Health care reform discussions almost always revolve around health insurance, as if care and insurance are synonymous. Understanding the difference can lead to the delivery of better care for less money, and help break the health care reform logjam in Congress.

An amendment introduced this week by U.S. Senator Maria Cantwell to America’s Healthy Future Act, currently being considered by the Senate Finance Committee, understands the difference. Senator Cantwell’s amendment would provide for coverage in a ‘direct primary care medical home’ plan, provided that plan is coupled with a quality wrap-around insurance program to cover non-primary care services.

What are direct primary care medical homes? They are primary care practices offering patients comprehensive primary care coverage outside of the traditional insurance system. They provide preventive and primary care, as well as chronic disease management and coordination of care with specialists and hospitals. Patients who elect this health care delivery model pay a flat monthly fee (ranging from $49 to $79 at my affiliated practice, Seattle-based Qliance Medical Group) for unlimited access to a primary care physician. This monthly fee covers everything from regular check-ups, women’s health exams, sprained ankles and broken arms to flu shots, and arthritis or diabetes management.

Direct primary care medical homes are already accomplishing what everyone wants health care reform to do:

• Lower costs

• Improve access

• Increase the quality of care

As a nation, we spend over $2 trillion a year on health care. We want to improve access, lower costs and expand quality coverage to the almost 50 million people who are currently uninsured – but we need to find a way to do this without breaking the bank.

There are ways to lower the overall cost of health care. An astonishing 40 percent of every dollar spent on primary care goes toward paperwork – either on the provider or insurer side – to complete the insurance reimbursement process. By eliminating the insurance payment mechanism and forming a direct relationship between a provider and patient, direct primary care medical homes have more resources available to spend on patient care.

The savings allow practices to offer more providers and longer office hours, even opening seven days per week. Smaller patient loads enable … Next Page »

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It only takes about 30 minutes from downtown Seattle to get to what some people like to call the “Silicon Valley of Ultrasound,” in Bothell, WA. So when I heard about another ultrasound startup company, one with a name that comes from the Latin word for “miraculous,” I figured it was worth checking out.

There’s actually a lot more substance to the story than that. Bothell, WA-based Mirabilis Medica doesn’t claim to have achieved any miracles. But it has a pretty ambitious goal. Its team of engineers are building an ultrasound machine that is supposed to offer a non-invasive way to get rid of uterine fibroids. The technology has potential to help relieve symptoms of these painful growths in the uterus that are the leading reason so many women get hysterectomies after their childbearing years.

The problem, and market opportunity, is a big one. As many as one out of five women in the U.S. suffer from fibroids, according to the National Institutes of Health. Women can take drugs, or get a couple of different surgical procedures, but the only cure is a radical one—complete removal of the uterus, a hysterectomy. About 625,000 women get hysterectomies in the U.S. each year, and about half of the time it is because they have uterine fibroid growths that cause painful cramping and bleeding, says Mirabilis CEO Mike Connolly. So if Mirabilis can come up with a way to get rid of these fibroids, without a doctor having to pull out a scalpel, it forecasts it will tap into a new market worth $1 billion a year.

“Right now, it’s basically like doctors are hitting a fly with a sledgehammer,” Connolly says.

Mirabilis, like practically every ultrasound company in Bothell, can trace its family tree to the University of Washington. The company got started in 2004, by Alex Lebedev on business, Shahram Vaezy on technology, and Michael Lau, a practicing gynecologist in Edmonds, WA, on the medical side. Connolly joined the company in October 2006, after he got an up-close look at the technology when he was a principal with vSpring Capital, an early investor. Besides vSpring, the company has raised about $11 million since the beginning from Charter Life Sciences, Arboretum Ventures, Split Rock Partners, and Dow Chemical.

The Mirabilis technology has two critical components. One uses the diffuse, low-intensity waves of diagnostic ultrasound to help doctors look inside the body and pinpoint the location of the fibroids. The other element is a high-intensity, tightly-focused therapeutic wave of ultrasound. That part is supposed to heat up tissue just enough to kill fibroid cells without causing any collateral damage or side effects.

Mirabilis has about 10 employees, including some engineers from one of the few successful therapeutic ultrasound companies, Liposonix, which uses ultrasound for body sculpting. The technical challenge … Next Page »

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Framingham, MA-based Interlace Medical, which develops medical devices for gynecologists, announced today it has raised $20.5 million in Series C funding. The round was led by Baird Venture Partners and HLM Venture Partners and included new investors Hambrecht & Quist Capital Management and Aperture Venture Partners. Previous backers New Leaf Venture Partners and Spray Venture Partners returned for this round as well. Interlace says the Series C funds will be used to initiate the commercialization of its MyoSure system, which is intended as a less invasive method of removing fibroids and polyps from the uterus.

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