September 1st, 2011 by DavidHarlow in Health Policy, News
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Many health care provider organizations have not been overly eager to jump onto the Accountable Care Organization (ACO) bandwagon, citing high startup costs and uncertain returns on investment given the complexity of the program. Well, recently, the CMS Center for Innovation has announced the Bundled Payment for Care Improvement initiative. This initiative incorporates elements of earlier CMS demonstration projects — the gainsharing demos and ACE (acute care episode) bundled payments demonstrations which the HealthBlawger has helped a number of clients around the country qualify for in the past — and builds on the broad authority granted to the CMS Center for Innovation under health reform.
The advantages to proceeding with a Bundled Payment for Care Improvement project include the opportunity to participate in CMS shared savings programs while only providing limited commitment of organizational resources, i.e., limited to one or more discrete service lines or episodes of care. Of course, investments in a culture of collaboration must be made, but the system-wide investment in IT and other infrastructure at the level called for in order to qualify as an ACO would not necessarily be required in order to proceed with this initiative.
There are a number of different models open to participants, and nonbinding letters of commitment are due as early as late September.
From the CMS Center for Innovation announcement: Read more »
*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*
November 15th, 2010 by DavidHarlow in Better Health Network, Health Policy, News, Opinion
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In October, the Office of Inspector General (OIG) issued a report on Fraud and Abuse Training in Medical Education, finding that 44 percent of medical schools reported giving some instruction in the anti-kickback statute and related laws, even though they weren’t legally required to do so. (As an aside, do we really live in such a nanny state? Over half of all medical schools don’t teach their students anything about this issue — because nobody’s making them — even though it is an issue that looms large in the practice of medicine.)
On a more positive note, about two-thirds of institutions with residency programs instruct participants on the law, and 90 percent of all medical schools and training programs expressed an interest in having dsome instructional materials on the subject of the anti-kickback statute, physician self-referrals (Stark) rules and the False Claims Act.
So in November, the OIG released a Roadmap for New Physicians – A Guide to Avoiding Fraud and Abuse, available on line and as a PDF. It’s a good 30-page primer on the subject. While some of the examples given are specific to newly-minted physicians, anyone in the health care industry would benefit by reading it. The document offers a window into the thinking of the OIG, its perspective on the wide range of issues summarized within, and is a good touchstone for any individual or organization seeking to structure a relationship that needs to stay within the bounds of these laws. Read more »
*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*
October 18th, 2010 by Shadowfax in Better Health Network, Health Policy, News, Opinion
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Those of you who’ve read this blog for any length of time know that I have been a pretty strong advocate for healthcare reform. This has been primarily motivated by my passion for universal coverage, but also with my frustration with the cost of the current healthcare system, the generally crummy outcomes, and the overall level of fragmentation in the whole affair.
Even today, I had to repeat blood tests on a cancer patient who came to the ER. He had had blood tests at the cancer center ACROSS THE STREET before presenting, but, so sorry, our computers don’t talk to theirs and it’s after 5pm now, so forget about getting those results.
So it’s with a mixture of enthusiasm and dread that I consider the coming onslaught of accountable care organizations (ACOs). What are ACOs? They’re the buzzword of the day, that’s for sure. Everybody knows they’re the next big thing. They’re coming. We’ll all be in an ACO by next Tuesday for sure. It’ll be nirvana. Right? Read more »
*This blog post was originally published at Movin' Meat*
June 7th, 2010 by GarySchwitzer in Better Health Network, Health Policy, News, Opinion, Research
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The worst-kept secret in journalism circles recently was that the New York Times was planning an article critical of the Dartmouth Atlas. Among the main points in the article:
• “The mistaken belief that the Dartmouth research proves that cheaper care is better care is widespread.”
• “The atlas’s hospital rankings do not take into account care that prolongs or improves lives.”
• “Even Dartmouth’s claims about which hospitals and regions are cheapest may be suspect.”
• “Failing to make basic data adjustments undermines the geographic variations the atlas purports to show.”
The Times has also published the correspondence it had with the Dartmouth team about methodology questions.
The Dartmouth team challenges each of these criticisms. The team says the Times made at least five factual errors and several misrepresentations. They write:
“What is truly unfortunate is that the Times missed an opportunity to help educate the American public about what our research actually shows — or about the breadth of agreement about what our findings mean for health care reform.” Read more »
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
