Posts Tagged ‘Medicare’
Monday, March 1st, 2010
The American College of Physicians (ACP) is urging Congress and the Obama administration to move ahead and pass healthcare reform legislation. ACP, whose membership includes 129,000 internists, internal medicine subspecialists, medical students, residents and fellows, offers this advice: “Don’t start over.”
“Let’s take the bills passed by the House and Senate and make them even better,” urges Bob Doherty, the ACP’s senior vice president of government affairs and public policy. “We shouldn’t toss them out and start from scratch.” An ACP report warns of the costs of failure to pass healthcare reform, quoting Congressional Budget Office projections that healthcare spending will climb to 25 percent of GDP by 2025. Similarly, the Census Bureau has warned that the number of the uninsured will soar to 60 million Americans by 2020 if reform does not occur.
ACP President Joseph Stubbs notes that “A highly partisan and polarized debate over healthcare reform legislation has regrettably taken the country’s ‘eye off the ball’ from the urgency of implementing reforms.” The ACP advocates building on existing legislation to reach ultimate agreement on a bill and create bipartisan proposals to cut the costs of the medical liability tort system with the goal of increasing the number of primary-care physicians.
Tags: American College of Physicians, Bob Doherty, Congress, Congressional Budget Office, healthcare reform, healthcare summit, internists, Joseph Stubbs, Medicare, Obama administration, primary-care physicians, US Census Bureau
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Tuesday, February 2nd, 2010
Americans spent an average of $7,681 per person on healthcare during 2008, just a 3.5 percent rise over the previous year - the slowest growth rate in 48 years. According to a report issued by the Department of Health and Human Services, healthcare spending totaled $2.3 trillion in 2008 and accounted for 16.2 percent of the GDP.
The culprit is the recession, which achieved what a generation of public officials attempted without success. Federal officials said the slowdown in health spending resulted from the soft economy, people delaying elective procedures, for example, and did not cite any factors that will alter the long-term outlook for continued increases as baby boomers age and physicians rely more on new technologies to treat patients.
According to Micah Hartman, a government statistician who contributed to the report, federal spending for health services and supplies grew 10.4 percent in 2008 and equaled 36 percent of federal receipts, up from 28 percent in 2007. “In 2008, federal Medicaid spending increased 8.4 percent - the highest rate of growth since 2003 - while state spending declined by 0.1 percent, the first decline in these expenditures in program history,” Hartman said. “Spending for healthcare by private businesses grew just 1.2 percent in 2008, in part because of a drop in the proportion of employer-sponsored insurance paid by employers. Private business’ health spending remained relatively flat as a share of compensation at 7.9 percent.”
In other findings, the report noted that “private health insurance premiums and benefits grew in 2008 at their slowest rate since 1967, 3.1 percent and 3.9 percent respectively.” The slowdown reflects a drop in the number of Americans with private health insurance. That fell to 195.4 million in 2008, compared with 196.4 percent in 2007.
Tags: GDP, Healthcare, healthcare reform legislation, healthcare spending, Medicaid, Medicare, Micah Hartman, President Barack Obama, recession
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Thursday, January 28th, 2010
In 2011, physicians will be eligible for extra payments from federal health insurance programs if they implement electronic medical record systems. The extra money is courtesy of President Obama’s American Recovery and Reinvestment Act stimulus bill signed into law early last year. To help physicians - especially those in small practices - pay for the several thousand dollar systems, private insurers are also offering financing incentives of their own.
UnitedHealth Group, for example, is offering interest-free loans to small practices that start using Ingenix CareTracker, an internet-based system. Chicago-headquartered Allscripts-Misys Healthcare Solutions, Inc., is offering a six-month, no-payment program for qualified buyers of its electronic healthcare records software.
Under the federal legislation, physicians who start using electronic medical records can receive more than $40,000 in Medicare payments over a five-year period. At present, the Obama administration is soliciting comments on new regulations to “lay a foundation for improving quality, efficiency and safety through meaningful use of certified electronic health record technology.” Although electronic records keeping will cut paperwork, control costs and create a more efficient system, physicians have been slow to adopt the technology because of the high cost of purchasing the equipment.
Even though 75 percent of Americans patronize doctors in small practices, less than 15 percent of physicians now use electronic records systems. UnitedHealth, which says its CareTracker system can cost less than $7,000 annually, is “helping physicians overcome the challenge of funding their upfront investment - the biggest barrier in implementing health information technology,” said Bill Miller, executive vice president of Ingenix, the firm’s health information technology subsidiary.
Tags: electronic medical records, Medicare, Obama administration, stimulus bill, UnitedHealth Group
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Tuesday, January 26th, 2010
A Glendale, AZ, family clinic operated by the non-profit Mayo Clinic is no longer accepting Medicare patients, saying government payments are too low. The more than 3,000 Medicare-eligible patients who use the facility will be forced to pay cash or find a physician at another location. The decision, which doesn’t impact other Mayo facilities in Arizona, Minnesota and Florida, is a two-year pilot project, according to spokesman Michael Yardley.
Mayo’s move may lead additional family physicians to drop Medicare patients, according to Lori Heim, president of the National Association of Family Physicians. “Many physicians have said, ‘I simply cannot afford to keep taking care of Medicare patients,’” Heim said. “If you truly know your business costs and you are losing money, it doesn’t make sense to do more of it.”
Mayo’s Yardley defended his organization, noting that “We firmly believe that Medicare needs to be reformed. It has been true for many years that Medicare payments no longer reflect the increasing cost of providing services for patients.” Nationally, physicians were reimbursed approximately 20 percent less for treating Medicare patients vs. privately insured patients in 2007. That payment gap has not changed over the last 10 years, says a report from the Medicare Payment Advisory Commission, a group that advises Congress on Medicare. At the end of 2008, approximately 45 million Americans were covered by Medicare, according to statistics from the Centers for Medicare & Medicaid Services. Although 92 percent of family physicians participate in Medicare, just 73 percent are accepting new patients under the program.
Medicare patients who opt to stay with their physician at Mayo’s Glendale clinic will pay $1,500 annually for a physical and three additional visits. Additionally, they will pay a $250 annual administrative fee.
Tags: American Academy of Family Physicians, American Medical Association, Arizona, health insurance programs, Mayo Clinic, Medicare, non-profit, Scottsdale, Urban Institute
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Monday, January 18th, 2010
Medicare is giving more than one million low-income senior citizens as much as $3,900 in additional prescription drug assistance. To promote the new program, the Social Security Administration has enlisted Chubby Checker, who introduced the dance and hit song “The Twist” in the early 1960s.
This “extra help” program, which took effect January 1, helps seniors who own life insurance policies or get regular financial help from relatives to pay for day-to-day expenses. Hilary Dalin, associate director for benefits at the National Council on Aging, notes that “The safety net is frayed and this is a way to start stitching it back together again.” Income limits are $16,245 a year for singles and $21,855 for married couples. Assets - stocks, bonds and bank accounts - are limited to $12,510 for singles and $25,010 for married couples, while the value of home and cars do not figure into the equation. Benefits vary according to income. The extra-help program eliminates premiums and yearly deductibles; co-pays can be as low as $1.10 for generic prescriptions and $3.30 for brand names. Approximately 32 million senior citizens participate in the Medicare Part D prescription program, with 30 percent of them currently enrolled in the extra-help program.
According to Chubby Checker, who is 68, “It’s extra help, and this is what I’m all about.” The promotional campaign includes, posters, brochures and a television public service announcement.
Tags: Chubby Checker, low-income seniors, Medicare, Medicare drug benefit, National Council on Aging
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Wednesday, January 13th, 2010
Representative John Dingell Jr.’s (D-MI) journey to making healthcare reform a reality dates back to 1932 when his father — John Dingell Sr., an architect of the New Deal — initially introduced Medicare legislation in the early days of Franklin D. Roosevelt’s presidency. The 83-year-old Dingell Jr., is one of the lead sponsors of the House legislation that will be reconciled with the Senate bill in conference committee.
Dingell, who is the longest-ever serving member of the House of Representatives, has introduced a national health insurance bill on the first day of every Congressional session as a tribute to his father. After John Dingell, Sr. died in 1955, his son assumed his father’s Congressional seat and the quest to make national health insurance a reality.
Commenting on the Senate’s recent passage of the Patient Protection and Affordable Care Act, Dingell said that “I commend my colleagues in the Senate on achieving this historic milestone. The journey is long, but the reward will be great. Unlike any other time in our history, we have two strong pieces of comprehensive health reform legislation that promise to deliver much needed access and relief to the American people. When President Obama signs a final, combined bill, we will be well on our way to fulfilling our longstanding moral obligation — providing quality, affordable coverage for every American. However, as is usually the case with any major overhaul, this is the first step in the process, not the last.”
Tags: Franklin Roosevelt, healthcare reform, House of Representatives, John Dingell Jr, John Dingell Sr, Medicare, Michigan, National Institues of Health, New Deal
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Wednesday, January 6th, 2010
In an historic move, the Senate voted to reform the way healthcare coverage is structured in the United States. The 2,077-page Patient Protection and Affordable Care Act, which passed 60 - 39, has the goal of restructuring the $2.5 trillion annual healthcare sector in just 10 years.
With an $871 billion price tag, the legislation will extend coverage to 41,000,000 Americans who currently lack any healthcare insurance. According to the Congressional Budget Office, 94 percent of citizens will have healthcare coverage by 2019. Of that, 26,000,000 will have coverage through innovative insurance exchanges; an additional 15,000,000 will be covered by expanded Medicaid and children’s health insurance programs.
In essence, the bill requires all legal residents to buy healthcare insurance. To offset the cost, the government will offer hundreds of billions of dollars of subsidies and expands Medicaid to people earning less than 133 percent of the federal poverty level. Individuals who fail to buy coverage face a $95 penalty in 2014, which rises to $750 in 2016. Companies with more than 50 employees who do not offer coverage would be subject to a $750 penalty for each full-time worker who has subsidized coverage through an insurance exchange.
In one little-discussed provision, the legislation creates an Independent Payment Advisory Board, which would control Medicare payment formulas. The board also would make yearly recommendations to the president, Congress and private entities on actions they would like to take to improve quality and control the rate of cost growth in the private sector. The Medicare recommendations are non-binding in years where growth is slower than the targeted rate.
Tags: Congressional Budget Office, healthcare reform, insurance exchanges, Medicaid, Medicare, Senate, subsidies
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Tuesday, January 5th, 2010
The powerful Service Employees International Union (SEIU) has blasted Senator Joseph Lieberman (I-CT) for his opposition to making Medicare available to Americans aged 55 - 64 as part of healthcare reform. SEIU strongly supports the expansion of Medicare, a move that Lieberman supported as recently as last September.
According to Andy Stern, SEIU president, “We have a handful of senators who think their point of view is so essential that they can stop progress. We think it’s time to take a vote, let the chips fall where they may.”
Stern expressed hope that some of the union’s healthcare reform objectives will be resolved in conference committee, which ultimately will resolve the Senate and House versions of the legislation.
Tags: Andy Stern, healthcare reform, House of Representatives, Joseph Lieberman, Medicare, SEIU, Senate
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Wednesday, December 30th, 2009
It’s almost - but not quite - a house call.
A new healthcare concept called “medical home” is emerging across the country, especially in Illinois. It is primary care devoted to prevention and to helping people with chronic conditions such as diabetes or arthritis manage their illness. In a medical home, a physician oversees a team of nurses, physicians’ assistants and health coaches who make certain that their patients get the care, support and education they need. Another benefit is that the plan frees up the doctor’s time to focus on the more serious medical issues.
Medicare recently announced a similar initiative, and healthcare reform legislation could champion medical homes. One pioneer in the field is Group Health Cooperative, a Seattle-based HMO that plans to convert 26 clinics in Washington and Idaho to medical homes. The pilot program, established two years ago, reduced ER visits by 29 percent and hospitalizations by 11 percent while improving the quality of care, according to a report in the September issue of the American Journal of Managed Care.
For medical homes to function properly, physician compensation will have to change, says Dr. David Swieskowski, chief executive of the Des Moines-based Mercy Clinics, Inc. The model works optimally when physicians are full-time, salaried employees. This payment arrangement is fairly rare, and insurance companies don’t reimburse physicians for taking extra time to talk to patients.
Medicaid introduced a version of medical homes in Illinois through Medicaid in 2006 and 2007. During that time, Medicaid assigned 1.9 million people to physicians who agreed to coordinate care for an extra monthly fee. As a result, immunizations, vision screenings and other types of basic care have improved, state officials say.
Tags: Group Health Cooperative, health coaches, HMO, Medicaid, medical homes, Medicare, Mercy Clinics, nurses, physician assistant, physicians
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Thursday, December 10th, 2009
Declaring that “failure is not an option” on healthcare reform, Senator Charles Schumer (D-NY) said that the legislation will be passed with or without Republican support. “We’re not going to not pass a bill,” Schumer said, pointing to a healthcare system that is broken because some 47 million Americans lack any kind of insurance coverage.
Before this can happen, Senate Majority Leader Harry Reid (D-NV) has the task of resolving issues within his own party regarding abortion, taxes and allowing the government to sell health insurance in competition with private insurers. Democratic leaders are working to persuade Senator Olympia Snow (R-ME) to cross party lines and vote in favor of the ultimate bill, even though she sided with her fellow Republicans on the recent procedural vote to move the debate to the full Senate floor.
Both the Senate and House of Representatives bills require all Americans to have healthcare insurance, and plan to make government subsidies available to help pay premiums. Insurance companies would be banned from denying coverage or charging extra for individuals with pre-existing conditions. New insurance marketplaces would be created for those Americans who have difficulty finding affordable coverage - such as the self-employed and those who own small businesses. Americans who currently have employer-provided coverage won’t see any big changes in their coverage. Senior citizens will see improvement in their prescription coverage.
As for paying for these bills? The House bill depends primarily on an income tax hike on upper-income individuals. The Senate bill would tax Cadillac insurance plans, increase the Medicare payroll tax for the wealthy and mandate fees on medical industries.
Tags: Blue Dog Democrats, Cadillac insurance plans, Democrats, Healthcare, House of Representatives, Medicaid, Medicare, President Barack Obama, public option, Republican, Senate, Senator Ben Nelson, Senator Blanche Lincoln, Senator Charles Schumer, Senator Harry Reid, Senator Olympia Snowe
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