Archive for January, 2012

Advocates Demand Clarity About Options For Patients In Financial Need

Many Americans continue to struggle with the high cost of medical care, unaware that non-profit hospitals are required to provide information about potential financial assistance or relief. But, a provision in the 2010 health law seeks to clarify what help hospitals should offer.

Advocates were on Capitol Hill Friday to raise awareness about the provision and to call on hospitals and community groups to increase access to care while also controlling costs. The health law requires hospitals to fulfill four requirements:  to develop written financial assistance policies that they make available to patients, to limit what they charge for services, to observe fair billing and debt collection practices, and to conduct regular community needs assessments to make sure help is going to communities that need it most.

Michael Miller, policy director at the national health advocacy group Community Catalyst, said that the need exists in the community for care for the uninsured. He said that hospitals and community groups must now figure out “what’s the most rational way to do this instead of [asking] are we going to pay for this or not.”


Friday, January 20th, 2012

Explaining Medicare’s ‘Premium Support’

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

Washington Monthly: The Yaz Men: Members Of FDA Panel Reviewing The Risks Of Popular Bayer Contraceptive Had Industry Ties
Last month, the U.S. Food and Drug Administration convened a committee of medical experts to weigh new evidence concerning the potential dangers of drospirenone, a synthetic hormone contained in popular birth control pills including Bayer AG’s Yaz and Yasmin. … the committee concluded by a four-vote margin that the benefits of drugs with drospirenone outweigh the risks. However, an investigation by the Washington Monthly and the British medical journal BMJ has found that at least four members of the committee have either done work for the drugs’ manufacturers or licensees or received research funding from them. The FDA made none of those financial ties public. … When asked whether the agency was aware of any financial ties between its advisors and manufacturers or distributors of drospirenone, FDA spokeswoman Morgan Liscinsky said, “No waivers were issued” (Jeanne Lenzer and Keith Epstein, 1/9).


Friday, January 20th, 2012

New Restrictions On Abortion Almost Tied Record Last Year

This story comes from our partner NPR‘s Shots blog.

If it seemed like 2011 was a big year for laws restricting abortion, it was.

In fact, according to “Who Decides? The Status of Women’s Reproductive Rights In the U.S.,” the 21st annual report compiled by the abortion-rights group NARAL Pro-Choice America, the 69 laws enacted restricting a woman’s reproductive rights were just one short of the record set in 1999.

“The bottom line here is that elections matter,” said NARAL President and CEO Nancy Keenan. “When you have a change of anti-choice politicians sitting in the statehouse, it affects women’s’ lives.”

Florida Gov. Rick Scott signed four bills in 2011 that placed new restrictions on abortions in the Sunshine State (photo by Gage Skidmore via Flickr)

In fact, the dramatic increase in laws restricting abortion and other reproductive health matters shouldn’t have come as much of a surprise given the results of the 2010 elections, noted NARAL Policy Director Donna Crane.

After the sweeping success of the Tea Party, only six states have governments where both houses of the legislature and the governor support abortion rights, while 19 states have a governor and majority of the legislature opposed to abortion.

The states that passed the largest number of abortion restrictions in 2011 all got new, anti-abortion GOP governors in 2009 or 2010: Florida, Arizona and Kansas.

Interestingly, however, those states don’t match the list of the top “pro-life” states as ranked today by the anti-abortion group Americans United for Life. AUL, which ranked states not just according to anti-abortion legislation but also issues including euthanasia, cloning and stem-cell research, put Louisiana, Oklahoma, and Pennsylvania at the top of its list. Bringing up the rear were Hawaii, California and Washington.

Meanwhile, the NARAL report shows that the 69 anti-abortion laws fell broadly into five separate categories:


Friday, January 20th, 2012

Today’s Headlines – January 20, 2012

Good morning and happy Friday to you! Here are your morning headlines post the GOP debate in South Carolina:

The Associated Press/Washington Post: Obama To Press Congress to Revisit Last Year’s Failed Attempt At $1.2T Deficit Cut
The proposal runs counter to the common wisdom in Washington that any major deficit reduction effort is unlikely in a presidential election year. … But also looming are sweeping across-the-board spending cuts required next year because of the supercommittee deadlock. … The threat of the across-the-board cuts was supposed to prod the panel, but it never got on track and collapsed just before Thanksgiving over intractable differences on tax increases and cuts to popular programs like Medicare (1/20).

The Wall Street Journal: Retiree Imbalance Underlies Filing
Here’s one way of understanding Eastman Kodak Co.’s problems: The company has twice as many retirees drawing benefits in the U.S. as it has active employees world-wide. … Kodak has been whittling away at those benefits for years and says it wants to accelerate the process in Chapter 11 proceedings. … The company said in a filing Thursday that it is liable for $1.3 billion in U.S. retirement benefits such as health care. … That could mean smaller payments to former workers like 62-year-old Robert Webster, who was a Kodak electrician from 1967 to 2005. Mr. Webster retired in 2005 and is worried about losing the health-care benefits he and his wife receive. He does small electrical jobs from time to time, but said he isn’t sure they would pay enough to cover the couple’s medical costs (Mattioli, 1/20).

For more headlines … (more…)

Friday, January 20th, 2012

CBO Report Card: Poor Grades For Some Medicare Cost Cutting Efforts

The underlying premise of some of the 2010 health law’s most ambitious changes to Medicare is using financial incentives to get doctors and hospitals to improve the quality of care and lower costs. Both accountable care organizations and the Value-Based Purchasing Program aim to give bonuses to hospitals that achieve such goals.

But a new study from the nonpartisan Congressional Budget Office gives more cause for pessimism. The CBO looked at four existing Medicare “value-based” demonstration projects and found that three of them resulted in no savings of note.

Here’s the summary chart:

CBO concluded that:

The key factor associated with success in the demonstrations of value-based payments was the nature of the incentive offered to providers. The bundled-payment demonstration achieved savings for the Medicare program, but the demonstrations that paid bonuses to providers on the basis of their quality scores, estimated savings, or both, produced little or no savings. The estimated savings in the Heart Bypass demonstration were in the range of 5 percent to 10 percent for five of the seven hospitals and were about 20 percent for the other two. Those differences were attributable to variations in the discounts that hospitals and physicians were willing to offer Medicare in their bundled-payment rates, which depended on such factors as the competitiveness of the local markets and providers’ strategic business decisions.

Coincidentally, on Wednesday, the same day that the CBO released its report, the Premier health care alliance also released the third year results of its “QUEST” effort to improve quality and lower costs for 157 hospitals.

Premier said that by sharing data and successful practices — not by offering financial incentives – member hospitals saved  a comgined $4.5 billion in wasteful spending while improving quality. Susan DeVore, the president and CEO of Premier, says that the common denominator for the hospitals that really excelled wasn’t money so much as a concerted commitment among hospital boards, executives and the rank-and-file employees to make changes.

Thursday, January 19th, 2012

No Easy Fix For Medicare Doctors’ Pay

If you were hoping for a quick resolution of the Medicare physician payment issue, think again.

The “doc fix” issue is part of a broader and more complicated debate: how to finance an extension of the current payroll tax cut for the rest of the year and federal benefits for the long-term unemployed.  Both parties want to stop a scheduled 27 percent cut in Medicare physician payments but disagree over how to pay for it.  The current extension expires at the end of February.

“There are a lot of key issues, a lot of them not easily solved…. I think we’ve got some work to do,” said Rep. Kevin Brady, R-Texas, a member of the House-Senate conference panel expected to begin talks on the issue next week.  “I don’t see these as simple issues…. If [they] were, it would have been done before the holidays,” he said Wednesday.


Thursday, January 19th, 2012

Today’s Headlines – January 19, 2012

Good morning! Here are your morning headlines:

The Associated Press/Washington Post: White House Says Health Overhaul On Track In Many States, But Prepares Federal Backstop Anyway
President Barack Obama’s health care overhaul is on track in many states, the White House asserted Wednesday. But officials said the administration is preparing a federal backstop anyway for states in which opposition to the new law has blocked planning (1/18).

The Wall Street Journal’s Washington Wire: White House Touts GOP Governors’ Support Of Health Insurance Exchanges
A White House report Wednesday highlights positive remarks made by several Republican governors and state legislators about setting up health insurance exchanges in their states, a key element of the health care overhaul law. While 26 states controlled by Republicans are suing the administration to overturn the health care law — and all of the GOP presidential candidates have said they would scrap it — some governors have been working on setting up exchanges in their state, arguing that they’re better off working with the federal government if the 2010 law stands (Radnofsky, 1/18).

For more headlines … (more…)

Thursday, January 19th, 2012

Vermont Moving Forward With Its Own Flavor Of Health Reform

Vermont lawmakers are taking steps to move the state toward a publicly-financed insurance program and craft a state health exchange, which is required by the 2010 federal health law and which state officials hope to use as the groundwork for their eventual move to a unique single-payer system.

Vermont Gov. Peter Shumlin (Photo by Vermont Governor's Office via Flickr)

Gov. Peter Shumlin’s administration this week offered a bill to the legislature that lays out a plan for building the exchange, a type of marketplace for individuals and small groups to buy health insurance. The proposal would combine the small group and individual health insurance markets, would bar the sale of health insurance to individuals and small employers outside of the exchange and would define a small employer to be 100 employees or fewer instead of 50, which had been under consideration. The bill also seeks to clarify how the state should integrate Medicaid, the state-federal health program for the poor and disabled, into the exchange.

Under the new system, an independent five-member panel called the Green Mountain Board will also be in charge of reviewing hospital budgets and defining final Certificate of Need as well as making health insurance rate decisions. That board is also working on a transition to a single-payer health system.


Thursday, January 19th, 2012

Washington State Bill Would Require Abortion Coverage

“Personhood” has dominated the abortion debate in recent months, highlighted by the failure of a high-profile constitutional amendment in Mississippi. And while abortion rights advocates in several states continue to defend against  other bills that would define an embryo or fetus as a person, advocates in Washington state are taking the offensive.

Photo by Alan Cordova via Flickr

Democratic members of the state legislature introduced a bill earlier this month that would maintain or expand abortion coverage. The “Reproductive Parity Act,” set for its first hearings on Thursday, would require private and public insurers that provide maternity coverage to cover abortion services as well. If passed, the law would be the first of its kind in the nation.

“This is Washington’s way of saying [abortion services] are basic health care coverage,” said Sara Kiesler, a spokeswoman for Planned Parenthood Votes Northwest, which is part of the coalition pushing the bill.

Melanie Smith, a lobbyist with NARAL Pro-Choice Washington, said advocates are concerned less about personhood initiatives than about abortion restrictions stemming from the 2010 federal health law.

In 2014, states will be required under that law to open insurance exchanges — online marketplaces for individuals and small businesses to compare and purchase plans. These exchanges, however, have several restrictions, including a prohibition against using federal funds for abortions. Smith said those purchasing coverage will have to pay two separate premiums: one for abortion services — based on their actual cost, estimated by the insurer — and one for everything else under the plan. Federal subsidies can be applied only to the latter.


Wednesday, January 18th, 2012

A Health Exchange Progress Report, Sort Of …

They’re making progress!  Well, at least 28 of them and the District of Columbia are.

That was the main talking point from the White House this morning during a press briefing revolving around a report stating that 28 states are “on their way” to establishing new marketplaces, called exchanges, where consumers can begin to shop for health insurance starting in late 2013. The report outlines some of the actions taken in those states — run by Democrats and Republicans — to get started on the exchanges.

When asked if that meant 22 states would not be ready in time, an administration official noted that “it would be premature at this point” to draw that conclusion.

He added that regulators are reviewing another round of grant proposals that, if all are approved, could bring the total to “well over 30 states” that are on their way. A total of $729 million in grants have gone to 49 states and the District, with only Alaska not seeking any, according to a chart in the report.

The report comes as some states, including Wisconsin and Kansas, have either said they won’t use their grants or will give them back. Last week, South Dakota’s governor said there is too much uncertainty for the state to move ahead with an exchange until after it learns the results of the Supreme Court case challenging the law, and the outcome of the November Presidential election.

Will that be too late? (more…)

Wednesday, January 18th, 2012

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