WEEKLY E-BULLETIN


Hospitals Receive Healthgrades Patient Safety and Patient Experience Awards

Healthgrades announced its 2015 Patient Safety Excellence (467 hospitals) and Outstanding Patient Experience (452 hospitals) awards last week. Healthgrades evaluated patient experience by applying a scoring methodology to 10 patient experience measures data supplied by the HCHAPS survey of patients’ perspectives of their hospital care. Patient safety was evaluated utilizing claims data from CMS, and the application of software and patient safety incidents as defined by the Agency for Healthcare Research and Quality. Click here for the safety awards, by state. Click here for the patient experience awards, by state. Click here for the company’s white paper entitled, “Asking the Right Questions to Improve Patient Experience and Safety” that identifies key observations involving award recipients.

 

Will Senate Pass Doc Fix Reform Bill This Week?

The U.S. Senate is expected to vote early this week on the House-passed bill that permanently repeals the physician Medicare payment formula and replaces it with a new physician payment plan. Although it is expected to pass, will it happen before the 21 percent payment cut takes effect April 15? Some senate conservatives are not happy that the legislation adds at least $140 billion to the federal deficit. And now, the CMS actuary released a report late last week warning that the bill will in the long run create the same shortfalls in Medicare physician payments that Congress thought it was remedying. Click here for that report. The AMA immediately blasted the report calling it “illogical, flawed and dangerous.” Click here. Click here for a report on how the new payment system may, or may not, work.

 

New Regs Streamline EHR Meaningful Use Requirements

CMS late Friday issued a new proposed rule for the EHR Meaningful use incentive programs designed to reduce complexity, and to simplify providers’ reporting. Among the changes: reducing the overall number of objectives to focus on advanced use of EHRs; removing measures that have become redundant or have reached wide-spread adoption; realigning the reporting period beginning in 2015 so hospitals would participate on the calendar year instead of the fiscal year; and allowing a 90 day reporting period in 2015 to accommodate the implementation of these proposed changes in 2015. Click here for details from CMS. Click here for the proposed regs.

 

Government Report Slams Health IT Vendors

The Obama administration took vendors of electronic health records to task last week for making it costly and cumbersome to share patient information and frustrating a $30 billion push to use digital records to improve quality and cut costs. The report, by the Office of the National Coordinator for Health Information Technology, listed a litany of complaints it has received about vendors allegedly charging hefty fees to set up connections and share patient records; requiring customers to use proprietary platforms; and making it prohibitively expensive to switch systems. Click here for the Wall Street Journal story. Click here for the ONC report.

 

Telemedicine Suffers Setback in Texas

Taking a stand against the rapidly expanding use of telemedicine, the Texas Medical Board voted late last week to sharply restrict the practice in the state, siding with organizations representing doctors over the objections of industry representatives who said the new rules would reduce access to medical care at a time of increasing demand. Click here for the NY Times report. Click here for the Houston Chronicle report.

 

New Coalition Pushes Health Care Cost Transparency

A coalition of insurers, pharmaceutical companies, and provider and consumer advocacy groups last week launched a new push for greater transparency regarding the actual costs of services. The group includes AARP, Novo Nordisk, the National Consumers League, the Ambulatory Surgery Center Association, the National Council for Behavioral Health and Aetna. Click here for details.

 

Reports: Hospital Spending Jumps; Overall Health Spending Doesn’t

Spending on hospital care grew by 9% in the 12 months ended in February, according to the latest report released late last week from Altarum. That was a big change from same period a year ago, when hospital spending increased 3.1%. The 9% jump was also more pronounced than what Altarum recorded from January 2014 to January 2015. In that 12-month span, hospital spending increased 6.1%. Click here for this very good report. Another report out last week, from the Urban Institute and Robert Wood Johnson, examines the overall decline in projected health care spending and concludes that credit for the slower growth should be placed in several places. Click here.

 

PA Governor Threatens Action in UPMC, Highmark Dispute

Pennsylvania Governor Tom Wolf issued a statement late last week saying his administration intends to consider suing UPMC to stop it from terminating its Medicare Advantage contract with Highmark. At issue is $143 million that UPMC says it is owed by Highmark for administering cancer treatments. Click here for the story from the Pittsburgh Business Times.

 

HHS Says NO To Year-Round Open Enrollment for Pregnant Women

HHS last week rejected a request by Democratic lawmakers and dozens of advocacy groups to allow women who become pregnant to enroll in Obamacare year-round. In a letter to Senate HELP ranking member Patty Murray (D-WA), HHS said “we have reviewed the statute and our regulations and have concluded that we do not have the legal authority to establish pregnancy as an exceptional circumstance.” Click here for the letter.

 

Court: Missouri Can’t Limit Health Insurance Navigators

An appeals court ruled late last week that Missouri can’t limit health insurance navigators’ ability to help people obtain insurance under the Affordable Care Act — a ruling that advocates say could have implications for other states that have instituted similar restrictions. Click here for more.

 

Medicaid Enrollment Growth Detailed

States enrolled 4.6 million newly eligible adults in Medicaid under the Affordable Care Act’s new adult eligibility group, according to data released last week by CMS. The second quarterly report provides state enrollment counts overall and for the new adult eligibility group in states that have expanded Medicaid. Overall enrollment for September 2014 totaled more than 57 million. CMS plans to post enrollment data for subsequent quarters in the coming months. Click here to get state-by-state numbers.

 

Medicaid Expansion Saves States Money: Study

States expanding Medicaid under Obamacare are seeing large budget savings without reducing services, according to a report out last week. A report from the Robert Wood Johnson Foundation anticipates $1.8 billion in budget savings and revenue gains across eight states — Arkansas, Colorado, Kentucky, Michigan, New Mexico, Oregon, Washington and West Virginia — by the end of 2015. Click here.

 

Big Disparity in Health Care Between Nation’s Largest States

43 percent of Floridians and Texans said they skipped a needed doctor’s visit, test, treatment or follow-up for cost reasons, compared to 31 percent of Californians and 30 percent of New Yorkers, according to a report out last week. Florida and Texas residents were also more likely to report that they had a hard time paying their medical bills or were paying off medical debt than residents of the other two states. All that comes from a new Commonwealth Fund report showing disparities in medical bill problems in the four largest states. Click here for the report.

 

Mental Health Access Serious Problem for More Than 500,000

More than a half-million adults who said they wanted help with their serious mental conditions last year couldn’t get it because they lacked the resources and weren’t eligible for Medicaid to pay for treatment, according to a new study out last week. Those people — an estimated 568,886 adults ages 18 through 64 diagnosed with a serious mental illness, serious psychological stress or substance use disorder at the start of last year — lived in 24 states that didn’t expand Medicaid eligibility under the Affordable Care Act in 2014. Click here for the study.

 

Study Says 9.3 Million Gained Health Insurance

A new survey by RAND estimates that there was a net gain of 9.3 million Americans with health insurance through mid-March 2014. This represents a drop in the share of the population that is uninsured from 20.5 percent to 15.8 percent. Click here for the RAND report.

 

VA Patient Delays Concentrated in South: Report

The chronic delays plaguing the Veterans Affairs health system are concentrated in a fraction of its hospitals and clinics — many of them in the South — that have done far worse than others in delivering prompt care, according to government data reviewed by The Associated Press. Click here for the report.

 

Medicare Advantage Gets Harder to Cut

CMS’ surprise announcement last week that it plans to increase by 1.25% payments to Medicare Advantage plans – rather than impose a 0.9% payment cut, as had been proposed by the agency – may demonstrate the difficulty the government has in making payment reductions to health programs that are so favorably entrenched in American society. Click here for the story.

 

False-Positive Mammograms Costing Nation $4 Billion a Year: Study

False-positive mammograms, which suggest a woman has breast cancer when she actually doesn’t, cost the nation $4 billion a year, new research released last week shows. A second study, also released last week, shows that new treatments for women who really do have breast cancer may cost more, but they are helping them survive longer than older treatments. Click here for the NBC News story.

 

Health Care Stocks Soar

Want to make money in the stock market? Invest in health care, says a new analysis. Since March 2011, health care stocks have generated total returns of nearly 150 percent, doubling the gains of the broad market. At the same time, biotech shares have more than quadrupled in value. To some, this rally is beginning to resemble the run that technology stocks enjoyed in the late 1990s, though this sector has received far less attention. Click here for the story.

 

IRS Claims Obamacare Tax Season Victory

The IRS is claiming victory on Obamacare in the 2015 tax season, according to press reports last week. An in-house IRS watchdog, said there’s definitely been “glitches” this tax season. But the agency hasn’t had the sort of problems it did with programs like the first-time homebuyer credit, for which it had far less preparation time. Click here for the report.