Health for life

1. Using traditional research to detect a "statistically significant" decrease in insurance claims expense is notoriously difficult.

2. Theres scientific statistical proof and then there is a reasonable business assurance.  The latter may be enough for business-minded health insurers.

3. The conclusion is based on published research.  Unpublished "in house" data have convinced many insurers to include the medical home in their covered benefit.  They know something AHRQ doesnt.

4. While medical homes alone may be insufficient to save money, that doesnt mean that medical homes that are part of a package of interventions (value-based purchasing, P4P, vendor-based population health management or an ACO) are unnecessary.

5. While there is no evidence of savings, there is also no consistent evidence of increased cost. That means the quality associated with the medical home represents high value.

That being said, the U.S. Agency for Healthcare Research and Quality (AHRQ) Evidence Report Technology Assessment on the Patient Centered Medical Home says:

"Based on a combination of good- and fair-quality studies, there is a low strength of evidence that PCMH implementation may lead to lower utilization (inpatient and emergency department) for some subgroups of patients, but this effect was not uniform. Moreover, total costs were not lowered in the reviewed studies.

However, three observational studies specifically designed to test PCMH do report lower inpatient and emergency department utilization among patients in the PCMH program. However, total costs were not statistically different for PCMH and non-PCMH patients in the three studies. None of the clinical trials of functional PCMH interventions had statistically significant differences between intervention and control arms for inpatient or emergency department utilization.

No studies reported statistically significant cost savings among PCMH patients. In fact, when taking into account program costs, two studies, one good-quality trial and one fair-quality observational study, reported greater total costs among intervention patients."

 Image from Wikipedia

Today, our Ask the Internet question is inspired by sheer astonishment.

Q: Yesterday on Twitter, Mark Bittman linked to an article about, “a novel tobacco product that some critics say too closely resembles Tic Tac breath mints,” made (natch) by Camel. He was justifiably concerned they would addict children.

Tweeter retroklahoma then discovered that CANDY CIGARETTES ARE STILL AROUND. Which … what? How? In America? IN 2010?!?! Ack.

So, I was wondering: what food’s very existence shocks you the most? Why? Is it too old-fashioned? Is it obviously bad for everyone who would consume it? Is it inexplicable using the rules of physics and/or nature?

A: Yeah. Candy cigarettes. Can you believe it? Even in the 80s, we knew that was some damaging badness. Is there a food product that elicits the same reaction from you? The comment section is open, folks.

Want to ask the interweb a question? Post one in the comment section, or write to Cheaphealthygood@gmail.com. Then, tune in next Tuesday for an answer/several answers from the good people of the World Wide Net.