Policy and Legislation
Managed Care Magazine recently ran a story on the Blue Cross Blue Shield of Massachusetts Alternative Quality Contract, which serves as a model for the ACO program under the Affordable Care Act. Check it out: Bay State Blues Combine Global Payment With Quality Metrics. The author of the piece, Joe Burns, contacted me as well as others in Massachusetts for comment.
Between 1980 and 2009, healthcare expenditures grew by 7.4 percent, which most economists agree would bankrupt the nation if continued. But a closer look at the statistics reveals that the last 10 years in that period saw only a 5.9 percent increase, and the spending growth from 2009 to 2011 dropped to 3.1 percent.
Findings in a JAMA article indicate that providers may need to focus on methods beyond care coordination and disease management in order to reduce costs among Medicare patients with chronic conditions and a high portion of spending,
Data from 10 states that will offer more health plans in the non-group market on their health insurance exchanges may also lower prices, according to analysis from Robert Wood Johnson Foundation.
At a June 18, 2013 Senate Finance Committee hearing, leading health care experts and U.S. Senators explored the high and variable cost of health care in America, as part of a special Senate Committee on Finance hearing on health care transparency.
After months of speculation on just where the Obama administration is toward the development of the new health insurance exchanges, the Government Accountability Office (GAO) has issued a 48-page report complete with timelines and a detailed report on just where the Obama administration is - - or at least was last month.
Major changes driven by the Affordable Care Act and rising consumer cost-sharing are slowing the rise in the healthcare growth rate, according to PwC's Health Research Institute (HRI).
Between 2005 and 2011, chemotherapy procedures in hospital outpatient settings for Medicare patients increased by more than 150 percent finds an analysis commissioned by members of the oncology community.
MedPAC has found that hospitals with a large portion of low-income patients also have higher readmission rates, and, therefore, higher penalties under Medicare's hospital readmissions reduction program. That imbalance was one of the reasons that MedPAC, in its annual June report to Congress, has recommended that Medicare modify its readmissions reduction policy.
The fiscally reckless Medicare Part D drug benefit - passed by a Republican Congress and signed by a Republican President - continues to add to the US federal deficit and debt. I'm resigned to this program's continuation but perhaps there is hope for it to be modified or somehow brought into better balance.