Some health executives are still calling for reform in the wake of Scott Brown's upset in the Massachusetts Senate race last week that undermined Democratic efforts to advance health reform, The (Richmond) Virginian-Pilot reports. "There are, however, elements in the bills passed in partisan votes late last year that local officials would like to see eliminated, changed or at least discussed more, including plans for Medicaid and cost containment" (Jeter, 1/26). Indeed, the Massachusetts election will likely benefit health care investors, a market analyst writes in Forbes : "It's much too early to know what changes will come to pass in this sector, but now it seems reasonable for investors to proceed under the assumption that it won't be saddled with a one-sided Democratic agenda. If there's to be any change, it is now more likely that legal mandates will be operationally manageable and tolerable from a cost standpoint" (Gerstein, 1/25). This information was reprinted from kaiserhealthnews.
The United States has an inefficient and expensive health care system, but it could be improved with a new integrated health care system detailed in a new study in the American Journal of Public Health (February 2010 Vol. 100 No. 2). According to the authors of "Integrating Public Health and Personal Care in a Reformed U.S. Health Care System" from Ben-Gurion University of the Negev (BGU) and UCLA, the American healthcare system is riddled with inefficiencies due to a lack of an integrated system that could promote an optimal mix of personal medical care and population health measures. BGU Prof. Chernichovsky and UCLA Prof. Arleen Leibowitz advocate establishing an integrated health care system with a National Healthcare Trust (NHT) that would provide funding for both personal medical care and public health prevention measures. The NHT would also direct spending to procedures that would have the greatest long-term results. The major innovation of this plan would be to incorporate existing private health insurance plans into a national system that rebalances health care spending between personal and population health services and directs spending to investments with the greatest long-run returns.
A clinic closure in Atlanta has patients and clinic officials struggling to find new providers that will treat low-income patients who need kidney dialysis, The Associated Press reports. "The treatment typically costs $40, 000 to $50, 000 a year, and Grady is just one of the struggling public hospitals cutting the service to reduce costs. Many indigent dialysis patients ... are illegal immigrants, so facilities that give them routine treatments receive no federal money for their care." The clinic closed in October, but patients have been getting private dialysis treatments funded by the clinic - Grady Memorial Hospital. Other hospitals in Miami and Las Vegas are facing similar cuts and dilemmas. "Patients who need dialysis can't survive long without it. Hospitals can get reimbursed by Medicaid, the state-federal program that helps low-income people, when they provide emergency dialysis for illegal immigrants in life-or-death situations. But the reimbursement doesn't come close to covering what hospitals actually spend.
Consumers can switch from original Medicare plans to Medicare Advantage plans until March 31 and to help them understand the options, The Associated Press offers answers to frequent questions about Medicare Advantage plans. "The average Medicare beneficiary has about 33 Advantage plans to chose from this year. ... In addition to basic Medicare coverage, many provide extras such as vision, dental or hearing coverage. Insurers have developed more than 2, 000 Medicare Advantage plans serving more than 11 million people, according to the Kaiser Family Foundation. All these options come with their own sets of variables like different deductibles, premiums and co-insurance." The AP answers questions and provides advice on selecting a plan by looking at factors such as premiums and hospitalization coverage (Murphy, 2/2). This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at kaiserhealthnews.
Medicare patients accounted for almost half of all stays (45 percent) at rural hospitals in 2007, while the percentage of Medicare beneficiaries who were admitted to urban hospitals was considerably lower (35 percent), according to the latest News and Numbers from the Agency for Healthcare Research and Quality. The federal agency's analysis also found that in 2007: -- About 25 percent of rural hospital patients were covered by private health insurance v. 36 percent of urban hospital patients. One-fifth of patients in both rural and urban hospitals had Medicaid and about 5 percent were uninsured. -- Half of the nation's 2, 000 rural hospitals had fewer than 50 beds compared with only one-fifth of urban hospitals. -- The top five illnesses among the two-thirds of rural residents who were hospitalized in rural facilities were: pneumonia (267, 000 stays); congestive heart failure (166, 000 stays); chronic obstructive lung disease (146, 000 stays); chest pain (110, 000); and fluid and electrolyte disorders, primarily dehydration and fluid overload (106, 000 stays).
Sebelius, Vilsack Celebrate One Year Anniversary Of Children's Health Insurance Law, Highlight Campaign To Cover Kids
Exactly one year after President Obama signed the Children's Health Insurance Program Reauthorization Act, HHS Secretary Kathleen Sebelius and Agriculture Secretary Tom Vilsack today announced that 2.6 million more children were served by Medicaid or the Children's Health Insurance Program (CHIP) at some point over the past year and released "The Children's Health Insurance Program Reauthorization Act One Year Later: Connecting Kids to Coverage, " a comprehensive review of the past year's accomplishments in finding and enrolling children in health coverage. Sebelius also highlighted "The Secretary's Challenge: Connecting Kids to Coverage, " a five-year long campaign that will challenge federal officials, governors, mayors, community organizations, tribal leaders and faith-based organizations to build on this success and enroll the nearly five million uninsured children who are eligible for Medicaid or CHIP but are not enrolled. As part of the Secretary's challenge, Vilsack and Sebelius announced plans to work with state Supplemental Nutrition Assistance Programs (SNAP, formerly the food stamp program), to encourage them to work with their state's Medicaid and CHIP programs to share data and identify uninsured children who are potentially eligible for coverage through Medicaid or CHIP.
Kansas Health Institute : "The Kansas Hospital Association will throw its lobbying clout behind a proposed increase in the state tobacco tax to restore a cut in the Medicaid rates paid to providers" (McLean, 2/3). Chattanooga Times Free Press : Tennessee "hospitals could lose a half billion dollars under the cumulative effect of Gov. Phil Bredesen's proposed TennCare cuts, the president of the Tennessee Hospital Association said today." The state legislature cut the state portion of the program by $170 million last year, and the Bredesen is proposing another $200 million in cuts this year. The state would also loose federal matching funds because of the cuts (Sher, 2/4). State House News Service/Cambridge Chronicle : "Gov. Deval Patrick's proposed $56 million cut to state-funded adult dental benefits undermines the health care reform movement launched in 2006, activists and lawmakers said Wednesday morning." Critics said the cuts would result in costs 2.5 times higher than continuing the dental benefits because of lost federal match funds (Norton, 2/3).
Virginia AG Works To Increase Outpatient Treatment For Mentally Ill; Iowa Hospitals Oppose Medicare Fraud Bill
News outlets report on health care developments in Virginia, the District of Columbia, California, Iowa, Maryland, Maine and Michigan. The Virginia attorney general wants to increase access to outpatient treatment for the mentally ill, The Washington Post reports. "After the shootings at Virginia Tech by a mentally ill student in 2007, the Virginia General Assembly changed the law the next year to allow more outpatient treatment. But even fewer people were ordered into outpatient treatment in the law's first year." On Thursday, recently-elected Attorney General Ken Cuccinelli II "will push for a new law that would allow doctors to order patients into outpatient treatment after they are stabilized in a hospital or institution." The Post reports that Cuccinelli said the law could result in significant savings for the state and "open up more bed space" in hospitals (Jackman, 2/4). In a separate article, The Washington Post reports on problems at District of Columbia-funded homes for the mentally ill.
The Cleveland Plain Dealer reports that Ohio's seven Medicaid managed care plans this month will make changes in the prescription drug plans that cover about 1.5 million people, although many of those beneficiaries will not face increased costs. The changes are expected to save the state about $243 million. "Members who are exempt, such as children under the age of 21, pregnant women, people who are in the hospital, those in a long-term care facilities such as nursing homes as well as consumers receiving hospice and family planning services will not have to pay [for prescriptions]. But about 400, 000 residents statewide will now have a co-pay for certain medications. It's $3 for drugs that require prior authorization from Ohio Medicaid and $2 for trade-name drugs. There's no cost for generics" (Tribble, 2/1). The Associated Press/Business Week reports on Medicaid in North Carolina. "State Medicaid leaders are in a fiscal bind. North Carolina's share of the $10 billion federal-state health care program for poor families, senior citizens and the disabled -- is on track to spend $250 million more than budgeted this year despite the Legislature's demands to cut more than $500 million from the Medicaid agency.
AAMC (Association of American Medical Colleges) President and CEO Darrell G. Kirch, M.D., issued the following comments on the Obama administration's FY 2011budget proposal: "President Obama's budget blueprint includes some wise investments that will yield long-term benefits for the health of all Americans. The administration's proposed $1 billion increase for the National Institutes of Health (NIH) recognizes the need for sustained, predictable growth in the nation's medical research enterprise. This boost to NIH funding will help find new cures and treatments; strengthen our economy by creating skilled and high-paying jobs; and produce new products, industries, and technologies. U.S. medical schools and teaching hospitals are also pleased that the president's proposal assumes no decreases in Medicare funding, as well as $371 billion to address Medicare's problematic physician payment formula. The AAMC strongly urges Congress to follow the president's lead and take immediate action to permanently repeal the current formula, and replace it with one that preserves stable and accessible care for Medicare beneficiaries.