A Bump In The Road To Accountable Care? The Pioneer accountable care organizations have long been the shining stars of the Affordable Care Act’s strategy to rein in the country’s out-of-control spending on health care. The 32 organizations are part of a Medicare pilot project called for in the health law that could revolutionize the health system by paying doctors and hospitals for quality of service rather than the volume of services. Pioneers would be offered a bonus for giving patients high quality care at a reduced cost. If they failed to hit certain quality targets or did not manage to reduce the cost of care, they would be dinged accordingly. For the first year of the program, everything seemed like smooth sailing. But the pioneers appear to have hit their first pothole—and the administration is scrambling to make sure the project goes forward. States balk at $15B Obama healthcare A newly unveiled component of President Obama’s healthcare law forcing insurers to pay annual fees is sowing angst in state capitols, where officials view the provision as a $15 billion tax that could disrupt Medicaid programs and other services. Right jabs GOP inaction on Obamacare Once again, conservatives are unhappy with how congressional Republicans are handling a fiscal fight in Congress. This time, their ire is because Republicans aren’t trying hard enough to defund, or at least whittle away at, the Affordable Care Act by attaching language to the continuing resolution that passed the House on Wednesday. Four partnership exchanges get initial nod Four more states were given tentative approval to operate health insurance exchanges in partnership with the federal government on Thursday. HHS conditionally approved state partnership marketplaces in Iowa, Michigan, New Hampshire and West Virginia, which allow them to operate various components of the marketplaces scheduled to begin enrollment in October. Those approvals increased the number of tentatively approved partnership states to seven, while 17 other states plus the District of Columbia were conditionally cleared to operate their own insurance marketplaces. At least 26 states will have exchanges fully operated by federal officials. OVERNIGHT HEALTH: Exchanges move forward The centerpiece of President Obama's healthcare law went another step forward Thursday as the Health and Human Services Department conditionally approved "partnership" exchanges in four more states. HHS gave conditional approval to partnership exchanges in Iowa, Michigan, New Hampshire and West Virginia. Arkansas A.G. Says He’ll Defend Abortion Ban Despite Concerns A day after Arkansas lawmakers voted to enact the most-stringent abortion restrictions in the nation, the state’s attorney general said he is preparing to defend the law against inevitable challenges – despite his personal feelings on the matter. Some abortion rights supporters indicated that they would sue Arkansas in federal court to try and overturn the law, which bars most abortions after 12 weeks of pregnancy. Minn. Senate approves health care marketplace bill After hours of debate, the Minnesota Senate approved a bill late Thursday night that will make major changes to the state's health care system to conform with the Obama administration's health overhaul. Lawmakers voted 37-28 to pass the measure, which implements the health insurance exchange, an online marketplace for 300,000 uninsured Minnesotans and others to shop for coverage plans and seek assistance to pay for them. The debate stretched late into the night as Republicans in the minority failed to force changes to a plan they consider too expensive, too intrusive and lacking in accountability in how the exchange is governed. 19 Pioneer ACOs Want CMS to Delay Pay-for-Performance Obligations Many health systems behind CMS' 32 Pioneer Accountable Care Organizations disagree with the Patient Protection and Affordable Care Act's approach to quality measurement and are demanding changes to the Pioneer program, according to a Washington Post report. When CMS first unrolled its ACO program, the agency proposed more than 70 quality metrics that would determine whether hospitals could receive bonus payments. In response to criticism from providers, CMS trimmed that list to 33 metrics in its final rule. Groups urge White House to reconsider ‘borderline discriminatory’ healthcare rule Groups in Massachusetts are urging the White House to reconsider a proposed rule on insurance premiums that they say is “borderline discriminatory” against small businesses. Some employers say reform limits hiring Wary employers are warning of possible future job cuts as they face the “unknown effects” of healthcare reform, according to a newly released look at the U.S. economy. Businesses, economists and market experts surveyed for the Federal Reserve's Beige Book report, an anecdotal snapshot of jobs, wages, prices and consumer spending, also said the Patient Protection and Affordable Care Act helped to restrain consumer spending, along with the expired payroll tax holiday. In Conservative Arizona, Government-Run Health Care That Works In a low-slung building in the vast desert expanse east of Phoenix, a small school of tropical fish peer out, improbably, from a circular tank into the waiting lounge of the Apache Junction Health Center. The hallways of the nursing home are still. Only half of the rooms are filled, and the men and women who live here seem surely in life’s final season. “These are folks that have chronic cognitive and physical disabilities that are not going to improve,” said George Jacobson, administrator of the nursing home. That this nursing home is sparsely filled with residents too disabled in mind or body to return home is a stunning achievement for Arizona’s public health insurance agency. A decade ago, 60 percent of Arizonans covered by Medicare and Medicaid, and deemed sick, frail or disabled enough to live in a nursing home, resided in a skilled nursing facility. Today, only 27 percent of them do, and the rest – nearly three out of four– live in assisted living facilities or at home with the help of nurses, attendants and case managers provided by government-paid health plans. House Spending Bill Cuts Funding For Exchanges You don’t hear much these days about Republicans trying to repeal the 2010 health care law. The Supreme Court ruling last June upheld most of the measure. President Obama’s re-election and Democrats’ continued control of the Senate have helped “Obamacare” implementation to move ahead. House GOP debates changing Medicare sooner than they'd planned As Rep. Paul D. Ryan readies the new GOP budget, House Republicans are debating whether to apply the party’s proposed Medicare changes a year earlier than planned, when Americans who are now 56 reach retirement age. No decision has been made, and Ryan declined to address the internal debate Wednesday. The party’s earlier promise to keep Medicare unchanged for those 55 and older has bumped up against its vow to balance the budget in 10 years. How Arizona Reconciled Government-Run Health Care With Its Conservative Ethos Outsourcing care to closely regulated private companies has allowed the state to both save money and keep patients out of nursing homes under Medicaid. In a low-slung building in the vast desert expanse east of Phoenix, a small school of tropical fish peer out, improbably, from a circular tank into the waiting lounge of the Apache Junction Health Center. The hallways of the nursing home are still. Only half of the rooms are filled, and the men and women who live here seem surely in life's final season. "These are folks that have chronic cognitive and physical disabilities that are not going to improve," said George Jacobson, administrator of the nursing home. Republicans Warm To Obama's Efforts Several Republican lawmakers signaled Thursday a willingness to work with President Barack Obama—or at least to hear him out—on how to reach a broad budget deal. After weeks of rancor and relatively little direct engagement, Mr. Obama has expanded his recent aggressive attempts to work around GOP leaders and make his pitch for a deficit-reduction plan directly to rank-and-file Republican lawmakers. New Idea on Tweaking Medicare Eligibility Raising the Medicare eligibility age to 67 from 65 is a third-rail for many Democrats, who argue that it could leave some seniors without access to insurance. It’s also difficult to do without disrupting the implementation of the federal health-care law, as we noted in this story, which makes it a tough proposition for the White House to swallow. But it turns out that that’s not the only option on the table. Researchers at the Urban Institute, a left-leaning think-tank, are arguing in a new paper that the government could save around $90 billion over ten years by allowing 65 and 66-year olds to buy into Medicare if they want, but asking middle and high-income ones to pay higher premiums and other out-of-pocket costs. Medicaid Expansion Divides Florida GOP As the Florida legislature convened this week, House Speaker Will Weatherford helped rally fellow Republicans opposed to expanding the state's Medicaid coverage to more than a million low-income residents, but he also acknowledged that his own family benefitted from a program for low-income families without health insurance. The dispute over the Medicaid expansion sanctioned by the federal health law has engulfed the state Republican Party, which controls the House, Senate and governor’s office, and left the fate of expansion in doubt. Idaho, Utah, N.M. Running Out Of Time To Set Up State Exchanges Three western states which had gotten tentative go-aheads to run their own online health insurance websites — Utah, Idaho and New Mexico — are running out of time to be ready for an Oct. 1 launch and experts doubt they will get green lights from the federal government. “We are not seeing enough progress that these states can easily get to final approval,” said Carolyn Pearson, vice president of consulting firm Avalere Health. Protesters march to urge Texas Gov. Rick Perry to expand Medicaid Several hundred protesters marched in Austin on Tuesday to protest Texas Gov. Rick Perry's hard stance against expanding Medicaid coverage in the state. Perry has dismissed calls to follow two tenets of the federal Affordable Care Act: expand Medicaid, the government program providing health insurance for sick or low-income people, and set up a health insurance exchange where people can shop for coverage. Hospitals want to delay a key Obamacare program In 2011, the Obama administration settled on 32 health care systems, scattered across the country, to lead the Affordable Care Act’s most ambitious cost-control effort. These hospitals and doctors would move Medicare away from paying doctors for volume—and toward paying for value. The group was given a name that has stuck: the pioneers. When I asked the Advisory Board’s Chas Roades to describe the group, he called them “The Lewis and Clarks of hospitals.” Diabetes costs nation $245 billion annually, study says The growing toll of diabetes cost the nation a record high $245 billion in 2012, a 41% increase from $174 billion in 2007, according to new research released today. The study Economic Costs of Diabetes in the U.S. in 2012, commissioned by the American Diabetes Association, estimated the health care and work-related costs of diagnosed diabetes. The full study will be published in the April issue of Diabetes Care. Arkansas Abortion Law Is Now Nation's Strictest Arkansas lawmakers voted Wednesday to bar most abortions after 12 weeks of pregnancy, overriding a veto by the state's governor to set the most-stringent abortion restrictions in the nation. The Arkansas House of Representatives voted 56 to 33 to enact the legislation, a day after the Senate voted 20 to 14 in favor of overruling Democratic Gov. Mike Beebe. Both chambers are controlled by Republicans, although six Democratic representatives were among the House members who voted to uphold the measure. Cruz: Spending bill must defund Obama healthcare law Sen. Ted Cruz (R-Texas) said Wednesday that he will object to a government spending bill if it does not cut off funds for President Obama's signature healthcare law. Cruz, a staunchly conservative freshman, said he will offer an amendment to delay the flow of funds to implement the healthcare law when the Senate takes up a continuing resolution to fund the federal government. Cruz amendment would defund Obamacare Sen. Ted Cruz (R-Texas) will offer an amendment to the continuing resolution – the bill to keep the government open after March 27 — that would defund the Affordable Care Act. “The very first priority of every elected official—Democrat and Republican—should be restoring economic growth, so we can ensure continued strength, prosperity, and opportunity for the next generations,” Cruz said in a statement. “Obamacare does precisely the opposite. It is already hurting small businesses, reducing the hours Americans are allowed to work, forcing employers to drop coverage, and leading to substantial increases in healthcare premiums—especially for young people.” GOP leaders push Obama on pre-existing conditions plan House GOP leaders asked President Obama Tuesday to make funds available in support of a temporary insurance plan for people with pre-existing conditions. The plan, known as PCIP, has struggled to get off the ground since it was enacted as part of the healthcare law. Last month, the Obama administration announced that it would close enrollment due to concerns that the program would be too costly. On Tuesday, Speaker John Boehner (R-Ohio) and six of his deputies asked Obama to transfer money to the PCIP from other accounts established by the law, such as the Prevention and Public Health Fund or the fund for state insurance marketplaces. Minnesota Legislature Hammers Out Exchange Bill The Democratic-majority Minnesota House has passed a key part of the Obama administration's health care law -- a state-based health insurance exchange. The bill's chief author called the measure the most significant health reform in 50 years. But abortion restrictions adopted Monday could run into trouble with Gov. Mark Dayton, a Democrat. The full Senate takes up its exchange bill on Thursday. Minnesota won conditional approval from the federal Department of Health and Human Service to have a state-based exchange in December, but actually setting up the new marketplace requires enabling legislation. GOP previews 10-year plan to eliminate deficits; House votes to prevent government shutdown The spending legislation was still pending on the House floor when Ryan began pulling back the curtain on his plan to eliminate deficits in 10 years. The government ran a deficit of more than $1 trillion for the past budget year, about $200 billion less than the year before, and the total federal debt is about $16 trillion. To achieve his 10-year goal of producing a surplus, Ryan said he would incorporate the tax increases on the wealthy that Congress passed on Jan. 1 over the objections of many House Republicans. The hike translates into an estimated $600 billion or more in additional revenue to the government. Sequester cuts hit healthcare. So MedCity News offers ‘Sequester Pricing’ for government One of the subplots at the HIMSS 2013 healthcare technology conference was the absence of hundreds of federal employees who did not make the trip because of the federal government sequester. Several major exhibitors who focus on the government noted that the sequester cuts meant they didn’t get a chance to showcase their emerging health IT solutions to some federal officials, who told them the sequester kept them away. Sequester won’t interrupt collection of taxes from 'ObamaCare' Implementation of the taxes and fees from President Obama’s healthcare law is on track despite the cutbacks at the IRS from sequestration. No Competition: The Price Of A Highly Concentrated Health Care Market As health care costs swell, the private insurance system that covers most working Americans is in crisis. Americans are paying higher and higher premiums for increasingly threadbare coverage, and employers are getting out of the business of providing health care altogether. Rising costs cannot be attributed purely to improving technology or increasing operating costs for providers, because Medicare has controlled per capita spending more effectively than commercial insurers that provide employer-sponsored coverage. Blue Shield and Aetna to raise healthcare rates over state objections Despite objections from regulators, health insurers Blue Shield of California and Aetna Inc. are proceeding with double-digit rate increases that state officials said were unreasonable. Officials at the California Department of Managed Health Care said increases that average more than 11% for about 47,000 individual and small-business policyholders of Blue Shield and Aetna were unreasonable. But state officials don't have the authority to reject changes in premiums, and increasingly health insurers refuse state demands to lower rates. Seeking a budget deal, Obama reaches out to Republican rank and file After more than two years of failed negotiations with GOP leaders, President Obama is for the first time reaching out directly to rank-and-file Republicans who have expressed a willingness to strike a far-reaching budget deal that includes higher taxes. In a flurry of meetings and phone calls over the past few days, Obama has courted more than half a dozen Republicans in the Senate, telling them that he is ready to overhaul expensive health and retirement programs if they agree to raise taxes to tame the national debt. Anger and Kudos as Florida Governor Tacks Left A few days after Gov. Rick Scott of Florida endorsed a Medicaid expansion, a U-turn so sharply executed that it flabbergasted his supporters, the head of a local Tea Party group typed up a “breakup note.” “I’m trying to determine how the Medicaid expansion is going to pay for the surgery to remove the knife planted in my back,” Henry Kelley, the Tea Party leader and an early supporter of Mr. Scott, wrote on his blog. GOP Rep. Boustany touts 'vigorous oversight' of health law The leader of a House subcommittee said "vigorous oversight" by Republicans is the only way to ensure that "we can all live with" President Obama's healthcare law now that it's taking effect. Rep. Charles Boustany (R-La.) spoke to hospital executives Tuesday and cited his own efforts to repeal the Affordable Care Act's long-term care insurance program as one example of how the GOP can still fight the law. Ryan Budget Plan Draws GOP Flak House Republican leaders, faced with the daunting task of writing a budget that would eliminate deficits within 10 years, are backing away from a proposal to revamp Medicare for more Americans than previously suggested. House Budget Committee Chairman Paul Ryan (R., Wis.) has in recent weeks floated the idea of rolling back the GOP promise that people 55 and older would be exempt from his signature plan to offer future retirees a subsidy to buy private health insurance as an alternative to traditional Medicare. Gunshot wounds drive up government health care costs Gunshot wounds and deaths cost Americans at least $12 billion a year in court proceedings, insurance costs and hospitalizations paid for by government health programs, according to a recent study. "I think people probably don't understand that as well as they ought to," said Ted Miller, author of a study that found that gunfire deaths and injuries incur a direct societal cost of $32 per gun. Caveat For Contraceptive Coverage; Early Retirees May Get Cheaper Plans On Exchanges This week, I answer readers' questions about birth-control coverage requirements under the Affordable Care Act and subsidized coverage on the state-based health insurance exchanges. What It Will Take to Achieve Healthcare Coverage for the Poor: Public-Private Partnership In the United States, 62% of personal bankruptcies are caused by medical expenses, according to a Harvard University study. In developing countries, poor families who typically live and work in the informal economy are highly vulnerable to health care shocks. According to Portfolios of the Poor, between 40 and 50% of all surveyed households faced significant health care expenditures over the course of the study. In one study in Hyderabad, India, almost 2/3 of households (64%) experienced a health shock costing Rs. 500 or more within the past year. McDonnell to feds: No Medicaid expansion Gov. Robert F. McDonnell sent a letter Tuesday to President Obama’s health secretary to stress that he and the General Assembly have not agreed to expand Medicaid. “The recently passed budget of Virginia contains language outlining a series of reforms that must be completed to the satisfaction of a new legislative commission prior to consideration of Medicaid expansion,” McDonnell (R) wrote to Health and Human Services Secretary Kathleen Sebelius. “Some media outlets and elected officials have labeled this as approving Medicaid expansion in Virginia. This is absolutely incorrect.” The Reason American Health Care Is Out Of Control Steven Brill’s Time magazine cover story last week on health care got a lot of attention for its tracking of astronomical costs in American health care back to their sources. But why are those costs so high anyway? Is it because an unfettered free market is not allowed to work when it comes to health and medicine? Quite to the contrary. It’s partly because an unfettered free market cannot work when it comes to health and medicine. Medicare trustee doubts future funding for Medicaid expansion A Medicare trustee is questioning whether the federal government will maintain its commitment to foot most of the cost of expanding Medicaid under the healthcare reform law. Charles Blahous released a report Monday cautioning states to "consider the likelihood that federal financing support may be ultimately reduced from current schedules." For doctors, too much information? What if your test results became just another electronic blip on your doctor’s busy radar? Florida may not expand Medicaid after all When Florida Gov. Rick Scott endorsed the Medicaid expansion last month, it was a huge turnaround: He had initially been one of the health law’s harshest critics. While that was a major moment for the Affordable Care Act, it did not secure the Sunshine State’s participation in a Medicaid expansion expected to cover 1.3 million Americans. One less-noticed factor in Florida — or in any other state — is that it’s not just the governor who has to get on board with expanding Medicaid. The state legislature generally has to sign off on the program and authorize the new spending it would entail. State Rep. Ron Young to introduce ‘Health Care Freedom Act’ in response to 'Obamacare' Florida House Panel Opposes Medicaid Expansion The Florida House of Representatives has signaled it won’t go along with Gov. Rick Scott to expand Medicaid coverage to more than a million low-income Floridians under the Affordable Care Act. The party-line vote came Monday shortly after a joint committee hearing on the law’s financial impact on the state. Under the federal health care law, the state has the option to expand the Medicaid program, with the federal government picking up the tab for the first three years. That support would fall to 90 percent in later years. Republican goal to balance budget could mean deep cuts to health programs Anxiety is rising among House Republicans about a strategy of appeasement toward fiscal hard-liners that could require them to embrace not only the sequester but also sharp new cuts to federal health and retirement programs. Letting the sequester hit was just the first step in a pact forged in January between conservative leaders and Speaker John A. Boehner (R-Ohio) to keep the government open and the nation out of default. Now comes step 2: adopting a budget plan that would wipe out deficits entirely by 2023. Paul Ryan floats change to Medicare plan Paul Ryan’s budget will show how Republicans can balance a budget that’s trillions of dollars out of whack. But the most significant unresolved issue comes down to a minuscule number: one year. Ryan — the House Budget Committee chairman — has privately been floating the idea of allowing his changes to Medicare to kick in for Americans younger than 56. In previous budgets, those 55 and older were exempted from his plan to turn Medicare into a premium-support — or voucher — program. House committee says 'no' to Medicaid expansion With a straight party-line vote, the House Select Committee on Patient Protection and Affordable Care Act voted against expanding Medicaid today. Republican members took turns making a case against Medicaid expansion, saying it would increase the federal deficit, diminish health care delivery to the elderly and other Floridians, and would drastically grow an already problem-laden program. Democrats cut in to offer support for Medicaid expansion, saying it made no sense for the state to reject billions of federal dollars and that the positive outcomes of Medicaid outweighed the bad. Key Senate panel approves Medi-Cal expansion A key Senate panel supported legislation Monday that would dramatically expand Medi-Cal, the state's public insurance program for the poor. The proposal, authored by state Sen. Ed Hernandez (D-West Covina) and Senate leader Darrell Steinberg (D-Sacramento), is part of a legislative package that aims to help California implement President Obama's healthcare overhaul. Beginning in January 2014, the federal Affordable Care Act requires most Americans to buy health insurance or pay a penalty. Gov. Jerry Brown has called a special session of the Legislature so that healthcare bills he signs can take effect within 90 days rather than next year. Ushering in the New Era of Healthcare I'm not a doctor...but I am a patient. I'm also a keen observer of the world around me--especially when it involves my health. For many healthcare professionals, I believe the recent challenges surrounding the industry have taken some of the enjoyment out of their work. Issues such as new and changing regulations, increased lawsuits, escalating costs, and barely manageable patient loads, among others, have all taken their toll on the doctors, nurses, and administrators who, I believe, entered the healthcare field to have a fulfilling, lifelong career serving people and helping them live better lives. Got A Health Care Puzzle? There Should Be An App! Kansas City, Mo., is looking to boost its health-tech cred. So the city that's home to Cerner Corp. and other health information firms seemed a natural to host something called the Hackovate Health Innovation Competition. A mashup of innovation and old-school hacking (though none of the participants was bent on doing harm, we're assured), the goal of the competition was to improve the nation's health system and help people navigate the complexities of the Affordable Care Act. To contain health care costs, pay doctors differently Lawmakers have spent decades dancing around how to stop health care costs from eating up greater and greater portions of our overall budget. Even now, the proposals on the table look at cuts in services, asking seniors covered under Medicare to pick up a higher proportion of out-of-pocket costs or assessing whether to eliminate the sustainable growth rate formula aimed at controlling Medicare spending on physicians. These proposals, at best, address the problem of health spending at the margins. The real culprit here is fee-for-service payment to doctors. Commission advocates ending fee-for-service system The National Commission on Physician Payment Reform is calling for eliminating the fee-for-service model within seven years, starting with a five-year transition period to a blended payment system. The group, whose honorary chairman is former Senate Majority Leader Bill Frist (R-Tenn.) and includes representatives from Tufts Medical Center, Harvard School of Public Health, CVS Caremark and WellPoint, said the sustainable growth rate repeal should be paid for by cuts in Medicare “physician payments and reductions in inappropriate utilization of Medicare services.” Mandating Inefficiency in the Health Care Industry Despite 50 years of failure, faith that the federal government can cure what ails the health care industry endures. That enduring faith drives a seemingly never-ending call for plans, both grandiose and modest, that attempt to address the failings of this sector. Grand redesigns of the health care system began when President Johnson signed Medicare and Medicaid into law in 1965, almost half a century ago. The purpose of these programs was to provide health insurance coverage for low-income people and the elderly who could not afford to purchase their own health insurance. Trillions of dollars later, scores of other government health programs and mandates have also been enacted – the Affordable Care Act (a.k.a. Obamacare) being the latest and largest example. Like its predecessors, the Affordable Care Act is supposed to provide insurance to 30 million of the 48 million Americans who still lack health insurance. Of these 30 million, 12 million will be added to the Medicaid rolls. Hard time understanding health reform law? Try figuring it out in Tagalog, Hmong or Vietnamese Set on a gritty corner of Oakland’s International Boulevard, the nonprofit Street Level Health Project offers free checkups to patients who speak a total of 22 languages, from recent Mongolian immigrants seeking a doctor to Burmese refugees in need of a basic dental exam. It also provides a window into one of the challenges for state officials who are trying to implement the Affordable Care Act, President Barack Obama’s sweeping health care overhaul. Feds responsible for health care exchange in Tenn. In Tennessee, Gov. Bill Haslam has decided the state will not to create its own health care exchange, leaving both the exchange's operation and its marketing to the federal government. TennCare Bureau spokeswoman Kelly Gunderson said that means it will be up to federal officials to make sure non-English speakers are aware of the program and explain the details to them. The health care leader we need Imagine a large company operating for seven years without a CEO. A company with a product that accounts for more than 15 percent of our nation’s gross domestic product. A company implementing the largest national effort at reform since its creation. A company set to gain an additional 30 million customers in the next year. Unfathomable. Obama Asks Health Plans to Report Rising Rates The Obama administration says it will require health insurance companies to report all price increases, no matter how small, to the federal government so officials can monitor the impact of the new health care law and insurers’ compliance with it. Under current rules, the federal government requires insurers to report information on rate increases of 10 percent or more. New rules being issued by the administration will extend this requirement to all rate increases for all health plans sold to individuals, families and small businesses — a total of 60 million people. The U.S. Health Care Rip-Off The U.S. health care system is the most expensive in the developed world and the gap with other countries isn’t narrowing. As I write in my latest Letter From Washington, a cover story in Time magazine, the American weekly, shows that many parties are to blame, though none admits responsibility. Nonetheless, in 2010, the last year for which data is available, the United States spent 17.6 percent of its gross domestic product on health care, according to the Organization for Economic Co-operation and Development. That’s at least 50 percent more than Canada, Great Britain or Germany, all of which spend less than 12 percent of G.D.P. on health care. A blueprint to improve health care for minorities With so many advances in medical technologies and treatments, many of us are living longer and healthier lives. Too often, however, how long we live and what we die of are largely determined by the color of our skin, our gender and where we live. Despite all the progress minorities have made over the past few decades in areas of employment, education and politics — health remains an area of significant disparity. Bill would open hospital board meetings in Vt. A leading advocate for single-payer healthcare in Vermont is pushing legislation that would require that hospital board meetings be subject to the state's open meeting law. Dr. Deb Richter of the Vermont chapter of Physicians for a National Health Program, says Vermont's hospitals spend about $2 billion a year, much of it coming from taxpayers who support public health insurance programs. Va. Medicaid panel faces contentious task There are blue-ribbon commissions and task forces in Virginia government that have done little more than huddle in conference rooms and pack hundreds of pages of dense bureaucratic jargon into binders set on backroom bookshelves or in forgotten archives boxes. There they gather dust for generations. The new Medicaid Innovation and Reform Commission won't have that luxury, provided it survives its infancy. Republicans revisit Medicare reform to cut spending Fired up as once-unimaginable spending cuts start to slice the federal budget, Republicans are launching a new phase in their austerity campaign — resurrecting the party's cost-cutting plan to turn Medicare into a voucher-like system for future seniors. Despite public uncertainty Saturday about the $85 billion in so-called sequester cuts, Republicans now believe they have momentum to ask Americans to make tough choices on Medicare, as rising healthcare costs combine with an aging population to form a growing part of future deficits. Perry standing pat on Medicaid expansion If Texas Gov. Rick Perry is feeling pressure to expand healthcare coverage to more than 1.5 million people under Medicaid, he sure isn't showing it. As the Republican governors of Florida, Ohio, New Jersey and Michigan dial back their opposition to the Affordable Care Act, more eyes are turning to the governor's antebellum mansion in Austin to see what he will do. Utah's governor still mulling Medicaid expansion About 100 people strolled into the lobby of Utah Gov. Gary Herbert's office Friday and piled up colorful paper-link chains meant to represent the state's uninsured that would be covered by Medicaid expansion. "Say yes to Medicaid expansion," the group chanted, standing in a circle around the pile. CMS: Hospital Readmissions Down to 17.8% Yesterday, CMS said President Barack Obama's 2010 healthcare law, the Patient Protection and Affordable Care Act has contributed to a significant drop in hospital readmissions for Medicare patients. Jonathan Blum, deputy administrator director of CMS, released the new figures at a Senate Finance Committee hearing yesterday, saying the law has already made "significant progress" in improving the U.S. health system. CMS issues rules on insurance program for small businesses The CMS issued both final and proposed rules Friday governing an insurance marketplace for businesses with fewer than 100 employees. The Small Business Health Options Program, created under the healthcare reform law, will offer a marketplace of insurance plan options for small businesses beginning in 2014. States will have the option to allow businesses with more than 100 employees to purchase coverage through the SHOP Exchanges beginning in 2017. Obama Clarifies Part of Health Law The Obama administration on Friday released new rules aimed at smoothing the rollout of a piece of the 2010 federal health-care law designed to give Americans more insurance options. Federal officials said insurers that get a contract to offer a so-called multistate plan will have to adhere to most of the insurance laws in each state, but in some cases they would be allowed to use a federally approved package of benefits rather than replicating ones set for each state. Liberty Counsel files brief in Affordable Care Act Liberty Counsel filed an appellate brief this week in its case against the Patient Protection and Affordable Care Act. Liberty Counsel represents Liberty University and two individuals in the case, Liberty University V. Geithner. Liberty Counsel argues the federal law in unconstitutional. Liberty University, which employs more than 5,000 people, has said the act forces employers — including religious institutions — to fund abortions. Health care overhaul rolls on despite budget havoc Airline schedules, food inspections, IRS taxpayer assistance and deployments of Navy ships could all be hampered by the government's automatic spending cuts. But President Barack Obama's health care law - a program Republicans have spent the last three years trying to kill - will roll out on time, the administration says. Nurse Practitioners Say How They’re Paid Affects Care They Can Provide Many nurse practitioners say restrictive payment policies impact how they care for patients more than state laws governing what care they can give, according to a new study. In the study, published Thursday by the National Institute for Health Care Reform, researchers found that while so-called “scope of practice” laws did not appear to restrict the primary care services nurse practitioners can provide to patients, they do affect how the advanced nurses are paid. ----------
|