health reform

The return of Harry and Louise

Anne Zieger — Mon, 18 Aug 2008 09:53:36 -0400

Those involved in healthcare in the early 1990s won't forget Harry and Louise, a fictional couple whose complaints over then-President Clinton's health reforms helped to derail the entire effort. The Harry and Louise ads were funded by the health insurance industry, which opposed the Clinton plan. Now, Harry and Louise are back on the national political scene. This time around, though, they're singing a different tune. Article

Survey: Universal healthcare would boost MD shortage

Thu, 15 May 2008 06:59:57 -0400

When it comes to universal healthcare coverage, it would appear that a significant minority of physicians find the idea to be intolerable, according to a new survey. The survey, by physician recruiter LocumTenens.com, found that of roughly 1,400 doctors who responded, 11 percent would change occupations and 9 percent would retire if a universal health insurance scheme was put into place. Meanwhile, 63 percent said that their practice patterns wouldn't change.

Given that the federal government already projects a shortfall of 55,100 physicians by 2020, this can't be good. However, it remains to be seen whether any potential health reforms might do something to discourage doctor flight; perhaps policymakers, aware of such concerns among doctors, will come up with incentives that slow such an exodus?

To learn more about the study:
- read this Atlanta Business Chronicle piece

Related Articles:
Doctor shortage slows Massachusetts health reform
Community clinics face doctor shortage
Congress under pressure to address MD shortage
Study contradicts idea of physician shortage

PA health plans pay PCPs to track care

Tue, 13 May 2008 06:59:54 -0400

A group of Pennsylvania health plans have come together to create a program paying family doctors and other caregivers to manage patient care more closely. Among other things, the program will make providers more accessible to patients through phone calls and email, as well as educating patients in better self-care. Plans involved, which include Independence Blue Cross, Aetna and four other insurers, are looking to spend $13 million over three years to finance the first phase of the initiative. All told, more than 150 primary care doctors are participating within 32 primary care practices, and about 220,000 patients in southeastern Pennsylvania will participate, which makes this one of the largest efforts of its kind in the U.S. The program is part of Gov. Ed Rendell's chronic-care model for the state, which should rollout statewide by year-end.

To learn more about the program:
- read this Philadelphia Inquirer article

Related Articles:
Health plans, MD groups plan 'medical home' project
Humana debuts national complex care management program
Primary care MDs should manage chronic diseases

FL, IA legislatures pass CON reforms

Tue, 06 May 2008 06:59:56 -0400

Picking up on a trend that seems to be mounting nationwide, Florida and Iowa legislators have passed bills that will reform their respective certificate-of-need processes. Fulfilling one of his often-stated goals, Florida Governor Charlie Crist (R) plans to sign the legislation, which not only simplifies the process, but also includes a "loser pays" section that tries to discourage lawsuits designed to delay the launch of a new facilities.

Meanwhile, Iowa's CON legislation may or may not pass, as Gov. Chet Culver (D) hasn't said where he stands. Passing CON reforms there is complicated by the fact that the reforms are buried in a larger bill that addresses varied financing and policy issues. The bill would let replacement critical-access hospitals serving 75 percent of the same area, providing 75 percent of the same services and keeping 75 percent of the same staff avoid the CON process entirely.

To learn more about these bills:
- read this Modern Healthcare article

Related Articles:
IA bill exempts some hospitals from CON process
FL governor wants to end CON law
GA may approve sweeping CON changes
AL study questions need for CON process
RI reviews med equipment CON process

DC health mandate generates pullout threat from provider

Tue, 06 May 2008 06:59:55 -0400

As states and other governmental bodies consider health reforms, there have been some repercussions in the business community, of course. In DC's case, the impact could be quite severe, as the region's largest private healthcare provider may pull its physician network--along with its planned $5 million annual contribution--out of the region if DC's current reform package goes through. The District's Healthy DC legislation originally would have required that its 45,000 uninsured residents receive special subsidized health coverage, which would be available for premiums of between $20 and $100 per month, or else pay a $250 fine. It would be made available to those making more than $21,000 per year who couldn't afford traditional coverage.

The city had entered into a contract with CareFirst BlueCross BlueShield, a not-for-profit health insurer, to provide the special coverage. However, CareFirst has since expressed concerns that the $50 million program might not be financially viable.

To learn more about the dispute:
- read this Washington Post article
- read this statement from D.C. Councilmember David A. Catania, who backs the reforms

Related Articles:
DC investigates CareFirst provider contracts
DC considers pharma rep licenses, data mining limits
VA, DC begin routing stroke patients to centers
Avoidable hospitalizations puzzle health leaders in D.C.

ALSO NOTED: Health IT standards progressing; VCs and researchers teaming up to build biotech firms; and much more...

Tue, 29 Apr 2008 06:59:50 -0400

> It's looking like the health IT industry should make significant progress this year in establishing clinical data standards. FierceHealthIT
> VCs and researchers are increasingly teaming up to create biotech startups. FierceBioResearcher

> The nation's Blue Cross and Blue Shield plans are contending that health reform won't work without putting some kind of pay-for-performance scheme in place. FierceHealthFinance

> Officials in New Jersey are concerned that raising co-pays will prevent many Medicaid patients from accessing services. Article

And Finally... In this part of the world, if you flirt with the ladies, you'll pay the price. Article

RI reviews med equipment CON process

Thu, 24 Apr 2008 06:59:55 -0400

Apparently concerned that something is lacking in how the process works, a group of Rhode Island lawmakers have set up a commission to study whether state health officials are managing the CON process correctly. Right now, state law dictates that hospitals need to obtain CONs before buying high-cost medical equipment--in an effort, of course, to cut down on medical cost inflation. Apparently, legislators aren't satisfied that current legislation is getting the job done. The commission study, which will be presented in May 2009, is part of a larger effort in which the state is taking a fresh look at its entire CON approach. In so doing, Rhode Island actually is taking a less aggressive approach than several other states, some of which are dropping CON rules entirely or thinking seriously about doing so.

To learn more about the commission:
- read this Modern Healthcare article (reg. req.)

Related Articles:
FL governor wants to end CON law
AL study questions need for CON process
GA to revamp CON system

Congress under pressure to address MD shortage

Mon, 14 Apr 2008 06:59:57 -0400

With the proposed 10 percent Medicare pay cut raising the stakes, Congress is under increasing pressure to fight the ongoing doctor shortage with new legislation. The Physician Shortage Elimination Act, which originally was filed back in mid-2006, would provide millions of dollars for more scholarships for medical students, as well as expanding residency training programs. Even without the pay cut, one-third of the nation's approximately 750,000 doctors are over 55 and likely to retire within the next decade. Meanwhile, medical school enrollment isn't keeping pace with U.S. population growth, which should climb 24 percent over the next 10 years. Clearly, something has got to give here--the question is who will do the giving.

To learn more about Congress's efforts:
- read this Hartford Courant piece

Related Articles:
Senate may roll back 10 percent Medicare fee cut for MDs. Report
AMA keeps fighting Medicare cuts. Report
Doctor shortage slows Massachusetts health reform. Report
Community clinics face doctor shortage. Report

Study: Hospital costs vary greatly by location

Mon, 07 Apr 2008 06:59:54 -0400

New data from Dartmouth Medical School highlights a problem that is likely to become more widely discussed as health reform schemes--and related calls for pricing controls--continue to move forward. Researchers compiling information for the Dartmouth Atlas of Healthcare, which comes out every two years, examined records of 4.7 million patients who died during 2001 to 2005. What they found was the kind of disparities in costs that continue to frustrate policy-makers and employers. For example, they found that for chronically ill patients in their last two years of life, Medicare spends an average of $59,379 in New Jersey, but only $32,523 in North Dakota, largely due to New Jersey patients getting more hospital care. (The national average for such spending was $46,412.) Unfortunately, more hospital care didn't equate to better outcomes; such patients were seen by more specialists, and spent more time in the ICU, but didn't live longer on average.

To learn more about the study:
- read this Associated Press article

Related Article:
SPOTLIGHT: Berwick: Quality cuts Medicare costs. Report

MA primary care MDs get mixed quality grades

Fri, 04 Apr 2008 07:59:55 -0400

A new report from a local quality organization suggests that while Massachusetts primary care physicians rank well when it comes to preventive care and management of chronic conditions, they're not quite as good at managing spending, and outcomes could be better. The Massachusetts Health Quality Partners report concluded that the state's doctors rank higher than the national average on 24 of 25 quality-of-care measures, and better than the 90th percentile on almost half of the measures. However, when it came to outcome measures, there were some issues. Only one of six outcomes measured scored above the national 50th percentile--diabetic patients who properly avoid high blood glucose levels.

To learn more about the study:
- read this Boston Business Journal article
- read the group's report

Related Articles:
Shortage of primary care docs in MA. Report
Doctor shortage slows Massachusetts health reform. Report
Bill creates physician quality reporting system. Report