET who blogs about medical data security, these concerns are noteworthy for large health care providers and solo practitioners alike.
Patients usually get NPPs (which typically look like this) during their first visit to a health care provider. Newer NPP templates are available for providers hoping to guide patients through this important information more effectively.
Digging deeper, we asked patients in that 54 percent if there would be anything their provider could do to retain them in spite of a breach. While 28 percent say there is nothing their provider could do that would convince them to stay, the greatest percentage of our respondents (37 percent) would stick with their doctor if they provided specific examples of how the practice’s security policies and procedures had improved after the breach. Not only do cloud-based systems typically come with lower upfront costs relative to on-premise systems (you can download a pricing guide here), they also offer data storage protections: For example, patient data cannot be physically stolen, as may be the case with on-premise servers, paper-based records and laptops or mobile devices. Digging deeper, we wanted to know if patients would react differently based on the type of breach their provider suffered. We find that the likelihood of switching providers depends considerably on the type of breach. The way HIPAA and HITECH are laid out places the onus largely on individual providers to determine how to implement the laws.
The government offers several digital tools and guides to help providers conduct an assessment on their own, but Cobb says practices may be better off hiring an outside firm or consultant to ensure everything is done correctly. The OCR warns there will likely be a spike in HIPAA violation fines once 2015’s audits begin, making it all the more important for providers to address any deficiencies right away.
The interface also provides access to the full text of articles via author index or subject index, or by a search form on article elements such as author names, words from title, subject, words from the full text and publication year. The extent to which competition among providers can increase health care quality and control costs may depend on the clinical setting. Our focus here is on competition among providers—most often for patients, but in some cases for payor contracts.2 2.
We suggest that the level of provider competition that is appropriate will vary based on the nature of the clinical services delivered.
Many people, including Porter and Teisberg, have therefore suggested that provider competition could play a similar role in health care, creating the same virtuous circle of innovation, improved quality, and efficiency. Opponents of provider competition argue that it is inimical to the delivery of good health out-comes at a reasonable cost.
For countries with public-sector health systems, provider competition raises another concern.
McKinsey’s experience working in more than 20 health systems around the world yields examples of situations in which provider competition has resulted in poor outcomes, duplicate costs, and inefficient allocation of resources. We have come to believe that as health care markets become less specialized and less reliant on expensive infrastructure, they can support an increasing number of providers. If the conclusion is true, however, many of the potential gains from increased provider competition are likely to be in primary and community care.
Not only did the new provider improve both access to care and the practice’s performance significantly, but it also may have created an important knock-on effect: the threat of private-sector competition appears to have galvanized performance in other nearby practices. These examples illustrate how health systems have increased provider competition successfully, but it is worth pointing out that in some circumstances, reducing the level of competition may be the wiser course (when care quality suffers because of low patient volumes, for example).
Changing the competitive structure of a market is rarely sufficient on its own to generate the ideal level of provider competition.


As we have shown, the level of provider competition that is healthy varies depending on the clinical setting. Health systems should instead seek, whenever possible, to sharpen the competitive dynamic among existing acute care providers. Before new providers are added, however, it is important that the health system carefully analyze whether the associated increase in system costs will be offset sufficiently by improved productivity and quality. We believe that the case for encouraging the intensity of competition and the emergence of new providers is clear-cut for care delivered, now or in the future, outside the hospital. Finally, some health systems may want to consider stimulating competition for control of certain providers, if they do not already permit such competition.
In January, health insurance provider Anthem discovered that hackers had broken into a database containing up to 80 million records. NPPs are written explanations of how a provider may use and share health information, and how patients can exercise their privacy rights. These HHS-recommended templates are more visually appealing and easier to understand than typical, paper-based guidelines.
Many of those same patients (13 percent) specifically say they would want the provider to purchase new software that protects patient data. For example, a cyberattacker could gain access to patient records by targeting a third party associated with a provider. Its primary goal is to provide universal and integrated access to scientific journals in the health science area within Ibero-american countries.
The strongest argument in favor of competition is that it can be designed and deployed to create potent incentives that encourage providers to innovate so that they can deliver higher quality at lower cost.
For example, because of the information asymmetry between providers and patients, health care consumers lack an effective way to choose among providers based on care quality.
A bariatric surgery provider requires a population base of about one million people to ensure that an adequate number of patients will request treatment.
For example, a provider can deliver routine childhood immunization services safely to a relatively small population (perhaps 10,000 or 20,000 people).
To enable patient choice to work, the Danes initially paid private-sector providers a rate above that paid to public-sector hospitals. Our experience suggests that health systems have three options if they want to change the structure of a health care market: they can bring in new providers to increase competition, enforce consolidation (possibly through mergers or acquisitions) to decrease competition, or carve out specific services and then issue a tender, which can either increase or decrease competition. Reimbursement mechanisms should be designed to ensure that all providers are encouraged to behave in ways that promote the interests of the overall system (for example, they should not be rewarded for offering unnecessary procedures and thereby driving up demand for care). As health systems increasingly attempt to shift the balance of care from hospital to nonhospital settings, much of the competition individual hospitals will face will come not from other hospitals but from non-acute providers. In developed countries, overcapacity in the acute sector is often more common than undercapacity; introducing new providers would therefore be a mistake.
Because many highly specialized services are natural monopolies, multiple acute care providers should not compete to offer those services within a limited geographic area.
Most markets, for example, can sustain a number of efficient and safe providers of elective surgery. Furthermore, competition for less specialized acute services will not achieve its desired ends unless mechanisms are in place to allow some providers to reconfigure the services they offer or, if necessary, exit the market entirely. Offering incentives for high-performing providers to take over and turn around low-performing providers can drive up quality and productivity as long as the impact on the overall level of competition in the market is appropriately regulated. Providers will learn best practices for handling health data to build patient trust, defend against a potential security breach and deal with the fallout after one has occurred. However, these findings provide a good baseline for gauging how damaging respondents perceive each type of breach to be.


It’s up to providers to routinely assess their own unique security threats and address them in a satisfactory manner. However, we have been most struck by health systems in which provider competition, managed effectively, has improved outcomes and patient choice significantly, while at the same time reducing system costs. The minimum clinical scale is also relatively low: the level of training needed to provide nutritional consultations and programs of physical activity is not as substantial as the level required to perform surgery. From an economic perspective, this is understandable—the private-sector providers needed to be compensated for the additional infrastructure required to support the treatments they could now offer patients and for the relative volatility of demand. In Derby, England, the commissioner brought in a private-sector provider to run a primary care practice.15 15. Our analyses suggest that six steps can help almost any health system capture the opportunities that provider competition may offer.Ensure information availability. It is also important that funding is linked to and follows each patient; otherwise, providers have little reason to compete with each other for patients.
To spark competition both within primary care and between primary care and acute care providers, most health systems will need to increase their primary care capacity to handle higher volumes and to improve the capabilities of their primary care clinicians and managers.
In some cases, however, the providers could be allowed to compete to become the sole deliverer of a specific service for a fixed period. Thus, encouraging sharper competition among existing providers or even, in some cases, introducing new providers could yield improved efficiency and better health outcomes. Furthermore, they suggest, in at least some health systems, provider competition can promote profit making and market success over patient care; it can also penalize the least well-off patients, thereby exacerbating health inequalities. Consequently, a small city could safely support multiple providers of childhood immunization services but only one hospital offering inpatient pediatric care. The winning provider of each service would be issued a license to deliver care for a specified time (perhaps ten years), along with clear outcome-based performance metrics.
In some countries, legislative or regulatory action may be required to make it easier for patients to switch providers, for funding to follow the patients, and for funding to reward excellence. Public-sector health systems can reshape their ownership rules to allow private-sector providers to enter the market.
The combination of these factors makes it difficult for a health care market to function efficiently and, consequently, to reap the full benefits of provider competition. Thus, we began to wonder if the question is not whether provider competition is intrinsically good or bad, but rather whether it is possible to identify specific circumstances in which the judicious use of provider competition is likely to produce the desired results. In an ideal world, providers would receive a quality-adjusted fee based on how their performance influences the outcomes achieved throughout the whole cycle of care, from diagnosis (or even prevention) through to recovery and monitoring. If competitive pressure is to exert the maximum influence on quality and productivity, the purchasers of health services (payors) must have the freedom to buy selectively and be given incentives to seek value for money.Reduce barriers to patients switching among providers. The remaining providers could focus on other types of acute care, reconfigure themselves to offer lower-acuity services, or simply exit that market.
However, a virtuous circle could be established in which competition among providers increases the quality and efficiency of care delivered. The ability of patients to change providers can be an important driver of improved quality. Health systems should ensure that patients can change health care providers as easily as they can switch mobile-phone networks.Reduce barriers to entry and exit. Allowing poor-performing providers to exit the market and high-performing providers to enter it is critical for encouraging innovation and providing incentives for high performance.



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