Idaho Senate Passes Otter's Insurance Exchange Bill
Magic Valley Times-News
February 22, 2013
http://magicvalley.com/news/local/govt-and-politics/idaho-senate-passes-otter-s-insurance-exchange-bill/article_8b95a3fa-7c7b-11e2-8fc8-0019bb2963f4.html
After a six-hour debate, Gov. C.L. "Butch" Otter has cleared another hurdle in his goal to set up an insurance exchange in Idaho. On Thursday afternoon, the Senate voted 23-12 to pass the bill, which would set up a state-based exchange in Idaho. Of Magic Valley’s five senators, all voted for the bill.
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Obama administration finalizes popular pieces of healthcare law
The Hill
February 22, 2013
http://thehill.com/blogs/healthwatch/health-reform-implementation/284399-obama-administration-finalizes-popular-pieces-of-healthcare-law
The Obama administration finalized some of the most politically popular parts of its signature healthcare law Friday, including new protections for people with pre-existing conditions.
The Health and Human Services Department released final rules implementing provisions of the Affordable Care Act that require insurers to cover people with pre-existing conditions and prohibit them from charging higher prices to those customers.
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Insurers: New rules will cause health costs to spike 'overnight'
The Hill
February 22, 2013
http://thehill.com/blogs/healthwatch/health-reform-implementation/284447-insurers-new-rules-will-cause-health-costs-to-spike-overnight
Regulations the Obama administration finalized on Friday will lead to a steep and sudden increase in healthcare costs for young people, the health insurance industry said.
America's Health Insurance Plans (AHIP) criticized the Health and Human Services Department for moving ahead with new restrictions on how insurers set their premiums.
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APNewsBreak: Govs to hear Oregon health care plan
San Francisco Gate
February 22, 2013
http://www.sfgate.com/news/medical/article/APNewsBreak-Govs-to-hear-Oregon-health-care-plan-4298620.php
Oregon Gov. John Kitzhaber will brief other state leaders this weekend on his plan to lower Medicaid costs, touting an overhaul that President Barack Obama highlighted in his State of the Union address for its potential to lower the deficit even as health care expenses climb.
The Oregon Democrat leaves for Washington, D.C., on Friday to pitch his plan that changes the way doctors and hospitals are paid and improves health care coordination for low income residents so that treatable medical problems don't grow in severity or expense.
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Mass. receives $44m to further health care overhaul
The Boston Globe
February 21, 2013
http://bostonglobe.com/lifestyle/health-wellness/2013/02/21/massachusetts-receives-million-further-health-care-overhaul/Yfq8HGopSIUqI0A6K4QS0L/story.html
Massachusetts will receive up to $44 million in federal money over three and a half years to continue ongoing efforts to change the state’s health care system. The Centers for Medicare & Medicaid Services announced Thursday that it would distribute $250 million to six states that are trying new methods of delivering care to people enrolled in government health care programs serving children, the poor, and the elderly.
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Maine wins $33 million to test health care innovations
Bangor Daily News
February 21, 2013
http://bangordailynews.com/2013/02/21/health/maine-wins-33-million-to-test-health-care-innovations/
Maine will receive up to $33 million from the federal government over the next three and a half years to test a plan to improve residents’ health care while cutting costs. Maine and five other states are the first recipients of more than $250 million in funding awards made under the federal Affordable Care Act, the U.S. Department of Health and Human Services announced Thursday. The money is designed to help states find new ways of paying for and delivering health care that could ultimately lower costs for Medicare, Medicaid and the Children’s Health Insurance Program while making those programs’ beneficiaries healthier.
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The GOP Splits Over Pressure to Slash Defense Budget
The Wall Street Journal
February 21, 2013
http://online.wsj.com/article/SB10001424127887323864304578318571638725986.html?KEYWORDS=medicare
Republicans head into the next budget battle with President Barack Obama torn between two long-standing goals: Strengthening the military and cutting federal spending. The prospect of deep cuts in defense is troubling to many in the party, which has traditionally supported robust defense spending. But increasingly, that impulse is giving way to arguments from GOP lawmakers, many of them new to Congress, who say the most important goal is to rein in federal deficits. They believe that steep, across-the-board spending cuts due to hit on March 1, while an imperfect tool, are the only way to accomplish their goal.
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HHS Secretary Sebelius says states are finding Medicaid expansion too good to pass up
The Washington Post
February 21, 2013
http://www.washingtonpost.com/politics/health_care/hhs-secretary-sebelius-says-states-are-finding-medicaid-expansion-too-good-to-pass-up/2013/02/21/c550ae58-7c5f-11e2-9073-e9dda4ac6a66_story.html
A day after Florida’s Republican governor endorsed a key part of the federal health care overhaul, the Obama administration says it’s encouraged by the progress. Health and Human Services Secretary Kathleen Sebelius says that states are deciding the Medicaid expansion is, quote, “simply too good to pass up.”
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Governors Fall Away in G.O.P. Opposition to More Medicaid
The New York Times
February 21, 2013
http://www.nytimes.com/2013/02/22/us/politics/gop-governors-providing-a-lift-for-health-law.html?emc=tnt&tntemail0=y
Under pressure from the health care industry and consumer advocates, seven Republican governors are cautiously moving to expand Medicaid, giving an unexpected boost to President Obama’s plan to insure some 30 million more Americans. The Supreme Court ruled last year that expanding Medicaid to include many more low-income people was an option under the new federal health care law, not a requirement, tossing the decision to the states and touching off battles in many capitols.
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Brown may forge alliance with GOP governors on health plan
Los Angeles Times
February 21, 2013
http://www.latimes.com/health/la-me-brown-healthcare-20130222,0,6307532.story
When Gov. Jerry Brown meets with the nation's other governors this weekend in Washington, D.C., he will find common ground with some unlikely counterparts on an unlikely issue: President Obama's healthcare plan. Among the governors now moving nearly as aggressively as Brown to implement the federal healthcare law are conservatives who have long fought to unravel it. They are finding that they cannot afford to pass up Obama's offer of billions of dollars in federal aid to cover expansion of their Medicaid programs for the poor.
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LTE: How Can We Make Health Care Work?
The New York times
February 21, 2013
http://www.nytimes.com/2013/02/22/opinion/how-can-we-make-health-care-work.html?_r=0
David Goldhill’s solution of catastrophic health insurance would not significantly reduce costs but would leave millions of Americans with inadequate health care. Health costs are highly concentrated. The top 50 percent of health care spenders account for more than 97 percent of health expenditures. Almost all of their “catastrophic” spending would still be insured, presumably by the government.
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Is Wal-Mart On The Forefront Of Health Care?
Medical Daily
February 21, 2013
http://www.medicaldaily.com/articles/14113/20130221/walmart-sams-club-solohealth-healthspot-kiosk-healthcare-obamacare.htm
Wal-Mart has started installing machines that test weight, blood pressure and eyesight at "SoloHealth" stations. The company that makes the kiosks is taking advantage of the oncoming waves of people who will soon become insured and will put increased demand on primary health care in the United States. This has spurned new innovations in cheaper and more convenient care.
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House of Representatives approves healthcare compact bill
Alabama Blog
February 21, 2013
http://blog.al.com/wire/2013/02/house_of_representatives_appro_2.html
Representatives approved another bill in opposition to the Affordable Care Act that would authorize a compact with other states to regulate healthcare. The bill by Rep. Mike Ball, R-Madison, would authorize Alabama to form a compact with other states to bypass federal regulations and let states administer programs like Medicaid through block grants. Under the idea, states would get a block grant equal to the amount of federal healthcare dollars given to their state, and states would be freed from federal regulations on how to spend the money.
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The GOP split on Obamacare
Politico
February 21, 2013
http://www.politico.com/story/2013/02/governors-on-aca-ideologues-vs-pragmatists-87879.html?hp=t2_3
The next stage of Obamacare is shaping up into a fight between two camps of Republican governors sure to duke it out in the 2016 presidential primary — ideologues versus pragmatists.
The ideological purists are big-name Southern governors — like Bobby Jindal, Nikki Haley, Bob McDonnell and Rick Perry — who have all said “hell no” to major pieces of the law, even turning down free federal cash to expand Medicaid in their states.
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Exclusive: An interview with Marilyn Tavenner, Obama’s pick to head Medicare
The Washington Post
February 21, 2013
http://www.washingtonpost.com/blogs/wonkblog/wp/2013/02/21/exclusive-an-interivew-with-marilyn-tavenner-obamas-pick-to-head-medicare/
For over a year now, Marilyn Tavenner has run the federal government’s largest agency: the Centers for Medicare and Medicaid Services. With a budget of nearly $1 trillion, Tavenner oversees everything from the implementation of the Affordable Care Act to programs that already administer health benefits to more than 80 million Americans. The White House nominated Tavenner for the post in November 2011, but with the fight over the Affordable Care Act still winding its way up to the Supreme Court, she never received a confirmation hearing. She was then renominated in January, and a hearing now looks likely.
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Doctor Groups Unite Against Unnecessary Tests & Procedures
Kaiser Health News
February 21, 2013
http://capsules.kaiserhealthnews.org/
Doctors do stuff — tests, procedures, drug regimens and operations. It’s what they’re trained to do, what they’re paid to do and often what they fear not doing. So it’s pretty significant that a broad array of medical specialty groups is issuing an expanding list of don’ts for physicians.
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7 Eye-Popping Details From The TIME Cover Story On Health Care Costs
Business Insider
February 21, 2013
http://www.businessinsider.com/time-health-care-costs-2013-2
In a new Time Magazine cover story, reporter Steven Brill writes a rather lengthy piece about the huge problem with health care costs in the United States.
The piece, titled "Bitter Pill: Why Medical Bills Are Killing Us," goes in-depth on the big problems facing hospitals, insurance companies, and the pharmaceutical industry — with patients often bearing the burden.
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Health-Plan Details Unveiled
The Wall Street Journal
February 20, 2013
http://online.wsj.com/article/SB10001424127887323549204578316471980409116.html?KEYWORDS=health+law
Health-insurance plans that cover tens of millions of Americans will have to pay for mental-health and substance-abuse treatments starting next year under federal rules the Obama administration finalized Wednesday. The provision, part of the 2010 Affordable Care Act, requires health plans for individuals and small businesses to cover 10 categories of services, including prescription drugs, maternity care and physical rehabilitation. Many of the specifics of what is covered in those categories will be left to states to decide.
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HHS releases rule on insurers' essential health benefits
USA Today
February 20, 2013
http://www.usatoday.com/story/news/nation/2013/02/20/essentialhealthbenefitsfinalrule/1933015/
The Department of Health and Human Services released its long-awaited final rule on essential health benefits today, allowing insurers and states to move forward on both the federal and state health exchanges. The rule defines what must be covered in exchange plans, prohibits discrimination based on age or pre-existing conditions, describes prescription drug benefits and determines levels of coverage.
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Affordable Care Act clears another hurdle toward implementation
The Washington Post
February 20, 2013
http://www.washingtonpost.com/business/economy/affordable-care-act-cleared-another-hurdle-toward-implementation/2013/02/20/6d89f99a-7bb0-11e2-82e8-61a46c2cde3d_story.html
President Obama’s Affordable Care Act cleared another hurdle toward implementation Wednesday when one of its fiercest opponents, Florida Gov. Rick Scott, embraced a key pillar of the law by voicing support for its critical Medicaid expansion component. Scott joins six other Republican governors who have recently come to back a provision meant to extend coverage to 17 million Americans nationwide.
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Florida Governor Now Supports Broader Medicaid
The Wall Street Journal
February 20, 2013
http://online.wsj.com/article/SB10001424127887323864304578316711049299402.html?KEYWORDS=medicaid
Florida Republican Gov. Rick Scott reversed course Wednesday and said he wants the state to expand Medicaid under the federal health law. That makes him the seventh GOP governor to back an expansion of the federal-state health program for the poor, including Ohio Gov. John Kasich and Michigan Gov. Rick Snyder. About 25 governors have expressed support for such a move.
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McDonnell to budget panel: No Medicaid expansion absent federal and state cost cutting reforms
The Washington Post
February 20, 2013
http://www.washingtonpost.com/business/mcdonnell-to-budget-panel-no-medicaid-expansion-absent-federal-and-state-cost-cutting-reforms/2013/02/20/3ec44096-7bc6-11e2-b147-36af0e207220_story.html
Gov. Bob McDonnell warned state legislative negotiators on Wednesday not to expand Medicaid in Virginia without major federal and state cost reductions first. McDonnell wrote to the legislature’s top budget chiefs — Senate Finance Committee chairman Walter A. Stosch and House Appropriations Committee chairman Lacey E. Putney — as they and 10 other negotiators grappled with Medicaid expansion, the largest remaining obstacle to reaching a budget compromise in time for Saturday’s final adjournment.
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Florida governor relents, will expand Medicaid under health care overhaul
The Washington Times
February 20, 2013
http://www.washingtontimes.com/news/2013/feb/20/florida-to-expand-medicaid-under-health-overhaul/
Florida Gov. Rick Scott on Wednesday became the latest Republican to green-light the expansion of Medicaid under President Obama’s health care law, a move that follows in the footsteps of other state leaders who opposed the president’s reforms and then accepted federal dollars to insure more low-income residents. Mr. Scott is the seventh Republican governor to support an expansion of Medicaid, after notable “Obamacare” critics such as Arizona Gov. Jan Brewer and Ohio Gov. John Kasich extended the entitlement program to those earning up to 133 percent of the federal poverty level.
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Rick Scott caves on healthcare opposition
Salon
February 20, 2013
http://www.salon.com/2013/02/20/rick_scott_caves_on_health_care_opposition/
After years of vocal resistance, Florida Republican Gov. Rick Scott, one of the country’s most outspoken critics of the Affordable Care Act, has acceded to one of the law’s core provisions, agreeing today to expand Medicaid coverage to 1.3 million Floridians. Scott, a former healthcare executive, started an advocacy group to fight the health law before being elected governor, and has continued fighting the law ever since. He joined with other Republican governors to oppose the ACA’s Medicaid expansion, arguing that it would be too expensive for their states, and took his legal challenge all the way to the Supreme Court.
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Report: Universal theme park will quit offering healthcare to part-time workers
The Hill
February 20, 2013
http://thehill.com/blogs/healthwatch/health-reform-implementation/283957-report-universal-theme-park-will-quit-offering-healthcare-to-part-time-workers
A 17,000-employee Florida theme park says it's dropping healthcare benefits for part-time workers as a result of President Obama's healthcare law.
Universal Orlando will quit offering coverage because its bare-bones plan is about to become illegal, according to a report in the Orlando Sentinel.
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ACA mental-health plan’s growing pains
Politico
February 20, 2013
http://www.politico.com/story/2013/02/aca-mental-health-plans-growing-pains-87803.html?hp=r14
The Newtown, Conn., killings brought plenty of calls from policymakers to beef up public mental health programs. The Affordable Care Act is trying to do just that — so far, with modest success. Aided by the health care law, some states have already put in place a model that creates a dramatically different way of caring for Medicaid mental health patients. But if the slow state uptake of the program is any indication, the patterns of spotty care for most low-income people with big mental health problems won’t change quickly.
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Pressure Rising To Avoid Federal Spending Cuts That Will Impact Health Programs
Kaiser Health News
February 20, 2013
http://www.kaiserhealthnews.org/Stories/2013/February/20/sequester-health-cuts.aspx
Pressure is mounting for Washington to find a way to avoid the automatic spending reductions set to begin March 1, with President Barack Obama Tuesday urging Congress to stop the "meat-cleaver approach" that he says will undermine U.S. military strength and "eviscerate job creating investments in education and energy and medical research."
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New healthcare rule expands benefits for substance abuse, mental disorders
The Hill
February 20, 2013
http://thehill.com/blogs/regwatch/healthcare/284005-new-health-care-regulation-expands-benefits-for-substance-abuse-mental-disorders
The Obama administration on Wednesday finalized a key Affordable Care Act rule predicted to expand substance abuse and mental disorder benefits to 62 million Americans. The rule, to take effect next year, lays out new “essential health benefits” standards for insurers, as required by the landmark legislation. It was designed to allow consumers a simplified and consistent way to shop for, and enroll in, healthcare plans that best suit them.
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EHR use tied to more women's health tests: study
Modern Healthcare
February 20, 2013
http://www.modernhealthcare.com/article/20130220/NEWS/302209954/ehr-use-tied-to-more-womens-health-tests-study
Primary-care providers who use electronic health records are more likely to order routine women's health tests than those without the systems, according to a study. The report in the Journal of the Medical Informatics Association is the latest to show that electronic systems increase healthcare utilization. And it found that the more sophisticated the EHR system, the more likely a clinician was to order screening tests such as breast and pelvic examinations, Pap smears, cholesterol tests, mammograms and bone mineral density tests, among others.
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Florida Senators Say No to State Run Health Care Exchange
Sunshine State News
February 19, 2013
http://www.sunshinestatenews.com/story/florida-senators-say-no-state-run-health-care-exchange
The committee reviewing how Florida should respond to the federal health-care law agreed Monday not to pursue setting up a state run exchange. At least, not for the next year or two. Meanwhile, a decision on the massive expansion of Medicaid’s managed care program in Florida is now tentatively set for March 4, the day before the 2013 regular session begins.
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With Cutbacks Days Away, Obama Tries to Pressure G.O.P.
The New York Times
February 19, 2013
http://www.nytimes.com/2013/02/20/us/politics/obama-to-turn-up-pressure-for-deal-on-budget-cuts.html?emc=tnt&tntemail0=y&_r=0
Days away from another fiscal crisis and with Congress on vacation, President Obama began marshaling the powers of the presidency on Tuesday to try to shame Republicans into a compromise that could avoid further self-inflicted job losses and damage to the fragile recovery. But so far, Republicans were declining to engage.
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Business owners urge Congress to take Medicare, Social Security cuts off the table
The Washington Post
February 19, 2013
http://www.washingtonpost.com/business/on-small-business/business-owners-urge-congress-to-take-medicare-social-security-cuts-off-the-table/2013/02/19/8ed17e6c-7add-11e2-82e8-61a46c2cde3d_story.html
Mike Roach checks customers’ purchase history every time he rings up a sale in his store, and in the past few months, he has noticed a pattern that bodes well for business. “I always pull up the data, and every day, there’s someone who hasn’t set foot in the store in four or five years,” said Roach, who with his wife has owned Paloma Clothing in Portland, Ore. for four decades. “They are gradually drifting back to our store as they regain confidence in their own economic situations and in the future of the economy.”
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How The Sequester Could Affect Health Care
NPR
February 19, 2013
http://www.npr.org/blogs/health/2013/02/19/172415025/how-the-sequester-could-affect-health-care
It's looking increasingly likely that $85 billion of automatic federal budget cuts known as a sequester will come to pass if Congress doesn't act by March 1. Congress and President Obama agreed on the cuts, which will be divided evenly between defense and domestic programs, including health care, back in the summer of 2011 as part of a last-ditch effort to force a deficit-reduction deal and avert a debt limit default.
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Simpson and Bowles Offer Up Deficit Fix
The Wall Street Journal
February 19, 2013
http://online.wsj.com/article/SB10001424127887323949404578312900950865818.html?mod=WSJ_hps_LEFTTopStories
Deficit hawks Alan Simpson and Erskine Bowles on Tuesday proposed a detailed plan for rewriting the tax code and implementing deep new spending cuts, hoping to offer a path to compromise for Democrats and Republicans. Messrs. Simpson and Bowles served as co-chairmen of the White House's 2010 deficit-reduction panel, which put together a bipartisan package of tax and spending changes that fell flat after the administration and congressional leaders took a look.
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CMS proposes Medicare plan MLR rules
Life Health Pro
February 19, 2013
http://www.lifehealthpro.com/2013/02/19/cms-proposes-medicare-plan-mlr-rules
The Centers for Medicare & Medicaid Services (CMS) is preparing to apply minimum medical loss ratio (MLR) requirements to providers of private Medicare plans. CMS plans to publish a proposed Medicare MLR rule (CMS-4173-P) in the Federal Register Feb. 22.
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Obama presses Congress for stopgap sequester fix
The Washington Post
February 19, 2013
http://www.washingtonpost.com/business/economy/obama-to-press-for-sequester-fix/2013/02/19/e647cd70-7a5d-11e2-82e8-61a46c2cde3d_story.html
President Obama urged Congress on Tuesday to pass a measure to delay for the rest of the year a series of automatic cuts to defense and other spending that is to take effect March 1. Speaking with fresh urgency at the White House, surrounded by firefighters and other emergency personnel, Obama said the automatic cuts, known as the sequester, would do great damage to the economy and must be avoided.
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Health Insurers Tumble Amid Medicare Proposal
The Wall Street Journal
February 19, 2013
http://online.wsj.com/article/SB10001424127887323495104578314322115844336.html?KEYWORDS=medicare
The late-Friday proposal is open to outside comments until March 1, ahead of a final announcement due April 1, so there is time for the industry to lobby for less pressure on rates. Insurers see Medicare Advantage—their version of the government health plan for seniors—as a key growth area, but expanding any presence there means taking on exposure to government payment decisions. The new proposal from the Centers for Medicare and Medicaid Services is "sharply unfavorable" and "significantly worse than expected," Goldman Sachs GS +1.71% analyst Matthew Borsch said in a note to investors.
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Healthcare CIOs see even bigger challenges beyond meaningful use
Modern Healthcare
February 19, 2013
http://www.modernhealthcare.com/article/20130219/NEWS/302199953/healthcare-cios-see-even-bigger-challenges-ahead-survey
Chief information officers in healthcare are caught between their immediate concerns and the unknown challenges of future healthcare payment reforms, but without all the information they'll need to steer their course. Consultants with the Deloitte Center for Healthcare Solutions summarize the findings of interviews with a dozen CIOs of major healthcare systems in a just-released, 11-page white paper, “Health System Chief Information Officers: Juggling Responsibilities, Managing Expectations, Building the Future.”
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Okla. panel approves rejection of health care law
San Francisco Chronicle
February 19, 2013
http://www.sfgate.com/news/article/Okla-panel-approves-rejection-of-health-care-law-4291612.php
A state legislator called on his colleagues Tuesday to formally reject federal health care reform, arguing that Oklahoma should add its voice to a growing chorus of opposition to the law.
Legislation from Rep. Mike Ritze, R-Broken Arrow, would essentially declare President Barack Obama's health care law unconstitutional and void in the state. Although it would carry little weight, Ritze argued that approval of the measure would add Oklahoma to the list of states showing they oppose the law, which was upheld by the U.S. Supreme Court last year.
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AHA Supports Marilyn Tavenner as CMS Chief
Becker’s Hospital Review
February 18, 2013
http://www.beckershospitalreview.com/legal-regulatory-issues/aha-supports-marilyn-tavenner-as-cms-chief.html
The American Hospital Association has written a letter to Senator Max Baucus (D), chairman of the Senate Finance Committee, supporting the nomination of Marilyn Tavenner as CMS administrator. In the letter, AHA President and CEO Rich Umbdenstock cited Ms. Tavenner's accomplishments as acting CMS administrator, including reducing red tape and regulatory burdens, spearheading the Partnership for Patients initiative, which has helped hospitals reduce infection rates, and pioneering new payment methods.
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Health-care-law backers worry about jump in premiums
Seattle Times
February 18, 2013
http://seattletimes.com/html/nationworld/2020384158_healthcostsxml.html
Less than a year before Americans will be required to have insurance under President Obama’s health-care law, many of its backers are growing increasingly anxious that premiums could jump, driven up by the legislation itself. Higher premiums could undermine a core promise of the Affordable Care Act: to make basic health protections available to all Americans for the first time. Major rate increases also threaten to cause a backlash just as the law is supposed to deliver many key benefits Obama promised when he signed it in 2010.
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Home Care Challenge: Retaining Workers, Keeping Costs Low
Hartford Courant
February 18, 2013
http://www.courant.com/health/connecticut/hc-home-health-care-20130218,0,2666357.story
Debbie Hardy, a home health care aide, is the reason that Frank Geraldino, 48, a paraplegic, is able to live in his Seymour apartment – rather than in a nursing facility. Hardy, of Ansonia, is an independent worker providing in-home personal care services, such as bathing and feeding, for people with serious disability. Medicaid covers the bill, but the patients are technically the employers, hiring and scheduling their own in-home care.
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Ky. insurance exchange grows into $39.5M operation
Modern Healthcare
February 18, 2013
http://www.modernhealthcare.com/article/20130218/INFO/302179998/ky-insurance-exchange-grows-into-39-5m-operation
Federal healthcare reforms have led to the creation of a government agency in Kentucky that will be comparable in staffing to the secretary of state's office with 30 employees but that has scores of contract workers and an annual budget more than 10 times larger at $39.5 million. The Office of the Kentucky Health Benefits Exchange, housed in a nondescript brown building as square as a Wal-Mart store on the outskirts of Frankfort, will help more than 600,000 uninsured Kentuckians arrange coverage under the Affordable Care Act.
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Healthcare reform: What should the medical device industry expect from the Sunshine Act?
Mass Device
February 18, 2013
http://www.massdevice.com/news/healthcare-reform-what-should-medical-device-industry-expect-sunshine-act
Medical device companies should brace for some unintended consequences now that the Centers for Medicare & Medicaid Services rules on the Physician Payment Sunshine Act are set: the overhead costs associated with compliance were slighted in the government insurance agency's reckoning.
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CMS Issues Rules on Loss Ratios for Medicare Plans
Medpage Today
February 18, 2013
http://www.medpagetoday.com/Washington-Watch/Reform/37415
Rules that spell out what Medicare plans must spend on care rather than marketing and overhead will mirror those of commercial plans, the Obama administration said late Friday. Starting in 2014, Medicare Advantage plans and Part D prescription drug plans will have to spend 85% of revenue on clinical services, prescription drugs, quality improvements, and other direct patient benefits, the Centers for Medicare and Medicaid Services (CMS) said in a proposed rule that details medical loss ratio (MLR) requirements established by the Affordable Care Act (ACA).
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States worry about rate shock during shift to new health law
Los Angeles Times
February 18, 2013
http://www.latimes.com/health/la-na-insurance-costs-20130218,0,1731504.story
Less than a year before Americans will be required to have insurance under President Obama's healthcare law, many of its backers are growing increasingly anxious that premiums could jump, driven up by the legislation itself. Higher premiums could undermine a core promise of the Affordable Care Act: to make basic health protections available to all Americans for the first time. Major rate increases also threaten to cause a backlash just as the law is supposed to deliver many key benefits Obama promised when he signed it in 2010.
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Health Benefits Are Cutting Your Pay
Real Clear Politics
February 17, 2013
http://www.realclearpolitics.com/2013/02/17/health_benefits_are_cutting_your_pay_302146.html
Not long ago, a 23-year-old woman joined my company as an assistant in the advertising sales department at a starting salary of $35,000. Smart, ambitious and poised, she should have a promising future. Unfortunately, her earnings prospects are threatened. Like many Americans, she’s unaware of how much of her compensation is being eaten up by health care costs, and how much this share will grow as long as the increase in health costs exceeds growth in gross domestic product. That’s just math.
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Some Employers Could Opt Out of Insurance Market, Raising Others’ Costs
The New York Times
February 17, 2013
http://www.nytimes.com/2013/02/18/us/allure-of-self-insurance-draws-concern-over-costs.html
Federal and state officials and consumer advocates have grown worried that companies with relatively young, healthy employees may opt out of the regular health insurance market to avoid the minimum coverage standards in President Obama’s sweeping law, a move that could drive up costs for workers at other companies. Companies can avoid many standards in the new law by insuring their own employees, rather than signing up with commercial insurers, because Congress did not want to disrupt self-insurance arrangements that were seen as working well for many large employers.
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Maine gets pieces in place for health care law
San Francisco Gate
February 17, 2013
http://www.sfgate.com/news/article/Maine-gets-pieces-in-place-for-health-care-law-4285804.php
Though Maine has not embraced all of the components of the federal health care overhaul, the state is still ahead of most others preparing for changes coming next year, an analysis shows.
Maine is one of 11 states, including New Hampshire and Vermont, to approve at least some of the Affordable Care Act's so-called market reforms, according to the Commonwealth Fund, a private group that promotes improved health care.
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NY state needs 1,200 more family docs to support healthcare reform
MedCity News
February 17, 2013
http://medcitynews.com/2013/02/ny-state-needs-1200-more-family-docs-to-support-healthcare-reform/
A persistent dearth of doctors in most of New York could slow the implementation of health care reform unless something is done to alleviate the shortage, a new analysis has concluded. The biggest inadequacy is in the number of primary care physicians, who now represent only 18 percent of all doctors statewide, according to a report titled "Doctor Shortage: Condition Critical" by the Healthcare Association of New York State, which writes policy on a variety of health care issues.
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States' choices set up national health experiment
Modern Healthcare
February 17, 2013
http://www.modernhealthcare.com/article/20130217/INFO/302179997/states-choices-set-up-national-health-experiment
President Barack Obama's healthcare overhaul is unfolding as a national experiment with American consumers as the guinea pigs: Who will do a better job getting uninsured people covered, the states or the feds? The nation is about evenly split between states that decided by Friday's deadline they want a say in running new insurance markets and states that are defaulting to federal control because they don't want to participate in "Obamacare." That choice was left to state governments under the law: Establish the market or Washington will. (See interactive map and other features.)
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Montgomery County sets Affordable Care Task Force
Dayton Daily News
February 17, 2013
http://www.daytondailynews.com/news/news/local-govt-politics/montgomery-county-sets-affordable-care-task-force/nWPrT/
The Patient Protection and Affordable Care Act guarantees health insurance for most Americans by 2014, including the approximately 80,000 uninsured Montgomery County residents. Montgomery County Commissioners want to develop a plan for implementing health care reform here and to make sure the health care delivery system can handle the expected influx of patients.
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Health care reforms: What’s in store in N.C.?
News-Record
February 17, 2013
http://www.news-record.com/news/756017-91/health-care-reforms-whats-in
Even at their best, Medicaid and health care reforms seem like a complicated mess. Throw in years of questionable state software projects, damning audits and one of the most complex pieces of federal legislation in history — President Barack Obama’s health care overhaul is intrinsically tied to Medicaid — and the whole thing becomes nigh impossible to follow.
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Medicare Drug Costs to Be Reduced for Seniors, U.S. Says
Bloomberg
February 16, 2013
http://www.bloomberg.com/news/2013-02-15/medicare-drug-costs-to-be-reduced-for-seniors-u-s-says.html
The elderly and disabled enrolled in Medicare will pay less for drugs next year and insurers that offer plans with extra benefits will see taxpayer subsidies reduced because of record low spending growth, the U.S. said. The standard deductible for Medicare’s drug program, called Part D, will be $310 in 2014, about 4.6 percent less than this year, the Centers for Medicare and Medicaid Services said in a statement. Copayments also will be reduced for the program that began in 2006.
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CMS issues proposed Medicare Advantage, Part D regs
Modern Healthcare
February 15, 2013
http://www.modernhealthcare.com/article/20130215/NEWS/302159959/cms-issues-proposed-medicare-advantage-part-d-regs’
The CMS issued proposed terms for insurers participating in the Medicare Advantage Part C insurance program—including a growth percentage benchmark of negative 2.2% that will be used to help determine 2014 capitation rates. The CMS also issued proposed beneficiary deductible levels, out-of-pocket thresholds, and coverage limits for Medicare Part D drug insurance program for 2014, as part of what the agency calls an advance notice and draft call letter.
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Will young adults face ‘rate shock’ because of the health-care law?
The Washington Post
February 15, 2013
http://www.washingtonpost.com/national/health-science/will-young-adults-face-rate-shock-because-of-the-health-care-law/2013/02/15/1a12bbae-70a6-11e2-a050-b83a7b35c4b5_story.html
Many young, healthy Americans could soon see a jump in their health insurance costs, and insurance companies are saying: It’s not our fault. The nation’s insurers are engaged in an all-out, last-ditch effort to shield themselves from blame for what they predict will be rate increases on policies they must unveil this spring to comply with President Obama’s health-care law.
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Federal Government To Run Insurance Marketplaces In Half The States
Kaiser Health News
February 15, 2013
http://www.kaiserhealthnews.org/Stories/2013/February/15/state-federal-exchange-partnership-deadline.aspx
It's official. The Obama administration will be running new health insurance marketplaces in at least 26 states— including the major population centers of Texas, Florida and Pennsylvania. The federal government had hoped more states this week would agree to form a partnership exchange—the deadline to apply was Friday—but the offer was largely rebuffed. New Jersey, Ohio and Florida, several of the biggest states that had not declared their intentions, officially said no late in the week.
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