WEEKLY E-BULLETIN


Senators Push Back Against Report Recommending Eliminating Critical Access Hospitals

20 U.S. Senators last week pushed back against a report from that the HHS OIG suggesting the government should eliminate 836 Critical Access Hospitals by removing their Necessary Provider status. It would take an act of Congress to give HHS that authority, so the bipartisan group of senators sent a letter to the Finance Committee saying “as your committee considers changes to Medicare policy, we believe that indiscriminate cuts to CAHs are not the answer.” Click here for the letter and see if your senators signed on. Click here for the OIG report.

CMS’ Two-Midnight Admissions Rule Transcript Available

CMS’ two-midnight hospital admission provision continues to generate wide discussion in hospitals across the country. Now available by clicking here is a transcript and audio of the national conference call CMS held August 15 to shed more light on the issue. Also click here for our policy team’s two-page summary.

GAO Says RACs, Other Contractors Impose Undue Burden on Providers

In a report released last week, the GAO has found that private contractors who identify fraudulent Medicare payments may be imposing an undue administrative burden on medical providers. Four different kinds of contractors examine medical records and other documentation from providers to determine whether the claims meet Medicare requirements. But each type of contractor uses a different review process, which can be confusing for providers and possibly harm the efficiency and effectiveness of the reviews, finds the GAO. Click here for the report. 130 House members (click here for list) and five senators (click here for list) have cosponsored legislation to reform RACs.

GAO Says Physician Ownership in IMRT Centers Results in Increased Use

Physicians who have a financial interest in radiation treatment centers are much more likely to prescribe such treatments for patients with prostate cancer, GAO investigators say in a new report. The latest study focused on a common and costly treatment for prostate cancer known as intensity-modulated radiation therapy, which directs highly concentrated beams of radiation at cancerous tumors. Click here for the report. Click here for the NY Times story.

Exchanges Scrambling to Get Up and Running

We are 35 days away from the October 1st scheduled launch date for the Affordable Care Act’s insurance marketplaces (exchanges) — online sites where uninsured people will be able to shop for coverage, sometimes using a government subsidy to purchase a plan. An estimated 7 million people are expected to use these portals to purchase health coverage in 2014. And according to a report in the Washington Post, state’s are scrambling to get them up and running, click here and here. Click here to see how 16 states and DC that are running their own exchanges are reaching out to the public.

Study: Health Costs Slowing, Premiums Up Modestly

Moderate by historical standards, annual premiums for employer-sponsored family health coverage reached $16,351 this year, up 4 percent from last year, according to a report last week from the Kaiser Family Foundation. Workers on average pay $4,565 toward the cost of their coverage. During the same period, workers’ wages and general inflation were up 1.8 percent and 1.1 percent respectively. Since 2003, premiums have increased 80 percent, nearly three times as fast as wages (31 percent) and inflation (27 percent). Click here for the detailed 8-page summary.

Moody’s: Hospital Expenses Exceeded Revenue in 2012

Expenses grew faster than revenues for not-for-profit hospitals in fiscal year 2012, according to a report released late last week by Moody’s Investors Service.  However, balance sheets remained stable. Expenses grew by a median 5.5% for the 402 hospitals and health systems rated by the agency, while median operating revenues grew just 5.2%.  Click here for more from Moody’s.

Number of Docs Taking Medicare Patients Increased Substantially

The number of physicians accepting new Medicare patients rose by one-third between 2007 and 2011 and is now higher than the number of physicians accepting new private insurance patients, according to a new report from HHS. In 2011, 1.25 million doctors billed Medicare. Click here for the report, which includes some very good graphs. Click here for the story from USA Today.

Employer Mandated Coverage Delay Will Have Little Effect: RAND

The one-year delay to the health law’s employer mandate will have little effect on the ultimate results of the Affordable Care Act, according to a study last week by the RAND Corp. Less than one percent of large firms will not offer health insurance in 2014 as a result of the delay, the study finds. But the delay will set the government back $11 billion — missed revenue from penalties and fines large employers would have had to pay next year. Click here for the study.

New Report Examines Causes for Medicare Spending Slowdown

Changes in Medicare payment rates and in beneficiary demand for services account for only about a quarter of the slowdown in fee-for-service Medicare spending growth between 2000 and 2010, according to a report last week from the Congressional Budget Office. While the other causes of the slowdown remain unclear, it “appears to have been caused in substantial part by factors that were not related to the recession’s effect on beneficiaries’ demand for services,” the report states. Click here for the 61-page report.

High Cost of IV Saline Solution Example of Problem in Health Care

The cost of a simple bag of IV saline solution was the focus of a NY Times story yesterday and underscores the new scrutiny on healthcare costs in general. Hospitals and other providers can charge patients hundreds of dollars a bag yet there is so little pricing transparency that these costs usually go unnoticed, according to the report. Click here for the story.

New Short Video Details How the Affordable Care Act Works

According to recent polling, many Americans remain confused about the Affordable Care Act and its impact on them. If you want an excellent primer on what its all about, the Kaiser Family Foundation is out with a great 6 1/2 minute cartoon video narrated by former network news anchor Charlie Gibson. You should view it and share with your colleagues, family and friends, click here. Click here for the last week’s Gallop Poll on Americans’ attitude and knowledge of the Affordable Care Act.

79 House Republicans Send Letter Urging ObamaCare Defunding

Seventy-nine House Republicans have signed a letter U.S. Rep. Mark Meadows (R-NC) sent to GOP leadership last week, urging them to use appropriations bills to defund the Affordable Care Act. “…we urge you to affirmatively defund the implementation and enforcement of Obamacare in any relevant appropriations bills brought to the House floor in the 113th Congress, including any continuing appropriations bill,” the letter says. Click here to see the letter and all the signatures. One U.S. Senator last week said the defunding drive in the senate is picking up support, click here.

GOP Leaders Unsure About Defunding Strategy

Defunding Obamacare doesn’t seem to be the strategy being pursued by House GOP leadership, according to reports last week. House Speaker John Boehner told his caucus last week that delaying, rather than defunding, is the prudent course, according to published reports, click here. However, there are reports that House leaders may be looking at the U.S. debt ceiling requirement as leverage to make changes to the Affordable Care Act, click here.

States’ Reticence on ObamaCare Implementation Not Unusual

Many states are refusing to help implement Obamacare – from denying a Medicaid expansion to not supporting health insurance exchanges. However, this is not precedent setting. Apparently states have made a habit of resisting new major federal laws, for about the past 200 years. Click here for the story.

Medicare ACOs Growing Faster Than Commercial ACOs

Medicare ACOs are growing faster than non-Medicare ACOs, according to a report out last week from Leavitt Partners. 253 Medicare ACOs now comprise more than half of all accountable care contracts nationwide. Click here to access the 11-page report.

IRS Issues Small Business Tax Credit Regs

The IRS late last week issued proposed rules on the Affordable Care Act’s small-business tax credit, available only to certain businesses with 25 or fewer full-time employees purchasing health coverage through a SHOP exchange. Click here for a copy of the proposed regs.

CDC Awards States $76 Million for Infectious Disease Work

The CDC last week announced an award to states of about $75.8 million through the Epidemiology and Laboratory Capacity for Infectious Diseases Cooperative Agreement. This funding helps states and communities strengthen core epidemiology and laboratory capacity needed to track and respond quickly to a variety of infectious diseases. Click here to see what each state received.

Number of Lyme Disease Cases Skyrocketing

Annual diagnoses of Lyme disease cases are about 10 times higher than previously reported, with as many as 300,000 individuals diagnosed each year with the tick-borne disease, according to the CDC last week. Cases were concentrated in 13 states, mostly in the Northeast and the upper Midwest. Click here for details.

Number of Women and Minorities in Radiology Unchanged

The percentage of women and minorities among radiologists and radiology residents has barely budged in the past eight years, according to a new study in Radiology. Women and minorities who are traditionally underrepresented in medicine — a group that includes blacks, Hispanics, American Indians, and Alaskan and Hawaiian native peoples — comprise just under one-fourth of practicing physicians and slightly more than one-fourth of radiology residents, the study team reported. Click here for the report.

CORRECTION:  It’s Penn State NOT the University of Pennsylvania

My apologies to the University of Pennsylvania because it was identified in last week’s report as the employer where more than 2,000 faculty and staff employees are protesting the University’s wellness requirements. The story should have read Pennsylvania State University. Here’s an updated story on Penn State’s controversial battle to reduce its health care costs. Click here for the story.