1. New Bill to Prevent Medicare Cuts for Physician Reimbursement
Reps. Allyson Schwartz (D-Pa.) and Joe Heck, D.O., (R-Nev.) March 9 introduced the Medicare Physician Payment Innovation Act (H.R. 5707), legislation that would permanently repeal the Medicare sustainable growth rate (SGR) formula, prevent a scheduled cut of over 30 percent in Medicare payments to physicians on Jan. 1, 2013, and continue the transition to new payment and health care delivery models.The bill establishes a five-year period of stability. In 2013, payments to all physicians would remain level and then would increase in each of the following four years by 0.5 percent for specialty physicians and by 2.5 percent for primary care services to “ensure access.” In an effort to replace the current system, the bill instructs the Centers for Medicare and Medicaid Services (CMS) to produce, by October 2016, no fewer than four alternatives to the traditional fee-for-service system (FFS) for physicians who are unable to participate in existing delivery and payment reform models.
2. A Primer on Health Care Spending in the U.S.
The Kaiser Family Foundation has released an updated primer on health care spending in the United States that reviews the growth in health care spending since 1970 and the impact of health care costs on families and employers. It also reviews the contributors to health care costs and some proposed approaches for addressing these rising costs, including provisions of the 2010 health reform law aimed at making health coverage more affordable and available, while attempting to contain health care spending.
Key facts include:
• In 2010, the U.S. spent $2.6 trillion on health care, an average of $8,402 per person.
• The share of economic activity (gross domestic product, or GDP) devoted to health care has increased from 7.2% in 1970 to 17.9% in 2009 and 2010.
• Health care costs per capita have grown an average 2.4 percentage points faster than the GDP since 1970.
• Since 2002, the rate of increase in national health care spending has fallen from 9.5% to 3.9%.
• Half of health care spending is used to treat just 5% of the population.
• Although only 10% of total health expenditures, spending on prescription drugs has received considerable attention because of its rapid growth (114% from 2000 to 2010).
• In 2008, 27% of the nonelderly with 3+ chronic conditions spent more than 10% of their income on health, compared to 11% of the total nonelderly population.
• Many policy experts believe new technologies and the spread of existing ones account for a large portion of medical spending and its growth.
The updated primer is available online at (http://www.kff.org/insurance/7670.cfm). For more information visit the Kaiser Family Foundation Website: http://www.kff.org/newsroom/weekly-update.cfm
3. Implications for ACOs of Variations in Spending Growth
An article in last week’s issue of The New England Journal of Medicine discussed some of the potential drawbacks to the current plan to reimburse Accountability Care Organizations based on national growth factors. One of the potential problems to ACO reimbursement is that health care spending, growth, and practice can vary widely by geographical location, a phenomenon reported on regularly by the Dartmouth Atlas of Health Care (www.darthmouthatlas.org). The authors of the article conclude that “under payment arrangements that use national growth factors to set spending targets, variation in local spending growth could cause many ACOs to achieve substantial savings or experience substantial losses that are unrelated to their efforts to improve efficiency in response to ACO contracts.” For more information, visit http://www.nejm.org/doi/full/10.1056/NEJMp1202004)
What is an Accountable Care Organization? See the new “OSR Legislative Affairs 101” article on ACOs.
4. FDA and AMA Views on Making More Drugs OTC
USA Today recently offered a point-counterpoint perspective on the pros and cons of a recent FDA proposal to make more prescription drugs, such as those to treat asthma, migraines, high blood pressure and elevated cholesterol, more accessible without visits to a doctor. The USA Today’s arguments for the proposal can be found here: http://www.usatoday.com/news/opinion/editorials/story/2012-05-06/drugs-over-the-counter/54791606/1
The arguments against the proposal were given by Dr. Peter W. Carmel, the president of the AMA, and can be found here: http://www.usatoday.com/news/opinion/story/2012-05-06/prescription-drugs-FDA-AMA/54791526/1
5.New State Health Data Available
Interested in health data for either your home state or the state where you are attending medical school? Statehealthfacts.org has added new and updated data. This data can serve as a valuable resource for advocacy efforts. The web tool allows you to use a health indicator (examples provided below) to compare your state to both other states, and the country as a whole. Some highlights include the most recent data from the Centers for Disease Control and Prevention (CDC) on teen birth rates and the latest information from the Urban Institute and Kaiser Commission on Medicaid and the Uninsured on Medicaid spending per enrollee. Updated state-by-state information on emergency room visits per 1,000 population, Medical Loss Ratio (MLR) rebates, and health insurance exchanges is also available. For more information, visit http://www.statehealthfacts.org/profile.jsp.
Your loyal Legislative Affairs team,
Brad Hunter – Northeast Region
Robert Sanchez – Central Region
Sean Vanlandingham – Southern Region
Claire Sadler – Western Region
William Teeter – National Delegate
Reps. Allyson Schwartz (D-Pa.) and Joe Heck, D.O., (R-Nev.) March 9 introduced the Medicare Physician Payment Innovation Act (H.R. 5707), legislation that would permanently repeal the Medicare sustainable growth rate (SGR) formula, prevent a scheduled cut of over 30 percent in Medicare payments to physicians on Jan. 1, 2013, and continue the transition to new payment and health care delivery models.The bill establishes a five-year period of stability. In 2013, payments to all physicians would remain level and then would increase in each of the following four years by 0.5 percent for specialty physicians and by 2.5 percent for primary care services to “ensure access.” In an effort to replace the current system, the bill instructs the Centers for Medicare and Medicaid Services (CMS) to produce, by October 2016, no fewer than four alternatives to the traditional fee-for-service system (FFS) for physicians who are unable to participate in existing delivery and payment reform models.
2. A Primer on Health Care Spending in the U.S.
The Kaiser Family Foundation has released an updated primer on health care spending in the United States that reviews the growth in health care spending since 1970 and the impact of health care costs on families and employers. It also reviews the contributors to health care costs and some proposed approaches for addressing these rising costs, including provisions of the 2010 health reform law aimed at making health coverage more affordable and available, while attempting to contain health care spending.
Key facts include:
• In 2010, the U.S. spent $2.6 trillion on health care, an average of $8,402 per person.
• The share of economic activity (gross domestic product, or GDP) devoted to health care has increased from 7.2% in 1970 to 17.9% in 2009 and 2010.
• Health care costs per capita have grown an average 2.4 percentage points faster than the GDP since 1970.
• Since 2002, the rate of increase in national health care spending has fallen from 9.5% to 3.9%.
• Half of health care spending is used to treat just 5% of the population.
• Although only 10% of total health expenditures, spending on prescription drugs has received considerable attention because of its rapid growth (114% from 2000 to 2010).
• In 2008, 27% of the nonelderly with 3+ chronic conditions spent more than 10% of their income on health, compared to 11% of the total nonelderly population.
• Many policy experts believe new technologies and the spread of existing ones account for a large portion of medical spending and its growth.
The updated primer is available online at (http://www.kff.org/insurance/7670.cfm). For more information visit the Kaiser Family Foundation Website: http://www.kff.org/newsroom/weekly-update.cfm
3. Implications for ACOs of Variations in Spending Growth
An article in last week’s issue of The New England Journal of Medicine discussed some of the potential drawbacks to the current plan to reimburse Accountability Care Organizations based on national growth factors. One of the potential problems to ACO reimbursement is that health care spending, growth, and practice can vary widely by geographical location, a phenomenon reported on regularly by the Dartmouth Atlas of Health Care (www.darthmouthatlas.org). The authors of the article conclude that “under payment arrangements that use national growth factors to set spending targets, variation in local spending growth could cause many ACOs to achieve substantial savings or experience substantial losses that are unrelated to their efforts to improve efficiency in response to ACO contracts.” For more information, visit http://www.nejm.org/doi/full/10.1056/NEJMp1202004)
What is an Accountable Care Organization? See the new “OSR Legislative Affairs 101” article on ACOs.
4. FDA and AMA Views on Making More Drugs OTC
USA Today recently offered a point-counterpoint perspective on the pros and cons of a recent FDA proposal to make more prescription drugs, such as those to treat asthma, migraines, high blood pressure and elevated cholesterol, more accessible without visits to a doctor. The USA Today’s arguments for the proposal can be found here: http://www.usatoday.com/news/opinion/editorials/story/2012-05-06/drugs-over-the-counter/54791606/1
The arguments against the proposal were given by Dr. Peter W. Carmel, the president of the AMA, and can be found here: http://www.usatoday.com/news/opinion/story/2012-05-06/prescription-drugs-FDA-AMA/54791526/1
5.New State Health Data Available
Interested in health data for either your home state or the state where you are attending medical school? Statehealthfacts.org has added new and updated data. This data can serve as a valuable resource for advocacy efforts. The web tool allows you to use a health indicator (examples provided below) to compare your state to both other states, and the country as a whole. Some highlights include the most recent data from the Centers for Disease Control and Prevention (CDC) on teen birth rates and the latest information from the Urban Institute and Kaiser Commission on Medicaid and the Uninsured on Medicaid spending per enrollee. Updated state-by-state information on emergency room visits per 1,000 population, Medical Loss Ratio (MLR) rebates, and health insurance exchanges is also available. For more information, visit http://www.statehealthfacts.org/profile.jsp.
Your loyal Legislative Affairs team,
Brad Hunter – Northeast Region
Robert Sanchez – Central Region
Sean Vanlandingham – Southern Region
Claire Sadler – Western Region
William Teeter – National Delegate