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When Bad Smells Happen to Good Eaters

Oh, the irony! Foods that can help you live longer, can make you smell so bad that nobody wants to live with you.

Here are some healthy foods that create foul body odors.

Garlic: It reduces the frequency of everything from the common cold to heart disease. But digested garlic produces sulfurous gasses that enter the bloodstream and are released through pores and lungs. The good news: If you and your dinner companions all eat garlicky foods, the body odor seems less obnoxious. Try eating parsley or drinking milk to reduce the smell.

Cumin Seeds: These iron-rich seeds beef up your immune system, fight some cancers, and enhance detoxification enzymes in the liver. But, eat cumin, and your sweat can reek for days. This is not the spice to consume before a big meeting or first date.

Asparagus: A great source of fiber, vitamins A, C, E and K, and glutathione, which protects against breast, bone and lung cancers. But when you digest asparagus, sulfur compounds are broken down and make your urine smell like spoiled cabbage.

Onions: They’re fiber-rich and known to lower cholesterol and improve circulation. But as you digest onions, heir volatile sulfur compounds enter the blood and are released through the lungs: Say hello to onion breath. Cooking onions before eating can reduce the odor; so can growing onions in low-sulfur soil.

Cabbage, Broccoli, Cauliflower: These cabbage family vegetables contain phytochemicals, vitamins and fiber that can lower your cancer risk. But at a price, because their sulfurous compounds are secreted in sweat that can produce a foul smell for up to six hours after eating one serving. You can minimize the bad odor by parboiling the vegetables in water with a pinch of salt.

Fish: It’s good for brain function and reducing heart disease risk. But the choline found in tuna and salmon creates a fishy smell that can emanate from sweat for a day after eating a single fish serving.

Related:
9 Foods that Fight Bad Breath
Oil Pulling for Oral Health: Why How it Works

Article source: http://www.care2.com/greenliving/when-bad-smells-happen-to-good-eaters.html

Healthy living: Whit McKinley

Whit McKinley, 50, lives in the same area of Jackson where his family has lived for several generations. After receiving a degree at Millsaps, he worked in a variety of jobs in Jackson, including Hal and Mal’s and an entertainment monthly a few might remember; the Diddy Wah Diddy. After graduation from Ole Miss law school, he worked as a law clerk for a number judges before entering private practice at Currie Johnson Griffin and Myers, where he has worked for nearly 20 years. He is married and the father of two “great kids who are hard at work at obtaining their degrees at college.”

When I was young, fitness was simply the lucky byproduct of being born tall, thin, and being able to eat anything at any time. I couldn’t gain weight if I tried. I probably reached my full height of 6 feet, 3 inches at age 15 and didn’t weigh over 155 pounds when I started college. There was no need for good eating habits, something that probably cost me down the road. I was active as a swimmer from age 6; first with the Hattiesburg Hub Fins and later with the old Jackson Aquatic Club. At age 16, despite being slow and butterfingered, I began to play basketball. Ultimately, I learned how to hold my own and fell in love with it. That, together with a variety of intramural sports, lasted me through college. I continued to play basketball and added doubles tennis through my 20s.

At age 29 I probably weighed 180 pounds. But with the combination of my metabolism slowing, repetitive ankle injuries, 10 years of smoking, and the lack of healthy eating habits; things really changed. As I continued my career and began raising kids, I exercised less and less, my fitness declined, and my weight continued to increase. My hair fell out, too! This pattern lasted until my mid-40s, when I weighed 200, plus my age, pounds. Walking up the hills in my neighborhood took more huffing and puffing than I care to remember.

Five years ago I decided had to make a change. I quit smoking with the help of a program at UMMC. I’m now tobacco-free. I started working out again regularly, at first by returning to swimming. I will always love swimming, but it’s not something you do with other people. So I added running. Between being slow and reinjuring my feet and ankles, I switched again and pulled my old Schwinn bike out of the garage and started riding. I stuck with it and in six months I upgraded to a road bike. I’m glad I did. The metro area is blessed with a great and growing group of cyclists.

I’ve lost a good deal of weight and turned a good bit of fat into muscle, but freely admit that before bed I have a weakness for a peanut butter and jelly sandwich with a glass of milk. Once a year or so, I commit to taking breads pastas and sugar out of my diet. Then Thanksgiving and Christmas arrive. I’ll keep working on it.

— As told to The Clarion-Ledger

My Workout

I ride my bicycle three times a week. I’ll jog with my one-eyed dog Jack when I can’t ride, or try to swim a mile when it’s raining. For me, biking has become a wonderful balance of great exercise and social activity with people who face similar challenges of balancing health, families, and career. Bikers are self-affiliated at a number of points including Jackson Metro Cyclists, Bike Walk Mississippi, and every bike shop in town. I am constantly amazed with the degree to which cyclists are closely knit, hard-working, highly educated people with families and children. Every biker I have met is a productive contributor at every phase of our local economy and community.

The Me File

What I’m reading:

With any time I have left over from work, family and fitness, I keep up with current events online. My guilty pleasure is reading young adult fiction, whether J.K. Rowling, Rick Riordan or Stephanie Meyer. I try to read one or two serious works of fiction a year; mainly Faulkner.

What I’m watching:

I watch more movies than TV, but I love “House of Cards.” As a boy I read Marvel comics and then Tolkien, so you can guess what I have recently enjoyed at the local cinemas.

What I’m listening to:

As for music, I mostly rely on software such as Pandora — and my kids — to provide what I like to hear.

Article source: http://www.clarionledger.com/story/life/2014/08/19/healthy-living-whit-mckinley/14266729/

5 towns to participate in ‘healthy-living challenge’

SAN FRANCISCO — Technology investor Esther Dyson thinks she has found the answer to America’s
growing health concerns, and has enlisted five smaller cities throughout the country to try to
prove it.

Dyson, an early investor in Square and a board member of Yandex, Russia’s answer to Google Inc.,
has drafted five towns to participate in a five-year-long test, or what she calls a “healthy-living
challenge.”

By introducing programs and urban-planning initiatives, such as wholesome school lunches,
corporate wellness programs and more bike paths, Dyson hopes to reduce overall rates of obesity and
chronic disease in these towns.

The five towns are Muskegon, Mich.; Lake County, Calif.; Spartanburg, S.C.; Clatsop County,
Ore.; and Niagara Falls, N.Y. These communities all have populations of fewer than 100,000 people,
and their local officials are fully on board with the initiative, Dyson said.

She calls this the “Way to Wellville,” in which such programs reinforce one another, promote
awareness, and — it is hoped — avert expensive health-care costs over the long term.

Its sponsor is a nonprofit organization called the Health Initiative Coordinating Council, or
HICCup, which Dyson founded. HICCup will help local officials find funding from social investors,
local businesses and philanthropic organizations.

Each of the towns expects to spend between $20 million and $80 million over the next five years.
HICCup, run by former insurance executive Rick Brush, has set aside $5 million for administrative
costs.

Dyson hopes to establish a model for other communities and provide direct feedback to
policymakers in government. Her experiment is timely, given the Obama administration’s support for “
population health” initiatives to cut spiraling costs. Population health advocates push for
increased funding for preventive measures for groups of patients to reduce rates of chronic
illness.

For instance, if a town invests a small sum in programs to inform citizens about the health
risks associated with fast food, as well as counseling for pre-diabetes, it could avoid thousands
of dollars in medical costs and reduced work productivity.

“The programs by and large won’t be remarkable,” Dyson said. “What’s remarkable is doing them
together, reinforcing one another, and critical density, in small self-contained communities where
they will have maximum impact.”

Article source: http://www.dispatch.com/content/stories/national_world/2014/08/19/5-towns-to-participate-in-healthy-living-challenge.html

Forgot the co-payment… Seven tips for an affordable, quality health system

Health policy debate over the past few months has been held to a $7 ransom. It’s as if the Medicare co-payment has been deified as the solution to all the health system’s ills.

Of course, the $7 co-payment was not the only policy initiative in the budget: there were also proposals to shift other costs to consumers – by increasing the pharmaceutical benefits scheme co-payment – or onto states, by reducing Commonwealth grants. Shifting costs to consumers has got a bad press, and the proposals to do so may not pass the Senate.

But there are other options. Here are seven tips policymakers can follow for better health reform.

1. Don’t panic

Health systems change slowly. Even the bogeyman of an ageing population is occurring slowly. People age by a day every day, so the so-called ageing effect is more like a grey glacier than a silver tsunami.

Sustainability panic will almost inevitably lead to wrong solutions – quick fixes that aren’t fixes at all. Shifting costs is easier than fixing system fundamentals and so it is, unfortunately, what is often advocated and pursued.

2. Change behaviour through incentives

Financial incentives are a powerful way to change health provider behaviour. The introduction of activity-based funding is the stand-out success in making the public hospital system more efficient. Instead of paying hospitals on what they say they do, or on their historic budget, they are now paid on what they actually do: their activity.

Activity-based funding gave hospitals incentives to improve their efficiency. One result was that they started to own the problems of their performance, rather than shifting responsibility back to governments and taxpayers.

But more needs to be done in other areas. For example, fee-for-service payments to medical practitioners may no longer be the best way to reward them to look after someone with a chronic condition. They, too, should be rewarded on their results.

3. Don’t reduce equity

Financial disincentives for consumers may have perverse effects and can reduce equity. This has been the focus of much of the recent debate about the $7 co-payment. We know the co-payment will impact more on the poor, who already pay a larger share of their income on health care.

The introduction of a co-payment may also increase total health system costs, if consumers delay seeing doctors for health conditions that are more expensive to treat later.

4. Use a range of policy instruments

Public policy is about using policy instruments to change the behaviour of individuals, professionals, communities and organisations.

Top-down instruments include provision of new services; financial levers (taxes, incentives, setting up markets); rules, laws, organisational changes and system targets; information provision; rhetoric; and changing values and culture (usually by a combination of the previous five and through education).

Bottom-up approaches focus on consumer empowerment, engagement and choice.

The previous federal government played with organisational changes, creating an alphabet soup of agencies in the health portfolio. The budget has begun a welcome rationalisation of those.


Australia’s system is one of the world’s best on objective criteria.
Flickr/Ted Eytan, CC BY-SA

On the other hand, the Rudd-Gillard improved financial incentives when it introduced activity-based funding of hospitals nationally in order to drive efficiency. Because the Commonwealth was to share in the costs as hospital spending grew, this aligned the incentives of the Commonwealth and states to be efficient.

But the budget abolishes that change from 2017 and returns to a formula based on state population and CPI changes, not hospital activity.

Change is more effective if the full range of policy instruments are used, provided they all work in the same direction. New structures and performance indicators should, for example, be reinforced by financial incentives.

5. Cut waste before cutting access or quality

Bob Brook, a doyen of American health policy, and Kathy Lohr famously questioned 30 years ago whether it will be necessary to ration effective care, and the rationing question is still being used as a scare tactic in the policy debate.

Not all care is based on evidence. There is also substantial waste in the health system. Previous Grattan Institute work has showed that a billion dollars could be saved by extracting efficiency savings from hospitals. Further savings could be made by improving workforce utilisation and reducing the excessive prices we pay for pharmaceuticals.

While there is waste in the system, it is surely unethical and unfair to reduce people’s access to necessary services. Waste should be the first target.

6. Use data, not anecdotes

The health system is awash with data, even if much of it is unnecessarily locked up in government computers. Data should be used to inform policy development, and model the effects of new policies. Organisations need to invest in the mindset and skills to use data in policy, and have the mandate to do so.

Although anecdotes help to sell policies, they shouldn’t be the basis of policy development. If they are, they will almost certainly distort policymakers’ perceptions and start them down the wrong paths.

7. Get real

Policymakers need to be realistic about what needs to be done and how long change takes. Sustainability panic leads to a focus on short-term solutions. Health care accounts for almost 10% of GDP – it is a big system. Policy makers should take a long-term strategic approach, planning for the long haul.

This may mean experimenting with changes, piloting them to check that they work as intended. It certainly requires openness to new ways of doing things.

In planning and evaluating changes, though, we must build on what works in the health system. Australia’s system is one of the world’s best on objective criteria. It costs less than the OECD average and the outcomes, in terms of life expectancy, are better than the OECD average.

That doesn’t mean it can’t be improved (see tip six above). But it does mean we shouldn’t throw the baby out with the bath water as we change the system.

This article is based on a talk today to the Consumers Health Forum symposium: Health in a Time of Change.

Article source: http://theconversation.com/forgot-the-co-payment-seven-tips-for-an-affordable-quality-health-system-30523

Forget the co-payment… Seven tips for an affordable, quality health system

Health policy debate over the past few months has been held to a $7 ransom. It’s as if the Medicare co-payment has been deified as the solution to all the health system’s ills.

Of course, the $7 co-payment was not the only policy initiative in the budget: there were also proposals to shift other costs to consumers – by increasing the pharmaceutical benefits scheme co-payment – or onto states, by reducing Commonwealth grants. Shifting costs to consumers has got a bad press, and the proposals to do so may not pass the Senate.

But there are other options. Here are seven tips policymakers can follow for better health reform.

1. Don’t panic

Health systems change slowly. Even the bogeyman of an ageing population is occurring slowly. People age by a day every day, so the so-called ageing effect is more like a grey glacier than a silver tsunami.

Sustainability panic will almost inevitably lead to wrong solutions – quick fixes that aren’t fixes at all. Shifting costs is easier than fixing system fundamentals and so it is, unfortunately, what is often advocated and pursued.

2. Change behaviour through incentives

Financial incentives are a powerful way to change health provider behaviour. The introduction of activity-based funding is the stand-out success in making the public hospital system more efficient. Instead of paying hospitals on what they say they do, or on their historic budget, they are now paid on what they actually do: their activity.

Activity-based funding gave hospitals incentives to improve their efficiency. One result was that they started to own the problems of their performance, rather than shifting responsibility back to governments and taxpayers.

But more needs to be done in other areas. For example, fee-for-service payments to medical practitioners may no longer be the best way to reward them to look after someone with a chronic condition. They, too, should be rewarded on their results.

3. Don’t reduce equity

Financial disincentives for consumers may have perverse effects and can reduce equity. This has been the focus of much of the recent debate about the $7 co-payment. We know the co-payment will impact more on the poor, who already pay a larger share of their income on health care.

The introduction of a co-payment may also increase total health system costs, if consumers delay seeing doctors for health conditions that are more expensive to treat later.

4. Use a range of policy instruments

Public policy is about using policy instruments to change the behaviour of individuals, professionals, communities and organisations.

Top-down instruments include provision of new services; financial levers (taxes, incentives, setting up markets); rules, laws, organisational changes and system targets; information provision; rhetoric; and changing values and culture (usually by a combination of the previous five and through education).

Bottom-up approaches focus on consumer empowerment, engagement and choice.

The previous federal government played with organisational changes, creating an alphabet soup of agencies in the health portfolio. The budget has begun a welcome rationalisation of those.


Australia’s system is one of the world’s best on objective criteria.
Flickr/Ted Eytan, CC BY-SA

On the other hand, the Rudd-Gillard improved financial incentives when it introduced activity-based funding of hospitals nationally in order to drive efficiency. Because the Commonwealth was to share in the costs as hospital spending grew, this aligned the incentives of the Commonwealth and states to be efficient.

But the budget abolishes that change from 2017 and returns to a formula based on state population and CPI changes, not hospital activity.

Change is more effective if the full range of policy instruments are used, provided they all work in the same direction. New structures and performance indicators should, for example, be reinforced by financial incentives.

5. Cut waste before cutting access or quality

Bob Brook, a doyen of American health policy, and Kathy Lohr famously questioned 30 years ago whether it will be necessary to ration effective care, and the rationing question is still being used as a scare tactic in the policy debate.

Not all care is based on evidence. There is also substantial waste in the health system. Previous Grattan Institute work has showed that a billion dollars could be saved by extracting efficiency savings from hospitals. Further savings could be made by improving workforce utilisation and reducing the excessive prices we pay for pharmaceuticals.

While there is waste in the system, it is surely unethical and unfair to reduce people’s access to necessary services. Waste should be the first target.

6. Use data, not anecdotes

The health system is awash with data, even if much of it is unnecessarily locked up in government computers. Data should be used to inform policy development, and model the effects of new policies. Organisations need to invest in the mindset and skills to use data in policy, and have the mandate to do so.

Although anecdotes help to sell policies, they shouldn’t be the basis of policy development. If they are, they will almost certainly distort policymakers’ perceptions and start them down the wrong paths.

7. Get real

Policymakers need to be realistic about what needs to be done and how long change takes. Sustainability panic leads to a focus on short-term solutions. Health care accounts for almost 10% of GDP – it is a big system. Policy makers should take a long-term strategic approach, planning for the long haul.

This may mean experimenting with changes, piloting them to check that they work as intended. It certainly requires openness to new ways of doing things.

In planning and evaluating changes, though, we must build on what works in the health system. Australia’s system is one of the world’s best on objective criteria. It costs less than the OECD average and the outcomes, in terms of life expectancy, are better than the OECD average.

That doesn’t mean it can’t be improved (see tip six above). But it does mean we shouldn’t throw the baby out with the bath water as we change the system.

This article is based on a talk today to the Consumers Health Forum symposium: Health in a Time of Change.

Article source: http://theconversation.com/forget-the-co-payment-seven-tips-for-an-affordable-quality-health-system-30523

Community Health says data stolen in cyber attack from China


BOSTON/NEW YORK (Reuters) – Community Health Systems Inc (CYH.N), one of the biggest U.S. hospital groups, said on Monday it was the victim of a cyber attack from China, resulting in the theft of Social Security numbers and other personal data belonging to 4.5 million patients.

Security experts said the hacking group, known as “APT 18,” may have links to the Chinese government.

“APT 18″ typically targets companies in the aerospace and defense, construction and engineering, technology, financial services and healthcare industry, said Charles Carmakal, managing director with FireEye Inc’s (FEYE.O) Mandiant forensics unit, which led the investigation of the attack on Community Health in April and June.

“They have fairly advanced techniques for breaking into organizations as well as maintaining access for fairly long periods of times without getting detected,” he said.

The information stolen from Community Health included patient names, addresses, birth dates, telephone numbers and Social Security numbers of people who were referred or received services from doctors affiliated with the hospital group in the last five years, the company said in a regulatory filing.

The stolen data did not include medical or clinical information, credit card numbers, or any intellectual property such as data on medical device development, said Community Health, which has 206 hospitals in 29 states.

The attack is the largest of its type involving patient information since a U.S. Department of Health and Human Services website started tracking such breaches in 2009. The previous record, an attack on a Montana Department of Public Health server, was disclosed in June and affected about 1 million people.

Chinese hacking groups are known for seeking intellectual property, such as product design, or information that might be of use in business or political negotiations.

Social Security numbers and other personal data are typically stolen by cybercriminals to sell on underground exchanges for use by others in identity theft.

Over the past six months Mandiant has seen a spike in cyber attacks on healthcare providers, although this was the first case it had seen in which a sophisticated Chinese group has stolen personal data, according to Carmakal. Mandiant monitors about 20 hacking groups in China.

NEW SCRUTINY

Cybersecurity has come under increased scrutiny at healthcare providers this year, both by law enforcement and attackers.

The FBI warned the industry in April that its protections were lax compared with other sectors, making it vulnerable to hackers looking for details that could be used to access bank accounts or obtain prescriptions.

Mandiant has tracked “APT 18″ for four years. When asked if the hackers were linked to the Chinese government, Carmakal said it was “a possibility” but declined to elaborate.

Another cybersecurity firm, CrowdStrike, which has also been monitoring “APT 18″ for about four years, said it believes the hackers are either backed by Beijing or work directly for the government, based on the targets they have chosen.

CrowdStrike Chief Technology Officer Dmitri Alperovitch said his firm has seen “APT 18″ targeting human rights groups and chemical companies.

“They are of above average skill” among Chinese hackers, said Alperovitch, whose company dubbed the group “Dynamite Panda.”

The issue of Chinese state-sponsored hacking is highly sensitive. Tensions between Washington and Beijing have grown since May, when a U.S. grand jury indicted five Chinese military officers on charges they hacked into American companies for sensitive manufacturing secrets. China has denied the charges.

FBI spokesman Joshua Campbell said his agency was investigating the Community Health case, but declined to elaborate.

The Department of Homeland Security said it believed the incident was isolated, although it shared technical details about the attack with other healthcare providers. An agency official told Reuters it was too soon to say who was behind the attack.

Community Health said it has removed malicious software used by the attackers from its systems and completed other remediation steps. It is now notifying patients and regulatory agencies, as required by law.

The company said it is insured against such losses and does not at this time expect a material adverse effect on financial results. Community Health’s stock rose 66 cents, or 1.3 percent, to close at $51.66 on the New York Stock Exchange on Monday.

(Reporting by Caroline Humer, Jim Finkle and Shailesh Kuber; Editing by Dan Grebler and Tiffany Wu)

Article source: http://www.reuters.com/article/2014/08/18/us-community-health-cybersecurity-idUSKBN0GI16N20140818

Pittsburgh Health Care Giants Take Fight To Each Other’s Turf

The headquarters for University of Pittsburgh Medical Center and Highmark Blue Cross/Blue Shield dominate the Pittsburgh skyline much as they organizations have dominated health care in the region for decades.i
i

The headquarters for University of Pittsburgh Medical Center and Highmark Blue Cross/Blue Shield dominate the Pittsburgh skyline much as they organizations have dominated health care in the region for decades.

Jeff Brady/NPR


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itoggle caption

Jeff Brady/NPR

The headquarters for University of Pittsburgh Medical Center and Highmark Blue Cross/Blue Shield dominate the Pittsburgh skyline much as they organizations have dominated health care in the region for decades.

The headquarters for University of Pittsburgh Medical Center and Highmark Blue Cross/Blue Shield dominate the Pittsburgh skyline much as they organizations have dominated health care in the region for decades.

Jeff Brady/NPR

Pittsburgh’s dominant health insurance company and its largest healthcare provider are, essentially, getting a divorce.

For decades, Highmark Blue Cross/Blue Shield and University of Pittsburgh Medical Center worked together. But as the line between insurance companies and health care providers across the country blurs, these longtime allies are venturing into each other’s business and becoming competitors.

In the process, patients can get caught in the middle. Day-care worker Gail Jameson has Highmark insurance and she’s been going to the same UPMC medical office for more than 20 years. “I could go in and just stop in if I needed to because it’s close to my work,” Jameson says. “I go past it every day.”

She’s about five years from retirement and was disappointed to learn her Highmark policy will no longer include UPMC providers. She has to find all new doctors through another health system that is unfamiliar to her.

The road to divorce began when insurer Highmark got into the hospital business. It bought the struggling West Penn Allegheny Health System, which was UPMC’s main competitor.

“Highmark stepped in in order to ensure that there was competition in the marketplace and there would continue to be consumer choice,” says Highmark President and CEO David Holmberg. In a town where UPMC controls more than 60 percent of the market, Holmberg says there needs to be healthier competition among providers.

YouTube

Highmark’s TV ad from 2013 encourages UPMC to sign a long-term service contract.

There’s another reason an insurance company would decide to become a healthcare provider: the Affordable Care Act. It tells insurance companies what basic services to offer; who they must insure and even what percent of premiums can go to administrative expenses and profits. That takes away a lot of what insurance companies used to do, so they’re looking for new reasons to exist.

“Insurers are trying to demonstrate that they bring value to the table and are doing more than just brokering a benefit … and doing more than paying bills,” says Gail Wilensky, senior fellow at Project HOPE.

Wilensky says some insurance companies are responding by building more efficient networks of high-quality providers. Highmark went a step beyond that and became a provider of health care itself.

UPMC responded by expanding its existing insurance business and refusing to sign a new long-term contract with Highmark, saying it could not both compete and work with Highmark.

YouTube

UPMC’s TV ad from 2013 explains why it can’t sign a new long-term service contract with Highmark.

“We couldn’t have a contract with them,” says UPMC President and CEO Jeffrey Romoff, “Because they [Highmark] have the burden of keeping their provider side alive. So, for every one of their insurance subscribers they will want to steer them to go to their own providers.”

The divorce of Highmark from UPMC is all but final now. An agreement between the two companies will expire on January 1, 2015. The state of Pennsylvania negotiated a transition agreement. It does things like ensure Highmark subscribers already in certain kinds of treatment at UPMC can continue receiving care.

Now the Pittsburgh health care landscape looks very different. “It went from one of the least competitive environments that you can imagine — a dominant insurer and a dominant health system joined at the hips with a long term contract,” says Romoff, “To one without a long-term contract with, now, five choices.”

In addition to the two new competitors, UPMC invited three large insurance companies into the Pittsburgh market: Cigna, Aetna and United Healthcare. “Competition is good,” says Romoff, “It keeps us all on top of our game. It gives us incentive to not be fat and sloppy.”

With competition come the marketing campaigns. UPMC is banking on its good reputation. Highmark will appeal to those concerned about price. “For some people their monthly premium and the cost of their health care may be more important than having access to everything,” Holmberg says.

In Pittsburgh now people have a lot more choices — and decisions — to make when it comes to their health care. That’s supposed to be a good thing. But for Jameson, who was satisfied with her Highmark-UPMC combination, the extra work is a pain. “I just don’t like change. I shouldn’t have to change,” says Jameson.

It’s not just patients dealing with change. Employers who buy insurance for their workers face difficult decisions too. With two insurance/provider networks that don’t allow access to each other, Pittsburgh employers can be put in the position of, effectively, choosing which doctors treat their workers.

“Employers want to provide benefits that allow them to be competitive and attract and retain a productive work force,” says Jessica Brooks, executive director of the Pittsburgh Business Group on Health. “They don’t want to be in the business of making personal life decisions around who their employees can see and who they can’t see,” she says.

The Affordable Care Act aims to increase the quality and affordability of health care. Creating competitive marketplaces is part of the plan. It will be a few years before people in Pittsburgh and around the country know whether the changes happening now make those goals reality.

Article source: http://www.npr.org/blogs/health/2014/08/19/341399014/pittsburgh-health-care-giants-take-fight-to-each-others-turf

Calif. Health IT Groups Urge Focus on Health Data Transparency

Two California-based health information technology organizations have sent letters to Sens. Ron Wyden (D-Ore.) and Chuck Grassley (R-Iowa) highlighting the importance of health care data transparency and interoperability, FierceHealthIT reports (Dvorak, FierceHealthIT, 8/15).

The letters came in response to a June request from Wyden and Grassley seeking ideas “to enhance the availability and utility of health care data” while protecting patient privacy from 200 health care industry individuals and groups. Tuesday was the deadline for responses to the senators’ query (Conn, Modern Healthcare, 8/12).

Details of West Health Institute Letter

La Jolla-based West Health Institute in its letter noted the need for “seamless, semantic interoperability” between electronic health record systems to ensure access to health data for health care providers, insurers, patients and patients’ families.

West Health argued that such interoperability would increase care quality and enable patients and stakeholders to make informed health care decisions.

West Health CEO Nicholas Valeriani said that the lack of interoperability within health IT systems “works against the ability of all providers engaged in the care of an individual patient to readily share observations and insights, and thereby frustrates the coordination of care that is essential to having optimal, patient-centered health care.”

Details of the Pacific Business Group on Health Letter

In a separate letter, San Francisco-based Pacific Business Group on Health recommended several moves to improve interoperability, including:

Collaborating with the Office of the National Coordinator for Health IT to establish a date for EHR interoperability; and

Using federal reimbursement incentives to reward providers who share health data effectively.

PBGH also wrote that patient-reported outcomes are a key of patient-centered health care systems but often are missing from such systems. Specifically, the organization argued that patient-reported outcomes could be used for:

  • Provider accountability; and
  • Consumer decisions (FierceHealthIT, 8/15).

Article source: http://www.californiahealthline.org/articles/2014/8/18/calif-health-it-groups-urge-focus-on-health-data-transparency

UPDATE 7-Community Health says data stolen in cyber attack from China


(Adds comments from Crowdstrike in paragraphs 14-16)

By Jim Finkle and Caroline Humer

BOSTON/NEW YORK Aug 18 (Reuters) – Community Health Systems
Inc, one of the biggest U.S. hospital groups, said on
Monday it was the victim of a cyber attack from China, resulting
in the theft of Social Security numbers and other personal data
belonging to 4.5 million patients.

Security experts said the hacking group, known as “APT 18,”
may have links to the Chinese government.

“APT 18″ typically targets companies in the aerospace and
defense, construction and engineering, technology, financial
services and healthcare industry, said Charles Carmakal,
managing director with FireEye Inc’s (FEYE.O) Mandiant forensics
unit, which led the investigation of the attack on Community
Health in April and June.

“They have fairly advanced techniques for breaking into
organizations as well as maintaining access for fairly long
periods of times without getting detected,” he said.

The information stolen from Community Health included
patient names, addresses, birth dates, telephone numbers and
Social Security numbers of people who were referred or received
services from doctors affiliated with the hospital group in the
last five years, the company said in a regulatory filing.

The stolen data did not include medical or clinical
information, credit card numbers, or any intellectual property
such as data on medical device development, said Community
Health, which has 206 hospitals in 29 states.

The attack is the largest of its type involving patient
information since a U.S. Department of Health and Human Services
website started tracking such breaches in 2009. The previous
record, an attack on a Montana Department of Public Health
server, was disclosed in June and affected about 1 million
people.

Chinese hacking groups are known for seeking intellectual
property, such as product design, or information that might be
of use in business or political negotiations.

Social Security numbers and other personal data are
typically stolen by cybercriminals to sell on underground
exchanges for use by others in identity theft.

Over the past six months Mandiant has seen a spike in cyber
attacks on healthcare providers, although this was the first
case it had seen in which a sophisticated Chinese group has
stolen personal data, according to Carmakal. Mandiant monitors
about 20 hacking groups in China.

NEW SCRUTINY

Cybersecurity has come under increased scrutiny at
healthcare providers this year, both by law enforcement and
attackers.

The FBI warned the industry in April that its protections
were lax compared with other sectors, making it vulnerable to
hackers looking for details that could be used to access bank
accounts or obtain prescriptions.

Mandiant has tracked “APT 18″ for four years. When asked if
the hackers were linked to the Chinese government, Carmakal said
it was “a possibility” but declined to elaborate.

Another cybersecurity firm, CrowdStrike, which has also been
monitoring “APT 18″ for about four years, said it believes the
hackers are either backed by Beijing or work directly for the
government, based on the targets they have chosen.

CrowdStrike Chief Technology Officer Dmitri Alperovitch said
his firm has seen “APT 18″ targeting human rights groups and
chemical companies.

“They are of above average skill” among Chinese hackers,
said Alperovitch, whose company dubbed the group “Dynamite
Panda.”

The issue of Chinese state-sponsored hacking is highly
sensitive. Tensions between Washington and Beijing have grown
since May, when a U.S. grand jury indicted five Chinese military
officers on charges they hacked into American companies for
sensitive manufacturing secrets. China has denied the charges.

FBI spokesman Joshua Campbell said his agency was
investigating the Community Health case, but declined to
elaborate.

The Department of Homeland Security said it believed the
incident was isolated, although it shared technical details
about the attack with other healthcare providers. An agency
official told Reuters it was too soon to say who was behind the
attack.

Community Health said it has removed malicious software used
by the attackers from its systems and completed other
remediation steps. It is now notifying patients and regulatory
agencies, as required by law.

The company said it is insured against such losses and does
not at this time expect a material adverse effect on financial
results. Community Health’s stock rose 66 cents, or 1.3 percent,
to close at $51.66 on the New York Stock Exchange on Monday.

(Reporting by Caroline Humer, Jim Finkle and Shailesh Kuber;
Editing by Dan Grebler and Tiffany Wu)

Article source: http://www.reuters.com/article/2014/08/18/community-health-cybersecurity-idUSL4N0QO3UD20140818

Community Health Systems Says Its Suffered Criminal Cyberattack

Community Health Systems Inc. said Monday that its computer network was a target of an external criminal cyberattack in April and June that affected data related to some 4.5 million individuals.

The rural hospital operator and cybersecurity firm Mandiant believe the attacker was an “Advanced Persistent Threat” group originating from China, it said. The attacker, which used highly sophisticated malware and technology to…

Article source: http://online.wsj.com/articles/community-health-systems-says-its-suffered-criminal-cyberattack-1408365259