December 26th, 2011 by RyanDuBosar in Health Tips
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Health care facilities should consider mandatory flu vaccinations for their employees if other attempts don’t increase rates to 90%, a draft statement from a U.S. Department of Health and Human Services (HHS) working group stated.
All public health services, HHS staff and Federally Qualified Health Centers should follow suit, stated the Health Care Personnel Influenza Vaccination Subgroup in draft recommendations.
The working group released five steps to boost vaccination rates:
–Employers should establish comprehensive flu infection prevention programs as recommended by the Centers for Disease Control and Prevention (CDC) to achieve the Healthy People 2020 influenza vaccine coverage goal of 90%.
–Employers should integrate flu vaccination programs into their existing infection prevention programs.
–HHS should encourage CDC and the Centers for Medicare and Medicaid Services to standardize the methodology used to measure Read more »
*This blog post was originally published at ACP Internist*
October 1st, 2011 by PreparedPatient in News, Opinion
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Cigna launched a $25 million “GO YOU” national branding campaign last week signaling that they are gearing up for tons of new customers as health reform rolls towards 2014. That new business will come from the millions of Americans now uninsured who will start getting government subsidies as an encouragement to buy health insurance coverage. If those uninsured folks don’t get coverage, they will have tax penalties to pay.
No insurer wants to be left behind in this expanding marketplace, so Cigna, by being first out of the gate, hopes to build brand awareness that will ring bells in 2014 when consumers must buy insurance. It’s a smart strategy. One industry consultant says “most insurers have not built enough brand equity with consumers.”
Cigna’s ad campaign positions health insurance as Read more »
*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*
September 19th, 2011 by Stanley Feld, M.D. in Health Policy, Opinion
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As we get closer to January 2012, the originally scheduled implementation date for Accountable Care Organizations (ACOs), the time has come to reexamine the showpiece of President Obama’s Patient Protection and Affordable Care Act (PPACA) of 2010.
The final rules for ACO’s are now scheduled for release on January 2012. The implementation was originally scheduled for January 2012. As the original rules are being studied and interpreted the program for ACOs implementation became more confusing. Dr. Don Berwick (CMS Director) has refused to discuss the final rules until they have been published in the Federal Register.
“The ACO program is based on the hubristic assumption that the federal government can design the best organizational structure for the delivery of care, foster its development, and control its operation for the entire country.
The federal government has big-footed health system reform. Although there is no one right way to organize care, the federal government (Dr. Don Berwick and President Obama) thinks it has found one—and exerts top-down, bureaucratic control through PPACA to implement it.”
ACOs are supposed to be organizations that improve coordinated care. If an ACO decreases the cost of care Read more »
*This blog post was originally published at Repairing the Healthcare System*
April 14th, 2011 by Happy Hospitalist in Health Policy, Humor, True Stories
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This was a classic moment of comical clarity that only comes along once a week. As you may or may not know, starting in 2013, The Medicare National Bank has promised to take back 1% of all of a hospital’s total Medicare revenue (to increase in future years) if the hospital has a higher 30 day readmission rate for congestive heart failure, acute myocardial infarction or pneumonia than an as yet undefined acceptable 30 day rate of readmission.
What does this mean? It means if the government decides that 20% is an acceptable rate for congestive heart failure 30 day readmission, and the hospital has a readmission rate of 25%, the hospital will be told to return 1% of all Medicare revenue for the year, not just their heart failure revenue.
Let’s use some hypothetical numbers, shall we? If a hospital generates $250 million dollars in a year on 25,000 Medicare discharge diagnosis related groups (DRGs) but only 100 of those discharge DRGs (or $1,000,000) were heart failure in 2013, what would happen if 21 CHF patients returned for readmission (a 21% thirty day readmission rate) within 30 days for heart failure instead of allowable 20%? The hospital would have to return 2.5 million dollars (1% of their total revenue on all Medicare admissions).
That one patient that took them from 20% to 21% will cost them 2.5 million dollars. The hospital would generate one million dollars in CHF revenue for the year and pay back 2.5 million dollars in penalty. That’s a pretty hefty price to pay considering that hospital profit margins from Medicare have been negative, on average, for most of the last decade. Read more »
*This blog post was originally published at The Happy Hospitalist*
May 23rd, 2010 by EvanFalchukJD in Better Health Network, Health Policy, News, Opinion
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Fortune magazine has made some news recently about the impact of healthcare reform on large employers:
Internal documents recently reviewed by Fortune, originally requested by Congress, show what the bill’s critics predicted, and what its champions dreaded: many large companies are examining a course that was heretofore unthinkable, dumping the healthcare coverage they provide to their workers in exchange for paying penalty fees to the government.
The only trouble? There’s no way these employers are seriously thinking about doing this.
I can understand why the employers would do the math. According to healthcare reform law, penalties for failing to provide health coverage are a small fraction of the cost of that coverage. But as with most everything else in healthcare, there’s much more to it than just a simple math equation. Here’s what I mean. Read more »
*This blog post was originally published at See First Blog*
