Accountable Care Organizations are a continuing source of interest to both health care providers and consumers. We at KHN have called them “the hottest three-letter word in health care.”
Now WBUR’s CommonHealth blog has put together a video animation that walks viewers through how ACOs work and what that means for consumers. The blog promises that this is only the first installment of what they’re calling “Wonk Cinema.” Enjoy.
Good morning!
Los Angeles Times: Lawmakers Reach Tentative Deal To Extend Payroll Tax Break
Despite discomfort in the Republican ranks, House and Senate negotiators reached a deal in principle early Thursday to extend a payroll tax break, continue unemployment benefits and ensure that Medicare doctors do not get a pay cut this year. … One of the issues holding up the agreement late Wednesday was Republicans’ insistence on a provision allowing Medicare to pay for services at newly built doctor-owned hospitals. Under the nation’s new healthcare law, such hospitals would no longer be reimbursed because their services were deemed too costly (Mascaro, 2/16).
The Washington Post: Congressional Negotiators Reach Deal On $150 Billion Economic Plan
In a pact early Thursday morning, congressional negotiators gave final approval to an economic plan worth more than $150 billion that would extend a payroll tax holiday and unemployment benefits. … It also includes a temporary fix for Medicare’s payment plan, which, left unchecked, would lead to a 27 percent drop in fees paid to doctors who treat elderly patients (Kane, 2/16).
For more headlines … (more…)
After wrangling for weeks over how to finance a Medicare “doc fix,” House and Senate conferees have a plan.
Photo by Jessica Marcy/KHN
The proposal would cut Medicare payments to hospitals and other providers for “bad debt,” Medicare payments to clinical laboratories and Medicaid “disproportionate share” payments to hospitals that serve many poor patients, and divert $5 billion from the health law’s $15 billion prevention fund.
In addition, Louisiana would not receive $2.5 billion in additional Medicaid funds included in the health law, according to a GOP aide. Critics of that provision had dubbed the money “the Louisiana purchase,” but it was defended by Sen. Mary Landrieu, D-La.
Those funds would be used to stop a scheduled 27 percent payment cut to Medicare physicians for the rest of the year, according to a tentative House-Senate conference deal that Congress is expected to consider this week. The “doc fix” is contained in a larger package designed to extend the current payroll tax holiday through the end of the year and provide additional financial assistance to the unemployed. If there is enough support in both chambers, Congress could approve the package by the end of this week before heading out of town for the weeklong President’s Day recess. (more…)
This story comes from our partner 
‘s Shots blog.
Last week, President Barack Obama announced that religious groups won’t have to pay for contraceptive services themselves. Instead, the cost would be borne by their insurance companies.
That compromise has raised a whole new set of questions on its own, though.
Here’s the way the new plan is being explained: Employers that object to paying for birth control — like a Catholic hospital — will no longer have to do so. Instead, their insurer will foot the bill. White House officials, like chief of staff Jacob Lew, say insurance companies don’t mind paying for contraception because it actually saves them money.
“If you look at the overall cost of providing health care to a woman the cost goes up, not down, if you take contraceptives out,” Lew said Sunday on ABC’s “This Week.” “This is not going to cost the insurance companies money because, on an overall health care cost basis, it won’t cost more.”
Good morning! Hope you had a great mid-week Valentine’s Day. Here are your headlines to get you going this morning:
Los Angeles Times: Deal Would Extend Jobless Benefits, Prevent Medicare Cut
One day after House Republican leaders made a major concession on the payroll tax cut, congressional negotiators struck a tentative deal that also would extend long-term unemployment benefits and prevent drastic reductions in doctors’ Medicare payments (Mascaro, 2/15).
The New York Times: Tentative Deal Reached To Preserve Cut In Payroll Tax
A vote on the measure would most likely happen by Friday, when Congress is set to recess for a week. But senior aides warned that negotiators still had to sign off formally on the agreement and that obstacles could surface given the long-running tensions over the measure. … The piece of the deal that would protect doctors from a huge cut in Medicare reimbursement fees would do so through cuts in the new prevention and public health fund established in the health care law, combined with reducing help for hospitals with bad debt and other health-care-related spending trims (Steinhauer, 2/14).
For more headlines … (more…)
Why does health care cost more in some areas of the country than others? It’s a question researchers have struggled with for decades, because the potential answers — unnecessary surgeries, generally bad health of patients or high prices charged by providers — each carry different prescriptions for how to hold down medical costs.
Now a new study from the Center for Studying Health System Change takes a novel approach by comparing claims among 218,000 autoworkers in 19 metropolitan areas. Because the autoworkers had the same private health plan through their union, the study didn’t have to worry about how different insurance benefits influenced health spending.
The study found a wide variance in the health spending per autoworker in 2009, from $4,500 in Buffalo, N.Y., to $9,000 in Lake County, Ill. (The full list is at the bottom of this post.)
Difference in provider prices, particularly among hospitals, accounted for a third of the variation. Hospitals in Lake County, for instance, charged 2 1/2 times what Medicare paid, while hospitals in Syracuse charged 30 percent more than Medicare did. (The variation among doctors’ prices wasn’t nearly as great.)
Most Californians say it is important to plan for end-of-life care but far fewer have done so, a gap that means they may not spend their dying days the way they wish.
According to a survey released Tuesday by the California HealthCare Foundation, 70 percent of Californians said they would prefer to die at home, and, in the case of an advanced illness, 67 percent said they would prefer to die a natural death if their heartbeat or breathing stopped.
But they often haven’t communicated those wishes to their loved ones or doctors.
For example, while 82 percent of Californians say it is important to put their end-of-life wishes in writing, only 23 percent have done so, and only 7 percent of Californians say their doctor has talked with them about their preferences.
It was the idea of Medicare reimbursing doctors for talking with their patients about their wishes and options at the end of life that sparked the “death panel” controversy during the health reform debate. The survey found that the politically-charged idea of paying doctors to talk with their patients about end-of-life options had broad support among Californians regardless of their political affiliation.
Good morning! Happy Valentine’s Day! ♥
The New York Times: House Republicans Yield On Extending Payroll Tax Cut
Congressional Republicans backed down on Monday from a demand that a payroll tax rollback be paid for with reductions in other programs, clearing the way for an extension of the tax cut for 160 million Americans through 2012. After months of partisan confrontation that left the tax break hanging in the balance, Republicans suddenly offered to extend the two-percentage-point cut while continuing to haggle over added unemployment benefits and a measure to prevent a drop in fees paid to doctors by Medicare. The payroll tax holiday and jobless benefits expire at month’s end, and doctors would face a 27 percent reduction in Medicare reimbursements (Steinhauer, 2/13).
The Chicago Tribune: House Republican Leaders Agree To Extend Payroll Tax Cut
Democratic leaders, including (House Democratic leader Nancy) Pelosi, were cool to the overture, largely because it failed to resolve two other issues that have been part of the $160-billion package along with the payroll tax cut — measures to continue long-term unemployment benefits and block a pay cut for doctors who treat Medicare patients. At the White House, Press Secretary Jay Carney said, “We need to do all three” (Mascaro, 2/13).
For more headlines … (more…)
Updated at 8:50 a.m. Feb. 14.
If it’s the middle of February, and it’s time for the yearly Washington ritual: A president proposes Medicare and Medicaid cuts, and then nursing homes and hospitals complain that those cuts will destroy the quality of care. Today was no different: President Barack Obama released his fiscal 2013 budget plan.
Photo by Karl Eisenhower/KHN
Since many of the about $360 billion in payment changes over 10 years were the same as those the president recommended to the congressional super committee last fall, this budget (like those of many other presidents) is dead on arrival on Capitol Hill.
That didn’t stop provider groups from slamming it, hard.
“This budget proposal would jeopardize the ability of teaching and children’s hospitals to train the next generation of physicians, harm care for the people in rural communities by reducing funding for critical access hospitals and reduce assistance that helps defray some of these costs to low-income seniors,” according to a statement from American Hospital Association president and chief executive officer Rich Umbdenstock. It would also hurt the industry’s ability to create jobs, he maintained. (more…)
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