Archive for August, 2011

Today’s headlines – August 25, 2011

Good morning! Today’s early morning highlights from the major news organizations, including reports about a new Congressional Budget Office report and the usually unlikely assumptions it makes — including the end of Medicare physician payment fixes.

The Washington Post: Budget Deficit To Hit $1.3 Trillion This Year, Congressional Analysts Report
The nonpartisan Congressional Budget Office says that revenue, coupled with the debt-reduction deal signed into law this month by President Obama, would cut projected deficits by $3.3 trillion, or nearly half, over the next 10 years. But that reduction will be realized only if lawmakers allow a series of tax cuts and other temporary revenue measures to expire. The prospect of that happening is considered dicey by many analysts, given the divisive political environment in Washington. The laws in question include … cuts in Medicare payment rates to doctors ( Fletcher, 8/24).

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Thursday, August 25th, 2011

Caveat Emptor: New Budget Projections Assume End Of ‘Doc Fixes’

Updated at on Aug. 25 at 3:48 p.m.

New figures released by the Congressional Budget Office today include a budget assumption that almost never comes true:  The imposition of steep Medicare cuts for physicians.

The CBO’s new baseline projections of the federal budget find reason to be hopeful, estimating that cumulative deficits will reach $3.5 trillion between 2012 and 2021 — a much shallower budget hole than the $6.7 trillion CBO projected in March. But that estimate – provided by the agency so that Congressional budget planners can work from a common set of numbers — assumes that sharp reductions in Medicare physician payment rates will go into place at the end of this year, since it is prescribed by current law.

Assuming Capitol Hill follows the past practice of stopping those scheduled cuts,  this fall lawmakers will not only be dealing with the debt deal’s “super committee” spending cuts – or lack thereof — but also be scrambling to find billions for another “doc fix.”

“As the CBO report shows, it is impossible to look at the federal budget in any serious way without acknowledging the budget hole that has been created by the broken Medicare physician payment formula,” AMA President Peter W. Carmel, M.D., wrote in an e-mail to KHN.  “As recently as 2005 the cost of permanent reform would have been $48 billion, but today it is estimated to be nearly $300 billion. If action is not taken now, the cost will continue to escalate to $500 billion in only a few short years.”

“The CBO report’s discussion of outlays and the deficit and debt underscore the steep hill leading to a permanent Medicare physician payment fix,” said former American Medical Association lobbyist Julius W. Hobson Jr., now a senior policy advisor for the firm Polsinelli Shughart.

In its report CBO also notes that should the Medicare physician payment cuts and other budget assumptions, such as expiration at the end of 2012 of Bush-era tax cuts and President Obama’s stimulus package, not occur, “much larger deficits and much greater debt could result.”

Wednesday, August 24th, 2011

Hospitals Have Got Your Back, Maybe a Little Too Quickly

Back surgery is one of the best documented examples of expensive medical treatments that drive up health care costs while not always helping patients, and sometimes even hurting them. The latest Medicare data show that hospitals frequently order MRI back scans for patients who haven’t even tried recommended treatments such as physical therapy.  An MRI often prompts surgery.

In 2009, 32.2 percent of Medicare patients with lower back pain who received a spine MRI at a hospital outpatient imaging center hadn’t tried a more conservative — and cheaper –  treatment than surgery, according to data published on Medicare’s Hospital Compare website this month.

Among 2,088 hospitals where Medicare had enough data to evaluate, Regions Hospital in St. Paul, Minn. had the highest rate: 63.5 percent of the 329 patients that got scans in 2009 handn’t received prior treatments first.


Wednesday, August 24th, 2011

Today’s Headlines – August 24, 2011

Good morning all you early risers! Today’s early morning highlights from the major news organizations, including reports that Medicare tries bundled payments and HHS may give states a second chance to avoid a federally-run health insurance exchange.

Politico: The Perils Of The Supercommittee
The event is an early glimpse of what the 12 supercommittee members could face after they try to slice $1.2 trillion in spending this fall: they’ll head home to sell their decisions to voters, many of whom are wary of losing Medicare and Social Security benefits, afraid of seeing their taxes increase — or will be peeved that Congress could not shift the fiscal trajectory of the country (Sherman, 8/23).

NPR: Medicare Trying Bundled Payments To Save Money, Improve Care
Medicare officials have unveiled the latest initiative to spring from last year’s overhaul, and it’s one some health economists have been lusting after for years: Bundling payments so that hospitals, doctors, and even post-hospital caregivers all have the same financial incentive to both work together and provide cost-effective care (Rovner, 8/23).

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Wednesday, August 24th, 2011

Medicare Is Taking A Page From Priceline

The Obama administration is offering a new pricing strategy for doctors and hospitals looking to improve care and lower costs of treating Medicare beneficiaries.

It could be called “Name Your Own Price” — except that’s already taken by a certain online travel website that has a certain Star Trek actor as its pitchman. But the principle is the same.

On Tuesday, the Department of Health and Human Services unveiled a Medicare pilot program that will pay participating hospitals, doctors and other health providers one, “bundled,” payment to treat a patient for a single episode of care. The program starts in 2012. To participate, providers will have to bid less, in total, than what Medicare would pay each provider separately. The traditional Medicare program pays each hospital and doctor a separate fee for its services, which critics say leads to uncoordinated care and incentives to drive up Medicare bills.


Tuesday, August 23rd, 2011

HHS Sponsors Contest To Develop Emergency Public Health Facebook Apps

UPDATED at 3:52 p.m. — After the Virginia earthquake.

Photo by Florian via Flickr

The first thing East Coasters did when the ground began to shake this afternoon was not duck under their desks, but to turn to their smart phones. The 5.8 magnitude earthquake that was felt from Durham to Toronto was immediately documented through social media like Facebook and Twitter.

It was an interesting coincidence for Stacy Elmer. She’s a special assistant to the Assistant Secretary for Preparedness and Response (ASPR), a division of the department of Health and Human Services created in the wake of Hurricane Katrina. Just yesterday, ASPR launched Elmer’s idea: the “Lifeline Facebook App Challenge” a contest for creative technology developers that will “provide actionable steps for Facebook users to increase their own personal preparedness and strengthen connections within their social networks for the sake of personal preparedness and community resilience.”

The competition will run till the end of hurricane season on Nov. 4. No word on what a Facebook public health application might look like, but the ideal, according to the HHS website, would include a method for users to identify three people as ‘lifelines’ or emergency contacts. It would also create and share personal preparedness plans, be mobile-device ready, and incorporate a Geographic Information System (GIS) for locating or “tagging.” No mention of batteries or bottled water.

Elmer noticed that during the aftermath of recent disasters, people were turning more to websites like Facebook rather than calling people on their cell phones. “I thought about how we can leverage that kind of behavior,” she said. The idea is to reduce pressure on jammed phone lines, since people would use social media sites to reconnect in the event of an emergency.

The HHS Assistant Secretary for ASPR, Dr. Nicole Lurie, said this competition was a great way for HHS to take advantage of emerging social media. “One of the things that is fundamental to a community’s resilience is its connections between people,” she said. “In the end it’s going to be friends and neighbors who are going to help each other out in an emergency situation.”

Tuesday, August 23rd, 2011

Today’s Headlines – August 23, 2011

Good morning! Rick Perry grabs headlines today as news outlets examine his positions on health policies.

Politico: Supercommittee Talks Have Begun, Says Fred Upton
The 12-member debt committee has already held conference calls and may have a website up by the end of the week, Rep. Fred Upton said Monday. Upton, a supercommittee member, told WNDU in South Bend, Ind., that the debt panel is already hard at work despite being spread about the country during the congressional recess (Berman, 8/22).

Los Angeles Times: Rick Perry’s Views On The Constitution Get Closer Scrutiny
Texas Gov. Rick Perry, faulting much of what the federal government did in the 20th century, has called Social Security a “failure” and “an illegal Ponzi scheme” and also cast doubt on the constitutionality of federal laws on food safety, minimum wages, bans on child labor, environmental protection and Medicare. …  Perry’s 191-page book drew little notice when it was published in November. But now that he is running for the Republican nomination for president, his views on Social Security and other federal programs will be carefully scrutinized (Savage, 8/23).

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Tuesday, August 23rd, 2011

Study: Fewer Doctors Are Offering Abortions

For women seeking an abortion, finding a doctor willing to offer the procedure is easier said than done.

Ninety-seven percent of obstetrician-gynecologists have encountered patients wanting an abortion, but only 14 percent performed them, according to a study published today in the journal Obstetrics and Gynecology.

Access to abortion has become more limited over the past few decades, according to the article. Another recent study found that in 2008, 87 percent of U.S. counties where 35 percent of reproductive-aged women live did not have a single abortion provider. Since 1996, however, all ob-gyn residents have been required to learn how to perform the procedure.


Monday, August 22nd, 2011

Today’s Headlines – August 22, 2011

It’s Monday! Good morning! Today’s early morning highlights from the major news organizations, including reports that seniors are facing difficult times in their retirement — with issues related to assisted living, housing and health benefits driving concern.

The Associated Press: Perry Wrestles With His Own Health Care Approach
Texas would be among the biggest beneficiaries of President Barack Obama’s health care overhaul, standing to gain coverage for nearly 4 million uninsured residents. But Gov. Rick Perry blocked moves to lay the groundwork for that expansion of coverage, and among the alternatives he’s supported is an untested regional solution that could prove as controversial as Obama’s remake (Alonso-Zaldivar, 8/22).

The Associated Press/Washington Post: Obama Faces Discontent Among Liberal Groups As He Faces Re-Election; Will Base Come Through?
Liberals disappointed with Obama for compromising with the GOP during the debt-ceiling showdown now are calling on him to hold firm against Republicans this fall. They want him to push a bold jobs agenda while drawing a strong line on taxes and protecting Medicare and Social Security. In recent weeks, the gripes have become so loud that the president himself acknowledged them during his Midwest bus tour this week (8/20).

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Monday, August 22nd, 2011

Majority Of Docs Face Malpractice Claims

Every week, Kaiser Health News reporter Shefali S. Kulkarni compiles a selection of recently released health policy studies and briefs for Kaiser Health News’ Daily Report.

This week in Research Roundup:

  • New England Journal of Medicine explorers the frequency of malpractice claims and cumulative risk of malpractice claims across specialties.
  • The Government Accountability Office examines the Health & Human Services Physicians Feedback Program.
  • Health Affairs looks into how many Medicare Advantage options is too many.
  • The Robert Wood Johnson Foundation and the Urban Institute evaluate the success of efforts to increase the enrollment of children in Medicare and CHIP.

Read more in the Daily Report.

Friday, August 19th, 2011

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