Archive for the ‘Syndicate to AP’ Category

CBO Projects Lower Medicare and Medicaid Costs

Reduced costs for medical services and labor have trimmed the 10-year projected cost of Medicare and Medicaid by $89 billion, the Congressional Budget Office said Wednesday.

Medicare spending is projected to drop by $49 billion — or less than 1 percent — from 2015 and 2024, while Medicaid spending is expected to drop by $40 billion — or about 1 percent — over the next decade, CBO said in an update to its April forecast.

Despite the long-term projected drop, federal spending for major health care programs will jump this year by $67 billion — or about 9 percent —  the agency estimated.  The largest increase will be for Medicaid, which is projected to grow by $40 billion, or 15 percent. Most of this short-term increase is attributable to the Affordable Care Act, including its Medicaid expansion and the financial assistance to help people purchase health insurance.

More than half of the states and the District of Columbia have opted for the health law’s Medicaid expansion. Subsidies to help eligible individuals purchase health on the law’s online marketplaces, or exchanges, and related expenses (mostly grants to states to establish exchanges) would total $17 billion this year, according to CBO.

CBO and the Joint Committee on Taxation’s projections of outlays and revenues arising from the health law’s provisions related to health insurance coverage have not changed substantially since the spring for 2014 or over the 2015–2024 period, according to CBO.

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Wednesday, August 27th, 2014

Report: Health Law Ups Taxes On Insurers With Big Pay Packages

While average compensation for top health insurance executives hit $5.4 million each last year, a little-noticed provision in the federal health law sharply reduced insurers’ ability to shield much of that pay from corporate taxes, says a report out today.

As a result, insurers owed at least $72 million more to the U.S. Treasury last year, said the Institute for Policy Studies, a liberal think tank in Washington D.C.

Researchers analyzed the compensation of 57 executives at the 10 largest publicly traded health plans, finding they earned a combined $300 million in 2013. Insurers were able to deduct 27 percent of that from their taxes as a business expense, estimates the report. Before the health law, 96 percent would have been deductible.

UnitedHealth Group, which paid CEO and President Stephen Hemsley about $28 million in pay and stock options in 2013, had the biggest tax bill among the 10 companies, the report found. Hemsley’s compensation accounted for nearly $6 million of the firm’s estimated $19 million in taxes that the report says it owed on  pay packages for five executives under the health law.

“They’re paying more in taxes just to protect these pay packages,” said Sarah Anderson, global economy project director at the institute.

The insurers’ lobby opposed the provision, saying deductibility rules should be consistent across all industries.

“Requiring plans to pay higher taxes does nothing to make coverage more affordable or accessible,” said Brendan Buck, spokesman for the trade group, America’s Health Insurance Plans, which had not seen the report.

Under the 2010 law, insurers can deduct only the first $500,000 of annual compensation per employee from corporate taxes, down from $1 million allowed before the law’s passage.  The law also requires insurers to include so-called “performance pay,” such as stock options, which often represent a hefty portion of an executive’s pay.

The provision is similar to limits Congress imposed on executives at the banks that took Troubled Asset Relief Program funds.  Most other industries can still deduct the first $1 million in compensation — and can exclude performance pay from their income tallies.

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Wednesday, August 27th, 2014

Wide Variation In Hospital Charges For Blood Tests Called ‘Irrational’

One California hospital charged $10 for a blood cholesterol test, while another hospital that ran the same test charged $10,169 — over 1,000 times more.

For another common blood test called a basic metabolic panel, the average hospital charge was $371, but prices ranged from a low of $35 to a high of $7,303, more than 200 times more.

The wide disparity in hospitals’ listed charges for routine blood tests at California hospitals was revealed in a study published in the August issue of BMJ Open. The study examined the listed charges for routine blood tests performed in 2011.

Researchers said their analysis found no rational explanation for the stark variation in listed prices, though teaching hospitals and government hospitals generally set lower charges than other facilities.

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Friday, August 15th, 2014

If You Have A Stroke, Better It Should Be In Paris

PARIS–I had a stroke last month, oh boy.

It’s just that I didn’t know it. Here’s what happened:

Frank Browning. (Photo by Christophe Sevault)

Only after three days of flashing, floating visual squiggles — commonly known as ocular migraines that usually last 20 minutes — do I email my old friend Dr. John Krakauer, who helps run stroke recovery at Johns Hopkins Hospital in Baltimore.

After a few questions he told me to get an MRI scan as soon as possible. In the U.S. that could involve the emergency room (with its hours-long wait) or a complicated process of getting the referral — and then finding a radiologist who would take my coverage. Here in France, it is so much simpler.

But even here, such a lot of bother, I think. My doctor’s away on vacation. Whom do I call? But since I’m now into my fourth day of rainbow hieroglyphics, I bike down to the renowned emergency eye service at Hospital Hotel Dieu, across from Notre Dame cathedral. It has historically served Paris’ poorest residents.

I offer my national health card, and the receptionist brushes it off. All they want is something with a picture ID. Three hours later I’ve been examined by four separate specialists. “You have no serious eye problem,” the retina specialist advises me, “but I agree with your friend at Hopkins. You should get a brain scan,” which they can’t do there. She scrawls out a note to one of France’s top neurology centers.

Back to the bike. I peddle to the Hopital Ste-Anne, a multi-specialty neurology center close to where France’s last guillotine stood.

Sweating, I climb the stairs directly to the glass reception door on the second floor. The head of the clinic smiles, reads the note I’ve brought from the eye doctor and immediately begins some simple tests to be sure I’m not an emergency case.

She taps my elbow, then asks me extend my hands and slowly draw each index finger to my nose. I pass. She asks me when the rainbow squiggles began as she scrolls down her computer screen. It’s 1:15, but I have a lunch appointment at 1:30.

“Go have lunch and come back at 2:30 for your MRI,” she tells me. “Oh yes,” she adds, “you really ought to check in downstairs first.”

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Monday, August 11th, 2014

Exchange Assisters Want More Training To Help Consumers — Even After They Enroll

With the Nov. 15 kick-off for this year’s health law enrollment season fast approaching, the need for more training for the  people who help consumers navigate the health insurance marketplace is growing increasingly clear.

Affordable Care Act navigator Adrian Madriz (R) speaks with Lourdes Duenas, who is looking for health insurance, during a navigation session in October 2013 in Miami, Florida (Photo by Joe Raedle/Getty Images)

For example, 92 percent of health insurance marketplace assister programs say they want more preparation than they received last year, according to survey findings released last month by the Kaiser Family Foundation.

This figure, highlighted during an Aug. 5 briefing, came out of a larger survey  conducted after the first open enrollment period concluded last spring. The survey polled people who supervised assistance efforts by navigators, in-person assisters, certified application counselors, federally qualified health centers and federal enrollment assistance programs which were promoting federal and state-based health care exchanges.

Out of 843 respondents, 41 percent indicated a desire for more training about how to help consumers after they enrolled in health plans. The same proportion wanted more support in addressing “tax filing issues,” according to the report. About 39 percent of respondents indicated the need for further training in distinguishing between qualified health plans. The same figure wanted more training in interpreting how immigration status shaped eligibility.

These numbers do not come as a surprise to people already involved in trying to help consumers use the health law’s online marketplaces.

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Thursday, August 7th, 2014

Fast Track For Primary Care Docs At One Calif. University

Some doctors in the state of California will soon be able to practice after three years of medical school instead of the traditional four. The American Medical Association is providing seed money for the effort in the form of a $1 million, five-year grant to the University of California at Davis.

UC Davis medical student Ngabo Nzigira interacts with a patient at a Kaiser Permanente clinic in Sacramento. (Andrew Nixon/Capital Public Radio)

Student Ngabo Nzigira is in his sixth week of medical school and he’s already interacting with patients, as he trains under the guidance of a doctor at Kaiser Permanente in Sacramento. (KHN is not affliated with Kaiser Permanente).

In a traditional medical school, Nzigira wouldn’t be in a clinic until his third year.  In this accelerated course, students can shave up to $60,000 off their education debt. Still, Nzigira initially had hesitations.

“I thought ‘Oh man, you want me to put the intensity and stress that is medical school in four years, you want me to condense it down to three years? I’m not sure about that,’” Nzigira says. But, after learning more, he became convinced it was a good path for him.

The curriculum cuts out summer vacations, electives and the residency search. It’s designed to get primary care physicians into the field faster, says Dr. Tonya Fancher, director of the program, called Accelerated Competency-based Education in Primary Care, or ACE-PC .

“There’s a huge problem, a huge shortage of primary care physicians,” Fancher says.

UC Davis says more people gaining health insurance coverage under the Affordable Care Act is expected to compound the need for primary care, and one of the goals of the new curriculum is to make family medicine a more appealing and lasting choice for young doctors.

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Thursday, August 7th, 2014

First Look At Medicare Quality Incentive Program Finds Little Benefit

One of Medicare’s attempts to improve medical quality –by rewarding or penalizing hospitals — did not lead to improvements in the first nine months of the program, a study has found.

The quality program, known as Hospital Value-Based Purchasing, is a pillar of the federal health law’s campaign to use the government’s financial muscle to improve patient care. Since late 2012, Medicare has been giving small increases or decreases in payments to nearly 3,000 hospitals based on how patients rated their experiences and how faithfully hospitals followed a dozen basic standards of care, such as taking blood cultures of pneumonia patients before administering antibiotics. As much as 1 percent of their Medicare payments were at stake in the first year and 1.25 percent this year, though most hospitals gained or lost a fraction of that. Hospitals were judged both on how they compare to others and how much they are improving.

The program is one of several payment initiatives instituted by the health law. Others include penalties for hospitals that have high rates of Medicare patients readmitted within 30 days and penalties that will go into effect this fall for hospitals with high rates of patient injuries or infections.

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Wednesday, August 6th, 2014

Large California Insurers Invite Others To Join Data Network

Now that two of California’s biggest health insurers have teamed up on a project to share patients’ digitized medical records, they are planning to invite other companies to join.

The project will initially cover about 9 million Californians, making it possible for doctors and hospitals to quickly access patients’ medical histories and avoid unnecessary tests and procedures.

Heads of the two rival insurers — Blue Shield of California and Anthem Blue Cross – said Tuesday that they eventually want to include as many people as possible in the network, dubbed Cal Index.

“Ultimately our goal is to have all payers and all providers participating in Cal Index,” said Paul Markovich, president of Blue Shield, during a call with reporters. “We are open to anyone and everyone who can and will contribute data.”

Organizers said they plan to reach out to other insurers with the idea of creating a comprehensive, statewide system. The project is set to go live later this year, bringing patients’ digitized lab, pharmacy, outpatient and hospital records into one place that can be accessed by both patients and their medical providers.

California’s Secretary of Health and Human Services Diana Dooley said she was excited about the project but cautioned that it needs to protect the privacy rights of consumers.

“Patients have expectations that their records will be private at the same time they want their providers to have access to enhance their medical options and outcomes,” she said. “This is the balance we are all striving for.”

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Wednesday, August 6th, 2014

Survey: Insurance Rates Lag In Health Law Holdout States

A Gallup poll released Tuesday says that the Affordable Care Act is significantly increasing the number of Americans with health insurance, especially in states that are embracing the law. It echoes previous Gallup surveys, and similar findings by the Urban Institute and RAND Corp.

The latest Gallup survey found that, nationwide, the number of uninsured Americans dropped from 18 percent in September 2013, to 13.4 percent in June 2014. States that chose to follow the ACA’s provisions most closely, both by expanding Medicaid and establishing their own new health insurance marketplaces, as a group saw their uninsured rate drop nearly twice as much as states that declined to do so.

“Those states that have not embraced those two major mechanisms have had about half of the decline in uninsured,” said Gallup’s Dan Witters. “So there’s a clear difference in the states that have implemented those mechanisms versus those who haven’t.”

Arkansas saw the biggest decline in its uninsured rate, from 22 percent to 12 percent. Kentucky, Delaware and Colorado also saw significant declines.

“To drop 10 percent in the uninsured rate within really just six months is really an incredible achievement,” said Arkansas Surgeon General Dr. Joe Thompson. Thompson lobbied for his state’s unique, bipartisan Medicaid expansion, which uses federal funding to buy private insurance for low income people. He says about 80 percent of those with new, private insurance in Arkansas purchased it with Medicaid subsidies.

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Wednesday, August 6th, 2014

Advocates Say Florida Consumers To Pay For State Lawmakers’ Decision

Republicans were quick to pounce Monday on Florida’s announcement that residents buying health insurance on the individual market for next year will face a 13.2 percent average increase in monthly premiums — one of the steepest rate hikes announced for any state. “Obamacare is a bad law that just seems to be getting worse,” said Florida Gov. Rick Scott, a Republican who is running for re-election.

But consumer advocates and Sen. Bill Nelson, D-Fla., the state’s former insurance commissioner, blame the increases on Florida lawmakers’  decision last year to suspend the state’s authority to negotiate and approve premiums on policies sold to people who buy insurance themselves instead of getting it through an employer.

The Republican-controlled Florida legislature voted to cancel that authority until 2016 because it did not want to have any involvement with insurance plans sold through the Affordable Care Act, saying that job should be done by the Obama administration. The federal government has authority to review but not change insurance rates.

Most health experts agree that state regulation of insurance rates helps hold down premiums. According to the National Conference of State Legislatures, about two dozen states empower regulators to approve or disapprove insurance premium changes, although the power varies widely.

A report by the Kaiser Family Foundation in 2012 found that one out of every five insurer’s requests for higher rates submitted to states in 2011 resulted in a lower rate increase or no increase at all. On average, approved rate increases were 1.4 percentage points lower than what insurers initially requested, a reduction of about one-fifth.

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Tuesday, August 5th, 2014

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