Friday, May 31, 2013

Health Differences May Explain Medicare Spending Variation

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Wednesday, May 29, 2013

Health Differences May Explain Medicare Spending Variation

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Tuesday, May 28, 2013

Good News on Innovation and Health Care

A recent New York Times column, Obamacare�s Other Surprise, by Thomas L. Friedman echoes what we�ve been hearing from health care providers and innovators: Data that support medical decision-making and collaboration, dovetailing with new tools in the Affordable Care Act, are spurring the innovation necessary to deliver improved health care for more people at affordable prices.

Today, we are focused on driving a smarter health care system focused on the quality � not quantity � of care.� The health care law includes many tools to increase transparency, avoid costly mistakes and hospital readmissions, keep patients healthy, and encourage new payment and care delivery models, like Accountable Care Organizations.� Health information technology is a critical underpinning to this larger strategy.�� �

Policies like these are already driving improvements. Prior to the law, nearly one in five Medicare patients discharged from a hospital was readmitted within 30 days, at a cost of over $26 billion every year.� After implementing policies to incentivize better care coordination after a hospital discharge, the 30-day, all-cause readmission rate is estimated to have dropped during 2012 to a low of 18 percent in October, after averaging 19 percent for the previous five years.� This downward trend translates to about 70,000 fewer admissions in 2012.

Insurance companies are also now required to publicly justify their actions if they want to raise rates by 10% or more.� Since the passage of the Affordable Care Act, the proportion of requests for double-digit rate increases fell from 75 percent in 2010 to 14 percent so far in 2013.

Reforms like these have helped slow Medicare and Medicaid spending per beneficiary to historically low rates of growth.

Mobilizing Use of Health Information Technology

Last week, we reached an important milestone in the adoption of health information technology.� More than half of all doctors and other eligible providers and nearly 80 percent of hospitals are using electronic health records (EHRs) to improve care, an increase of at least 200 percent since 2008.

Friedman wrote of Dr. Jennifer Brull, a small-town Kansas family doctor, as an example of how health IT is making a difference in real patients. One of our �physician champions,� Dr. Brull installed alerts in her EHRs to improve the rate of colon cancer screenings for her patients. She found colon cancer early in three patients as a result � so early that they did not need chemotherapy or radiation.

Friedman also cited several companies, like Lumeris of St. Louis, that are using health IT and �mountains� of ��HHS data now in electronic form to improve health outcomes. Mike Long, the CEO of Lumeris, says his company is analyzing hospital, insurance and HHS data and getting the information to physicians in real time. � [W]e wind up delivering better care. �And it�s lower cost,� Long said.

Government Data as Fuel for Innovation

Since the early days of the Administration, we have provided the public with high quality health data.� Making our data more accurate, available and secure brings transparency to a traditionally opaque health care market and allows innovators and entrepreneurs to use it for discovering innovative applications, products, and services to benefit the public.

Earlier this month, the Administration released unprecedented data about what hospitals across the country charge for the 100 most common Medicare inpatient stays, which can vary widely. �For example, average inpatient charges for hospital services in connection with a joint replacement range from $5,300 at a hospital in Ada, Okla., to $223,000 at a hospital in Monterey Park, Calif.

In May, we announced a $1 billion challenge to help jump start innovative projects that test creative ways to deliver high quality medical care and lower costs to people enrolled in Medicare and Medicaid.

There is much work yet to be done to change the habits of the health care system. But by encouraging transparency and market-based innovation around health data, we are playing to America's greatest strength to solve our most pressing problems.

Good News on Innovation and Health Care

A recent New York Times column, Obamacare�s Other Surprise, by Thomas L. Friedman echoes what we�ve been hearing from health care providers and innovators: Data that support medical decision-making and collaboration, dovetailing with new tools in the Affordable Care Act, are spurring the innovation necessary to deliver improved health care for more people at affordable prices.

Today, we are focused on driving a smarter health care system focused on the quality � not quantity � of care.� The health care law includes many tools to increase transparency, avoid costly mistakes and hospital readmissions, keep patients healthy, and encourage new payment and care delivery models, like Accountable Care Organizations.� Health information technology is a critical underpinning to this larger strategy.�� �

Policies like these are already driving improvements. Prior to the law, nearly one in five Medicare patients discharged from a hospital was readmitted within 30 days, at a cost of over $26 billion every year.� After implementing policies to incentivize better care coordination after a hospital discharge, the 30-day, all-cause readmission rate is estimated to have dropped during 2012 to a low of 18 percent in October, after averaging 19 percent for the previous five years.� This downward trend translates to about 70,000 fewer admissions in 2012.

Insurance companies are also now required to publicly justify their actions if they want to raise rates by 10% or more.� Since the passage of the Affordable Care Act, the proportion of requests for double-digit rate increases fell from 75 percent in 2010 to 14 percent so far in 2013.

Reforms like these have helped slow Medicare and Medicaid spending per beneficiary to historically low rates of growth.

Mobilizing Use of Health Information Technology

Last week, we reached an important milestone in the adoption of health information technology.� More than half of all doctors and other eligible providers and nearly 80 percent of hospitals are using electronic health records (EHRs) to improve care, an increase of at least 200 percent since 2008.

Friedman wrote of Dr. Jennifer Brull, a small-town Kansas family doctor, as an example of how health IT is making a difference in real patients. One of our �physician champions,� Dr. Brull installed alerts in her EHRs to improve the rate of colon cancer screenings for her patients. She found colon cancer early in three patients as a result � so early that they did not need chemotherapy or radiation.

Friedman also cited several companies, like Lumeris of St. Louis, that are using health IT and �mountains� of ��HHS data now in electronic form to improve health outcomes. Mike Long, the CEO of Lumeris, says his company is analyzing hospital, insurance and HHS data and getting the information to physicians in real time. � [W]e wind up delivering better care. �And it�s lower cost,� Long said.

Government Data as Fuel for Innovation

Since the early days of the Administration, we have provided the public with high quality health data.� Making our data more accurate, available and secure brings transparency to a traditionally opaque health care market and allows innovators and entrepreneurs to use it for discovering innovative applications, products, and services to benefit the public.

Earlier this month, the Administration released unprecedented data about what hospitals across the country charge for the 100 most common Medicare inpatient stays, which can vary widely. �For example, average inpatient charges for hospital services in connection with a joint replacement range from $5,300 at a hospital in Ada, Okla., to $223,000 at a hospital in Monterey Park, Calif.

In May, we announced a $1 billion challenge to help jump start innovative projects that test creative ways to deliver high quality medical care and lower costs to people enrolled in Medicare and Medicaid.

There is much work yet to be done to change the habits of the health care system. But by encouraging transparency and market-based innovation around health data, we are playing to America's greatest strength to solve our most pressing problems.

Wednesday, May 22, 2013

Latest Health Hurdle: Buying Insurance Without A Bank Account

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Thursday, May 16, 2013

Swell Of Goodwill For First Medicare Chief Confirmed Since 2004

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Wednesday, May 15, 2013

Obamacare Issues Beg the Questions that Single-Payer Answers

In recent days, many of us have read and tried to follow the reports that Congressional offices are engaged in discussions about how to make sure their health insurance coverage available under the Affordable Care Act (Obamacare) remains affordable for Congresspersons and their staff members. If you�d like to read more about the hullabaloo, this piece from the Washington Post probably explains it as clearly as any.

Basically, a mischievous amendment drafted and inserted by Republicans and later agreed to by Democrats anxious to pass the ACA leaves some challenging issues to be resolved regarding the employer�s (in this case the Federal government, a.k.a., you and me) contributions to paying their share of premiums for Congressional members and their staff members. Negotiations and discussions continue, but some fear that some Congressional staff may leave their positions rather than take on the bigger financial burdens of paying more of their health insurance premiums. Stay tuned, if you are worried about how this plays out.

For the human beings involved who have health needs and families to support just as the rest of us do, I hope a fair resolution is reached in the short term. In the longer term, this should serve as yet another reinforcement of the need to move well beyond the incredibly unaffordable Affordable Care Act to the common sense, common decency, and simplicity of a single-payer, Medicare for all for life model for our dysfunctional health care system.

If Congressional members and their staffs are having difficulties comprehending and navigating the details of the ACA, imagine the millions and millions of �average� Americans who will face incredible confusion, expense, and delays of access to needed health care as we slog through the details of the ACA. Most of us will not have anyone to negotiate or advocate for us when we try to make decisions about health coverage. We will have �navigators� who will explain various plans available on the exchanges but that�s vastly different from having true advocates to make sure we aren�t overburdened with costs or enrolling in coverage that really isn�t coverage at all but simply compliance with the mandate to carry the financial product that is insurance. I am already worried, just as millions of others are.

Why would single-payer, Medicare for all for life be so much better? Simplicity � everybody is in, nobody is out. Vastly reduced administrative costs � strip out the profit made on misery and deception and advertising and claims denials and delays. Incredibly improved access to providers of our choice. No need to navigate me to one plan or another. No need to bankrupt me with co-pays, deductibles and out-of-pocket expenses. No need for anyone in charge of profit-making to lemon drop (get rid of those with costly medical conditions or who are aging) or cherry pick (keep the healthy, less costly folks enrolled). We all have one single standard of high quality care under a social insurance model, not a model aimed at maximizing profits.

Some of us will face harsh realities more quickly than Congressional members of staffers on the Hill. In just four days, I must decide once and for all whether or not to spend more than $800 a month on my coverage for the next several months or just go bare until the exchange (more stealthily named the �marketplace�) is up and running here in Colorado in January 2014. No matter what I, as a two time cancer survivor and 58 year old, think is possible financially for me or even wisest from a health standpoint over the next eight months, once I get to October of this year, I will be able to begin exploring what I may be able to find under the ACA for my coverage. I am so grateful that my husband is covered under Medicare and a supplemental (as are many member of Congress, I suspect).

When my time comes to decide about my health and my life, there will be no committee convened that worries about my costs or my coverage as is the case with the current effort on behalf of the Congressional members and staffs my tax dollars cover. I will decide alone, likely in front of my computer screen, making calculations about paying my bills and other living expenses. And I guarantee that my coverage will be bare bones as no one will want to cover me and though under the ACA they will not be able to deny me coverage, insurance companies will be able to age-rate my premiums and make sure they factor in my health history. My premiums will likely be so high that I will either have to opt to pay a penalty for not having coverage or I will be grossly under-insured.

None of this is necessary. None of it. Under a Medicare for all for life, single-payer model, we are all in one risk pool, we all pay a fair and progressive tax or premium for our coverage, and our medical and health decisions will no longer be business calculations. We will be free of this mess. We must thunder forward through the confusion of this difficult transition to the unnecessary complexity of the ACA to the day when we all are covered simply as a matter of human right and public good.

Donna Smith is the Executive Director of Health Care for All Colorado and the Health Care for All Colorado Foundation.

Thursday, May 9, 2013

Medicare Pulls Back Curtain On Hospital Bills

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Monday, May 6, 2013

Pfizer Goes Direct With Online Viagra Sales To Men

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Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

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