Category: Uncategorized

Medibank and pay for performance

The recently publically listed health insurer Medibank Private is currently in controversial negotiations with private health care providers such as Calvary Health Care, Ramsay Health Care and Healthscope. These organisations represent some of the major players in the delivery of care in private hospitals.

Under current arrangements health insurers negotiate the cost that health providers are reimbursed for the delivery of services. The nature of health care is that complications and side effects or adverse events can occur. For example a patient has surgery, is discharged, but then develops a wound infection at home is readmitted to hospital for antibiotics within a month. In both private and public sectors this would be considered an unplanned readmission. Given the nature of medicine there is an expected baseline rate of unplanned readmissions. There is however the potential for wide variance in readmission rates between facilities. Readmission rates   and other adverse events may reflect quality and appropriateness of care (e.g. excessively early discharge), lack of community services to prevent readmission, patient complexity (e.g. patients with multiple comorbidities) and a whole raft of other variable. Medibank asserts that some of these adverse events are identiiable and preventable and should they occur Medibank would not reimburse the event or perhaps diminish the amount of reimbursement.
This could be seen as a blatant cost saving exercise based on the premise that Medibank must make a profit in an environment of rising costs and a baseline situation where about 85% of its revenues from insurance premiums are paid out. On the otherhand Medibank could assert that he proposal will be a driver for quality improvement and improving patient safety and outcomes. The providers argue that the lost list of items that won’t be covered is unreasonable or unrealistic and that many of the items that are cited as preventable adverse events aren’t really avoidable. That may the case and whilst there should be room to negotiate over individual items the direction the Medibank has signalled is concordant with developments in the public health care sector. Indeed in other systems various models for pay for performance are in trial or already implemented.
The problem for the private health care providers is that even if admissions for adverse events are funded as per the status quo it is in their interest to try and improve outcomes as a way of reducing their own internal costs and managingflow and activity levels.
The patients are paying with their premiums and also their health. They should be expecting that their health care providers are doing thir best to improve safety and deliver quality outcomes. Afterall, there must be benefits to private health care. Is it worth paying the premium if the only advantage is timeliness and a private room without at least equivalent outcomes from treatment? It also might raise the level of competition within the private system by using published outcome measures as a form of branding to attract business.
My guess is that a modified form of the Medibank proposal will be the outcome of these negotiations and this will signal a landmark change for health funding across the whole healthcare sector.

The Leonard Bernstein Edition – Disc 72 to 80 – The Series is Complete!

Disc 72 – A Great Tribute to the Innovators in Jazz  by America’s Great Musical Ambassador

Aaron Copland – Danzon Cubano

Elliott Carter – Concerto for Orchestra

W.C. Handy – St. Louis Blues (Concerto GRosse arranged by Anfredo Antonini) with Louis Armstrong (trumpet) and his Quintet (Edmund Hall on clarinet, Trummy Young on trombone, Billy Kyle on piano, DAle Jones on bass and Barrett Deems drums)

Dave Brubeck – Dialogues for JAzz Combo and Orchestra with the DAve Brubeck Quartet

Larry Austin – Improvistations for Orchestra and Jazz Soloists

New York Philharmonic
Disc 73

Aaron Copland – El Salon Mexico

Oscar Lorenzo Fernandez – Reisado do Patoreio: BAtuque

Mozart Camargo Guarnieri – Dansa brasileira

Silvestra Revueltas – Sensemaya

Lukas Foss – Phorion

Ralph Vaughn Williams – Fantasia on a Theme by Thomas Tallis for Double String Orchestra and Fantasia on “Greensleeves”

Darius Milhaud – La Creation du monde – Ballet op.81

New York Philharmonic
Disc 74 – Music of Our TIme

Gyorgy Ligeti – Atmospheres

Morton Feldman – Out of “Last Pieces”

Edison Denisov – Crescendo e Diminuendo

Gunther Schuller – Triplum

Luigi Dallapiccola – Tartiniana for Violin and Orchestra with Ruth Posselt on violin and the Columbio Symphony Orchestra

all other pieces with the New York Philharmonic
Disc 75 – American Masters

Walter Piston – The Incredible Flutist Suite

Edward Burlingame Hill – Prelude for Orchestra

William Schumann – In Praise of Shahn

Columbia Symphony Orchestra and New York Philharmonic
Disc 76 – Rhapsodies

Franz Liszt

Hungarian Rhapsody No.1 in F Minor S 359/1

Hungarian Rhapsody No.4 in D minor S 359/4 with Julius BAker on flute

George Enescu – Romanian Rhapsody No.1 in A major op.11/1

Johannes Brahms

Hungarian Dance No.5 in F-sharp minor

Hungarian Dance No.6 in D-flat major

Wolfgang Amadeus Mozart – German Dance in C major K 605/3

Franz Liszt – Les Preludes (d’apres Lamartine) S 97 (Symphonic Poem for Large Orchestra)

Grigoras Dinicu – Hora Staccato

Ermanno Wolf-Ferrari – I gioielli della Madonna: Intermezzo II

New York Philharmonic
Disc 77 – Overtures

Wolfgang Amadeus Mozart  – Le Nozze di Figaro

Otto Nicolai – Die lustigen Weiber von Windsor

Emil Nikolaus von Reznicek – Donna Diana

Johann Strauss II – Die Fledermaus & Die Zigeunerbaron

Ambroise Thomas – Mignon

Carl Maria von Weber – Der Freischutz, Euryanthe, Oberon

New York Philharmonic
Disc 78 – Dances from Operas

Alexander Borodin – Prince Igor: Polovtsian Dances

Charles Gounod – Faust – Ballet Music

Amilcare Ponchielli – La Gioconda: Dance of the Hours

Nikolai Rimsky-Korsakov – Snow Maiden: Dance of the Tumblers

Camille Saint-Saens – Samson et Dalila: Bacchanale (Act III)

Giuseppe Verdi – Aida – Dance of the Priestesses (Act I), Dance of the Moorish Slaves (Act II), Ballet (Act II), Grand March (Act II)

Pyotr Ilyich Tchaikovsky – Eugene Onegin: Waltz (Act II)

New York Philharmonic
Disc 79 – Overtures

Felix Mendelssohn – Ruy Blas op.95 & De Hebriden (op.26)

Franz Schubert – Des Teufels Lustschloss D 84

Robert Schumann – Manfred & Genoveva

Carl Maria von Webere – Aufforderung zum Tanz op.65

Engelbert Humperdinck – Hansel und Gretel: Abendsegen

Ermanno Wolf-Ferrari – Il segreto di Susanna

New York Philharmonic
Disc 80 – Great Marches

John Philip Sousa – Semper Fidelis, The Thunderer, Washington Post, Hnds Across the Sea

Josef Franz Wagner – Under the Double Eagle

William Steffe – Battle Hymn of the Republic

Charles A. Zimmermann – Anchors Aweigh

John Philip Sousa – Stars and Stripes Forever!

Traditional – The British Grenadiers

Thomas Arne – Rule, Britannia

Claude Joseph Rouget de Lisle – La Marseillaise

Edwin E. Bagley – The National Emblem

Giacomo Meyerbeer – Le Prophete: Coronation March

Felix Mendelssohn – Athalie: War March of the Priests

Giuseppe Verdi  – Aida: Grand March

Kenneth J. Alford – Colonel Bogey

John Stafford Smith – The Star-Spangled Banner (twice)

The New York Philharmonic

The Leonard Bernstein Edition – Discs 67 to 71

Disc 67 – Pyotr Ilyich Tchaikovsky

Ouverture solemnelle “1812” op.49

Hamlet op.67

Serenade for String Orchestra in C major op.48

Andante Cantabile for String Orchestra
New York Philharmonic
Disc 68 – Pyotr Ilyich Tchaikovsky

The Nutcracker Suite op. 71a

Swan Lake op.20

The Sleeping Beauty op.66

Eugene Onegin
New York Philharmonic
Disc 69 – Richard Wagner – Orchestral Music from the Operas

Der fliegende Hollander: Overture

Rienzi: Overture

Lohengrin – Preludes to Acts I & III

Die Meistersinger von Nurnberg – Preludes to Acts I & III, Dance of teh Apprentices, Entry of the Masters

Die Walkure – Ride of the Valkyries, Magic Fire Music
New York Philharmonic
Disc 70 – Richard Wagner

Tannhauser – Overture and Festive March

Tristan and Isolde – Prelude and Liebestod
New York Philharmonic
Disc 71 – Russian Masters

Mikhail Glinka – Ruslan and Lyudmila: Overture

Alexander Borodin – In the Steppes of Central Asia

Reinhold Gliere – The Red Poppy: Russian Sailors’ Dance

Mikhail Ippolitov-Ivanov – Caucasian Sketches op.10

Sergei Prokofiev

Scythian Suite Op.20

The Love for Three Oranges op.33a

Lieutenant Kije – Suite op.60

Dimitri Shostakovich – The Age of Gold – Suite op. 22a

Nikolai Lopatnikoff – Concertinon for Orchestra op.30
New York Philharmonic with Engelbert Brenner on english horn  and Leonard Davis on viola (Ippolitov-Ivanov)

Columbia Symphony Orchestra for the Lopatnikoff

The Leonard Bernstein Edition – Discs 61 -66

Disc 61 – Richard Strauss

Also Sprach Zarathrustra op.30 – David Nadien on violin

Till Eulenspiegels lustige Streiche op.28

Don Juan op.20

New York Philharmonic
Disc 61 – Johann Strauss II & I

Johann Strauss II

An de schonen, blauen Donau op.314

Wiener Blut op.354

Perpetuum mobile op.257

Tritsch-Tratsch-Polka op.214

G’schichten aus dem Wienerwald op.325

Kaiser-Walzer op.437

Fruhlingsstimmen op.410

Kunstlerleben op.316

Auf der Jagd op.373

Rosen aus dem Suden op.388
Johann Strauss I 

Radetzky-Marsch op.228
New York Philharmonic
Disc 63: R.Strauss and Stravinsky

Richard Strauss

Festival Prelude op.61

Salome: Dances of the Seven Veils op.54
Igor Stravinsky

Pulcinella Suite
New York Philharmonic with E.Power Biggs on organ
Disc 64: Stravinsky

Igor Stravinsky

Le Sacre du printemps

Petrouchka
New York Philharmonic
Disc 65: Stravinsky

Igor Stravinsky

Le Sacre du printemps – London Philharmonic

L’Oiseau de feu – Suite – New York Philharmonic
Disc 66: Tchaikovsky

Pyotr Ilyich Tchaikovsky

Romeo and Juliet

Capriccio italien

Francesca da Rimini

Marche slave
New York Philharmonic

The Leonard Bernstein Edition – The Last Couple of Weeks – Discs 43 – 60

Disc 43
Claude Debussy – Images pur orchestre

Maurice Ravel – Pavane pur une infante defunte (Joseph Singer on horn)

Maurice Ravel – Ma mere l”oye

New York Philharmonic

Disc 44
Claude Debussy
La Mer
Prelude a l’apres-midi d’un faune
Jeux
Nocturnes

New York Philharmonic

Disc 45
Antonin Dvorak
Carnival Concert Overture op.92
Slavonic Dances op.46

Bedrich Smetana
The Bartered Bride Overture
The Bartered Bride: 3 Dances
The Moldau (Vltava) – Symphonic Poem from My Fatherland (Ma Vlast)

New York Philharmonic

Disc 46
Emmanuel Chabrier
Espana

Manuel De Falla
El amor brujo
Fanfare pur une fete
La vida breve: interlude and dance
El sombrero de tres picos
Suite No.1
Suite No.2
El amor brujo: Danza ritual del fuego

Marilyn Horne – mezzo-soprano
New York Philharmonic

Disc 47
George Gershwin
Rhapsody in Blue (Bernstein on piano)
An American in Paris

Ferde Grofe
Grand Canyon Suite (John Corigliano on violin)

Columbia Symphony Orchestra (Rhapsody) and the New York Philharmaonic Orchestra

Disc 48
Edvard Grieg
Peer Gynt Suite No.1 op.46
Peer Gynt Suite No.2 op.55
Norwegian Dance op.35/2
March of the Dwarfs op.54/3

Jean Sibelius
Valse Triste op.44/1
The Swan of Tuonela op.22/3
Finlandia op.26

New York Phalharmonic

Disc 49
Paul Hindemith
Symphonic Metamorphoses on Themes by Carl Maria von Webber
Concert Music for String Orchestra and Brass op.50

Arthur Honegger
Pacific 231
Rugby
Pastoral d’ete

New York Philharmonic

Disc 50
Gustav Holst
The Planets op.32

Edward Elgar
Pomp and Circumstance MarchNo.1 in D major op.39

Camerata Singers with Abraham Kaplan as chorus master
New York Philharmonic

Disc 51
Charles Ives
The Unanswered Question
Holidays Symphony
Central Park in the Dark
The Gong on the Hook and Ladder or Fireman’s Parade on Main Street
The Circus Band

Camerata Singers with Abraham Kaplan as chorus master
New York Philharmonic
Seiji Ozawa & Maurice Peress conducting Central Park in the Dark

Disc 52
Modest Mussorgsky
Pictures at an Exhibition
A Night on Bare Mountain

Paul Dukas
L’Apprenti sorcier

New York Philharmonic

Disc 53
Sergei Prokofiev (without narration)
Peter and the Wolf op.67

Camille Saint-Saens
Le Carnaval des animaux with Ruth Segal and Naomi Segal on pianos
Danse macabre with David Nadien on violin

New York Philharmonic

Disc 54
Sergei Prokofiev (with Bernstein narrating)
Peter and the Wolf op.67

Camille Saint-Saens
Le Carnaval des animaux with Ruth Segal and Naomi Segal on pianos

New York Philharmonic

Disc 55
Maurice Ravel
Bolero
Alborada del gracioso
La Valse
Rapsodie espagnole

Orchestre National de France
New York Philharmonic (Rapsodie)

Disc 56
Maurice Ravel
Bolero
La Valse
Rapsodie espagnole
Alborada del gracioso

New York Philharmonic

Disc 57
Maurice Ravel
Daphnis et Chloe
La Valse

Schola Cantorum with Hugh Ross as chorus master
New York Philharmonic

Disc 58
Ottorino Respighi
Pini di Roma
Feste romane

Jean Sibelius
Luonnotar op.70 Phyllis Cirtin soprano
Pohjola’s Daughter

New York Philharmonic

Disc 59
Nikolai Rimsky-Korsakov
Scheherazade op.35 with John Corigliano violin
Capriccio espagnol

New York Philharmonic

Disc 60 – Overtures
Gioachino Rossini
Il barbiere de Siviglia
L’italiana in Algeri
Guillaume Tell
La gazza ladra
Seriramide
La scala di seta

Franz von Suppe
Leichte Kavallerie
Dicter und Bauer

New York Philharmonic

The Leonard Bernstein Edition – Concertos and Orchestral Works – Discs 41 & 42 – Bernstein conducts Copland

Disc 41
Aaron Copland
Appalachian Spring
Four Dance episodes from Rodeo
Billy the Kid Ballet Suite
Fanfare for the Common man from Symphony No.3, 4th movement

New York Philharmonic

Disc 42
Aaron Copland
Music for the Theatre – Suite in 5 Parts for Small Orchestra
Connotations for Orchestra (Copland on piano)
Inscape

New York Philharmonic

El salon Mexico

Columbia Symphony Orchestra

The Leonard Bernstein Edition – Concertos and Orchestral Works – Discs 37 – 40

Disc 37 

Georges Bizet

Carmen Suite No.1

Carmen Suite No. 2

L’Arlesienne Suite No.1

L’Arlesienne Suite No.2

Julius Baker on flute, David Wilson on violin and William VAcchiano on cornet. 

The New York Philharmonic

Disc 38

Jacques Offenbach – Gaite Parisienne

Franz von Suppe – Die schone Galanthee – Overture

Ferdinand Herold – ZAmpa – Overture

Ambroise Thomas – Raymond – Overture

The New York Philharmonic

Disc 39

Johaness Brahms

Akademische Festouverture op.80

Tragische Ouverture op.16

Serenade No.2 in A major op.16 for small orchestra

Variations on a Theme by Joseph Haydn op.56a

New York Philharmonic

Disc 40

Benjamin Britten

The Young Person’s Guide to the Orchestra op.34 – Variations and Fugue on a Theme of Purcell

versions perfomed with and without narration

Four Sea Interludes op.33a from Peter Grimes

Passacaglia op.33b from Peter Grimes

Suite on English Folk Tunes “A Time There Was..” op.90

Narration by Henry Chapin

Leonard Bernstein

The Leonard Bernstein Edition – Concertos and ORchestral Works Discs 32-36 The Composer Conductor

Disc 32

Leonard Bernstein – The Age of Anxiety or Symphony No.2 for Piano and Orchestra – Philippe Entremont on piano

Leonard Bernstein – Facsimile

The New York Philharmonic conducted by Leonard Berstein

Disc 33

Leonard Bernstein – The Age of Anxiety or Symphony No.2 for Piano and Orchestra – Lukas Foss on Piano

The New York Philharmonic

Leonard Bernsein – Serenade after Plato’s Symposium for Solo Violin, Strings, Harp and Percussion – Isaac Stern on violin

The Symphony of the Air

Disc 34

By Leonard Berstein

Overture to Candide

Symphonic Dances from West Side Story

On the Water Front – Symphonic Suite from the Film

Fancy Free (Ballet)

The New York Philharmonic conducted by the composer

Disc 35

By Leonard Bernstein

Prelude, Fugue and Riffs for Solo Clarinet and Jazz Ensemble – Benny Goodman and the Columbia Jazz Combo

Three Dance Episodes from On The Town 

Serenade after Plato’s Symposium for Solo Violin, Strings, Harp and Percussion – Zino Francescatti on violin

The New York Philharmonic

Fancy Free Ballet – Columbia Symphony Orchestra

Disc 36

Leonard Berstein – Dybbuk

David Johnson Baritone, John Ostendorf Bass

The New York City Ballet Orchestra conducted by the composer