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Protect Healthcare Reform
There is no greater battle before us than to fight the ignorance and misinformation campaign of those who would seek to defund Obamacare. The outcome may well affect the well being of generations of Americans.
Presidents since Teddy Roosevelt have understood the need and the importance of reforming healthcare in America. Obamacare may well be President Obama’s greatest achievement and will be long remembered after everyone has forgotten that he was the first African American president. The law’s flaws do not outweigh its many benefits, the most important of which is that it has shifted the focus of healthcare from procedure based to performance based — doing tests on sick patients is no as profitable to healthcare providers as keeping patients from getting sick.
We must not let this important first step to fix to the healthcare system to die by the actions of a narrow minded minority. Contact your Senators and Representatives.
The ACP Advocate Blog — “If I were King”
Bob Doherty, ACP’s Senior Vice President, Governmental Affairs and Public Policy, blogs about important health policy issues in The ACP Advocate Blog.
This is from Doherty’s August 2 blogpost, “If I were King.” It is a thoughtful article that focuses on the issues that need to be addressed in U.S. healthcare and offers sensible approaches to resolving them.
“But yet, is my wish list really too much to expect from elected lawmakers in Washington who take a solemn oath to a Constitution that requires them to promote the common welfare and ensure domestic tranquility? Is it too much to ask that we provide every American with health insurance, that we free doctors from unnecessary red tape and paperwork, that we enact policies that support the value of primary care, that physicians and nurses put aside their differences so that they can work together to provide the best possible care to patients, that we facilitate choice and completion by posting comparative information on price and quality, that we keep guns out of the hands of insane people and convicted felons and that we limit access to guns that allow murderers to kill as many people as possible in as little time as possible (including schoolchildren), that we repeal the ridiculous SGR formula, and that we reform our politics so government can actually start governing again? Is that really too much of a fantasy to ask of the people we elect?”
See on advocacyblog.acponline.org
To change health care, we need more physician leaders
From Dr. Davis Liu’s post on kevinmd.com:
“We see our health care system not doing better because we do not have the structure or leadership to move the system because we have no system. There is no common leadership. There is no common culture. There is no common goal. Instead it is hundreds of thousands of doctors often working in small groups not having the types of conversation and the follow through needed to change norms or culture. This stunning gap of what we know works and what actually happens continues to harm patients. Whether accountable care organizations will be the right microculture to improve health care remains to be seen. What really matters is whether there is leadership at these organizations willing to have the difficult one to one conversations on a consistent basis. I believe that physician leaders, who both have clinical expertise and credibility, are best suited for this role.”
See on www.kevinmd.com
Cutting Off Your Nose to Spite Your Face
Honest, rational, intelligent Americans must stand-up to the new nit-wit movement of some fringe members of the Republican Party to defund ObamaCare, at whatever cost, including shutting down the United States government.
Most people who oppose ObamaCare refuse to understand it, and politicians shamelessly promote and take advantage of that ignorance.
Let’s try to be honest. ObamaCare is an historic first step at fixing an out of control and hopelessly broken healthcare system. The Deloitte 2013 survey of U.S. physicians found that most physicians “believe that the performance of the U.S. health care system is suboptimal, but the Affordable Care Act [i.e., ObamaCare] is a good start to addressing issues of access and cost.” ObamaCare is already making positive changes in healthcare, and millions of middle-class Americans are currently being helped by ObamaCare. No more pre-exiting conditions and arbitrary lifetime caps. By requiring healthcare insurance to contain minimum benefits that are needed by most Americans, we can purchase a policy and know what is covered and what is not and not fear denials later when we need to use our coverage. There are many examples of how ObamaCare is helping patients and providers.
ObamaCare’s goal is improved access to affordable healthcare — for the life of me, I cannot understand why that causes such irrational responses? Of course, ObamaCare is flawed and costly, requires too much regulation, and is full of special interest tinkerings (like all legislation these days unfortunately), and it can be (and deserves to be) much improved. To defund it or repeal it and start from scratch will leave us with the same uninsured population, spiraling out of control costs, and no hope for improvement.
Shame on Marco Rubio, Rand Paul, Ted Cruz, and all the other members of the Congressional flatworld caucus. Improving healthcare in America, including making the necessary changes to ObamaCare, is a job for smart, dedicated people, not petty, stupid ones. This is a time for more conversation and less baying at the moon.
Physician Payment Sunshine Act
The vilification of physicians continues …
The Physician Payment Sunshine Act has been around for a while now, but things are getting ready to heat up. On August 1, the federal regulations implementing the Physician Payment Sunshine Act go into effect.
The regulations were finalized last February, to “implement the requirements in section 6002 of the Affordable Care Act … . That provision requires applicable manufacturers of drugs, devices, biologicals, or medical supplies covered under [Medicare or Medicaid or CHIP] to report annually to the Secretary certain payments or other transfers of value to physicians and teaching hospitals. [The Act] also requires applicable manufacturers and applicable group purchasing organizations to report certain information regarding the ownership or investment interests held by physicians or the immediate family members of physicians in such entities.”
Medical Economics published a very good summary of the Sunshine Act, “Sunshine Act: 7 things you need to know.” Manufacturers and GPOs on August 1 will start gathering data on physicians with whom they have made a specified payment or other transfers of value or who have investment or ownership interests in the manufacturers or GPOs. The nearly 80 triple-columned pages of regulations define the various terms and explain how the data is to be gathered and reported. The data will be reported to CMS electronically by March 31, 2014 and will be available online to patients and others.
In a related story, Medical Economics reported yesterday that there is now an app for physicians to track reports made regarding them pursuant to the Act.
Healthcare Reform’s Impact on Physician Practices
On August 1 in Tampa and on August 23 in Sarasota, Akerman is co-sponsoring a Lunch ‘n’ Learn Program on the impact of healthcare reform on physician practices. If you would like to attend either event, please follow the applicable link and RSVP.
I will be one of the panelists. My topic is “Mergers, Hospitals, and Networks, oh my! — What are Physician Practices Doing to Survive?”
Thousands Of Mississippi Consumers May Not Be Offered Insurance Subsidies – Kaiser Health News
Tens of thousands of uninsured residents in the poorest and most rural parts of Mississippi may be unable to get subsidies to buy health coverage when a new online marketplace opens this fall because private insurers are avoiding a wide swath of the state. No insurer is offering to sell plans through the federal health law’s marketplaces in 36 of the state’s 82 counties, including some of the poorest parts of the Delta region, said Mississippi Insurance Commissioner Mike Chaney. As a result, 54,000 people who may qualify for subsidized coverage would be unable to get it, estimates the Center for Mississippi Health Policy, a nonpartisan research group.
See on www.kaiserhealthnews.org
Private commercial insurance companies are making this decision to deny healthcare coverage to thousands of poor rural Mississippians. This is not the fault of Obamacare. What is the solution – to give those people access to healthcare or not. State legislatures can no longer ignore the poor — the point is why should the private healthcare insureres be allowed to pick and choose like this – if they want to be licensed in Mississippi, they should be required to provide coverage throughout the state.
The Gulf Between Doctors and Nurse Practitioners
Nurse practitioners believe that they can lead primary care practices and admit patients to a hospital and that they deserve to earn the same amount as doctors for the same work. Physicians disagree.
For several years now, health care experts have been issuing warnings about an impending severe shortfall of primary care physicians. Policy makers have suggested that nurse practitioners, nurses who have completed graduate-level studies and up to 700 additional hours of supervised clinical work, could fill the gap.
Already, many of these advanced-practice nurses work as their patients’ principal provider. They make diagnoses, prescribe medications and order and perform diagnostic tests. And since they are reimbursed less than physicians, policy makers are quick to point out, increasing the number of nurse practitioners could lower health care costs.
See on well.blogs.nytimes.com
Online health communities improve chronic care quality
Online health communities can be powerful tools for addressing chronic care issues as the number of people afflicted with such ailments rises, according to a study published this week in the Journal of Medical Internet Research.
For the study, researchers define online health communities (OHCs) as Internet-based platforms that unite a group of patients, a group of professionals, or both, using blogs, chats, forums and wikis. In this case, the researchers–from Radboud University Medical Centre in the Netherlands–illustrated using OHCs for ParkinsonNet, a professional network made for participants with Parkinson’s disease in which providers deliver patient-centered care.
ParkinsonNet utilized community managers; in this case, it was a marketing and communications expert. The community manager distributed posters, information pamphlets, and “business cards” to patients and health professionals as part of educating people about the OHC.
See on www.fiercehealthit.com
New direction for Medicaid in Alabama
About 120,000 Medicaid patients in the Shoals and Tennessee Valley will receive most of their health care from a network of willing providers within a 10-county region beginning in late 2016
The new direction for the state agency is part of a plan legislators approved earlier this year to control Medicaid’s ballooning costs.
State leaders plan to turn Medicaid from its current fee-for-service model to a managed care approach, beginning in fiscal 2017.
To make the transition, Medicaid officials are splitting the state into five areas where Regional Care Organizations — largely run by healthcare providers — will operate.
“The (Regional Care Organizations) came about because we’ve been on a fee-for-service type system with Medicaid, which doesn’t encourage providers to maximize efficiencies,” said Rep. Ed Henry, R-Hartselle, one of several lawmakers on Gov. Robert Bentley’s Medicaid study commission.
“This reform measure is to try to put efficiencies in Medicaid,” he said. “We pay providers a set amount per patient and if they deliver that care for cheaper, they make money. If they don’t, they lose money.”
David Spillers, CEO of Huntsville Hospital, said the regional organizations, or RCOs, will be a complete change in how Medicaid providers are reimbursed. The Huntsville Hospital system includes 12 medical facilities in north Alabama, including Helen Keller Hospital in Sheffield.
See on www.timesdaily.com
Joseph Rugg's Health Law Blog 