CBO: HIT adoption will require federal intervention July 30, 2008
Posted by Obi Jo in E Health, health reform.Tags: Congress, E Health, health information technology, health reform, physician payments, Physicians
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CBO director advocates government promotion of HIT, but warns against proposed physician bonuses
No question, there needs to be federal and state support of unified health information technology implementation. However, the Federal government should be in the business of incentivizing doctors and hospitals in this regard as opposed to asking them to underwrite the costs of these transitions in the current budget limited environment. Also, at the federal level, with input from the burgeoning e-health industry, guidelines on what HIT should encompass should be developed, as opposed to a federal HIT system, which will, like most government based endeavors, most likely be cumbersome, bureaucratic and slow to respond to the rapidly changing e-health market. Let’s let our private sector do what it does best, with the role of the federal government limited to oversight, guidance and development with the health care leadership of strategies to make the HIT transition a smooth reality . . . jomaxx
“Federal intervention will be needed if the United States hopes to advance nationwide healthcare IT (HIT) adoption, according to Congressional Budget Office (CBO) Director Peter Orszag.” On Thursday, while testifying before the House Ways and Means Subcommittee on Health, “Orszag said allowing the free market to evolve into using electronic health records will be too slow.” He added, “If the federal government chose to intervene directly to promote the use of health IT, it could do so by subsidizing that use, or by requiring it.” But, Orszag warned that “paying out bonuses for healthcare IT use would likely only reward the 10 percent or so of physicians who already use healthcare IT, and would be too costly to the federal government, with little progress achieved.”
. . . read more at this link
http://www.healthcareitnews.com/story.cms?id=9642&fromRSS=true
Medicare pushes MD’s to use e-prescriptions July 30, 2008
Posted by Obi Jo in E Health, health insurance.Tags: E Health, health care reform, health reform, Medicare, physician payments, Physicians
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Medicare incentive payments may encourage physicians to use e-presecriptions
At last Medicare (and hopefully private insurers as well) will begin to put money where their mouth is – that is instead of asking physicians to carry the burden of initiating e-medicine tools, such as e-prescribing – they are now willing to pay physicians for this transition in service to help underwrite the costs. In the end, the benefits for patients, payers, and doctors as well, will be great. The article below from USA Today comments on these issues from a number of perspectives. Making these transitions will be painful for some, but in the end will be a major step forward for the healthcare system as a whole . . . jomaxx
“The move to get doctors to file prescriptions electronically is gathering steam, and may get a further boost from new Medicare rules that give doctors money to go electronic — and take it away if they don’t.” According to Pharmacy Health Information Exchange, which transmits “e-prescriptions from doctors’ offices to pharmacies,” between 2004 and 2007, “e-prescriptions increased from 700,000 to 35 million.” Yet, “that only amounts to about six percent of U.S. doctors who regularly sent e-prescriptions in 2007,” something the government hopes to change. Health and Human Services Secretary Mike Leavitt stated that a “new four-year program” announced last week “will give doctors who start e-prescribing incentive payments,” which will be the equivalent of “two percent of their billable Medicare charges for 2009 and 2010, one percent for 2011 and 2012, and 0.5 percent in 2013.” And, “[i]f doctors don’t get on board, they could face penalties beginning in 2012.”
. . . link to the full article in USA Today @ http://www.usatoday.com/news/health/2008-07-28-eprescribe_N.htm
U.S. to Probe Health Plans That Cancel Sick Members July 26, 2008
Posted by Obi Jo in health insurance, health insurance access, health reform.Tags: health care reform, health insurance, health insurance access, health Insurance exclusions
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Congressional Committee to investigate health insurer cancellation practices
As reported by an article in Bloomberg, Congress is beginning to hold hearings regarding the practices of health insurers canceling policies for paying subscribers. Although the health insurance industry denies it, the fact is that they practice extensive exclusionary policies both in the underwriting and renewal process. These practices must be ended. The private health insurance industry must realize, that if it is to survive, these policies must be terminated, sooner rather than later. Discrimination against those unlucky enough to get ill or injured (I think that will be all of us!) should be abolished . . . jomaxx
A “U.S. congressional committee will investigate the health insurance industry’s practice of revoking benefits when policyholders develop costly illnesses.” The insurer practice of post-claims underwriting in individual policies “can leave families without coverage and facing substantial medical bills, witnesses told the House Oversight and Government Reform Committee” on Thursday. Rep. Henry Waxman (D-Calif.), the committee’s chairman, said that “he plans to request documents from health insurers.” Rep. Waxman claimed that “[i]nsurers are using technicalities…to rescind policies after individuals get sick and accumulate hundreds of thousands of dollars in medical bills.” But, the insurance industry contends that the policy “revocations [are] necessary when they discover that members committed fraud, or misrepresented their health in applying for coverage.” And, according to Stephanie Kanwit, a representative for America’s Health Insurance Plans, “[o]nly 0.2 percent of the policies bought by individuals and families directly from health plans are canceled by insurers each year.”
Way to go Guv Arnold ! July 26, 2008
Posted by Obi Jo in Insurance, health insurance, health insurance access, health reform.Tags: health insurance, health insurance access, health Insurance exclusions, health reform
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California governor signs law banning insurers from rewarding employees for canceling, limiting patient coverage
Governor Schwarzenegger proved that he IS BACK. This is a great bill and just one step needed in the right direction. All barriers to purchasing and maintaining private health insurance need to be removed if a private health insurance industry is to survive. That the states have to take this action, one at a time, instead of the federal government banning this and other onerous practices by health insurers is unfortunate. However, the history of our multi-state republic is that it is the states that often lead the way for Washington DC to follow. See the excerpt and link to the LA Times article below. Keep it up Governor! . . . jomaxx
“Gov. Arnold Schwarzenegger (R) signed into law Tuesday a ban against health insurance companies rewarding employees with bonuses for canceling or limiting a patient’s coverage.” The measure is an attempt “to curtail the practice that the industry has defended as a little-used guard against fraud that helps control costs.” Insurance industry “[c]ritics contend that insurers use confusing applications for individual policies to trap people into making mistakes that can later be used against them.” Then, “[w]hen a policyholder gets sick, they say, insurers scour old medical records looking for an undisclosed condition or symptom to use to justify cancellation.” Assemblyman Ted Lieu (D) introduced the rescission legislation “after the Times disclosed that…insurer Health Net paid bonuses to an employee in charge of canceling coverage based, in some years, partly on how many policies she canceled.”
So what did that prove? July 17, 2008
Posted by Obi Jo in health insurance.Tags: health reform, healthcare, Medicare, physician payments, Physicians
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Congress rebuffs Presidential veto on Medicare
President Bush’s veto of the Mediare pay package confirms his out of touch mindset and his, as well as others, committment to private insurers over doctors and patients. Since Congress has now overidden his veto, the gesture was futile. Instead of seizing upon this as an opportunity to open debate about the flawed legislative process he chose to antagonize a large segment of the population, many of whom may actually support him. Shame on you Mr. President for missing such a great chance . . . jomaxx
Who Pays for Efficiency? July 13, 2008
Posted by Obi Jo in health insurance, health reform.Tags: E Health, health insurance, health reform, healthcare
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The complexities of trying to save money in the health system are real. This article points to just a few. Better technology means higher costs. Electronic and computer systems mean higher costs. The bottom line is that patients must bear some of these costs and insurers as well. Insurers have the most to gain from the placement of high tech systems in doctors offices and hospitals in terms of financial return. That return needs to be funneled back into the system to underwrite the implementation of these services. Prevention is also touched upon by this article, but it should be noted that many insurers pay for only limited preventive services, whereas they pay for almost all services received in an emergency room. No question, all incentives must be realigned . . . jomaxx
Physicians get only about 11 percent of the savings from electronic health records; the real benefit goes mainly to private and public insurers because, for one, they are paying for fewer unnecessary tests, and automated record-handling is a big cost saving for the payers, according to a study by the Center for Technology Leadership, a medical research group. “The doctors bear all the costs, and others reap most of the benefit,” said Dr. David J. Brailer, who was the national health information technology coordinator in the Bush administration from 2004 to 2006. “The incentives are totally awry.” . . . see complete link to article
http://www.nytimes.com/2007/06/11/business/businessspecial3/11save.html?_r=1&pagewanted=print&oref=slogin
President Bush announces he will Veto the Physician Payment Fix July 12, 2008
Posted by Obi Jo in Insurance Profits, health insurance.Tags: Congress, health insurance, Insurance Profits, physician payments, President
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Yes, Mr. President, the Democratically controlled Senate and it’s leader, Senator Harry Reid (D-NV) are wrong to tie these two issues together. It is deplorable political posturing, no matter the heroics of Senator Kennedy of Massachusetts. However, you too are not playing in the real world. The insurers you seek to protect will NOT lose any money at all with this bill, only the possible growth of new entrants into Medicare Advantage plans, and that is over several years. Physicians stand to lose a great deal immediately. Medicare already only pays them about 30 cents on a dollar billed. Do you wish for them to leave the practice of medicine, stop accepting new Medicare patients or stop seeing Medicare patients altogether? Mr. President, sign the bill. Then why not address the issue of multiple targeting in bills in Congress, a favorite tactic of BOTH parties . . . jomaxx
President Bush intends to block a bill protecting doctors from a cut in their Medicare pay, even though Congress seemingly has enough votes to override his veto, a White House spokesman indicated on Thursday.
To pay for rescinding the 10.6 rate cut, lawmakers would reduce spending on private health insurers serving about 9 million elderly and disabled patients through Medicare Advantage. . . . see link to article
http://www.cbsnews.com/stories/2008/07/10/national/printable4249448.shtml
Small Business Is Latest Focus in Health Fight July 11, 2008
Posted by Obi Jo in health insurance, health insurance access, health reform.Tags: health insurance, health reform, small business
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Almost one half of all the uninsured in America work for small businesses or are self employed. The fact that many cannot get health insurance is a factor both of cost and access. The refusal of private carriers to insure ‘all comers’ is at the root of the problem. Anyone should be able to get health insurance as long as they pay the premium. That is why Real Health Reform believes (see the plan) that individuals should be mandated to have health coverage. It is simply responsible citizenship. Asking small businesses to subsidize this is unnecessary and counter to productivity. Federal legislation is needed to force private insurers to drop all exclusionary tactics, clauses, rules and language so that most of the uninsured can access health insurance . . . jomaxx
Small Business Is Latest Focus in Health Fight
As the number of people without health insurance continues to rise, many states and Congress have begun to focus on one of the biggest causes: the growing number of small business owners and their workers who are unable to afford coverage.
The states are taking a variety of approaches. To help ease the burden of insurance premiums that have roughly doubled since 2000, some, like Arizona, are extending tax credits to small employers that provide medical coverage.
Others, including New Mexico and Montana, are exploring ways to let small businesses band together to amass the purchasing power of big employers. Massachusetts plans to let small businesses benefit from its state-supervised insurance program. And some states, like Colorado, have passed tougher laws governing what insurers can charge small companies . . . see link below for full article
http://www.nytimes.com/2008/07/10/business/smallbusiness/10bizhealth.html?ref=smallbusiness
‘Report card’ targets health plans’ performance July 11, 2008
Posted by Obi Jo in Insurance, Insurance Profits, health insurance, health reform.Tags: health, health insurance, health insurance reform, physician payment, Physicians
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Providers are beginning to turn the tables on payers by rating them. For years providers, primarily physicians, have been increasingly subject to review, ratings and in some cases, grading or report cards. The criteria used are usually made up unilateral by payers with little or no input from providers. Well physicians are fighting back. They now intend to make sure the insurers feel the glaring light of exposure for their well known tactics of delaying and denying payment. The insurance game must end for the Real Health Reform to proceed . . . jomaxx
AMA’s ‘report card’ targets health plans’ performance
Claims payments are a sore spot for physicians, who complain about the time and paperwork burdens associated with filing claims under multiple systems with varying sets of rules, especially when those claims are denied and must be contested. Physicians want to focus on caring for their patients, not fighting health insurance red tape that may delay, deny, or shortchange payments for their services. The goal of the AMA campaign is to hold health insurance companies accountable for making claims processing more cost-effective and transparent, and to educate and empower physicians so they are no longer at the mercy of a chaotic payment system that takes countless hours away from patient care,” said William Dolan, a member of the AMA’s board of trustees
See article at: http://thehill.com/business–lobby/amas-report-card-targets-health-plans-performance-2008-06-16.html
Physician reimbursements flawed July 11, 2008
Posted by Obi Jo in Insurance Profits, health insurance, health reform.Tags: health insurance, health reform, physician payment, Physicians
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Once again it is clear that the health insurance industry has become an investment oriented enterprise, divorced from the true intent of insurance (globally shared risk). Because they have become ‘premium retention arbitragers’, their goal is to hold on to the premium dollars they have on deposit at all costs. One easy way to do this is to deny and delay payment to physicians and other health providers. This stalling tactic, long recognized by providers and hospitals, is well known and routinely practiced. It is to be condemned fully. Insurers love to trot out misdeeds by a small minority of providers to justify their behavior, but in fact they treat all providers the same – with disrespect, with suspicion and in many cases with outright disdain. Only health insurance reform can lead to Real Health Reform . . . jomaxx
AMA calls physician reimbursements flawed
Failings by insurers and Medicare add more than $200 billion a year to the nation’s healthcare tab, report says.
Insurance companies often fail to properly reimburse doctors, needlessly adding more than $200 billion a year to the nation’s healthcare tab, the American Medical Assn. said Monday. An analysis of 3 million medical claims over a six-month period beginning in October also found that doctors in the U.S. spend 14% of the fees they receive from insurers and Medicare on the process of collecting those fees, the AMA said in a report issued at its annual meeting in Chicago.
The analysis sized up insurers and Medicare on how often they paid on time, how often they denied claims and how often they paid at the contracted rate and other measures.
