Archive for August, 2011

Today’s Headlines – August 31, 2011

Good morning! It’s the last day of August, time to start thinking about fall … and these stories! Today’s early morning highlights from the major news organizations, including details about the GOP tax expert who has been named to help run the deficit-reduction “super committee” as well as the health policy ideas Republican governors are offering in the context of the nation’s fiscal fix.

The Washington Post: GOP Tax Expert To Help Run Debt-Reduction ‘Super Committee’
A veteran Senate GOP tax expert with long experience working across the aisle was tapped Tuesday to help run a powerful new congressional debt-reduction committee, buoying hopes that the panel would produce a plan to tame borrowing. … The announcement comes as the panel … gears up for its September debut. Created this summer as part of an epic battle to raise the legal limit on government borrowing, the 12-member panel must identify a plan by Thanksgiving to slice at least $1.2 trillion from projected borrowing over the next decade or risk triggering across-the-board cuts in January 2013 (Montgomery, 8/30).

For more headlines … (more…)

Wednesday, August 31st, 2011

Economists Caution: ACOs May Not End Wasteful Health Spending

Expensive technologies like proton beam therapy and hot chemo baths are among the reasons America’s health care spending is rising at an unsustainable clip and making the federal deficit so hard to tame.

But two of the nation’s top health care economists are expressing doubts that accountable care organizations — one of Obama administration’s most-hyped mechanisms to save money — will be able to overcome the medical system’s lust for the new new thing.

Established through last year’s health law, ACOs are networks of doctors and hospitals that would collaborate to provide quality care at lower cost, with the motivation of keeping a share of the savings they deliver to Medicare and private insurers. Medicare has been working for months to get the program running by next year.

In a paper delivered last week at a Federal Reserve Bank of Kansas City symposium in Jackson Hole, Wyo., Harvard’s Katherine Baicker and Amitabh Chandra warned that ACOs may not want to rein in the use of expensive technologies that haven’t been proved superior to old-fashioned approaches, since the new stuff is often a major lure for patients.

They write:

[W]e do not know how well ACOs will sidestep cost-ineffective technologies, particularly if the latest shiny innovation increases market share. The viability of ACOs will depend on the receptiveness of physicians to capitated payments — some specialists will see their incomes fall and are unlikely to take these cuts quietly. While their concerns may not resonate with patients, they might if providers claim that valuable care is being withheld. Designers of ACOs are therefore keenly interested in measuring ACO performance and patient satisfaction, but current quality measures only capture truly negligent care.

The authors also warn that even if ACOs do achieve savings by performing fewer procedures, “some of the savings from lower quantities may be offset with higher prices as ACOs exert market power” by charging more to private insurers.

Their paper has the relatively snappy title of “Aspirin, Angioplasty, and Proton Beam Therapy: The Economics of Smarter Health Care Spending.” It’s the latest argument that’s been made about the need to limit the use of fancy technology, as political accusations of “death panels” have receded for the moment.

But the Harvard professors are bleak that fixing most of America’s wasteful health spending, including that on iffy technology, will be enough. They conclude:

The U.S. has yet to wrestle with the question of public policy priorities in a world of scarce resources: even with perfect productive efficiency, we cannot cover all services for all people. … By first ensuring that health care resources are used more productively, we will be in a much better position to move towards spending the “right” amount on health.

jrau@kff.org

Tuesday, August 30th, 2011

Today’s Headlines – August 30, 2011

Good morning! Today’s headlines include a report about a new federal and state program that will apply scrutiny to any health-premium increase of more than 10 percent.

The Wall Street Journal: Steep Rises In Health Premiums Scrutinized
A new federal and state program on health-insurance rates will determine whether bad publicity alone is enough to stop insurers from levying steep increases. Starting Thursday, the Obama administration and states will automatically scrutinize any proposed health-premium increase of 10% or more as part of the 2010 health-overhaul law. The change applies to an estimated 34.8 million insurance policies that Americans buy on their own or get through a small employer—two markets where consumers have faced particularly hefty increases in recent years (Adamy, 8/30).

USA Today: Health Care Fraud Prosecutions On Pace To Rise 85%
New government statistics show federal health care fraud prosecutions in the first eight months of 2011 are on pace to rise 85% over last year due in large part to ramped-up enforcement efforts under the Obama administration. The statistics, released by the non-partisan Transactional Records Access Clearinghouse, show 903 prosecutions so far this year. That’s a 24% increase over the total for all of fiscal year 2010, when 731 people were prosecuted for health fraud through federal agencies across the country. Prosecutions have gone up 71% from five years ago, according to TRAC (Kennedy, 8/29).

For more headlines … (more…)

Tuesday, August 30th, 2011

Poll: Employees Don’t Want Changes In Their Health Insurance

Employees love to gripe about rising health care costs, but a new poll finds most are not willing to sacrifice to pay less for their insurance.

Only 27 percent of people with insurance provided through their employer said they would  accept a more restricted list of doctors and hospitals in their networks, according to the latest monthly poll from the Kaiser Family Foundation. (KHN is an editorially-independent program of the foundation.) Less than a third of those polled were willing to pay more for brand name drugs or pay higher deductibles in return for lower premiums.

Only one idea floated in the poll — having people participate in corporate wellness programs promoting healthy behaviors — won over a majority of employees: 68 percent said they’d be willing to take part in one of these programs in exchange for lower premiums.

The poll found that most workers don’t blame their companies for the escalating cost of health care. Two out of three said they were offered the best coverage the company could afford given financial circumstances. A whopping 88 percent reported a somewhat or very positive experience with their employer-provided health care plan. (more…)

Monday, August 29th, 2011

N.C. Employers Embrace Medicaid Medical Home Network

North Carolina employers are trying to find out if there really is no place like home.

As in medical homes, that is.

For the first time, people with job-based insurance in the state will soon be offered a chance to tap into a well-known medical home network that has primarily served Medicaid enrollees since 1998.

Photo by Andy Callahan via Flickr

That network is one of the longest running and most studied medical homes, a term that encompasses efforts to better coordinate primary care, often by creating a more team-based approach that links physicians with other medical providers, such as nurse practitioners, nutritionists, pharmacists and mental health experts.

Today, drug maker GlaxoSmithKline, pharmacy chain Kerr Drug, analytics firm SAS, the state and Blue Cross and Blue Shield of North Carolina announced that their employees will be able to voluntarily enroll in the nonprofit Community Care of North Carolina network.

The network, made up of physicians, hospitals, social service agencies and county health departments,  is credited with saving the state millions of dollars since its founding in 1998.  In recent years, the program has expanded to serve some Medicare patients under a special waiver.

(more…)

Monday, August 29th, 2011

Today’s Headlines – August 29, 2011

Good Monday morning! We back to work after hunkering down for the weekend’s hurricane. Today’s early morning highlights from the major news organizations, including more coverage of GOP presidential hopeful Rick Perry’s thoughts on health policy and politics. Here’s what we’re reading:

The Associated Press: Deficit Panel Members Had Moments Of Independence
Even lawmakers most loyal to their leaders and political party on occasion buck them with a flash of independence or bipartisanship. That includes some of the six Republicans and six Democrats given the task of finding up to another $1.5 trillion deficit savings over the next decade (Margasak, 8/29).

The Washington Post: Rick Perry Has Distanced Himself From George W. Bush’s Brand Of Conservatism
Perry, who closely allied himself with Bush earlier in his career, was a supporter of Bush’s tax cuts and praised his leadership on national security issues. But he has been critical of Bush’s fiscal stewardship and his attempts to court the political middle by taking on issues such as education, immigration and Medicare. He has said that “this big-government binge [in Obama’s tenure] began under the administration of George W. Bush” (Bacon, 8/28).

For more headlines … (more…)

Monday, August 29th, 2011

Candidate Perry’s Prescription: Medical Malpractice Reform

Just a few weeks into his campaign, Texas Gov. and presidential candidate Rick Perry isn’t talking a whole lot about health care, except to criticize President Obama for last year’s law. And he’s not considered a health care expert. But he’s is passionate on one point: Fixing the nation’s health care system must include a major reform of the medical malpractice system.

Photo by Darren McCollester/Getty Images

In 2009, Perry and fellow GOP presidential competitor Newt Gingrich wrote in a Washington Post op-ed that Texas has successfully controlled health care costs, and at the same time has improved quality by enacting tort reforms in 2003. “Fewer frivolous lawsuits have attracted record numbers of doctors to the state as medical malpractice insurance premiums dropped by half,” they wrote.

They also mention Christus Health, a large Catholic nonprofit system with a significant presence in Texas, which reduced its liability defense payments from about $100 million in 2003 to $2.3 million last year. The savings went to expanding health-care services in low-income communities.

(more…)

Friday, August 26th, 2011

Who Is Influencing Health Care?

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

Salon / Global Post: What’s Happening To A Model Healthcare System?
Right-wing radio host Rush Limbaugh once vowed to flee to Costa Rica if President Barack Obama’s health care reforms took effect. Limbaugh might have overlooked a couple of critical details: Costa Rica’s respected universal healthcare system is highly socialized. It’s also on the verge of going broke. … Costa Rica’s broad coverage ranked better than most of the Americas, including the United States, in a 2000 World Health Organization index. Now, hobbled by mismanagement, the system has become overwhelmed by a burgeoning population that includes an increasing number of elderly and new immigrants who rely on the public system for care (Alex Leff, 8/23).

(more…)

Friday, August 26th, 2011

Today’s Headlines – August 26, 2011

Friday! Getting ready for a hurricane? Here are some stories to distract you:

Today’s early morning highlights from the major news organizations, including reports about presidential politics and health reform — most notably, Rick Perry’s assault on Mitt Romney’s Massachusetts record.

The Wall Street Journal: Health Law Puts Governors In Pickle
Texas Gov. Rick Perry, along with a slew of other Republican governors, faces a dilemma: Do they apply for millions of dollars in federal grants by September to begin establishing state-run health insurance exchanges, or let the deadline slide, lose the federal money and risk falling into a federally run exchange? Republican governors are unanimous in their condemnation of President Barack Obama’s health care law. But one by one, many of them are moving forward to build state exchanges, which are intended to help people not covered by large-company plans buy private health insurance at subsidized rates (Weisman, 8/26).

The Hill: Perry: Romney Realizing Massachusetts Healthcare Law Is ‘Huge Problem For Him’
The Massachusetts healthcare law passed by Mitt Romney (R) as governor is a “huge problem,” Texas Gov. Rick Perry (R) said Thursday of his top competitor for the GOP presidential nomination. Perry assailed the state healthcare law for its similarities to President Obama’s nationwide healthcare reform law, which the Texan called a “total debacle” (O’Brien, 8/25).

For more headlines … (more…)

Friday, August 26th, 2011

Big Virginia Hospital System Cuts Management Jobs

With its well-regarded hospitals dominating Northern Virginia and $2.3 billion in net operating revenue last year, Inova Health System must be the envy of many hospital groups. But in a sign that even the strongest players feel pressure to save money and operate more efficiently, Inova this week trimmed many of its mid-level management positions.

Inova cut 117 management jobs, 84 through attrition, spokesman Tony Raker said in an email. “Inova is responding not only to economic challenges but to anticipated changes (as well as unknowns) within the health care reform environment,” he wrote. “While the economy is a universal challenge, hospitals and health care systems face specific hurdles as the nation struggles with escalating health care costs and, in turn, providers struggle with continuing reductions in Medicare compensation, infrastructure maintenance, higher material costs not to mention technological investments necessary to maintain service excellence.”

Raker wrote that the change was designed to reduce the levels of bureaucracy between senior managers and patients and improve patient care. After the cuts, Inova will have 889 management positions. “It should be stressed that while reducing expenses is a component of our strategy, cost reductions were not the primary driver of the management restructuring,” Raker added.

“Many hospitals are clearly feeling cost pressures,” says Alwyn Cassil, director of public information at the Center for Studying Health System Change, a Washington research group. “States are already cutting Medicaid rates and reductions in the growth of Medicare payment rates are coming, so it’s not surprising that hospitals are squirreling away nuts for the winter.”

With 1,750 licensed beds, Inova, which is non-profit and based in Falls Church, Va., last year reported more than 95,000 admissions, 786,000 outpatient visits and a third of a million emergency room visits. Inova is such a presence in the Virginia suburbs of Washington that federal anti-trust regulators successfully blocked its attempted aquisition of another hospital group back in 2008 because it would have given Inova control of nearly three-quarters of the market.

jrau@kff.org

Thursday, August 25th, 2011

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