December 5th, 2011 by Stanley Feld, M.D. in Health Policy, Opinion
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In reviewing Ezekiel Emanuel’s New York Times article I thought of an interesting question. In Dr. Emanuel’s view it is not worth having tort reform or healthcare care insurance reform. He claims these reforms are an insignificant burden to the cost of the healthcare system.
I have demonstrated that the evidence for tort reform and reform of the healthcare insurance industry proves him wrong.
The question then is where is the $2.5 trillion dollars the U.S. healthcare system spends going?
President Obama and Dr. Emanuel think it is going to physicians. President Obama’s idea to control healthcare costs is to reduce physician reimbursement.
Physicians have the weakest expression of its vested interests among all the stakeholders because of lack of effective leadership.
Simple arithmetic reveals that reducing physician reimbursement will yield an insignificant reduction in healthcare costs.
Never the less on January 1st Medicare is going to decrease physicians’ reimbursement by 27%. This decrease is the result of the application of the government’s Sustainable Growth Rate (SGR).
The Sustainable Growth Rate (SGR) is a complicated and defective formula intended to contain the overall growth of Medicare spending for physicians’ services. The intent was to keep physicians’ reimbursement in line with the nation’s ability to pay for that medical care. The SGR formula uses the gross domestic product per capita in a complicated and inaccurate way. Read more »
*This blog post was originally published at Repairing the Healthcare System*
November 25th, 2011 by GruntDoc in Health Policy, Opinion
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Update: this happened 2 years ago. So, I wrote this thinking it was a new development, but it isn’t. Anyone know how this experiment has played out?
I’ve wondered for years if hospital organizations (and big organized clinics) had done the math on whether they could do without Medicare, and apparently Mayo has. More after the quote
President Obama last year praised the Mayo Clinic as a “classic example” of how a health-care provider can offer “better outcomes” at lower cost. Then what should Americans think about the famous Minnesota medical center’s decision to take fewer Medicare patients?
Specifically, Mayo said last week it will no longer accept Medicare patients at one of its primary care clinics in Arizona. Mayo said the decision is part of a two-year pilot program to determine if it should also drop Medicare patients at other facilities in Arizona, Florida and Minnesota, which serve more than 500,000 seniors.
Mayo says it lost Read more »
*This blog post was originally published at GruntDoc*
November 10th, 2011 by DavidHarlow in Health Policy, Opinion
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On my way to the annual two-day blowout health law seminar put on by Massachusetts Continuing Legal Education (MCLE) on Monday — I was second in the lineup, speaking about post-acute care and some of the innovations in that arena for dual eligibles, among other things — I heard a fascinating piece on NPR on one of the ideas floating around the supercommittee charged with cutting $1.2 trillion from the federal budget. The idea: increase the minimum age for Medicare eligibility from 65 to 67, and save a bundle for Medicare in the process.
The problem with this deceptively simple idea (Social Security eligibility is migrating from 65 to 67, too, so it seems to be a sensible idea on its face), is that while it would save the federales about $6 billion, net, in 2014, it would cost purchasers of non-Medicare coverage (employers and individuals) about $8 billion, net. Why? The 65 and 66 year olds are the spring chickens of Medicare — they actually Read more »
*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*
November 4th, 2011 by DavidHarlow in Health Policy, Opinion
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The final Accountable Care Organization regulations are out, the initial flurry of commentary is out (including my own ACO webinar with simultaneous #ACOchat tweetchat – available for replay; slides here : “ACOs, Bundled Payments and the Future of Health Care“), and we can now all catch our collective breath and contemplate the draft vs. final ACO regulation comparisons, the meaning of this new, final set of regulations, guidances and statements from CMS, FTC, DOJ, OIG, and IRS on ACOs and Medicare Shared Savings Programs, and all of the attendant antitrust, antikickback, Stark, and other fraud and abuse matters, and of course tax issues.
So, now that these final regulations are out, and the mythical characteristics of the ACO will soon be dispelled (see under: unicorn), I propose a new animal kingdom metaphor for discussion of Accountable Care Organizations:
The Camel’s Nose is in the Tent.
The definition of a camel, as those of you who tuned into my ACO webinar already know, is Read more »
*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*
November 1st, 2011 by GarySchwitzer in Opinion, Research
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Why doesn’t the US have the best health care system in the world? That’s the question The Commonwealth Fund Commission on a High Performance Health System asks in its report, “Why Not the Best? Results from the National Scorecard on U.S. Health System Performance, 2011.” Excerpt:
“U.S. health system performance continues to fall far short of what is attainable, especially given the enormity of public and private resources devoted nationally to health. Across 42 performance indicators, the U.S. achieves a total score of 64 out of a possible 100, when comparing national rates with domestic and international benchmarks. Overall, the U.S. failed to improve relative to these benchmarks, which in many cases rose. Costs were up sharply, access to care deteriorated, health system efficiency remained low, disparities persisted, and health outcomes failed to keep pace with benchmarks. The Affordable Care Act targets many of the gaps identified by the Scorecard.” Read more »
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
