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Guest opinion: Medicare Part D: A success story for Florida’s seniors
Lawmakers in Washington are working hard to reduce entitlement spending and lower the deficit. These are worthy goals. However, during this process, it’s vitally important that policymakers not compromise successful federal programs.
Medicare Part D is such a program. Part D needs to be preserved and protected, as it has dramatically improved seniors’ access to prescription drugs and has cost taxpayers far less than expected.
Part D employs a unique market-based structure that offers enrollees genuine choice in their coverage and harnesses competition to keep prices down. The government doesn’t directly provide coverage through Part D — private insurers do. Seniors are free to choose among a broad range of plans based on their needs. The government monitors the market and provides financial support to enrollees.
See on www.news-press.com
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The New Values Voters: People Of Faith For Health Care Reform
Faith communities have also spoken out for reforming our health care system, urging that it reflect the values of human dignity, shared responsibility, compassion, stewardship of resources, and concern for those who are vulnerable. Advocates for reform include the U.S. Conference of Catholic Bishops, the United Methodist Church, the Evangelical Lutheran Church in America, the Episcopal Church, the Union for Reform Judaism, the Central Conference of American Rabbis, and others.
Such support is also reflected in the values of people in the pews. A 2009 survey by the Pew Forum on Religion and Public Life showed 6 in 10 Americans—including 48 percent of white evangelicals, 55 percent of Catholics, 56 percent of white mainline Protestants, and 72 percent of the religiously unaffiliated—favoring a government guarantee of health insurance for all citizens, even if it would mean raising taxes.
See on thinkprogress.org
Park Nicollet’s experiment with ACOs – TwinCities.com
In 2005, Park Nicollet Health Services started participating in a pilot project that was the first to test the idea of “accountable care organizations” in the federal Medicare program.
Called the Physician Group Practice Demonstration Program, Park Nicollet was one of 10 large multi-specialty groups across the country that agreed to adopt a new payment relationship from Medicare for a portion of its patients.
The premise was straightforward: If Park Nicollet and other groups could provide care at a lower cost while meeting quality standards for patients, the groups would share the savings with Medicare.
But as a study published this month in the Journal of the American Medical Association shows, results from the Physician Group Practice, or PGP, project have been mixed. Overall, researchers found that the five-year pilot delivered only modest savings, although savings were larger for a subset of patients, many of whom have complex health problems.
“(Park Nicollet) received a bonus payment in only one year of the PGP,” said Carrie Colla, a researcher with the Dartmouth Institute for Health Policy and Clinical Practice. “But in the (subset), they saved quite a bit of money.”
Improving care while lowering costs for complex patients is one of the key challenges facing the nation’s health care system, said Dr. David Abelson, the chief executive officer at St. Louis Park-based Park Nicollet, during an August 2011 interview about the pilot project.
See on www.twincities.com
For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.
For an aggregation of other articles on improving healthcare, go to my internet magazine Scoop.it! Changing Health for the Better.
From HMOs to ACOs: Meet the newest model in health care management – TwinCities.com
When critics look at health care in America, many describe a system that’s fragmented, inefficient and burdened with waste.
Doctors and hospitals generally are paid a fee for every service they provide, the critique goes, so they lack financial incentives to effectively coordinate care and make sure patients get only the services they need.
Patients often have a front-row seat on the dysfunction, critics say, as they are shuffled off to specialists without needed paperwork, undergo unnecessary tests or make repeat hospital visits when medical centers don’t get it right the first time.
Enter “accountable care organizations,” a new structure in health management that the federal government, health insurers and some physicians hope will tame the woes. Doctors, hospitals and clinics would be given responsibility to provide care for a group of patients — within a budget. If health care providers better coordinate care to provide good quality for less money, they can share in the savings.
Republicans and Democrats “agree that transitioning from fee for service to global payments in health care will be necessary in order to deal with the budget deficit,” Bottles wrote in an email. “The consolidation of the health care industry will continue no matter which party prevails in the November election.”
This push for accountable care organizations (or “ACOs”) is driving a consolidation trend among health care companies that’s increasingly being felt in Minnesota. The clearest example is a plan announced in August to combine the HealthPartners and Park Nicollet health systems into one of Minnesota’s largest nonprofit health companies, with 20,000 employees, including 1,500 physicians.
See on www.twincities.com
For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.
For an aggregation of other articles on improving healthcare, go to my internet magazine Scoop.it! Changing Health for the Better.
Partnership for Patients — a public-private partnership to improve the quality, safety, and affordability of health care
The Partnership for Patients is a public-private partnership that helps improve the quality, safety, and affordability of health care for all Americans.
The Obama Administration has launched the Partnership for Patients: Better Care, Lower Costs, a new public-private partnership that will help improve the quality, safety, and affordability of health care for all Americans. The Partnership for Patients brings together leaders of major hospitals, employers, physicians, nurses, and patient advocates along with state and federal governments in a shared effort to make hospital care safer, more reliable, and less costly.
The two goals of this new partnership are to:
* Keep patients from getting injured or sicker. By the end of 2013, preventable hospital-acquired conditions would decrease by 40% compared to 2010. Achieving this goal would mean approximately 1.8 million fewer injuries to patients with more than 60,000 lives saved over three years.
* Help patients heal without complication. By the end of 2013, preventable complications during a transition from one care setting to another would be decreased so that all hospital readmissions would be reduced by 20% compared to 2010. Achieving this goal would mean more than 1.6 million patients would recover from illness without suffering a preventable complication requiring re-hospitalization within 30 days of discharge.
See on www.healthcare.gov
For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.
For an aggregation of other articles on improving healthcare, go to my internet magazine Scoop.it! Changing Health for the Better.
Obama, Ryan address AARP group in dueling speeches
NEW ORLEANS, La. — President Obama, speaking Friday by satellite feed just minutes before a speech by GOP vice presidential nominee Paul Ryan, took a pre-emptive shot at the AARP’s “Life@50+” convention, telling the group not to believe the criticisms that would follow.
“Contrary to what you’ve heard and what you may hear from subsequent speakers, Obamacare actually strengthened Medicare,” Obama said.
The Romney-Ryan camp claims the president’s health care law raids Medicare of billions of dollars, and it has made that assertion a central theme of its campaign.
Speaking to the group, which counts among its membership more than 37 million people over the age of 50, the president tried to discredit that argument.
“When you hear this notion … that we somehow took $716 billion, robbed it from Medicare beneficiaries and seniors, I want you to know that is simply not true,” he said. “What we did was we went after waste and fraud, and over-charging by insurance companies, for example. Those savings do come out to $716 billion.”
Moments later, Ryan tried going on the offensive — warning the crowd of what he claims will be catastrophic consequences to Medicare if voters stick with Obama.
His message was not well received.
“The first step to a stronger Medicare is to repeal Obamacare, because it represents the worst of both worlds. It weakens Medicare for today’s seniors and puts it at risk for the next generation,” Ryan said to a chorus of boos.
See on politics.blogs.foxnews.com
For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.
For an aggregation of other articles on improving healthcare, go to my internet magazine Scoop.it! Changing Health for the Better.
Medicare Advantage Enrollees Face $515 Cut to Medicare Advantage Plans
ObamaCare imposes major cuts on the popular Medicare Advantage program, and while the Obama administration has largely delayed them until after the election, enrollees will lose an average $515 in benefits in 2013, according to an IBD analysis.
Some 14.4 million people are expected to enroll in Medicare Advantage in 2013, up from 13.1 million this year, the Center for Medicare and Medicaid Services (CMS) said Wednesday. Advantage plans are run by private firms, providing more benefits at a somewhat higher cost — usually 13% to 17% — to the government than traditional Medicare.
That added cost has made Advantage plans a target. ObamaCare will cut MA by at least $7.4 billion in 2013.
See on news.investors.com
For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.
For an aggregation of other articles on improving healthcare, go to my internet magazine Scoop.it! Changing Health for the Better.
D.C. Week: Lawmakers Talk Health Before Heading Out — Focus is on Medicare Advantage Plan Cuts under the ACA
WASHINGTON — Members of Congress tackled several health-related issues this week before leaving the nation’s capital and hitting the campaign trail for a final election push.
Democrats and Republicans traded jabs this week on health reform’s impact on Medicare Advantage plans, with one side praising the law’s effects and the other predicting it will hurt the program.
The Obama administration reported that the Affordable Care Act (ACA) has strengthened Medicare Advantage. Since the ACA was passed in 2010, Medicare Advantage premiums have fallen by 10% and enrollment has risen by 28%, according to a statement from the Department of Health & Human Services (HHS).
HHS also projected enrollment to increase 11% in the next year with premiums remaining steady.
But Republicans in the House of Representatives held a hearing Friday on Medicare Advantage plans and took the opportunity to bash cuts in the plan under the ACA saying it will negatively impact enrollment and benefits for seniors.
See on www.medpagetoday.com
For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.
For an aggregation of other articles on improving healthcare, go to my internet magazine Scoop.it! Changing Health for the Better.
CMS Press Release: Medicare Advantage Program is projected to remain strong with an increase of 11% for 2013
Enrollment in the Medicare Advantage (MA) program is projected to increase by 11 percent in the next year and premiums will remain steady, Health and Human Services Secretary Kathleen Sebelius announced today. Since the Affordable Care Act was passed in 2010, Medicare Advantage premiums have fallen by 10 percent and enrollment has risen by 28 percent.
“Thanks to the Affordable Care Act, the Medicare Advantage and Prescription Drug programs have been strengthened and continue to improve for beneficiaries,” said Secretary Sebelius. “Since the law was enacted in 2010, average premiums have gone down, enrollment has gone up, and new benefits and lower drug costs continue to help millions of seniors and people with disabilities.”
For the third year in a row, the Centers for Medicare & Medicaid Services (CMS) used authority provided by the Affordable Care Act to protect beneficiaries from significant increases in costs or cuts in benefits. Access to supplemental benefits remains steady and beneficiaries’ average out-of-pocket spending remains constant.
The average MA premium in 2013 is projected to increase by only $1.47 from last year, coming to $32.59. However, if beneficiaries choose lower cost plans at the same rate in 2013, as they did in 2012, the average premium is expected to increase by only 57 cents. Access to the Medicare Advantage program will remain strong, with 99.6 percent of beneficiaries having access to a plan. Additionally, the number of plan choices will increase by 7 percent in 2013.
Last month, CMS announced that the average estimated basic Medicare prescription drug plan premium was projected to be $30 in 2013, holding steady from last year. Today’s projections show that access to a Medicare prescription drug plan will remain strong in 2013. Everyone with Medicare will have access to a wide range of plan choices.
The Annual Open Enrollment Period for health and drug plans begins on October 15 and ends December 7.
See on www.cms.gov
For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.
For an aggregation of other articles on improving healthcare, go to my internet magazine Scoop.it! Changing Health for the Better.
Report faults Medicaid patient cost in New York’s residential centers for the developmentally disabled
ALBANY — New York’s residential centers for the developmentally disabled cost Medicaid about $1.9 million a year for each patient, and federal overpayments that total $15 billion since 1990 should end immediately, according to a congressional oversight committee.
In a report this week, the House Committee on Oversight and Government Reform said the overpayments represent “massive waste,” are likely illegal and should stop immediately. The report also faulted lax oversight.
“Overwhelming evidence suggests that the federal government has failed to question New York state’s excessive developmental center payment rates adequately,” the report said. “Given the extraordinarily dire federal budget situation, the Center for Medicare and Medicaid Services’ failure to prevent the massive Medicaid overpayments flowing to New York state’s developmental centers needs to be corrected immediately.”
See on www.timesunion.com
For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.
For an aggregation of other articles on improving healthcare, go to my internet magazine Scoop.it! Changing Health for the Better.
Joseph Rugg's Health Law Blog 