A news report by Kaiser Health News says that children's hospitals are growing and this growth spurt has led to questions about spending. The report says that the hospitals have hired lobbyists to obtain ensure special treatment by Congress and ensure that the highest insurance rates are paid to their facilities.
Source: Kaiser Health News Article
Thursday, September 29, 2011
Survey: Physicians Say They Over-Treat Patients
A recent survey of physicians conducted by the VA Outcomes Group and the Dartmouth Institute for Health Policy and Clinical Practice reveals that they feel that they are over-treating their patients. Many physicians indicate that this is caused by pressures caused by the fear of malpractice suits, the realignment of financial incentives towards more aggressive treatment, and shortened time to spend with patients.
A report about the survey is published in the September 26 issue of Archives of Internal Medicine.
Source: Dartmouth Institute for Health Policy and Clinical Practice News Release
A report about the survey is published in the September 26 issue of Archives of Internal Medicine.
Source: Dartmouth Institute for Health Policy and Clinical Practice News Release
DOJ Requests Supreme Court Review of Health Care Reform Law
The U.S. Department of Justice (DOJ) requested that the United States Supreme Court review the constitutionality of President Obama's signature health care reform law after a 3 judge panel of the U.S. Court of Appeals for the 11th Circuit struck it down. The timing of the request virtually assures that a decision on the Affordable Care Act will come in the thick of next year's presidential campaign.
In a statement, DOJ stated:
“The Department has consistently and successfully defended this law in several court of appeals, and only the 11th Circuit Court of Appeals has ruled it unconstitutional. We believe the question is appropriate for review by the Supreme Court.
“Throughout history, there have been similar challenges to other landmark legislation such as the Social Security Act, the Civil Rights Act, and the Voting Rights Act, and all of those challenges failed. We believe the challenges to Affordable Care Act — like the one in the 11th Circuit — will also ultimately fail and that the Supreme Court will uphold the law.”
A Washington Post news story about the appeal may be viewed here.
Source: DOJ News Release
In a statement, DOJ stated:
“The Department has consistently and successfully defended this law in several court of appeals, and only the 11th Circuit Court of Appeals has ruled it unconstitutional. We believe the question is appropriate for review by the Supreme Court.
“Throughout history, there have been similar challenges to other landmark legislation such as the Social Security Act, the Civil Rights Act, and the Voting Rights Act, and all of those challenges failed. We believe the challenges to Affordable Care Act — like the one in the 11th Circuit — will also ultimately fail and that the Supreme Court will uphold the law.”
A Washington Post news story about the appeal may be viewed here.
Source: DOJ News Release
HHS launches new Affordable Care Act initiative to strengthen primary care
The U.S. Department of Health and Human Services (HHS) launched a new initiative made possible by the Affordable Care Act to help primary care practices deliver higher quality, more coordinated and patient-centered care. Under the new initiative, Medicare will work with commercial and state health insurance plans to offer additional support to primary care doctors who better coordinate care for their patients. This collaboration, known as the Comprehensive Primary Care initiative, is modeled after innovative practices developed by large employers and leading private health insurers in the private sector.
“Thanks to the Affordable Care Act, we are helping primary care doctors better coordinate care with patients so they get better care and we use our health care dollars more wisely,” said HHS Secretary Kathleen Sebelius.
The voluntary initiative will begin as a demonstration project available in five to seven health care markets across the country. Public and private health care payers interested in applying to participate in the Comprehensive Primary Care Initiative must submit a Letter of Intent by November 15, 2011. In the selected markets, Medicare and its partners will enroll interested primary care providers into the initiative.
Primary care practices that choose to participate in this initiative will be given support to better coordinate primary care for their Medicare patients.
This support will help doctors:
- Help patients with serious or chronic diseases follow personalized care plans;
- Give patients 24-hour access to care and health information;
- Deliver preventive care;
- Engage patients and their families in their own care;
- Work together with other doctors, including specialists, to provide better coordinated care.
CMS will pay primary care practices a monthly fee for these activities in addition to the usual Medicare fees that these practices would receive for delivering Medicare covered services. This collaborative approach has the potential to strengthen the primary care system for all Americans and reduce health care costs by using resources more wisely and preventing disease before it happens.
Across the country, systems which are based on comprehensive, higher-functioning primary care, similar to the strategy that CMS seeks to test in this initiative, show that patients are healthier and avoid having to seek care in more complex and expensive settings when primary care practices have the resources to better coordinate care, engage patients in their care plan, and provide timely preventive care. Large businesses have been able to make independent investments to promote more comprehensive primary care – improving the health of their employees and lowering their health care costs, thus making it easier for them to hire more workers and invest in their workforce.
“We know that when doctors have time to spend time with their patients and can better coordinate care with specialists, people are healthier and we have lower costs in the health care system,” said CMS Administrator Donald Berwick, M.D.
The Comprehensive Primary Care initiative is just one part of a wide-ranging effort by the Obama Administration to promote coordinated care and lower costs for all Americans, using important new tools provided by the Affordable Care Act. Accountable Care Organizations (ACOs) are another way that doctors, hospitals and other health care providers can work together to better coordinate care for patients, which can help improve health, improve the quality of care, and lower costs. Under the Bundled Payment initiative, payments for multiple services patients receive during an episode of care will be linked to help improve and coordinate care for patients while they are in the hospital and after they are discharged. The Partnership for Patients is bringing together hospitals, doctors, nurses, pharmacists, employers, unions, and state and federal government to keep patients from getting injured or sicker in the health care system and to improve transitions between care settings.
For more information, please see the Comprehensive Primary Care initiative web site at: http://innovations.cms.gov/areas-of-focus/seamless-and-coordinated-care-models/cpci/
For an overview fact sheet about the Comprehensive Primary Care initiative, visit: http://www.healthcare.gov/news/factsheets/2011/09/primary-care09282011a.html
Interested parties may obtain answers to specific questions by e-mailing CMS at: CPCi@cms.hhs.gov.
For more information about the CMS Innovation Center, please visit: http://www.innovations.cms.gov.
Source: HHS News Release
Study: Health Insurers Pushing Premiums Higher; Outpaces Worker Pay
After several years of relatively modest premium increases, annual premiums for employer-sponsored family health coverage increased to $15,073 this year, up 9 percent from last year, according to a recently released Kaiser Family Foundation/Health Research & Educational Trust 2011 Employer Health Benefits Survey. On average, workers pay $4,129 and employers pay $10,944 toward those annual premiums.
Premiums increased significantly faster than workers’ wages (2.1 percent) and general inflation (3.2 percent). Since 2001, family premiums have increased 113 percent, compared with 34 percent for workers’ wages and 27 percent for inflation.
"This year’s nine percent increase in premiums is especially painful for workers and employers struggling through a weak recovery," Kaiser President and CEO Drew Altman, Ph.D. said.
According to Maulik Joshi, Dr.P.H., president of HRET and senior vice president for research at the American Hospital Association, "survey findings related to the impact of early provisions in health reform provide valuable insight for employers, providers, consumers, and policymakers as they prepare for additional provisions to take effect by 2014."
The 13th annual Kaiser/HRET survey of small and large employers provides a detailed picture of trends in private health insurance costs and coverage. This year’s survey also looked at employers’ experiences with several already implemented provisions of the 2010 health reform law affecting employer coverage.
In particular, the survey estimates that employers added 2.3 million young adults to their parents’ family health insurance policies as a result of the health reform provision that allows young adults up to age 26 without employer coverage on their own to be covered as dependents on their parents’ plan. Young adults historically are more likely to be uninsured than any other age group.
"The law is helping millions of young adults to obtain health coverage. In the past, many of these young adults would have lost coverage when they left home or graduated college," said study lead author Gary Claxton, a Kaiser vice president and co-executive director of the Kaiser Initiative on Health Reform and Private Insurance.
The study also finds 31 percent of covered workers are in high-deductible health plans, facing deductibles for single coverage of at least $1,000, including 12 percent facing deductibles of at least $2,000. Covered workers in smaller firms (3-199 workers) are more likely to face such high deductibles, with half of workers in smaller firms facing deductibles of at least $1,000, including 28 percent facing deductibles of $2,000 or more.
These numbers in part reflect the rise of consumer-driven plans, which are high-deductible plans that include a tax-preferred savings options such as a Health Savings Account or Health Reimbursement Arrangement. Over the past two years, more firms have started to offer these plans, and the share of covered workers enrolled in this type of plan has doubled, from 8 percent in 2009 to 17 percent in 2011. Plans that can be used with a Health Savings Account have lower premiums than other plan types, but must have annual deductibles of at least $1,200 for an individual and $2,400 for a family this year.
The survey finds that 56 percent of covered workers are in "grandfathered" plans as defined under health reform. Grandfathered plans are exempted from some health reform requirements, including covering preventive benefits with no cost sharing and having an external appeals process. To obtain this status, employers cannot make significant changes to their plans that reduce benefits or increase employee cost.
One in four covered workers (23 percent) are in plans that changed their cost-sharing requirements for preventive services as a result of a requirement of the health reform law that non-grandfathered plans provide certain preventive benefits without cost sharing. In addition, 31 percent of covered workers are in plans that changed the list of preventive services due to health reform.
Other findings from the study include:
- Worker-only coverage. Premiums for worker-only health coverage increased 8 percent in 2011 to reach $5,429 annually. Workers on average pay $921 toward this coverage.
Offer rate. The share of firms offering health insurance to their workers is 60 percent this year, comparable to the levels in 2009 and earlier years. Last year’s survey found an unexplained sharp increase in the share of the smallest firms (3-9 workers) offering coverage, boosting the overall offer rate; this year’s results suggest that the one-year bump did not reflect a change in the long-term trend.
- Cost-sharing for office visits and drugs. Covered workers facing copayments for in-network physician office visits on average pay $22 for primary care and $32 for specialty care. For covered workers with three- and four-tier drug plans, average copayments are $10 for generic drugs, $29 for preferred brand-name drugs, $49 for non-preferred brand-name drugs, and $91 for specialty drugs.
- Retiree health benefits. Among large firms (200 or more workers), about one in four (26 percent) offer retiree health benefits in 2011, unchanged from last year and down significantly from 32 percent in 2007.
Full survey results are available online at http://ehbs.kff.org.
Now in its 13th year, the survey is a joint project of the Kaiser Family Foundation and the Health Research & Educational Trust. The survey was conducted between January and May of 2011 and included 3,184 randomly selected, non-federal public and private firms with three or more employees (2,088 of which responded to the full survey and 1,096 of which responded to a single question about offering coverage). A research team at Kaiser and HRET conducted and analyzed the survey, led by Kaiser’s Gary Claxton and including researchers at the NORC at the University of Chicago (working on the project under contract to HRET). For more information on the survey methodology, please visit the Survey Design and Methods Section at http://ehbs.kff.org.
A New York Times article on the study may be viewed here.
Source: Kaiser Family Foundation News Release
Monday, September 26, 2011
Report on Health Care Reform 1st Anniversary Issued
One year after the Affordable Care Act’s Patient’s Bill of Rights took effect, the U.S. Department of Health and Human Services (HHS) released a report summarizing some of the achievements of the health reform law. In the eighteen months since the president signed the Affordable Care Act into law, health reform has had a tangible effect in the lives of millions of Americans. The report discusses how the law is helping to give hardworking families the security they deserve and the reforms in the Affordable Care Act that have helped hold down insurance premiums, hold insurance companies more accountable and strengthen Medicare.
Recent reports, including the U.S. Census and the National Health Information Survey, have indicated that approximately one million additional young Americans now have insurance coverage due to the Affordable Care Act according to experts. The Patient’s Bill of Rights made it illegal for insurance companies to deny coverage to a child with a pre-existing condition or place a lifetime limit on the care they will provide. Through Affordable Care Act initiatives, 19 million seniors with Medicare have received new free preventive benefits, while efforts to cut fraud and abuse have extended the Medicare Trust Fund by 8 years, strengthening the Medicare program.
To read more about the many accomplishments of the law visit: http://www.healthcare.gov/law/resources/reports/patients-bill-of-rights09232011a.pdf
To read a blog commemorating the anniversary by Assistant Secretary for Public Affairs Richard Sorian visit: www.healthcare.gov/blog
Source: HHS News Release
Recent reports, including the U.S. Census and the National Health Information Survey, have indicated that approximately one million additional young Americans now have insurance coverage due to the Affordable Care Act according to experts. The Patient’s Bill of Rights made it illegal for insurance companies to deny coverage to a child with a pre-existing condition or place a lifetime limit on the care they will provide. Through Affordable Care Act initiatives, 19 million seniors with Medicare have received new free preventive benefits, while efforts to cut fraud and abuse have extended the Medicare Trust Fund by 8 years, strengthening the Medicare program.
To read more about the many accomplishments of the law visit: http://www.healthcare.gov/law/resources/reports/patients-bill-of-rights09232011a.pdf
To read a blog commemorating the anniversary by Assistant Secretary for Public Affairs Richard Sorian visit: www.healthcare.gov/blog
Source: HHS News Release
Wednesday, September 21, 2011
Task Force Recommendations on Health Text Messaging, Mobile Health Tech Released
The U.S. Department of Health and Human Services (HHS) announced new recommendations to support health text messaging and mobile health (mHealth) programs. The department has been actively exploring means to capitalize on the rapid proliferation of mobile phone technology and platforms, such as text messaging, to develop programs and/or partnerships with the overall aim of improving public health outcomes. The potential to provide citizens with an expansive level of access to health resources can help HHS achieve its goal of a healthier nation and help individuals and families get critical information that can improve -- and even save -- their lives.
In November 2010, HHS established the Text4Health Task Force as part of the agency’s commitment to promoting innovation at HHS. The task force, comprised of public health experts across HHS, was charged with providing recommendations for HHS’ role in encouraging and developing health text messaging initiatives which would deliver health information and resources to individuals via their mobile phones. The report recommends that: 1) HHS develop and host evidence-based health text message libraries that leverage HHS’ rich and scientifically-based information, 2) HHS develop further evidence on the effectiveness of health text messaging programs, and 3) HHS explore and develop partnerships to create, implement and disseminate health text messaging and mHealth programs.
The full HHS Text4Health Task Force recommendations are available for public comment at http://www.hhs.gov/open.
Since January 2010, and consistent with these recommendations, HHS has invested $5 million dollars to develop its eHealth/mHealth smoking cessation resources aimed at increasing quitting attempts among teens, young adults and adults. HHS launched several new initiatives that have been guided by the HHS Text4Health Task Force.
The National Cancer Institute (NCI) at the National Institutes of Health is launching the SmokeFreeTXT program, a mobile smoking cessation service specifically designed for teens and young adults across the United States. The service is an extension of the core smoking cessation website, www.smokefree.gov, which consistently achieves between 70,000 – 100,000 visits on a monthly basis. Teens and young adults in the U.S. can enroll in this program by visiting http://smokefree.gov/smokefreetxt/default.aspx.
“More than 70 percent of smokers want to quit, we are committed to providing evidence based information to smokers through emerging and innovative technology,” said HHS Secretary Kathleen Sebelius.
NCI is also launching a library of smoking cessation messages which provide the foundation for an interactive text-based intervention for adult smokers called QuitNowTXT. The QuitNowTXT text messages offer tips, motivation, encouragement and facts based on information tailored to the user’s response and are available at http://smokefree.gov/hp.aspx. These mobile texting resources will be integrated into the department’s comprehensive tobacco control strategy to further address the burden of tobacco use across our nation.
HHS is also pursuing opportunities to forge a global public-private partnership to make the QuitNowTXT program available to other countries to reach adult tobacco users. This initiative aims to collaborate with interested countries to support mHealth/text-based demonstration projects using this new text messaging resource, which are now freely available on the mHealth Alliance’s HealthUnbound.org website. Drawing on the experience gained from these demonstration projects, the countries and partners will identify and disseminate best practices for tobacco cessation mHealth/text-based interventions.
“Mobile device texting initiatives, like this one, have the potential to be a powerful tool to support tobacco cessation globally. Text messaging is widely available, inexpensive, and allows for immediate delivery of cessation information,” said HHS Chief Technology Officer Todd Park.
The QuitNowTXT initiative is consistent with the UN’s Political Declaration of the High Level Meeting on the Prevention and Control of Non-communicable Diseases, which calls upon member states to “encourage the development of multisectoral public policies that create equitable health promoting environments that empower individuals, families and communities to make healthy choices and lead healthy lives”.
A description of projects related to the HHS Text4Health Task Force recommendations can be found at: http://www.hhs.gov/open. The tobacco control message libraries, along with other libraries (smoking cessation for pregnant women, early childhood health, emergency response, etc.) will also be available to the public on HealthData.gov in the future.
Source: HHS Press Release
In November 2010, HHS established the Text4Health Task Force as part of the agency’s commitment to promoting innovation at HHS. The task force, comprised of public health experts across HHS, was charged with providing recommendations for HHS’ role in encouraging and developing health text messaging initiatives which would deliver health information and resources to individuals via their mobile phones. The report recommends that: 1) HHS develop and host evidence-based health text message libraries that leverage HHS’ rich and scientifically-based information, 2) HHS develop further evidence on the effectiveness of health text messaging programs, and 3) HHS explore and develop partnerships to create, implement and disseminate health text messaging and mHealth programs.
The full HHS Text4Health Task Force recommendations are available for public comment at http://www.hhs.gov/open.
Since January 2010, and consistent with these recommendations, HHS has invested $5 million dollars to develop its eHealth/mHealth smoking cessation resources aimed at increasing quitting attempts among teens, young adults and adults. HHS launched several new initiatives that have been guided by the HHS Text4Health Task Force.
The National Cancer Institute (NCI) at the National Institutes of Health is launching the SmokeFreeTXT program, a mobile smoking cessation service specifically designed for teens and young adults across the United States. The service is an extension of the core smoking cessation website, www.smokefree.gov, which consistently achieves between 70,000 – 100,000 visits on a monthly basis. Teens and young adults in the U.S. can enroll in this program by visiting http://smokefree.gov/smokefreetxt/default.aspx.
“More than 70 percent of smokers want to quit, we are committed to providing evidence based information to smokers through emerging and innovative technology,” said HHS Secretary Kathleen Sebelius.
NCI is also launching a library of smoking cessation messages which provide the foundation for an interactive text-based intervention for adult smokers called QuitNowTXT. The QuitNowTXT text messages offer tips, motivation, encouragement and facts based on information tailored to the user’s response and are available at http://smokefree.gov/hp.aspx. These mobile texting resources will be integrated into the department’s comprehensive tobacco control strategy to further address the burden of tobacco use across our nation.
HHS is also pursuing opportunities to forge a global public-private partnership to make the QuitNowTXT program available to other countries to reach adult tobacco users. This initiative aims to collaborate with interested countries to support mHealth/text-based demonstration projects using this new text messaging resource, which are now freely available on the mHealth Alliance’s HealthUnbound.org website. Drawing on the experience gained from these demonstration projects, the countries and partners will identify and disseminate best practices for tobacco cessation mHealth/text-based interventions.
“Mobile device texting initiatives, like this one, have the potential to be a powerful tool to support tobacco cessation globally. Text messaging is widely available, inexpensive, and allows for immediate delivery of cessation information,” said HHS Chief Technology Officer Todd Park.
The QuitNowTXT initiative is consistent with the UN’s Political Declaration of the High Level Meeting on the Prevention and Control of Non-communicable Diseases, which calls upon member states to “encourage the development of multisectoral public policies that create equitable health promoting environments that empower individuals, families and communities to make healthy choices and lead healthy lives”.
A description of projects related to the HHS Text4Health Task Force recommendations can be found at: http://www.hhs.gov/open. The tobacco control message libraries, along with other libraries (smoking cessation for pregnant women, early childhood health, emergency response, etc.) will also be available to the public on HealthData.gov in the future.
Source: HHS Press Release
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