Jan. 23, 2012

New CBO Report Raises Red Flags on Most Medicare Demos

The Congressional Budget Office last week issued a new analysis that says Medicare’s value based purchasing, disease management and care coordination demonstration projects over the past 20 years have produced mixed results.  The Heart Bypass Center demo achieved savings to Medicare of about 10 percent with no apparent adverse outcomes. Other demos were not as fruitful. CBO provides suggestions to making future demos more successful. It looks at Premier’s VBP demo, the 10 member Physician Group Practice demo, Home Health Pay for Performance demo and several others.  This 9-page report is a good read for hospitals considering participation in CMS’ bundled payment and related demo programs. Click here to read.

New Report: Premier’s Demo Saves 25,000 Lives, Billions of Dollars

About the same time, Premier announced the results of the first three years of its QUEST program saying  hospitals have saved an estimated 24,820 lives and reduced health care spending by nearly $4.5 billion. The program includes 157 hospitals participating across 31 states, including urban/rural, large/small, teaching/nonteaching, and safety net hospitals. The initiative also aligns with national hospital reporting programs, such as the Medicare value-based purchasing program. Click here for details.

Congress Considers Doc Pay Fix Tomorrow

The House-Senate Conference committee is meeting tomorrow to discuss the physician payment fix, according to an announcement from the Ways and Means Committee last week. A number of provider cuts could be on the table as a way to off-set the Restoration of funds to the physician payment formula. Physicians face a 27 percent Medicare payment cut March 1 unless Congress acts.  The AHA is out with a new report saying current and proposed cuts could cost 278,000 hospital jobs. Click here for the association’s new study. The Association of American Medical Colleges has weighed in with a letter opposing a House GOP proposal to reduce Evaluation and Management Services payments (seen here).

HHS:  Most Non-Profit Religious Employers Must Cover Contraception

HHS on Friday announced a new twist to a rule that was first announced last year on covered preventive services that will require many nonprofit religious employers to cover contraception by August 2013. The August 2011 interim final rule required most health insurance plans to cover preventive health services for women, including recommended contraceptive services, without charging a copayment, coinsurance payment, or deductible. Compliance is required by Aug. 1 for most new and renewed health plans. Under Friday’s announcement, nonprofit employers “who, based on religious beliefs, do not currently provide contraceptive coverage in their insurance plan, will be provided an additional year, until Aug. 1, 2013, to comply.”  Employers who want the extra year must certify that they qualify for the delay. Click here for more. Click here for the Catholic Health Association response.

One in Five Americans Had Mental Illness Last Year:  New Report

According to a new government report out last week, one in five Americans suffered mental illness last year. The rate of mental illness was more than twice as high among those aged 18 to 25 (29.9 percent) than among those aged 50 and older (14.3 percent). Adult women were also more likely than men to have experienced mental illness in the past year (23 percent versus 16.8 percent). Click here for details.

Comparative Effectiveness Committee to Announce Spending Priorities

Wonder what’s happening with those billions of dollars set aside for comparative effectiveness research?  Well, the Patient Centered Outcomes Research Institute is about ready to release its spending priorities, according to Kaiser Health News (click here). PCORI’s executive director also has a good update on the Institute’s activities including a new RFI for its Methodology Committee. Click here to read.

Most States Moving Forward With Reform and Exchanges:  White House

The White House last week issued a new report saying that all states have taken steps to implement health care reform and that more than half are well on their way to establishing state exchanges. The report highlighted the activities of ten states: Alabama, Colorado, Idaho, Michigan, Minnesota, Mississippi, Nevada, New York, Pennsylvania, and Rhode Island. Click here to read the 9-page report – a good summary of the status of exchanges is on page 9.

AHA, Law Firm Issue Guidelines on Health System Ownership Issues

America’s hospitals are facing an increasing pressure to improve health care services, lower health care costs, and meet community needs that is driving an interest in integration of health care providers, according to the American Hospital Association and Jones Day law firm in a report issued last week.  Called “Principles and Guidelines for Changes in Hospital Ownership,” the report outlines a series of voluntary guidelines intended to help hospital and health system leaders with a growing number of system issues.  Click here for a copy of the 25-page report.

Congress Tackles ADD Drug Shortages

Attention Deficit Disorder drug shortages is the focus of  congressional Democrat. Energy and Commerce Committee members sent letters to the as DEA and to the CEOs of Shire Pharmaceuticals and Novartis. They cited recent reports of shortages of the generic versions of drugs used to treat ADD. Reports indicate that drug manufacturers may be manipulating the market to create an artificial shortage of the generic ADD drugs and force patient to purchase the more expensive brand-name drugs. Click here for more.

GAO Hits HHS and NQF for Reform Slowdown

The National Quality Forum came in for some criticism last week by the GAO as the oversight agency released a report indicating that NQF is not keeping pace with it requirements to produce measurements needed by HHS to evaluate cost saving measures under the health reform law. This could spell trouble for on-time implementation of the law. Click here for the GAO report.

U.S. Leads Developed World with Teen Births: CDC

Approximately 400,000 teens aged 15–19 years give birth every year in the United States, and the teen birth rate remains the highest in the developed world, according to a report last week from the CDC. Click here to read.