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Daily Rounds: The Master Medicaid Fix; Cancer Math; 'Parsimonious' Doctors?; Higher-Protein Diets

A doctor's fix for health-care delivery (Governing) - "During the 1980s, Dr. Bob Master served as Massachusetts Gov. Michael Dukakis's Medicaid director. Today, Master is working on health-care delivery reform from a different vantage point — as a CEO of the Commonwealth Care Alliance, an unusual non-profit that works with primary care physicians to better serve dual eligibles and Medicaid recipients with complex conditions and chronic illnesses. He has developed a unique and influential perspective on how health-care delivery change needs to happen; a perspective that is skeptical of states' current efforts to extend managed care organizations (MCOs) to vulnerable populations." (Governing)

The math behind screening tests (Scientific American) - "Individual cases dictate what tests and treatment are best, of course, but one factor underlying all these tests is a bit of numerical wisdom that, though well known to mathematicians, bears repeating: when one is looking for something relatively rare (not just cancer but even for, say, terrorists), a positive result is very often false. Either the “detected” life-threatening cancer is not there, or it is of a sort that will not kill you." (Scientific American)

Should doctors be parsimonious about health care? (NPR) - "A major medical group issued ethical guidelines on Monday that take the provocative position of urging doctors to consider cost-effectiveness when deciding how to treat their patients. The American College of Physicians, the second-largest U.S. doctors' group after the American Medical Association, included the recommendation in the latest version of its ethics manual, which provides guidance for some 132,000 internists nationwide." (NPR)

Study finds higher protein diets lead to more weight gain, muscle (The Boston Globe) - "While unwanted pounds undoubtedly come from eating more calories than the body burns, the process is far more complicated than the overly simplistic calories in/calories out paradigm, according to a new study published today in the Journal of the American Medical Association. Those extra calories we eat, whether protein, fat, or carbohydrates, all result in the same extra padding of body fat, but how much lean muscle we put on is dependent upon the amount of protein we consume." (The Boston Globe)

State forms private insurance cooperatives - (The Worcester Business Journal) "The Retailers Association of Massachusetts and the Massachusetts Association of Chamber of Commerce Executives will be the first two private health insurance cooperatives allowed by the state.
As part of economic development legislation passed in 2010, the state is allowed to certify up to six group purchasing associations, which allow small businesses to enter into collaborative purchasing agreements with larger organizations. The state's Division of Insurance announced that the retailers and chamber executive groups will be the first two cooperatives. There are 45 organizations that can work with these two groups, a list of which can be seen here." (The Worcester Business Journal)

This program aired on January 4, 2012. The audio for this program is not available.

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