(MedPage Today) — But proposed adoption of medical loss ratio proves controversial
Category: health policies
Price’s Health Reform Hit From The Right
I recently discussed Rep. Tom Price, MD’s Empowering Patients First Act in quite positive terms. Not everyone is on board. My good friend Dean Clancy labels the bill Health Care Cronyism: Section 401, for example, authorizes new federal “best practice” guidelines written by medical societies, designed to give physicians extra protections from malpractice lawsuits. These guidelines aren’t merely educational, though. They’re established as powerful litigation tools in state courts. If a physician can show he followed them, his accuser must meet a higher burden of proof to establish negligence. That may be a good idea, but it’s unconstitutional. The power to regulate civil justice is reserved to the states under our federal system. There’s neither a legal nor a practical justification for federal
Most Employers Will Use Private Benefits Exchanges by 2018
A new survey from Array Health reports four of five insurance executives anticipate that most employers will use private exchanges to offer benefits by 2018. According to the survey, private exchanges are a win-win situation because they reduce administrative costs. We like private exchanges because they pave the way for individual health insurance to be the standard. The Array report seems to support this conclusion: More exciting, perhaps, is the future outlook around business savings as single-insurer private exchanges start to move with consumers – from group settings to individual plans – keeping loyal consumers tied to particular insurance brands through the exchange model. They have to overcome an internal PR hurdle, according to the survey, because employees are not too thrilled about employers making defined
“Transparency” Will Not Fix Medicare Physician Fees
The Government Accountability Office (GAO) has released a report criticizing the way the federal government sets physicians’ fees in Medicare. It concludes that “Better Data and Greater Transparency Could Improve Accuracy.” I doubt it. Note the mind-numbing detail of this process: The government delegates its assumed authority to a group of physicians who comprise the Relative Value Scale Update Committee (RUC). The government “reviewed 1,278 RUC work relative value recommendations for about 1,200 unique (new and existing) services)” in the last four years. The Center for Medicare & Medicaid Services (CMS) is the agency that supervises this mess: CMS’s process for establishing relative values embodies several elements that cast doubt on whether it can ensure accurate Medicare payment rates and a transparent process. First, although CMS officials
Think About the Worst Corporate Merger Ever – Then Add Obamacare
I hate to recycle the old slight about “re-arranging the deck chairs on the Titanic,” but the latest news from state exchanges makes it impossible to avoid: Under the Affordable Care Act, the federal government gave states a collective $4.8 billion to set up and customize their own exchanges for their own state residents. The idea was that the federal government would help prop up the exchanges, and then states would have to make them self-sustainable by this year. However, a number of states including California and Oregon are having trouble financing their exchanges now that federal funding is drying up. Covered California, for example, is running a deficit of $80 million. To save on costs, California is reportedly in talks with Oregon, another
Are Insurers Prevailing Over Drug Makers?
Less than a year ago, it looked like health insurers were sending up trial balloons to see if they could get the federal government to regulate the research-based pharmaceutical industry as a utility. This was a reaction to high prices for new drugs like Sovaldi®. Today, the issue is being dialed back: Express Scripts, the largest pharmacy benefits manager in the U.S. initially refused to put Sovaldi® on its formulary. Now, it looks like both sides might have come to a businesslike accommodation: That taught Amgen and other drugmakers a lesson. Avoiding hostility with insurers and PBMs is now a paramount industry goal. “Every company is saying, ‘We don’t want to replicate what happened with Sovaldi. So let’s sit down and talk,’ ” says
Morning Break: Tattoo Trauma, Beer at Bedside, Ugly Food
(MedPage Today) — Health news and commentary from around the Web, gathered by the MedPage Today staff.
Diabetes-Specific Health Plan Boosts Medication Adherence (CME/CE)
(MedPage Today) — But benefits were modest at 1-year follow-up.
Cost Challenges: Hepatitis C
(MedPage Today) — 10 days, 10 questions: Day 9 — “How can patients and insurers afford the new agents?”
Health Spending Unscathed In Shrinking Economy
This morning’s terrible revision to first quarter GDP – from an initial estimate of 0.2 percent real growth to a real loss of 0.7 percent – confirms that health spending stands over our weak economy like a colossus. In the initial estimate, personal consumption spending on health services increased by $23 billion (chained 2009 dollars). Today’s second estimate reports $24.2 billion (Table 3, line 17). So, we can be pretty confident that the folks at the Bureau of Economic Analysis who do this good work have mastered how to measure spending on health services. This emphasizes how much of our prosperity is being devoured by a health system that is still driving everyone crazy, post-Obamacare. The real drop in GDP was a loss of $30.6 billion. Quarter over quarter figures
Summer 2014 Field Placements
The following organizations are actively seeking HPAM interns for Summer 2014 placements. Please send your resume and letter of interest to Nina Cleveland, ninac64@uga.edu, if interested. Athens Regional Medical Center, Local Hospital CDC- Division of Communications Services; Strategic and proactive Communications Branch, Federal Gov CDC-ATSDR and National Center for Environmental Health, Federal Gov CDC-Global Migration and Quarantine, Federal gov read more