Brian Klepper
I write for publication when I want to get a message out to a wider audience. In the marketplace of ideas, the ability to articulate possibilities is still the most powerful tool we have.
Sunday, September 16, 2007
The New York Times
To the Editor:
''Unveiling Health Care 2.0, Again'' (Week in Review, Sept. 16) is right. Only innocents believe that meaningful health care reform will occur simply because the American people want it and the presidential candidates promote it.
Health care economists agree that as much as half of the industry's costs is waste, but that excess constitutes a significant portion of the financial baselines of most health care organizations.
The health care industry, the nation's largest
Friday, August 3, 2007
Medscape
Hymin Zucker, MD; Brian R. Klepper, PhD
Author Information
To the Editor,
I could not agree more with Brian Klepper in his piece on financial conflicts in medicine.[1] It is my belief that even the most moral and honest physicians will transform after years of honest practice as long as the only real way to advance financially is to stretch the boundary of what is right for the patient.
I have seen it since my emergence into private practice when I was instructed to include chest x-rays,
Sunday, July 1, 2007
Florida Times-Union
If you're like me, your medical records are scattered all over Northeast Florida.
The problem is that it's health care Babel out there. Nobody has my complete history.
Currently, fewer than one-quarter of doctors store their patients' information in electronic medical records that can be traded. And even if they did, the health care industry has not yet defined standards for records, so most systems can't talk to each other.
If I landed in an emergency room tomorrow, even if the doctors
Friday, June 1, 2007
Community Oncology
The day after The New York Times ran its exposé on oncology drug rebates, “Doctors Reap Millions For Anemia Drugs,” I was at a national roundtable meeting with 20 physicians (no oncologists), hospital administrators, health plan executives, disease managers, and stop-loss brokers. The topics were the state of healthcare and innovative programs that hold promise for the future.
Someone mentioned the article. By that time, it had circulated, everyone had read it, and all agreed: Rebates
Friday, May 18, 2007
Medscape Web Video Editorial
The Cleveland Plain Dealer recently ran an article about a prominent physician who held a financial stake in a spinal procedure that he and his well-known clinic promoted. The procedure was more costly and surgically complex than another more proven approach for the same condition.
Ironically, the doctor sat on the clinic's Conflict of Interest Committee, and on its Board of Governors that last year ousted a cardiologist for failing to disclose stent royalties.
Financially conflicted care is
Friday, May 18, 2007
Florida Times-Union
Jacksonville Business Journal
When any of the 2.6 million patients who live within reach of the Inland Northwest Health System show up for care, expected or not, the 35,000 clinicians and other health care professionals in Greater Spokane, Wash., already have their electronic medical records at their fingertips.
In general, these patients probably get better care than elsewhere in the country, because more complete information lets doctors and nurses make better decisions. It also helps facilitate lower-cost care, because
Sunday, April 1, 2007
Disrupting The Drivers of the Health Care Crisis
Chapter, Innovation-Driven Health Care, Edited by Richard Reece MD
Hospitals [and surgeons], if they wish to be sure of improvement...must analyze their results, to find their strong and weak points, [and] must compare their results with those of [their peers]...[They should] make this information publicly known so that the future patients might make informed decisions. -- Ernest Codman, 1914
Perfect Information - a term used in economics to describe a state of complete knowledge about the actions of other players that is instantaneously updated as new
Thursday, February 1, 2007
Cancer Care & Economics
Over the past several years, new structures known as Regional Health Information Organizations, or RHIOs, have begun to appear on the healthcare scene. RHIOs are intended to be neutral coalition platforms that facilitate the secure exchange of electronic healthcare information in ways that let everyone who touches healthcare—patients, employers, physicians, hospitals, and health plans—make better decisions.
In a sense, RHIOs are community healthcare utilities that support better decision-
Friday, December 1, 2006
Smart Business Pittsburgh
Is it too dramatic to suggest that U.S. health care is collapsing? That crisis is around the corner? We read (and know firsthand) that costs are soaring, that uninsurance and underinsurance are rising. But a collapse?
For answers, Smart Business asked Brian Klepper, president of the Center for Practical Health Reform. He spear-heads a national health care reform effort that has attracted the participation of business and health care leaders.
What is the state of U.S. health care?
To really
Friday, December 1, 2006
Brian Klepper and David Pauker
Community Oncology
December 2006 ■ COMMUNITY ONCOLOGY 753 Volume 3/Number 12
The editors of Community Oncology chose seven oral cancer drugs and asked the authors to analyze differences in pricing among the drugs within three communities, each market a different size. The drugs are anastrozole (Arimidex), exemestane (Aromasin), imatinib (Gleevec), sunitinib (Sutent), erlotinib (Tarceva), temozolomide (Temodar), and thalidomide (Thalomid). The markets are Chicago, Illinois; Portland, Oregon; and Virginia Beach,
Tuesday, November 7, 2006
Brian Klepper and Alain Enthoven
HealthLeaders
Recently, a flurry of national articles has explored the notion--held by several prominent economists--that increased healthcare spending reflects the choices of an affluent population, and will continue to drive a strong economy.
Many healthcare professionals--physicians, hospital executives, insurance administrators and analysts--see it differently. As one colleague bluntly puts it, “It's a train wreck everyone knows is just around the corner."
Healthcare insiders know that the industry's
Wednesday, November 1, 2006
Cancer Care and Economics
Our nation's health care system is facing an economic meltdown of unprecedented proportions. Over the past 20 years, medical inflation has averaged double the general inflation rate. In the 5 years between 1999 and 2004, premiums—where costs converge from throughout the continuum— rose 5.5 times the general inflation rate, 4.0 times workers'earnings, and 2.3 times the growth of business income.
The private sector is increasingly unwilling to pay for rising health care costs. A recent Kaiser
Sunday, October 1, 2006
Community Oncology
Established in 1996, Regents Health Resources in Brentwood, Tennessee, helps hospitals and physicians develop and manage their medical imaging services. Brian Baker’s primary focus as vice president of the company is advising practices that are opening new outpatient imaging centers. He helps practitioners make sense of the bewildering array of imaging technologies so they can figure out which is best for them and their patients.
Mr. Baker began his career more than 20 years ago as a
Friday, September 1, 2006
Community Oncology
Board certified in internal medicine and with a Master’s degree in public health, Fiona Wilmot’s passion has long been “the delivery of the best care for the patient at the right time in the right setting,” she says. Toward that end, Dr. Wilmot works with physicians and pharmacists to develop medical policies related to new technologies and therapeutics for Blue Shield of California (BSC). She also manages the Transplant Center of Excellence Program with a team of specialized nurse case 
Monday, July 24, 2006
Florida Times-Union
You've just changed health plans and your child's pediatrician isn't in the network.
So in the throes of an asthmatic episode, you take him to a new doctor's office. In the exam room, a nurse asks you to list his medications. Flustered, you recite the ones you remember. Then she enters his name into the computer.
Up come his drugs - there's one you missed - as well as all health information about him that's available in the computers of Northeast Florida's doctors' offices, hospitals, labs
Saturday, July 1, 2006
Community Oncology
July 2006 ■ COMMUNITY ONCOLOGY 411 Volume 3/Number 7
© 2006 Elsevier Inc. All rights reserved.
A recent Health Affairs article,1 given play in The New York Times,2 showed that the prescribing behaviors of oncologists caring for Medicare patients between 1995 and 1998 were influenced by the lucrative economics of their drug retailing arrangements.
The study’s investigative team was comprised of prominent researchers, including a Dana-Farber oncologist. When interviewed, the investigators
Thursday, June 22, 2006
Medscape
It is impossible to not be moved by the profoundly important concerns that these letters express[1] as well as by physicians' general frustration at their perceived inability to affect the problems. As many authors point out, doctors lack the professional unity to drive meaningful change, and are only one of many influential groups that shape American health policy and markets.
The problems are formidable. Some, such as healthcare's high fragmentation, the power exerted by corporate
Thursday, June 1, 2006
Community Oncology Washington Update
LIKE MANY THINGS IN LIFE, health coverage favors scale. Larger businesses evade benefit mandates that smaller ones must cover. No national numbers on small business health benefits exist, but recent data from Florida, which is probably representative on this issue, showed that the number of small businesses offering health benefits fell 52% between 1996 and 2004. Benefit mandates aren’t the main drivers of unrelenting cost growth, but they contribute to it.
Private health coverage—bought by
Monday, May 1, 2006
Community Oncology
May 2006 ■ COMMUNITY ONCOLOGY 241 Volume 3/Number 5 © 2006 Elsevier Inc. All rights reserved.
A pediatric oncologist by training, Dr. Reeves began his practice in the US Air Force, eventually rising to become Chief of Clinical Medicine in Europe. After leaving the military, he served Sierra Health Services in Las Vegas as chief medical officer and then, in 1997, joined Humana Inc., as chief medical officer, where he focused on aggressive medical management and performance improvement 
Thursday, March 23, 2006
Medscape
Medscape General Medicine. 2006;8(1):77. ©2006 Medscape
Posted 03/23/2006
In recent months, doctors have faced dramatic Medicare cuts.[1] It is unclear whether these cuts will be realized this budget year. However, physicians should make no mistake: It's not if, but when. The Medicare discussion is only leading the edge of an inundation of healthcare cuts.
Over the last 5 years, premiums -- in which healthcare costs converge from the entirety of the continuum -- have risen 5.5 times as
Friday, March 3, 2006
Health Care Crisis for Business
Charlotte Observer
Business leaders must push reform to rein in costs and protect coverage
Last September the CEOs of several Fortune firms -- Costco, Verizon, Honeywell, Starbucks, Drugstore.com -- met in Washington to register alarm over unrelenting health-care cost growth. The meeting sent two important messages.
First, if not restrained, health-care costs will trump every firm's profitability and competitiveness. No commitment to generous benefits can withstand them. Over the last five years health-care
Wednesday, March 1, 2006
Community Oncology
Brian Klepper is looking at the big picture in healthcare and it's a train wreck. That is, it will be, he says, unless the many and disparate special interest groups--all of whom are convinced they can fix the healthcare problem in this country--come together and latch on to a higher, common purpose. As it stands, each interest group attacks the piece of the problem that's of concern to it. But, says Dr. Klepper, they're all imperiled because they ignore the larger issue: the explosion in the
Monday, February 27, 2006
Jacksonville Business Journal
Business First of Louisville
In January’s State of the Union Address, President Bush called for expanding Health Savings Accounts (HSAs) as one sensible approach to curb rising healthcare costs. An HSA is a tax-favored healthcare-dedicated savings account that a patient controls. Combined with out-of-pocket requirements and a High Deductible (also called “Consumer Directed”) Health Plan (HDHP), these financing devices can provide comprehensive coverage. Federal 2006 HDHP family coverage guidelines call for deductibles of
Friday, February 10, 2006
Jacksonville Business Journal
Orlando Business Journal
A Florida Hospital Association task force recently released a new report on hospital emergency departments (EDs). It's guaranteed to curl the hair of everyone interested in whether these vital services will be there when they're needed.
The bottom line? We need action to protect EDs' core mission: saving lives and stabilizing the injured and sick.
Anytime and for everyone, EDs are ready for nearly everything that happens to people. But over time, EDs also have assumed other roles.
Beyond
Friday, January 20, 2006
Jacksonville Business Journal
In what is surely the first spark of a national firestorm, Maryland's Legislature has passed a law requiring firms with 10,000 or more employees to spend at least 8 percent of their payrolls on health coverage. Alternatively, they can pay the difference into a state Medicaid fund. Thirty states, including Florida, are expected to consider similar legislation in 2006.
The law's proponents argue that large rogue firms -- Wal-Mart is of course the target here -- flaunt benefits conventions,
Friday, December 9, 2005
Florida Times-Union
Jacksonville Business Journal
Orlando Business Journal
Of the many problems that plague health care, two are the most serious.
The first is the industry's fragmentation. The way we pay for products and services encourages millions of health care professionals and organizations Ð physicians, hospitals, health plans, drug and device manufacturers, support firms -- to make self-interested decisions daily, independent of their impacts on the larger system. The rich reimbursements, $1.8 trillion in 2005, have made many groups wealthy and have
Sunday, October 16, 2005
Business' Dilemma
Florida Retail Federation
Executive Summary
Recent media accounts and regional policy efforts have singled out the retail sector’s approach to health benefits, charging that its offerings to employees and their dependents are particularly stingy, and that retail firms have steered their low income employees to publicly funded Medicaid coverage. In Florida, a March St. Petersburg Times article asserted that “...taxpayers may be double-subsidizing low wage employment by paying companies to create jobs and by paying for
Monday, October 10, 2005
The Business Case For Reform
Modern Healthcare
Employers must demand needed change
to create a sustainable system of care
Among the revelations of the latest Kaiser Family Foundation annual Employer Benefits Survey was a precipitous drop in employer-sponsored coverage. The percentage of employers offering health coverage fell from 69% to 60%, a 13% decline, in just five years. Exploding premium costs – growing 5.5 times the rate of inflation and 2.3 times business-income growth between 1999 and 2004 – are pricing individual and
Wednesday, June 1, 2005
Boards Leading the Future: A Leadership Perspective on Healthcare Reform
The Governance Institute
By now hospital boards should have no doubt that, in healthcare and in their organizations, the future will involve more services with fewer resources. The increasingly unstable healthcare market is traceable to a system structure that promotes uncontrollable cost growth. How can boards can guide their organizations through the gathering storm and cultivate stability throughout the broader healthcare enterprise?
Over the last three years, healthcare premiums—where costs converge from
Thursday, February 26, 2004
HealthLeaders
The dynamics of American policymaking render massive social change nearly impossible. Healthcare's $1.6 trillion annual flow, distributed throughout a highly fragmented industry, makes it particularly intractable. Powerful groups promote their interests without regard for consequences on the larger system. Virtually any worthwhile proposal threatens some special interest and creates resistance to change
So it is little wonder that no deep change has been effected in American healthcare for
Monday, February 9, 2004
The Path To Instability
Brian Klepper and Jeannette Corbett
The Palm Beach Post
The Fort Lauderdale Sun-Sentinel
Health care is now a daily worry in households and boardrooms, as much a concern as terrorists or the economy, and more immediate. Every day, more purchasers -- individuals, corporations, and government -- are priced out of the market for health care, and the resulting turmoil threatens both the health care industry and the larger U.S. economy.
Premiums grew a breathtaking six times as fast as the economy this year, and eight times as fast last year.
In some regions, enrollment in job-
Friday, May 12, 2000
Jacksonville Business Journal
Way back at the end of last year, a prominent health care consulting firm issued the weighty prediction that two Internet giants -- Healtheon/WebMD and former U.S. Surgeon General C. Everett Koop -- would consolidate and strengthen their positions, becoming the dominant forces in the e-health marketplace.
With 1,000 programmers, Healtheon/WebMD especially was on a tear, acquiring profitable companies for stock, planning to roll out information-management capabilities and announcing it would
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