Ready, [bleep], Triple AIM!

FRIDAY, DEC 14th UPDATE

I thought about deleting this post when I got home. The title now seemed to be a retrospectively ill-timed "play on words" in light of the incomprehensible horror that took place today in an elementary school in Newtown, Connecticut.

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It's downright ɪˌkliːzɪˈæstɪkəl at HHS

From The Lancet, however, (by way of the Washington Post), comes a cautionary tale.

New Burden of Disease study shows world’s people living longer but with more disability

More people are surviving to die of diseases that occur only in old age. These include Alzheimer’s disease, deaths from which tripled from 1990 to 2010, and Parkinson’s disease, whose deaths doubled. At the same time, people are living with conditions that don’t kill them but that affect their health.

“These are things like mental disorders, substance abuse, musculoskeletal pain, vision loss, hearing loss . . . that cause a huge amount of disability but not a whole lot of death,” said Murray, who heads the Institute for Health Metrics and Evaluation at the University of Washington.

‘Discounted’ time

People are living longer lives, but the time they are gaining isn’t entirely time with good health. For every year of life expectancy added since 1990, about 91 / 2 months is time in good health. The rest is time in a diminished state — in pain, immobility, mental incapacity or medical support such as dialysis. For people who survive to age 50, the added time is “discounted” even further. For every added year they get, only seven months are healthy.

“Progress in reducing disability just hasn’t kept pace with progress in reducing mortality,” said Joshua A. Salomon of the Harvard School of Public Health, one of the project leaders.

The trend of adding increasing amounts of bad health to life is known as the “expansion of morbidity.” It is likely to be the biggest challenge to patients, doctors and people who pay for medical care for the next few centuries...

Yep. I know this all too well from my recently concluded next-of-kin/caregiver experience.

"LET'S DON'T KID OURSELVES THAT WE'RE GOING TO BE ABLE TO 'Q.I.' OUR WAY OUT OF THE LARGER PROBLEM."

- Brent James, MD, M.Stat, 1994

Yep. As true today -- if not moreso -- than when I first heard those words in person 18 years ago.

And now here I am, newly minted Medicare Bene.

My timing is Fiscal Cliff Perfection.
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FRIDAY MORNING UPDATE

No HIPAA Ominbus Final Rule yet.
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Countdown

More to come...