health policy report

Cut or keep reimbursement at a flatline, increase paperwork, and doctors will like Medicaid even less. That's what's been happening in Florida since authorities kicked off a new pilot program moving beneficiaries into HMOs, according to new research by the Georgetown University Health Policy Institute. In 2005, former Florida governor Jeb Bush (R) signed a law creating the pilot program, which also caps spending growth at 8 percent over five years. Since that time, it appears that …

Washington state governor Chris Gregoire (D) has put her John Hancock on a new law which should make some significant changes to the state's health system. Among other things, the measure will boost health coverage for children and young adults, in part by requiring health plans and state employee programs to cover unmarried children up to age 25 on parents' policies. The law will also encourage the use of EMRs. Perhaps most significantly, the bill will set up a pilot program to test a …

How often do you see the insurance industry petition the government to set up another federal agency? Well, in this case, this most unlikely of events has actually occurred. America's Health Insurance Plans (AHIP), the association representing health insurers, has asked Congress to create an agency dedicated to comparing the effectiveness of existing medical treatments, drugs and devices with new ones. (It would be intriguing to see whether some doctors' instincts are correct that snazzy …

Medicare fraud continues to drain billions from federal coffers, though the volume of CMS overpayments and errors has fallen over the past two years, according to CMS's top official. Acting CMS administrator Leslie Norwalk told the House Energy and Commerce Subcommittee on Health that the agency has seen a significant jump in fraud and abuse over the past few years. Fraud among DME vendors, orthotics, prosthetics and supplies vendors continues to be a trouble spot, Norwalk said. For …

With state officials and hospitals struggling to provide enough beds--and meet the need for post-discharge treatment--a growing number of Massachusetts children are having trouble getting needed mental health services. Mentally-ill children and adolescents face long ED waits, and when they are discharged, may not have access to outpatient programs. In February, for example, 156 children who were ready to leave inpatient psychiatric settings didn't have access to outpatient treatment. This …

New research presented at the annual meeting of the American Association of Clinical Endocrinologists suggests that the majority of U.S. diabetics--a full three out of five--experience at least one major, costly complication, including heart disease, stroke, eye damage, chronic kidney disease or foot amputation. The research, which analyzed data gathered by the National Center for Health Statistics between 1999 and 2004, also found that one in 10 diabetics has two complications, one in …

If you're convinced that people won't settle for cut-rate retail clinic care, think again. Though some quality concerns remain, most U.S. residents who have visited a retail clinic are satisfied with the service they received, according to a new survey by The Wall Street Journal Online and Harris Interactive. The research, which surveyed 2,441 U.S. adults, found that five percent had visited a retail clinic. Nearly half (44 percent) visited for a vaccination, 33 percent …

Taking on a very tough problem, two federal legislators have re-introduced a bill which would reward doctors who provide ED- or other emergency-related care with 10 percent Medicare pay increases. The bill also establishes a commission which would look at related issues such as overcrowding in the ED, med mal issues in providing ED-based care, and the shrinking availability of specialists willing to take call. Right now, ED physicians end up with $140,000 in uncompensated care annually, …

Earlier this week, AMA officials testified in front of a Senate Judiciary Committee, saying that consolidation in the health insurance industry has curtailed physician's abilities to negotiate with insurers. "We have watched with growing concern as large health plans pursue aggressive acquisition strategies to assume dominant positions in their markets," the association commented. Officials also allege that the lack of competition between insurers inflates patients' premiums. The AMA …

Speculation is in the air in the wake of Mark McClellan's announcement that he will step down as CMS administrator. McClellan said he will join a think tank focused on improving the U.S.'s healthcare system. Now the question is: Who will replace him? The New York Times reports that CMS Deputy Administrator Leslie Norwalk is an obvious candidate. CQ HealthBeat says that Herb Kuhn, …