TAP Pharmaceutical Products, which paid $884 million to settle civil and criminal fraud charges three years ago and whose current and former executives are immersed in a Boston criminal trial, is clearly not going to be allowed into the No Spin Zone.
TAP, a Lake Forest, Ill.-based joint venture of Abbott Laboratories and Japanese pharmaceutical giant Takeda Chemical Industries, was busy last week trying to change its image by touting its compliance with federal laws, even as 11 of its current and former executives were on trial for bribery and kickbacks.
The spinning took place at the Health Care Compliance Association's annual institute in Chicago. TAP's compliance program occupied an extra large exhibitor's space at the compliance conference and even footed the lunch bill for 1,300 HCCA members. The highlight was a game show that allowed participants to test their knowledge of TAP's corporate integrity agreement, compliance program, and new sales and marketing practices. Questions included what and how much a sales rep is legally allowed to give doctors without triggering federal kickback violations. TAP also operates a hot line to advise employees on steering clear of legal troubles, says Mark Graves, assistant ethics and compliance officer.
The game show software was co-developed with TAP by Naperville, Ill.-based Hildebrand Creative Group and TAP sales teams have played it for prizes. Owner Dennis Hildebrand says the format has worked so well that he's sold it to rivals Abbott and Pfizer, as well as a hospital system, Phoenix-based Banner Health System.
Not a woman's world
Women in Connecticut are awakening to the idea that "consumer-driven healthcare"-that euphemism for "you pay more"-means them.
ConnectiCare, based in Farmington, is the latest health plan to dun women as much as 40% more for premiums than men. The policy, which takes effect July 1, will reflect the higher costs of insuring women, says spokeswoman Deborah Hoyt. The gender-based policy will affect only companies with 50 or fewer employees.
"We're spreading costs to people who use healthcare more, such as older people and women of child-bearing age," she says. For example, rates for women ages 25 to 29 under the typical HMO plan would cost $247 per month, or 1.4 times the $176 monthly premium for men, to align rates with actuarial data on costs and usage. Rates would change as people aged.
Hoyt says the gender-based rates only apply to smaller companies whose employee healthcare use can be harder to track on an individual basis. The insurer also operates in Massachusetts and is moving into New York, both of which bar gender-based rates, Hoyt says. Rate-setting policies vary by state.
Hoyt says the policy is necessary for small regional insurers such as hers to compete with entrenched industry players such as UnitedHealth Group in Minneapolis and Anthem Blue Cross and Blue Shield in Indianapolis, which both set gender-based rates.
Anthem has used gender-based rates in Connecticut since the early 1990s, says Carol Pompano, an Anthem spokeswoman. Connecticut allows insurers to use four factors in setting rates: gender, age, group size and area. It's up to the employers whether they pass along the differentials to their employees, but generally "Companies are asking employees to share more of the costs," Pompano says.
Language barriers have long been among the causes of poor-quality healthcare nationwide, but one public-health school is translating the need into a new education program.
The School of Public Health at the University of North Texas Health Science Center in Fort Worth has launched a master's level academic program to prepare students to become professional health interpreters, linguistic researchers and leaders in the field of health applied linguistics. The health interpreting and health applied linguistics program will be the only degree program in the U.S. to include the fields of health communication, medical interpreting and healthcare access.
The status of medical interpreting in the U.S. is dismal, says program director Holly Jacobson. Interpreters are undertrained and overworked, and often lack knowledge of the crucial aspects of the interaction that occurs between doctors and patients of different linguistic and cultural backgrounds (See commentary, p. 21). Such use of interpreters without adequate training has a direct, negative impact on patient care, she says.
"Most medical interpreting programs that currently exist provide 40 hours or less of very basic classroom training, which isn't nearly enough for preparing competent interpreters," she says.
Students in the program, which is accepting applications for fall of this year, would complete 200 hours of interpreting hours at collaborating healthcare provider sites in Tarrant County. The need is great; area providers are struggling to provide effective services to the growing Latino Spanish-speaking community.