WEEKLY E-BULLETIN


 

Journalists Put Hospital Inspection Reports Online; Check Out Your Hospital

A new website unveiled last week is bound to cause headaches for hospitals across the United States.  The Association of Health Care Journalists has put federal hospital inspection reports online, making them easier to access, search and analyze. This site includes details about deficiencies cited during complaint inspections at acute care and critical access hospitals throughout the United States since Jan. 1, 2011. It does not include results of routine inspections or those of psychiatric hospitals or long-term care hospitals. It also does not include hospital responses to deficiencies cited during inspections. Click here to check out your hospital and your competitors.

 

New CMS Patient Satisfaction Ratings Will Be Posted

CMS announced last week it is creating a new survey to augment its consumer-oriented physician compare website with quality and patient satisfaction scores. CMS will now make available the quality measures collected under PQRS, and the new Consumer Assessment of Healthcare Providers and Systems Survey for Physician Quality Reporting which will support inclusion of patient satisfaction ratings as well. Click here for CMS’ detailed announcement in the Federal Register, where they are looking for written comments to the proposal. It is a very brief read.

 

Most States Failing Price Transparency: Report

29 states have failed a new price transparency evaluation conducted by the Catalyst for Payment Reform and the Health Care Incentives Improvement Institute. Only Massachusetts and New Hampshire received “A’s.” The two organizations worked together to review state-specific laws focused on price transparency for health care. The review generated two products, a report card on state price transparency laws and a reference table that provides the details of price transparency laws for each state. Click here for the interactive state map and report.

 

Health Insurers Say Hospital Prices Soaring

The nation’s largest health insurance industry released a report last week saying unadjusted inpatient hospital prices per admission grew by 8.2% per year from 2008 to 2010 for the commercially insured population; or $13,016 in 2008 to $15,236 in 2010. The report estimates that approximately 1.3 to 1.9 percentage points of the growth in prices can be attributed to increased intensity per admission. Price levels and trends varied considerably across admission types, states, and localities. Click here for the report. The American Hospital Association shot back at insurers. Click here to read.

 

RAC Reform Bill Introduced

Reps. Sam Graves (R-MO) and Adam Schiff (D-CA) last week introduced the Medicare Audit Improvement Act (H.R. 1250) to improve the Recovery Audit Contractor program and other Medicare audit programs. Specifically, the Medicare Audit Improvement Act would reinstate and make statutory a hard cap on Additional Document Requests (ADRs) on the part of Medicare auditors to 2% of hospital claims with a maximum of 500 ADRs per 45 days. Click here for more information.

 

TeleHealth Bill Introduced

Sens. John Thune (R-SD) and Amy Klobuchar (D-MN) last week reintroduced the Fostering Independence Through Technology Act (S. 596). The legislation would create pilot projects aimed at increasing the use of remote monitoring technology for home health patients and reducing unnecessary hospital readmissions or patient transfers from home to higher acuity care settings. Click here for additional information.

 

County-By-County Health Status Released

For those health care organizations focusing on population health solutions, a major new study revealed that residents of the nation’s least healthy counties die at twice the rate of those living in their states’ healthiest counties, despite a major improvement in the rate of premature deaths. A quick state-by-state look at the most and least healthiest counties can be seen by clicking here. Click here to review a very good, detailed interactive national map showing every state and county.

 

Report Gives First State-By-State Estimates of Immigration Status Exclusions from Medicaid

A new Robert Wood Johnson Foundation study released last week provides the first state-specific estimates of the number of uninsured low-income adults that will be excluded from the Medicaid expansion because of their immigration status. The report says safety net health care providers are likely to continue to be key providers for these populations after health reform, and the need for safety-net care will not be spread evenly across states. Click here to see the state-by-state analysis.

 

GOP-Led States Rethinking Medicaid Expansions

Texas and other GOP led states are getting increasing pressure to reconsider a Medicaid expansion under Obamacare. For example, the largest state whose governor has rejected an expansion, Texas, may be reconsidering. Chambers of commerce representing companies such as Exxon Mobil Corp. and Kimberly-Clark Corp. are challenging Governor Rick Perry and lawmakers to expand health care for the poor in the state with the highest percentage of uninsured people. Click here for the story. Arkansas, Louisiana, Ohio, Florida and Maine are considering a new twist on Medicaid expansion. Click  here for the story from the Washington Post.

 

Moody’s Warns States That Don’t Expand Medicaid

States that opt out of Medicaid expansion but have large numbers of uninsured residents will be at high risk of budget shortfalls as the federal government reduces payments to disproportionate share hospitals (DSH) under the Affordable Care Act, Moody’s warned in a new report. Click here for the Moody’s report.

 

Adjusting Medicare for Geographic Disparities May Not Help: IOM

Paying doctors and hospitals Medicare rates based on their geographic region would not result in more efficient care, an Institutes of Medicine committee has found. A preliminary report released last week casts doubt on proposals by Congress to address regional payment disparities by pegging rates to a geographic index. The method could reward some underperforming doctors and penalize others who overperform relative to their area, the committee found. Click here for the IOM report.

 

Insurers Spending Little to Improve Quality: Report

A new Commonwealth Fund report out last week sheds light on how health insurers are spending their premium dollars. Overall, health insurers devoted 84% of premium revenues to medical expenses, 11% to administrative overhead, 0.7% to quality improvement activities, and 0.5% to premium rebates.  Insurers retained the remaining 3.9% of premium revenues as operating surplus (i.e., pretax profits). Click here for the very good and detailed ten page analysis.

 

Framework Proposed for Transition from Fee-For-Service

As the U.S. health care system moves away from fee-for-service (FFS), exactly what is next? The Partnership for the Future of Medicare believes the FFS payment model should be phased out over the next five to seven years and has developed a vision of what this transition period might look like. It also includes specific policy recommendations that will most efficiently and effectively move Medicare away from FFS and pave the way for wider adoption of new, quality-driven payment models. Click here for the four page summary.

 

Kaiser Model Could Be Future: NY Times

Will the future of health care in the United States look like Kaiser Permanente’s current model? That’s the topic of a New York Times story from last week. Click here to read.

 

Senators Push Pediatric Dental Coverage in Exchanges

A group of nine Senate Democrats wants CMS to rework the Essential Health Benefits regulation so that pediatric dental coverage is covered in the exchanges and not as a separate dental plan with its own out-of-pocket limit. In a letter to CMS released last week, the senators said, “We find it deeply concerning that CMS would allow stand-alone dental insurers to set limits as high as $1,000 per child beyond what the law intends families to pay for services considered essential health benefits.” Click here to see more including the letter.

 

Key House Members Propose Life Science Policy Ideas

Republicans on a key health committee in the House last week released a series of policy ideas aimed at promoting health innovation that they plan to pursue in the 113th Congress. The five “policy concepts,” as the Energy & Commerce Committee terms them, are meant to serve as a road map for where the panel is headed. They expect to come up with additional ideas on health insurance, Medicare, Medicaid and possibly other issues. Click here to review the committee’s Life Sciences innovation agenda.

 

CMMI Leader Outlines Innovation Programs and Status

The physician who heads the Center for Medicare and Medicaid Innovation at CMS, Richard Gilfillan, was on the Senate Finance Committee hot seat last week as he defended his agency’s numerous demonstration projects, like ACOs and bundled payments. Click here for his opening testimony, which is a very good summary of the projects now underway at CMMI.

 

Taxpayers Funding Major Research That Profits Private Companies

Members of Congress are taking a new look at the investment taxpayers make each year in the development of drugs and devices that are then marketed by major private companies, according to a NY Times report out last week. Tightening federal research dollars may make it necessary for major pharmaceutical companies to show a return to taxpayers when the research is performed by federal agencies. Click here for the story.

 

EHR Payment Incentives Top $12 Billion

Medicare and Medicaid electronic health record incentive payments were estimated at $12.3 billion paid to a total of 219,000 physicians and hospitals through February since the program’s inception, according to a report out last week. CMS is expected to post final figures for February later this month as it captures more complete data. Click here for the story. However, CMS is sending out letters informing a random segment of providers that their Medicare billing activities will be audited. Click here for that report.

 

FDA Wants New External Defibrillator Review

A new FDA proposal would require the manufacturers of external defibrillators to file premarket approval applications to demonstrate that the devices are safe and effective. According to the agency, there have been more than 45,000 adverse events associated with the defibrillators from 2005 to 2012 and dozens of recalls. Click here for details.

 

Study Says Nursing Fatigue Raising Quality Concerns

Fatigue leaves a majority of nurses concerned about their ability to perform safely, with two-thirds of nurses reporting they had nearly made a mistake at work because of fatigue and more than a quarter saying they had made a fatigue-related error, according to a survey out last week. Click here for the survey results.

 

One in Three Seniors Dies with a Form of Dementia

A report published by the Alzheimer’s Association finds that one in three U.S. seniors dies with Alzheimer’s disease or another form of dementia. The rate of Alzheimer’s-related deaths jumped 68% from 2000 to 2010, while deaths caused by heart disease and other major illnesses have dropped, the report finds. Click here for the report.

 

CBO Says Obamacare Costs Mostly Unchanged in 3 Years

The Congressional Budget Office’s estimates of the net budgetary impacts of the health law’s coverage provisions have “changed little” since March 2010, CBO said in a brief last week. The CBO and the Joint Committee on Taxation now estimate that the coverage expansions will cost $1.165 trillion over the 2013-2022 budget window, within $1 billion of their August 2012 estimate. That’s after the groups tweaked their assumptions about exchange and Medicaid enrollment. Click here to read the CBO update.

 

GOP, Dems React Differently to Obamacare’s 3rd Anniversary

Last week marked the 3rd anniversary of the enactment of Obamacare. CMS touted the new law with saving seniors more than $6 billion in drug costs and other benefits (click here). The GOP members of the House Energy & Commerce Committee issued a scathing report entitled “Broken Promises” focusing on the Affordable Care Act. Click here to review their new website.