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01/26/2015

Weekly E-Bulletin


Healthgrades Announces 2015 Hospital Clinical Excellence Awards

Healthgrades last week announced the 261 recipients of the 2015 Distinguished Hospital Award for Clinical Excellence™. Healthgrades says this places these hospitals among the top 5% in the United States for the lowest rates of risk adjusted mortality and in-hospital complications across a broad spectrum of hospital services and specialty areas. Click here for the list.

 

Key House Committee Remains Unsure About Doc Payment Fix

A key House committee held the first hearings of the 114th Congress on a permanent solution to the Sustainable Growth Rate (SGR) last week. The current SGR patch expires March 31st, and time is running short to produce a permanent solution that can garner bi-partisan support in the House and Senate – and that President Obama will sign. It is looking more likely that Congress will again pass a short-term patch to give the Committees more time to develop a permanent solution (and a way to pay for it). Click here for an excellent SHC summary with links to all testimony.

 

Two Primary Care Demos Get Mixed Performance Reviews

CMS last week released the first evaluation reports for two primary care demonstration projects: the Comprehensive Primary Care Initiative and the Multi-Payer Advanced Primary Care Practice. The agency said the first demonstration cut hospital admissions by 2 percent and emergency department visits by 3 percent during its first year. But the demo didn’t generate enough savings in Medicare to offset the care management fees that CMS paid to practices. Results were best in Oklahoma and New Jersey but not good in Ohio and Kentucky. The second demonstration generated roughly $4.2 million in savings. Click here for the CPCI results. Click here for the Multi-Payer results.

 

BCBS: Knee, Hip Replacement Costs Vary Widely; More Transparency Needed

Pushing for more price transparency, a new report says the costs for knee and hip replacements–the two fastest-growing medical treatments in the country–vary by more than $20,000 from one place to another. The Blue Cross Blue Shield Association analysis says, for example, a total knee replacement in Dallas costs anywhere between $16,000 and $61,000. And the cost for a total hip replacement in Boston varied from $17,000 to almost $74,000. Click here for the report where dozens of metro areas are included.

 

Grassley Slams Hospital Collections Practices…Again

U.S. Senator Charles Grassley (R-IA), who chairs the Senate Judiciary Committee, is expressing astonishment that not-for-profit hospitals garnish the wages of low-income patients who should have qualified for charity care at the institutions where they received treatment, according to reports last week. Grassley said he is astounded that some of these institutions have been systematically sending low-income patients to collections. Grassley sent a letter to one health system demanding answers to a series of questions regarding collections. Click here for the letter.

 

Medicare Quality Bonuses Dwarf Penalties

Medicare will award quality bonuses to the majority of hospitals it assesses, but in most cases, other penalties will offset those gains, according to a Kaiser News analysis. The average penalty, at $1.2 million, vastly outweighs the average bonus of about $213,000 for large hospitals. The gap is smaller for hospitals with 200 beds or fewer, with an average bonus of $32,000 and an average penalty of $131,000. Overall, only 28 percent of the hospitals will either get extra money or break even. Click here for a state-by-state review. Click here for a hospital-specific PDF. Click here for the story.

 

Interstate Physician Licensing Compact Gains Momentum

In a move seen to boost telemedicine, lawmakers in eight states last week introduced legislation that would implement the Federation of State Medical Boards’ interstate licensing compact. The compact, released by the federation last September, would streamline the process to license doctors to practice in multiple states. The states are Iowa, Minnesota, Nebraska, South Dakota, Texas, Utah, Vermont and Wyoming. Click here for details.

 

Centering Could Be Key To Reducing Pre-Term Births

Want to reduce the number of pre-term births, increase birth weights, cut spending on NICUs and generally improve pregnancy outcomes? Try Centering, according to a Boston Globe report last week. Essentially group care for pregnant women, Centering continues to demonstrate favorable outcomes for moms and babies. Click here for the story.

 

Government’s Rx and Medical Device Payment Data Base Riddled with Errors: Report

Amid much anticipation and after a lengthy delay, the government in September unveiled its Open Payments database, saying it would bring transparency to relationships between physicians and the drug and medical device industries. But this openness has been clouded by numerous errors that detract from its usefulness. according to reports last week. Click here for the story. Click here for the Open Payments data base analyzing the top companies.

 

Who Would Hurt If Supreme Court Nixes Federal Subsidies?

What could happen if the Supreme Court says later this year that the Affordable Care Act does not allow the government to subsidize Americans who enroll in Obamacare in states that use federal health exchanges. A study released last week by the Robert Wood Johnson Foundation and Urban Institute says those with incomes below 400% of the federal poverty level would be most likely to become uninsured, although over 500,000 individuals with incomes above 400% FPL would lose coverage. Click here for the analysis.

  • Which state will have the highest insurance costs if subsidies are lost in those 37 states? Alaska, Wyoming, Delaware, Wisconsin and South Carolina, according to HealthPocket. Click here.
  • State lawmakers have introduced hundreds of bills to either enhance or tear down Obamacare in their states. Click here for a summary report from the Center for Public Integrity.
  • U.S. health insurers that waged a campaign against Obamacare hit an all-time high on the stock market last week after UnitedHealth Group Inc. said it would add hundreds of thousands of new customers because of the law. Click here.

 

New Regs Designed to Aid Health Insurance Shoppers

HHS, Labor and Treasury last week issued proposed rules to help people who are shopping for health insurance coverage better understand their options. All health plans and issuers are required to provide consumers with a standardized, brief summary of what a health insurance policy or employer plan covers. This information allows consumers to make “apples to apples” comparisons when they are shopping for health insurance coverage, and to have a clear summary of what their insurance covers. Click here for complete details and a copy of the rules.

 

Report Details Growth of Medicaid Enrollment

Just over 54 million Americans were enrolled in Medicaid in March of last year, according to data released last week by CMS. 22 states reported 3.2 million newly eligible adult enrollees. But the count is missing information from six states — California, Michigan, New Hampshire, North Dakota, Pennsylvania and D.C. — which could significantly sway totals in future updates. Click here for the state-by-state data.

 

Survey Compares States’ Medicaid, CHIP Policies

A new survey from the Kaiser Family Foundation released last week provides a comprehensive look at where states stand with their Medicaid and Children’s Health Insurance Program eligibility levels and enrollment, renewal and cost-sharing policies as of January 2015, one year into implementation of the Affordable Care Act’s major coverage provisions. Click here for the survey results.

 

Hospitals’ 2013 Charity Care Grew: AHA

Despite the Medicaid expansion in many states and state insurance exchanges, hospitals provided $46.4 billion in uncompensated care in 2013, according to the latest data from the AHA. That’s $500 million more than in 2012. The total includes “bad debt” (services for which hospitals anticipated but did not receive payment) and charity care (services for which hospitals neither received nor expected payment because they determined, with help from the patient, the patient’s inability to pay). It does not include Medicaid and Medicare underpayment. Click here for the report.

 

Obama Seeks Funding for Precision Medicine

President Obama will seek hundreds of millions of dollars for a new initiative to develop medical treatments tailored to genetic and other characteristics of individual patients, administration officials say. The proposal, mentioned briefly in his State of the Union address, will be described in greater detail in his budget in the coming weeks. The effort is likely to receive support from members of both parties, lawmakers said. Click here for the NY Times story.

 

Health Care Spending Growing

Healthcare spending grew at a 5.1 percent annual clip between November 2013 and November 2014, the Altarum Institute reported. Spending for the third quarter of 2014 rose 5.5 percent compared to the year-ago quarter, which was the highest growth rate since the first quarter of 2008. Spending in November, year over year, increased in all major categories. During the same time, healthcare prices barely budged. Click here for the report.

 

Iowa CO-OP Fails

Iowa’s insurance commissioner announced Friday that he would seek liquidation of CoOportunity Health, a carrier formed with $146 million in federal grants and loans under the Affordable Care Act. CoOportunity, which was one of 23 such health insurance cooperatives nationally, covered a total of nearly 120,000 people in Iowa and Nebraska before hitting financial shoals late last year. Click here for the Des Moines Register story.

 

CMS Begins Dialysis Star Ratings

CMS last week added star ratings to the Dialysis Facility Compare website. Summarizing performance data that dialysis facilities provide, the CMS system gives a rating on a one-to-five-star scale based on information about the quality of care and services. DFC joins the Nursing Home Compare and Physician Compare websites in expanding the use of star ratings. CMS also anticipates adding star ratings to Home Health Compare and Hospital Compare in 2015. Click here for details from CMS.

 

Largest Dialysis Company Forecasting More Growth

The world’s largest kidney dialysis provider and German healthcare group Fresenius plans to raise its dividend for the 22nd year in a row after hitting its financial targets for 2014, its chief executive said last week. Fresenius, which owns Europe’s largest private-sector hospitals chain, has forecast 14 to 16 percent sales growth for 2014 and net income growth of 2 to 5 percent, adjusted for currency fluctuations. Click here for the story.

 

Measles Outbreak Raises Concerns About Vaccinations

A major measles outbreak traced to Disneyland has brought criticism down on the small but vocal movement among parents to opt out of vaccinations for their children, according to reports last week. In a rash of cases that public health officials are rushing to contain, at least 70 people in six states and Mexico have fallen ill since mid-December, most of them from California. The vast majority of those who got sick had not gotten the measles-mumps-rubella, or MMR, vaccine. Click here for the story.

 

CDC: Opioid Use Growing Among Reproductive-Aged Women

Between a quarter and a third of reproductive-aged women filled a prescription for an opioid painkiller each year from 2008 to 2012, according to the CDC. That figure is concerning because taking opioids during pregnancy can cause birth defects and problems for the mother. The CDC found that 39 percent of Medicaid-enrolled women filled an opioid prescription each year during the period studied, compared to 28 percent of women with private coverage. Click here for more from the CDC.

 

CMS Change Will Allow Schools To Receive Medicaid Funds

Schools may soon be providing more health care to students with chronic health conditions, thanks to a CMS policy change long sought by states and children’s health advocates. The change, announced quietly and unexpectedly last month by CMS, will allow public schools to receive Medicaid money for health services they provide to eligible students for the first time since 1997. Click here for the report.

 

Little Health Progress Cited in 2014 on Tobacco Front

Little progress was made at both the state and federal levels in 2014 to protect Americans from the toll that tobacco takes on health, according to ALA’s 13th annual State of Tobacco Control report released last week. No states passed comprehensive smoke-free laws or significantly increased tobacco taxes. The federal government still hasn’t finalized its proposal to give the FDA authority to regulate e-cigarettes and cigars. Click here for their state-by-state report card.

 

Docs Turning to Digital for Rx

A new analysis shows that physicians are beginning to rely more on digital communications and sales for their pharmaceutical decisions rather than on more traditional pharma sales representatives. Digital tools now appear to have a greater impact. Click here for the story.

 

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