New evidence changes recommendations for aspirin in prevention of heart disease

The recommendations here have changed quite a bit. It's now all about risk.

For those between 50-59 years with a 10% or greater risk for cardiovascular disease, the evidence for taking aspirin is pretty good. For those between 60-69, the evidence is not solid and it's a good time for a chat with the doctor or advanced practitioner. For those under 50 or 70+, there isn't good evidence and again, time for a talk with the doc.

Not sure of your risk? That's a number you should know. It's much more important than LDL alone. Many calculators exist; here's one.

Notes from a primary care quality summit

WellOK attended a primary care quality summit in Oklahoma City today and joined physicians, advanced practitioners and other quality-focused individuals from across the state in helping to answer the question: How do we improve the health of Oklahomans? 

The group believed employers do need a place at this table and welcome the business community in joining the quest for (and the expectation of receiving) highest-quality care. They also wished we would begin an expansion into OKC to engage employers there.

Talk about price of care, not price of insurance!

Yesterday, I was reviewing claims for a manufacturing company. One claim stood out as emblematic of the challenges people have being good healthcare consumers. Here's a classic example of price failure:

An employee had a common blood chemistry test, called Comprehensive Metabolic Profile, done at the outpatient department of a prestigious referral health system. Other specialized tests were done at the same time.  The "list" price for blood chem was $978 and the PPO allowable was $625.

This employee could have had the blood chem test done at a local lab nearby (full price less than $10) and had a copay less than a cup of coffee at Starbucks. Instead, this employee had $125 out-of-pocket.

I wonder if anyone had an honest conversation about price with this employee before lab was drawn?

Why does the national conversation focus on the cost of insurance and not the cost of care itself?

May 26th WellOK meeting in collaboration with CMMI and OCHI

Here is the agenda for the May 26th meeting in conjunction with Centers for Medicare & Medicaid Innovation and Oklahoma Center for Healthcare Improvement.  The Business Track starts at 9:45 AM and concludes at 1:00 PM. WellOK members are also welcome to attend any of the sessions.

The meeting place is the Learning Center at the University of Oklahoma-Tulsa Schusterman campus. The registration site provides a map.

Click here to register. Please contact us if any questions.

Plan to attend our May 26th meeting about value-based insurance design and high value primary care

This year, we are again collaborating with Centers for Medicare and Medicaid  Innovation and the Oklahoma Center for Healthcare Improvement. This regional meeting brings together 63 practices, Medicare's innovation laboratory, health systems, payers and other community leaders around high-value primary care and healthcare transformation. WellOK is running a business track focusing on value-based insurance design and we will also have sessions showcasing innovations from four leading Tulsa providers.

Please contact us at for further information.

Two new members in WellOK

Last month, we welcomed the University of Tulsa and Dr Gerard Clancy. Dr Clancy is the VP of Health Affairs and the Dean of the College of Health Sciences. He has been a strong advocate for high-quality, accessible care in our community.

This month, we welcome Shannon Hammons, Director Human Resources, at HoganTaylor. HoganTaylor will be doing the accounting work for our non-profit organization. Ms. Hammons is enthusiastic about the mission of our organization.

Two more hospitals doing Leapfrog and another "A" rated hospital for safety

Thanks to the efforts of WellOK's Board of Directors, two more hospitals in our area are doing the voluntary Leapfrog voluntary survey.

Oklahoma Surgical Hospital completed and submitted their survey at the end of 2015. Hillcrest Medical Center announced they will do the survey in 2016.

These are two giant steps forward in WellOK's quest for transparency in our region's healthcare. Both Oklahoma Surgical Hospital and Hillcrest Medical Center are to be congratulated for this contribution to patients in the greater Tulsa area.

The Leapfrog Group announced 1750 hospitals in the US. a record number, have enrolled in the hospital survey program.

Leapfrog Group published the Fall 2015 hospital safety ratings. These safety ratings are derived from publicly available data for over 4000 hospitals in the US. Bailey Medical Center in Owasso continues to carry an "A" rating for safety. Saint Francis South on 91st Street just achieved an "A" safety rating.

Research proves the value of Diabetes Prevention Programs such as ours in Greater Tulsa

A major research paper has looked at many studies that evaluated the cost-effectiveness of diabetes prevention programs. Researchers at the CDC and the HealthPartners Foundation in Minnesota reviewed 28 published studies and concluded that programs such as the National Diabetes Prevention Program reduced long-term expenditures by delaying or preventing Type 2 diabetes for people at risk for it.

QuikTrip, the Greater Tulsa YMCA, Oklahoma State Department of Health and WellOK have collaborated to create the first employer-sponsored program in our area. Now in its third month, this program is showing good results.

The annual cost of diabetes medications per person with diabetes (in 2012 US dollars) is $1423. Prevention programs cost about $429. Factoring in other costs for diabetes, employers can make a solid economic case for sponsoring these programs.

The research is available here. The Community Preventive Services Task Force just published a recommendation statement about diabetes prevention.

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