New health law is a prescription for distortion
By: JO CIAVAGLIA
Bucks County Courier Times
The onslaught of misinformation and distortions about the Patient Protection and Affordable Care Act this political season isn't helping the many Americans who are confused about the law.
Who hasn't seen political ads claiming that under the health law, Medicare will be cut $500 billion.
But are any of these claims true?
Yes and no. Mostly it depends on what health coverage you have, who pays for it, how much you earn and how you earn it, according to health care policy and reform experts.
Next year employers will be required to list the value of employee health benefits on W2 forms. No, you won't be taxed on it.
But combine a take-no-prisoners political season with a law as voluminous and complex as the Patient Protection and Affordable Care Act, and confusion explodes. Experts who've studied the new reforms say the truth is out there, but it can be hard to find.
Four out of 10 surveyed believed the health care law would require Americans to provide a government ID card to get hospital care. (It doesn't.)
Almost as many believed that committees would review medical histories of some people and decide whether they can get medical care paid for by the government. (That's also untrue).
Six in 10 think the law increases the federal deficit. (The nonpartisan Congressional Budget Office projects the law will shrink the deficit.)
"The great irony is the law was designed to avoid a government takeover," said Timothy Jost, a law professor at Washington and Lee University who specializes in health care reform and policy. "It's a law that is intended to make private insurance work and it's troubling that it's being attacked as a (government) takeover of the markets
Monday, October 25, 2010
Sunday, October 24, 2010
New Healtrh reform drives cost acutting
SAN DIEGO 10/23/2010 — According to Van Gorder of Scripps Ihnstitute of San Diego.
"....the health reform plan, signed by Obama this year, was health insurance reform. It was not a reform that went to the heart of escalating health care costs.
But now Scripps Health, which runs 5 hospitals and 20 clinics in the San Diego area, is in the midst of a corporate restructuring they claim will make a big difference in cost. CEO Chris Van Gorder, in fact, believes their reorganization will eventually save $150 million a year.
Scripps Health was built from the union of several large hospitals. But the vertical corporate structure, in which each hospital had a chief operating officer who ran the place, remained intact. That meant every hospital within the system did things in a different way. They used different staffing levels and different materials. And that has required different levels of funding.
“We know, for example, that at one of our hospitals an open-heart case costs $3,000 more than it does to do the same kind of operation at another one of our hospitals,” said Van Gorder.
He said they’re trying to solve that problem by getting horizontal, in a corporate sense…. by getting rid of the silos and putting everything in one bin.
Van Gorder said the company has reassigned the top managers of its five hospitals to make them responsible for operations across the system. The goal is to standardize hospital operations and bring best practices to each site. This even applies to serving coffee.
“We’re spending $680,000 dollars a year for coffee and we’re using 15 different brands,” said Van Gorder. “If we standardize and buy at a larger scale we can get better buying power.”
Scripps claims it can save $200,000 dollars on coffee alone.
But if this is such a good idea, why didn’t Scripps do it five years ago? Van Gorder says strained relations between Scripps doctors and the company administration in the past have made it difficult to make dramatic changes.
"....the health reform plan, signed by Obama this year, was health insurance reform. It was not a reform that went to the heart of escalating health care costs.
But now Scripps Health, which runs 5 hospitals and 20 clinics in the San Diego area, is in the midst of a corporate restructuring they claim will make a big difference in cost. CEO Chris Van Gorder, in fact, believes their reorganization will eventually save $150 million a year.
Scripps Health was built from the union of several large hospitals. But the vertical corporate structure, in which each hospital had a chief operating officer who ran the place, remained intact. That meant every hospital within the system did things in a different way. They used different staffing levels and different materials. And that has required different levels of funding.
“We know, for example, that at one of our hospitals an open-heart case costs $3,000 more than it does to do the same kind of operation at another one of our hospitals,” said Van Gorder.
He said they’re trying to solve that problem by getting horizontal, in a corporate sense…. by getting rid of the silos and putting everything in one bin.
Van Gorder said the company has reassigned the top managers of its five hospitals to make them responsible for operations across the system. The goal is to standardize hospital operations and bring best practices to each site. This even applies to serving coffee.
“We’re spending $680,000 dollars a year for coffee and we’re using 15 different brands,” said Van Gorder. “If we standardize and buy at a larger scale we can get better buying power.”
Scripps claims it can save $200,000 dollars on coffee alone.
But if this is such a good idea, why didn’t Scripps do it five years ago? Van Gorder says strained relations between Scripps doctors and the company administration in the past have made it difficult to make dramatic changes.
Monday, August 9, 2010
Medicare revisited
Medicare celebrated its 45th birthday on July 30.
In 1965, President Lyndon B. Johnson signed the Medicare bill into law, providing government-sponsored health insurance for Americans 65 and older and younger people with disabilities.
Although every senior in the United States grew up without Medicare, most Americans today accept this single-payer, government-created and government-administered system as one of their rights as citizens, much like the right to vote.
Yet before we reach the age of 65, most of us don't have a clue how Medicare works. We only know it's there.
Misunderstandings about the Medicare program surfaced during recent discussions over the administration's sweeping health reform bill that finally passed in March.
Unclear on the concept, elders in some states vented outrage against the Obama administration, whose bill included Medicare changes, for "meddling" in "their" Medicare.
Others, also unclear on the facts, protested a provision in the bill that would have reimbursed physicians for time-consuming conversations with patients and family regarding the patient's wishes at the end of life. Mistakenly condemning these as "death panels," they raised loud and confusing voices, and the provision was removed from the bill.
But the uninformed ranters remain. To help clarify confusion, here are a few basic facts.
The health reform bill proposed by President Obama and passed by the
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Congress in March is called the Affordable Care Act. You will often hear bureaucrats referring to ACA. They mean the new health care law.
Among the most immediate changes:
# The infamous "doughnut hole," in which Medicare recipients must pay full price for their medication, will close completely by 2020. This year, those in the hole will receive a $250 rebate. Starting in 2011, a 50 percent discount will be available for brand-name drugs.
# The open-enrollment period, during which a Medicare recipient may choose a prescription drug program, will be extended.
# Starting in 2011, co-payments or deductibles will be removed for annual checkups and mammograms, colonoscopies and some other preventive tests. There will be no charge for these tests.
Other provisions are designed to improve delivery of medical care, prevent frequent readmissions to hospitals and, in the process, cut health care costs.
According to the Kaiser Health Foundation, nearly 18 percent of hospital admissions among Medicare beneficiaries in 2005 occurred within 30 days of being discharged from the hospital. Critics of high costs say that readmission can be prevented by better care in the hospital and improved coordination between patients and doctors after release.
Until now, hospitals, paid separately for each hospital stay, have had no incentive to prevent readmission, experts say. Under the new law, payments to certain hospitals with high readmission rates will be reduced starting in 2013, a spokeswoman for the federal Centers for Medicare & Medicaid Services said in a phone interview.
Among health care providers, pilot projects to streamline health care delivery and coordinate care are already underway.
These are only a few of the changes and modifications included in the new law.
For more information, call the Health Insurance Counseling Advocacy Program (HICAP) at 650-627-9350 or 800-434-0222.
In 1965, President Lyndon B. Johnson signed the Medicare bill into law, providing government-sponsored health insurance for Americans 65 and older and younger people with disabilities.
Although every senior in the United States grew up without Medicare, most Americans today accept this single-payer, government-created and government-administered system as one of their rights as citizens, much like the right to vote.
Yet before we reach the age of 65, most of us don't have a clue how Medicare works. We only know it's there.
Misunderstandings about the Medicare program surfaced during recent discussions over the administration's sweeping health reform bill that finally passed in March.
Unclear on the concept, elders in some states vented outrage against the Obama administration, whose bill included Medicare changes, for "meddling" in "their" Medicare.
Others, also unclear on the facts, protested a provision in the bill that would have reimbursed physicians for time-consuming conversations with patients and family regarding the patient's wishes at the end of life. Mistakenly condemning these as "death panels," they raised loud and confusing voices, and the provision was removed from the bill.
But the uninformed ranters remain. To help clarify confusion, here are a few basic facts.
The health reform bill proposed by President Obama and passed by the
Advertisement
Congress in March is called the Affordable Care Act. You will often hear bureaucrats referring to ACA. They mean the new health care law.
Among the most immediate changes:
# The infamous "doughnut hole," in which Medicare recipients must pay full price for their medication, will close completely by 2020. This year, those in the hole will receive a $250 rebate. Starting in 2011, a 50 percent discount will be available for brand-name drugs.
# The open-enrollment period, during which a Medicare recipient may choose a prescription drug program, will be extended.
# Starting in 2011, co-payments or deductibles will be removed for annual checkups and mammograms, colonoscopies and some other preventive tests. There will be no charge for these tests.
Other provisions are designed to improve delivery of medical care, prevent frequent readmissions to hospitals and, in the process, cut health care costs.
According to the Kaiser Health Foundation, nearly 18 percent of hospital admissions among Medicare beneficiaries in 2005 occurred within 30 days of being discharged from the hospital. Critics of high costs say that readmission can be prevented by better care in the hospital and improved coordination between patients and doctors after release.
Until now, hospitals, paid separately for each hospital stay, have had no incentive to prevent readmission, experts say. Under the new law, payments to certain hospitals with high readmission rates will be reduced starting in 2013, a spokeswoman for the federal Centers for Medicare & Medicaid Services said in a phone interview.
Among health care providers, pilot projects to streamline health care delivery and coordinate care are already underway.
These are only a few of the changes and modifications included in the new law.
For more information, call the Health Insurance Counseling Advocacy Program (HICAP) at 650-627-9350 or 800-434-0222.
Friday, May 21, 2010
New Health Care Rules begin in June
By Christopher Behnan • DAILY PRESS & ARGUS • May 16, 2010
Staring June 23, the law creates a health subsidy for retirees between the ages of 55 and 64. The program will subsidize 80 percent of approved claims totaling $15,000 to $90,000.
That program is planned to expire in 2014.
Also this year, employers with less than 25 employees that contribute at least 50 percent of premiums per employee may be eligible for a tax credit.
The credit wouldn't be filed until next year's tax return, but employers should start calculating employee hours required to determine full-time equivalency data, Porta said.
The government will count a 4.98 full-time equivalency as four full-time employees rather than rounding it up to five, for a greater credit.
read more
In that case, employers can bump up their staff's hours slightly to obtain the higher credit, Porta explained.
"It can make a difference. You want to maximize the tax credit," he said.
Staring June 23, the law creates a health subsidy for retirees between the ages of 55 and 64. The program will subsidize 80 percent of approved claims totaling $15,000 to $90,000.
That program is planned to expire in 2014.
Also this year, employers with less than 25 employees that contribute at least 50 percent of premiums per employee may be eligible for a tax credit.
The credit wouldn't be filed until next year's tax return, but employers should start calculating employee hours required to determine full-time equivalency data, Porta said.
The government will count a 4.98 full-time equivalency as four full-time employees rather than rounding it up to five, for a greater credit.
read more
In that case, employers can bump up their staff's hours slightly to obtain the higher credit, Porta explained.
"It can make a difference. You want to maximize the tax credit," he said.
Saturday, May 1, 2010
Health insurers end cancellations
Rueter's
Susan Heavey and Lewis Krauskopf - Analysis
WASHINGTON/NEW YORK
Fri Apr 30, 2010 12:51pm EDT
WASHINGTON/NEW YORK (Reuters) - U.S. health insurers are avoiding the controversial but rare practice of canceling coverage when a customer gets sick, but it is unclear how regulators will enforce the ban, which could affect thousands of policyholders.
read more
Susan Heavey and Lewis Krauskopf - Analysis
WASHINGTON/NEW YORK
Fri Apr 30, 2010 12:51pm EDT
WASHINGTON/NEW YORK (Reuters) - U.S. health insurers are avoiding the controversial but rare practice of canceling coverage when a customer gets sick, but it is unclear how regulators will enforce the ban, which could affect thousands of policyholders.
read more
Friday, April 23, 2010
Companies Drop Employer-Sponsored Health Insurance
Clarifying Health
Thursday, April 22nd, 2010
The Health Care Reform bill signed into law on March 23, 2010 is the death knell for employer-sponsored group health insurance. And that’s a good thing.
read more
Thursday, April 22nd, 2010
The Health Care Reform bill signed into law on March 23, 2010 is the death knell for employer-sponsored group health insurance. And that’s a good thing.
read more
Wednesday, April 14, 2010
Agencies Seek Health Care Implementation Comments
LIfe and Health Magazine
Article by ALLISON BELL
Published 4/12/2010
"Federal regulators are asking members of the public for comments on how the government should implement the Patient Protection and Affordable Care Act..."
"..... how states define 'unreasonable rate increases,' rules for public disclosure of rate increase information, ideas about how to go about excluding plans that impose 'unreasonable rate increases' from the new state health insurance exchange system, and ideas about how to minimize the rate review process paperwork burden."
And now the real work of health care reform begins.read more
Article by ALLISON BELL
Published 4/12/2010
"Federal regulators are asking members of the public for comments on how the government should implement the Patient Protection and Affordable Care Act..."
"..... how states define 'unreasonable rate increases,' rules for public disclosure of rate increase information, ideas about how to go about excluding plans that impose 'unreasonable rate increases' from the new state health insurance exchange system, and ideas about how to minimize the rate review process paperwork burden."
And now the real work of health care reform begins.read more
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