Washington Budget Leaders Want More Cuts in Health Care

A major budget reform announcement this week, from the President’s former chairmen of the 2010 Simpson-Bowles Fiscal Commission, included significant cuts to health care programs between 2014 and 2023. It’s not too likely that this plan will be adopted in whole by Congress, but it provides continued pressure to reduced health care spending. A total of $565 billion in health care reductions, including $70 billion in post acute care and $65 billion from hospitals. Click here for their recommendations summary.


Reform Rather Than Cuts Will Save Medicare Billion: Study

Another major health care reform proposal announced last week from the Bipartisan Policy Center says $300 billion can actually be saved in Medicare by creating “Medicare Networks,” increasing competition between Medicare Advantage plans, significantly reforming fee-for-service programs, modernizing benefits by eliminating first dollar supplemental coverage. There are a lot of well-known political names associated with the policy organization. That should help some of their ideas gain traction. Click here for the 18-page summary. There is also a 140-page report.


Truven Announces Top 15 U.S. Health Systems

Truven Health Analytics last week released its fifth annual study identifying the top U.S. health systems based on balanced system-wide clinical performance. The study gathered data from more than 300 organizations and singled out 15 hospital systems based on a composite score of eight measures of quality, patient perception of care, and efficiency. Click here to see the list.


Consumer Reports Publishes Expanded Hospital Safety Report

Consumer Reports (CR) has published an expanded hospital safety report, almost doubling the number of hospitals that fall under the updated hospital safety ratings that the magazine first published last August. The expanded review has grown from 1,159 hospitals to 2,031 hospitals. CR says its report still shows low scores across five measures: readmissions, complications, communication, the overuse of CT scans, and infections. The average score for all hospitals was 49. Click here for a summary. Click here for a state-by-state map. Seeing the scores of individual hospitals requires a subscription.


CMS Planning Big RAC Changes: Report

Significant changes coming to CMS’ Recovery Audit Contractors, according to a published report last week. Current RAC contracts are expected to expire in February 2014. The new RAC contract period is to extend from 2014 to 2018. One of the biggest changes is that CMS will have recovery auditors in all four geographical RAC regions, as currently configured, with a fifth “nationwide” RAC responsible for identifying overpayments among home health hospice facilities and durable medical equipment. Click here for the report.


Physician Leader Blames RACs for Reliance on Observation Status

The president of the Pennsylvania Medical Society blamed Medicare’s recovery auditor (RAC) program and government mandates for Medicare coverage for hospitals’ growing reliance on holding patients for observation, sometimes for several days, rather than admitting them. Richard Schott, M.D., told the York Daily Record hospitals are fearful of audits and potential penalties for admitting patients Medicare determines should have been treated as outpatients. Click here for the story.


Hospitals Make Money From Surgical Errors: Study

A controversial story out last week about how hospitals make money from surgical errors. The study first appeared in the Journal of the American Medical Association and was picked up by the NY Times and other publications. The study says hospitals profit from their own mistakes because insurers pay them for the longer stays and extra care that patients need to treat surgical complications that could have been prevented. Click here for the JAMA abstract. Click here for the NY Times story.


Hospitals Actively Seeking State Medicaid Expansions

In states across the country, hospitals are working hard to help assure their states will approve expansions of Medicaid, as provided in the Affordable Care Act, but permitted on a state-by-state basis by the Supreme Court last year. Ohio is one of the states where the GOP Governor announced he would support an expansion, but the GOP-controlled legislature appears to be going the other way. Click here for the story.


State Exchange Education Campaigns Underway

Meanwhile, other states are forming large coalitions to help educate their citizens about how to take advantage of new health exchanges. Click here for this story from Texas.


Study: Massachusetts Exchange Experience Signals Problems for National Plan

The Massachusetts experience with health insurance exchanges suggests Americans could still be facing financial challenges to pay for coverage, a Health Affairs study indicates. The study of 393 families receiving unsubsidized insurance through the Massachusetts exchange, established in 2006, indicates that those on the lower end of the income spectrum, those with fair to poor health and those with more children often faced unexpectedly high out-of-pocket costs for health care. The authors say Americans in similar circumstances could be at risk for heavy costs in Affordable Care Act insurance exchanges, set to go online later this year. Click here for the study.


House GOP Members Want Answers on HHS Exchange Funding

Key House committee chairmen are raising issues about how HHS is paying for the implementation of the Affordable Care Act and the department’s plans to transfer funds to set up federal health exchanges. GOP Reps. Issa (CA), Lankford (OK) and Jordan (OH) say it appears that the department’s plans to use funds outside of the Health Insurance Reform Implementation Fund are “inconsistent with the law.” Click here to read their letter.


FTC Says Agency Is Active on the Hospital Merger Front

With the number of hospital mergers continuing to increase, you would think the federal government may not be as interested in stopping consolidations it thinks are anti-competitive, well, think again. The Chairwoman of the Federal Trade Commission (FTC) testified before the Senate last week and clearly articulated the agency’s ongoing interest in anti-competitive behavior, as defined by the FTC. Click here for her 14-page testimony.


Senators Raise Issues with Meaningful Use IT Funding

Senate Republicans released a white paper last week outlining problems they have identified in the 2009 stimulus bill’s health IT “meaningful use” initiatives. The lawmakers said that the program is leading to increased health care costs and potential waste and abuse and that it threatens patient privacy. One of their biggest concerns: they say there no clear pathway from stage 1 to stage 3, in which records should be able to communicate between health systems or physicians. Click here for their 28-page report.


HHS Asking for Info on Changes to HIPAA

The Obama Administration’s effort to curb gun violence is also impacting current health care regulations. HHS is asking for feedback on possible regulatory changes to the HIPAA privacy rule over concerns raised by some states that it may be a barrier to reporting to the National Instant Criminal Background Check System, the database containing information on individuals prevented from owning guns. The federal notice released Friday notes that a 2012 GAO report found 17 states had submitted fewer than 10 records of individuals banned from owning guns for mental health reasons. Click here to review the request for comment.


Immigration Bill Will Impact Health Care

A bipartisan group of Senators last week introduced comprehensive immigration legislation. It will certainly have an impact on health care. Green card provisions could affect the supply of physicians. The bill would eliminate per-country limits, which mostly impacts physicians looking to emigrate from India. About 30% of international medical graduates that come for U.S. training are from India, but many more from there are waiting in an eight to 10 year backlog due to a country-specific annual limit. Click here for more.


Mental Health Package Moving Slowly in Senate

The Senate made progress last week on bipartisan mental health package last week, although the outcome is far from certain. The package was tacked onto the gun bill, which has been derailed. There may be efforts to attached mental health onto other bills. The Congressional Budget Office has an analysis, which includes an $800 million price tag over five years. Click here for 5-page the CBO report.


Docs Now Lead Hospitals in ACO Count: Report

The number of physician-led accountable care organizations has recently surpassed the number led by hospitals, becoming the largest backers of the payment and delivery model.  This is according to an analysis last week from the American College of Physicians. Click here for the story.


Health IT Execs Offer HHS Solutions

HHS asked the health IT community for recommendations on how to accelerate and improve health information exchange and interoperability among providers, and the College of Healthcare Information Management Executives has responded with an 11-page letter loaded with recommendation. Among the ideas: keep regulations flexible and don’t mandate participation in certain types of exchanges. Click here to see the letter.


Dependence on Health IT Grows

Healthcare executives and physicians are becoming increasingly dependent on healthcare technology, according to new research released last week. Of 432 healthcare executives who responded to a survey, close to 93% percent said that they’ve become more reliant on technology and they’re positive about the impact it’s having on the industry. Roughly 70% said the increased use of technology has increased employees’ creativity, while 65% agreed there is even more room for efficiency gains. Click here to read the report.


More than Half of Children’s Hospitals Using EHRs

The percentage of children’s hospitals that adopted electronic health records (EHR) increased from 21% in 2008 to 59% in 2011, according to a study published last week in the journal Pediatrics. While pediatric and adult major teaching hospitals had the same EHR adoption rates, more children’s hospitals are using EHRs and have achieved meaningful use compared with adult hospitals overall. Click here for the report in Pediatrics.


New Colorectal Cancer Screen Could Reduce Deaths

A new noninvasive screening test can detect most cases of colorectal cancer and also many precancerous polyps, potentially helping to sharply reduce the death toll from the disease, according to results of a study released last week. Click here for the news from Exact Science. Click here for the NY Times report.


New Rx Tracking System for Supply Chain Announced

A bipartisan group of senators last week announced a legislative initiative that would set up a tracking system that requires manufacturers, wholesale distributors and others in the drug supply chain to supply transaction information when there is a change in ownership. It would also strengthen licensing requirements and require the FDA to keep a public database of wholesale distributors. Senators include Harkin (D-IA), Bennet (D-CO), Alexander (R-TN), and Burr (R-NC). Click here for a two-page committee summary. Click here for a copy of the 107-page bill.


Federal Basic Health Plan Now Has Timeline for Release

According to a release late last week from Senator Maria Cantwell (D-WA), the Federal Basic Health Plan will begin enrollment in October 2014 and begin operations in January 2015, who has been a strong advocate of the program. Proposed regulations are expected in September 2013, and final rules are planned for release in March 2014. Click here to see the one page timeline.


HHS Announces Pathway to Shut Down Early Retiree Program

A new notice from HHS released late last week details how the administration will shut down the Early Retiree Reinsurance Program, a temporary program that is scheduled to sunset at the end of this year. The $5 billion program quickly ran out of money soon after it launched, and enrollment was shut down in mid-2011. Click here for the eight page report.