Archive for July, 2011

Today’s Headlines – July 22, 2011

Good Morning and Happy Friday! Even as the debt talks continue, some news outlets explore the impact of this uncertainty on Medicare, Medicaid and state budgets.

The Associated Press: Amid Debt Talks, House Budget Plan Faces Senate
The Senate is moving to cast away a budget cutting plan passed by the Republican-controlled House, clearing the way for increasingly urgent government talks over raising the nation’s debt ceiling. President Barack Obama and House Speaker John Boehner searched once more for an ambitious $4 trillion grand bargain, but officials said wide differences remained. Less than two weeks from an Aug. 2 deadline that could precipitate a first-ever government default, the continuing Obama-Boehner talks kept alive the possibility of substantial deficit reduction that would combine cuts in spending on major benefit programs like Medicare and Medicaid and revenue increases through a broad overhaul of the tax code (7/22).

For more headlines … (more…)

Friday, July 22nd, 2011

The Effect Of Bedside Manner; Migraines And Sexism

Every week, Kaiser Health News reporter Jessica Marcy selects interesting reading from around the Web.

Time: Your Doctor’s Bedside Manner Could Affect Your Health
Even if your doctor doesn’t have the best beside manner, you’re probably willing to excuse her behavior as long as she treats your condition and makes you healthy again, right? Well, you might not want to be so forgiving. It turns out that rudeness and incivility among doctors, in particular in the operating room, can actually lead to poorer health outcomes and even higher death rates among patients. Dr. Andrew Klein, director of (the) comprehensive transplant center at Cedars Sinai in Los Angeles, and his colleague Pier Forni, founder of the Johns Hopkins Civility Project at Johns Hopkins University, collected data on previous studies of surgeons’ behavior in the operating room and the subsequent outcomes of the patients on whom they performed procedures. They found that when doctors were more courteous to operating room staff, their patients were more likely to survive and avoid complications than the patients of docs who were O.R. boors (Alice Park, 7/19).

Columbia Journalism Review: A Shout Out To The Palm Beach Post
The Palm Beach Post deserves kudos for exposing how Florida governor Rick Scott conducted the business of his urgent care clinics in the state, and what his actions reveal for health care to come. Scott is something of health care’s bad boy, having gotten into trouble running Columbia/ HCA, the giant for-profit hospital chain owned by the Frist family of Tennessee. That’s Frist as in former Sen. Majority Leader Bill Frist. In the late 1990s, the FBI uncovered a Medicare billing fraud scheme involving Columbia hospitals. Columbia later settled the case and paid a fine. Two execs went to jail, and Scott got millions in walking away money. Post health and science reporter Stacy Singer discovered that the same practices Scott pushed at Columbia—bottom-line, bonus-focused management that encouraged a culture of cheating—were deployed at his Solantic Urgent Care clinics, which have just been sold to a New York private equity firm. Using the old-fashioned reporting technique of plowing through government documents, Singer revealed the aggressive, profit-first strategy that guided the management of the clinics (Trudy Lieberman, 7/20).

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Thursday, July 21st, 2011

Health Coverage Holding Up Better For Union Members

Labor unions, under pressure by states and employers to shoulder more of their health care costs, have fared relatively well at protecting workers’ health benefits during the recession, according to a study released today.

Photo by Richard Eriksson via Flickr

The study by the nonpartisan Employee Benefit Research Institute in Washington found that from 2007 to 2009 union workers were less likely to lose employer-based health coverage than nonunion workers.

Union workers covered by health insurance through their own job fell from 82 percent to 80.4 percent between 2007 and 2009, a 2 percent drop, EBRI found. For nonunion workers with coverage through their own job, coverage fell from 55.9 percent to 52.2 percent over the period, a 6.5 percent decline.

Additionally, the overall percentage of union workers with any employment-based coverage fell from 93.4 percent to 91 percent –a 2.6 percent decline, while among nonunion workers it fell from 74.3 percent to 70.6 percent –a 5 percent decline

“The analysis shows that unionization is a key to many workers having health benefits, and that during tough economic times, union worker health benefits suffer less,” said Paul Fronstin, director of EBRI’s Health Research and Education Program and author of the study.

But Fronstin warned that as unionization in the private sector continues to decline, so will the overall percentage of workers with employer-based coverage.

Last September, the Census Bureau released a study that showed that the bad economy caused a sharp increase in the number of the uninsured in 2009, to 50.7 million people.

Thursday, July 21st, 2011

Preserve Or Repeal The CLASS Act? Debt Talks Focus In

As debt-talks smolder in Washington, a proposal by the bipartisan “Gang of Six” senators to cut health program spending and increase revenue has scored a lot of attention. Among the proposal’s key health program tenets is the repeal of the Community Living Assistance Services and Supports Act, the CLASS Act, that is part of last year’s health care law.

Home health worker April Quinn brushes Holly Hawthorne's hair to make sure there are no knots in it from laying in bed in this photo from early 2011. Hawthorne, 32, is in the Medicaid managed long care program. (Photo by Joshua Anderson)

The CLASS Act is a voluntary, long-term care insurance program in which working Americans who join would generally have premiums withheld from their paychecks. After they have contributed for five years, they would be eligible for a cash benefit if they became disabled and suffered from at least two limitations in daily activities, such as eating, bathing and dressing. Some critics are worried that the CLASS Act would become a new unsustainable entitlement, but advocates say the program would provide assistance to people who need long-term care but can’t afford it.

At ThinkProgress, Judy Feder, Harriet Komisar and Paul Van de Water write about why CLASS should be preserved. “On the help side, CLASS addresses a huge hole in our social safety net: neither private insurance nor Medicare protects people against the risk of needing extensive and long-term help with fundamental tasks of daily living like eating, bathing or getting dressed,” they write, adding, “On the deficit side, CLASS actually helps the budget in the coming decade because CLASS will collect premiums well before it will be obligated to pay benefits. Over the long term, the Secretary of Health and Human Services is required to design benefits and set premiums to assure that the program covers its costs — a standard CBO judged that CLASS can satisfy over the next 75 years.”

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Thursday, July 21st, 2011

Advocates Press For Federal Aid In Making Mental Health Records Electronic

Joan Sivley believes that health information technology could have helped her son Dan from unnecessary suffering as he struggled for eight years to get an accurate diagnosis of schizo-affective disorder. During that time, he shuffled through various psychiatric hospitals and residential centers, paying as much as $30,000 a month out of pocket, only to receive conflicting diagnoses and a myriad of medications.

Photo by jigpu via Flickr

The Nashville, Tenn., mother joined other advocates at a briefing for congressional staff on Capitol Hill Wednesday to push to have mental and behavioral health providers receive the same incentives to move to electronic health records that the federal government is offering to other doctors and hospitals dealing with physical ailments. She noted the importance of having providers take an in-depth family medical history and talk to each other about past treatment plans, adding, “Each provider acted as though it was an island.”

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Thursday, July 21st, 2011

Today’s Headlines – July 21, 2011

Good Thursday morning! It’s going to top 100 degrees in Washington today, which is almost as hot as the debt talks are getting. Here’s what we’re reading — indoors — to stay cool.

Today’s early morning highlights from the major news organizations, including reports about some of the specific cuts included in the “Gang of Six” deficit-reduction plan.

The Washington Post: As Debt Talks Intensify, Obama Opens Door To Short-Term Deal To Buy More Time
The contentious budget talks that have dominated Washington for months intensified Wednesday, prompting President Obama to say he would accept a short-term hike in the debt ceiling if it gave lawmakers time to finalize a comprehensive deal. … The White House concession added to a whirlwind week in which negotiations appeared to be changing daily. At first, leaders were focused on a fallback plan that would raise the debt ceiling but do little to control future borrowing. Then they started considering an ambitious, but complicated, bipartisan strategy for raising taxes and cutting cherished health and retirement programs (Kane and Montgomery, 7/20).

For more headlines … (more…)

Thursday, July 21st, 2011

Leading Venture Capitalists Place A Bet On ACOs

The Silicon Valley investors who thought the nascent tech start-up Google was a good idea back in 1999 are now putting their money behind another zany scheme: accountable care organizations, the networks of doctors and hospitals that experts hope will save the health system millions of dollars.

Kleiner Perkins Caufield & Byers, the venture capital firm that also provided early funding for Genentech, Amazon.com and AOL, and other investment companies are pouring $61 million into Essence Group Holdings Corp., a St. Louis-based company that helps doctors build the networks.

The money will help Essence’s technology arm, Lumeris, market software that enables collaboration among doctors, hospitals and insurers in accountable care groups. Essence believes the market for related products and services could reach $80 billion, and that as much as $1 trillion in revenue could pass through the accountable care organizations that use them within 10 years.

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Wednesday, July 20th, 2011

Hospice Companies Focus In On Nursing Home Patients

Dying patients in nursing homes are an increasingly lucrative market for hospice companies, which have expanded rapidly into these facilities, according to a new federal audit.

Photo by ulrichkarljoho via Flickr

The Department of Health and Human Services Office of the Inspector General found that Medicare spending on hospice care for patients in nursing facilities grew by 69 percent over just four years, from $2.6 billion in 2005 to $4.3 billion in 2009. More than a third of total Medicare hospice spending in 2009 was for the care of 337,000 patients in nursing homes.

About 58 percent of the higher Medicare spending was due to increased enrollment. But much of the spending also was caused by nursing home patients’ length of hospice stay, which is three weeks longer than that of patients overall, such as those who receive services at home. The report found hospices with more than two-thirds of their patients in nursing homes earned on average $21,306 per patient, which was $3,182 more than the overall average cost per hospice patient.

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Wednesday, July 20th, 2011

Hospital Executives Open To ACOs, Survey Finds

Hospitals and other health care providers have complained that federal regulations for accountable care organizations (ACOs) – a proposed model of care in which doctors and hospitals work together to cut unnecessary treatment of patients and share in the savings – don’t offer enough financial rewards and are too burdensome. But the results from a recent poll of hospital executives tell a different story.

According to a US News & World Report survey of 1,852 hospital executives, more than 33 percent of executives said it is “extremely likely” that their facility will, in fact, become part of an ACO. Another third said it was fairly likely. But when asked if they thought “over time ACOs will significantly improve the quality and efficient delivery of health care,” most responses fell in the middle of “extremely likely” and “not at all likely.”

The survey results come as some hospitals and physicians have expressed disappointment in how the government is handling ACOs. The American Hospital Association criticized Medicare’s ACO regulations. In a June memo to Dr. Donald Berwick, who heads the agency that oversees Medicare, the organization says that while many hospitals are already engaged in “ACO-like” efforts, the “excitement about Medicare ACOs has dwindled dramatically,” and, “substantial changes are needed to make the program operationally viable and attractive to potential participants.” The letter goes on to say that “the proposed rule places too much risk and burden on providers with little opportunity for reward in the form of shared savings, especially in light of the significant start-up and operating costs that providers must bear with little or no assistance.”

Wednesday, July 20th, 2011

Seniors’ Advocates Warn About Cuts To Entitlements

With officials from both parties considering cuts to entitlement programs as part of a deal to raise the federal debt ceiling, advocates for seniors are taking their message to Capitol Hill Wednesday to press Congress about the impact of potential cuts to Medicaid and Medicare.

Photo by Karl Eisenhower/KHN

About 250 members of the National Association of Agencies on Aging, also known as n4a, are expected on the Hill as the group’s annual conference in Washington comes to an end.

“In the midst of this debate, we already know that we’ve been compromised in our ability to reach out and serve everybody who needs our services,” Sandy Markwood, CEO of the association, said to members Tuesday.

A survey conducted by the association in 2010 found that Area Aging Agencies suffered substantial losses in local funding as a result of the economic downturn.  Forty-eight percent reported that they had cut services, and almost a fifth eliminated some programs altogether. At the same time, about half had increased caseloads and instituted waitlists for some of their services, while most were reducing staff, according to Markwood.

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Wednesday, July 20th, 2011

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