The Daytona Beach News-Journal reports that as the recession continues to increase the number of people without jobs, many more are seeking health care through the state's Medicaid program, "driving up costs and playing a major role in a potential $3 billion state budget shortfall next year. The shortfall could lead to cuts in Medicaid ... while also forcing lawmakers to make tough election-year spending choices among health and education programs. ... Florida has grappled with increasing Medicaid costs for years, but projections for the 2010-11 year are eye-opening: The program could serve nearly 3 million people -- at an overall cost of about $19.1 billion" (Saunders, 1/24). The Ithaca Journal reports that fate of the national health care legislation will affect New York state's budget. "That's because problems related to New York's federal Medicaid reimbursement formula could evaporate if congressional Democrats decide to significantly scale back their goals for health care reform.
Computed tomographic colonography (CTC), also known as virtual colonoscopy, remains effective in screening older patients for colorectal cancer (CRC), produces low referral for colonoscopy rates similar to other screening exams now covered by Medicare, and does not result in unreasonable levels of additional testing resulting from extracolonic findings, according to a study published in the February issue of Radiology. CT colonography employs virtual reality technology to produce a three-dimensional visualization that permits a thorough and minimally invasive evaluation of the entire colon and rectum. Previous CTC trials have demonstrated excellent performance in average risk individuals. However, concerns remained that such results may not be applicable to older Medicare beneficiaries. Researchers at the University of Wisconsin School of Medicine and Public Health analyzed various CTC performance and program outcome measures for screening individuals aged 65-79. "These results confirm that CTC is a safe and effective colorectal cancer screening tool for the older individual.
The (Raleigh, N.C.) News-Observer : "The state's drug assistance program for HIV patients has been capped at its current enrollment, with budget cuts hitting at the same time more people need help, state officials said Monday." Because patients with HIV are more likely to spread the virus when not on medications, public health officials are worried about denying medications (Avery, 1/26). Kansas Health Institute News Service : "Last year, nine of the state's 27 community mental health centers spent more money than they took in. A new survey shows that even more of the centers are now facing potential money troubles" (Ranney, 1/25). Associated Press/The Seattle Times : "The uncertain future of the federal health-care overhaul has wrinkled Washington state's hopes of landing a $1 billion bailout to fix its budget deficit this year, Gov. Chris Gregoire said Monday. That change could bring stronger momentum for tax increases and budget cuts at the Legislature, now a quarter of the way through its scheduled eight-week session" (Woodward, 1/25).
Congressional Democrats are facing a critical decision about whether to use the procedural maneuver known as budget reconciliation to pass a health care reform bill, The New York Times reports. Democrats could push the measure through the Senate with a simple majority vote but could trigger "a political backlash." "The procedure is also subject to complex rules that could make it difficult for Democrats to include all the provisions needed to win approval of the bill, especially among rank-and-file House Democrats. For instance, it might be difficult to include provisions related to insurance coverage for abortions." Top Democrats have long known that they may need to use reconciliation, The Times reports, adding that leaders are "no longer confident" some House Democrats "would be willing to go along" with the vote(Herszenhorn and Pear, 1/25). Related KHN story: How The Budget Reconciliation Process Works (1/21). "Only changes that affect taxes and government spending would normally be allowed to pass with a majority of 51 senators, " The Associated Press reports.
A cardiologists' lobby filed suit against Health and Human Services Secretary Kathleen Sebelius, claiming cuts to heart care services, especially diagnostic tests, are unjustified, The Philadelphia Inquirer reports. A judge has already ruled that he can't intervene on the cardiologists' behalf, leaving the doctors to go through the government's complaint process "before considering a suit." The president of the American College of Cardiology "contends the pay cut will make doctors give up their private practices and work for hospitals, " which could limit access to some services for patients, and end up costing more, since hospitals charge more for the same services. The argument for the cuts is that Medicare determined it was overpaying for the services. For instance, "spending on nuclear stress tests per Medicare beneficiary doubled between 2000 and 2006, " suggesting that providers considered the services lucrative (Burling, 1/13). This information was reprinted from kaiserhealthnews.
National groups are calling for a permanent solution to the doctor payment formula and warning about a possible shortage in doctors and impending decline in Medicare payments. The Virginian-Pilot reports: "If Congress doesn't intervene, a funding formula will trigger a 21 percent cut in reimbursements to doctors in the Medicare and Tricare programs on March 1, a group of national organizations warned Thursday. That, the group said, will force doctors to drop out of the programs and make it tougher for elderly and military beneficiaries to get health care. Representatives of the groups -- AARP, the American Medical Association and the Military Officers Association of America -- appeared in a videoconference from five cities, including Norfolk" (Walzer, 1/22). Wisconsin Radio Network reports that Ardis Hoven, the AMA's board chair-elect, told reporters that under the current payment system doctors are not keeping up with the cost of care and that as the Baby Boom generation moves into Medicare the pressure on doctors could become much worse and force more physicians to refuse to take Medicare patients.
The New York Times : "Passage of a comprehensive [health] bill looked impossible after the Democrats' loss of a Senate seat in Massachusetts. As an alternative, lawmakers in both parties said, some pieces of the bills already passed by the House and the Senate could be pulled out and packaged together in a measure that would command broad support." The piecemeal reform could include ensuring that insurers could not deny coverage on pre-existing conditions to children; allowing parents to keep their children up to age 25 or 26 on their insurance policies; expanding Medicaid through financial incentives for states to cover childless adults and parents; offering grants to states to establish insurance exchanges; extending tax credits to small businesses to allow them to cover more workers; and ridding the system of out-of-network costs for emergency care. Additionally, Medicare reimbursement changes could be included to reward providers of "high-quality, lower-cost care." Lawmakers would also like to close the Medicare prescription coverage "doughnut" hole (Pear and Herszenhorn, 1/21).
News outlets report on rural health issues including the decline in the number of doctors accepting Medicare patients in Arizona and the search for low-cost health solutions in Mississippi. The Arizona Republic reports that a growing number of doctors in rural Arizona are refusing to see new Medicare patients and notes it is a problem that other parts of the country are reporting also. "Medicare, some doctors say, pays too little, and the red tape is too much. ... Medical professionals say the Prescott area may serve as a valuable lesson for the nation as Congress seeks to expand health care: Even if most Americans are covered under some form of insurance, many still may not find a doctor willing to see them." The situation is worsened by the shortage of primary care doctors and the sustainable growth rate payment system, which reimburses doctors less for Medicare patients (Alltucker, 1/24). The Los Angeles Times reports on Dr. Aaron Shirley, a 77-year-old Mississippi pediatrician who thinks a key to reducing infant mortality may come from Iran: "In May, Shirley and two colleagues flew to Iran for 10 days to study a low-cost rural healthcare delivery system that, according to the World Health Organization, has helped cut infant deaths by 70% over the last three decades.
New Year's Resolution For Older Adults: Take Advantage Of New Changes To Programs That Help With Medicare Costs
Many 2010 New Year's resolutions will likely focus on staying healthy and saving money. Older adults can help keep both of these resolutions by using BenefitsCheckUp, a free, online benefits screening service developed and maintained by the National Council on Aging (NCOA). Beginning in January, federal changes to Medicare Savings Programs (MSP) and Medicare's Low Income Subsidy ("Extra Help") mean a simplified application process and greater eligibility for these important programs. MSP provides support to seniors by helping with Medicare costs such as the monthly Part B premiums and, in some cases, other premiums, deductibles, and co-pays. Medicare's Extra Help assists with the cost of Medicare prescription drug coverage. Seniors, particularly those with low income and limited resources, can access new information on these and other benefits programs, as well as an updated Medicare Rx Extra Help Online Application form by visiting http://www.benefitscheckup.org. "Throughout the New Year, NCOA wants to help low-income older adults remain economically secure, " said Stuart Spector, senior vice president at NCOA.
Health care reform legislation could be worse for America's seniors than the Administration and Congressional leaders are publicly stating, according to The Senior Citizens League (TSCL), one of the nation's largest nonpartisan seniors advocacy organizations. Among other concerns, The Senior Citizens League is focusing on two main objections to the current health care reform bill: 1. Shaky Medicare Financing: The bill will not shore up Medicare's financing, despite claims to the contrary; and 2. Reduced Access to Care: Seniors may have reduced access to medical care as providers experience cuts and go out of business. 1. Shaky Medicare Financing: Lawmakers supportive of the bill have consistently stated that health care reform would keep the Medicare trust fund in the black for several additional years. However, the nonpartisan Congressional Budget Office (CBO) calls that claim into question, accusing the government of "double-counting." In its December 23, 2009 memo, the CBO states that, "в the majority of the health insurance trust fund savings would be used to pay for other spending under the [health care bill] and would not enhance the ability of the government to redeem the bonds credited to the trust fund to pay for future Medicare benefits.