1. Insurance companies announce plan to keep benefits regardless of ACA decision
Three of the five largest health insurance companies (United Health, Aetna, and Humana) announced last week that they will continue with the more popular insurance reforms regardless of the Supreme Court Ruling on the Affordable Care Act (ACA) expected to occur at the end of the month. This would include provisions such as allowing children to remain under their parents’ coverage until age 26, having no lifetime limits, and providing preventative health services. The insurance companies have not claimed to continue insuring people with pre-existing conditions.
Critics of the announcement warn that the insurance companies may be signaling to the Supreme Court that even if they overturn the ACA in its entirety, the insurance companies will police themselves and no longer require legislative consumer protections. Conversely the insurance companies maintain that these provisions are low-cost, good for peoples’ health, and keep rising health costs down.
Read the ABC News or New York Times coverage for more information
2. Residents respond to duty-hour regulations
When the ACGME Duty Hours task force implemented the newest duty hours restrictions in July 2011 (80-hour work weeks, 16-hour consecutive work hour limitations, and increased supervision), program directors and residents had mixed feelings about the regulations. In addition to concerns that interns would be less prepared for senior roles, many feared that increasing the number of hand-offs and decreasing continuity would negatively impact patient care as well.
A follow-up study conducted in February 2012 polled 6202 residents regarding the perceived effects of these duty hours regulations. Though the regulations now require interns to have ‘immediately available’ supervision, 73.8% of residents polled believe that the availability of supervision was unchanged. When asked about the effect on education, 40.9% report a worsened education vs. 16.3% who noted an improvement. Additionally a majority (51.5%) believes they were less prepared for more senior roles. In comparing interns to senior residents, 61.8% of interns reported a ‘positive change’ while 49.7% of senior residents believe their quality of life has suffered. Overall 48.4% of residents disapprove of the regulations compared to 22.9% that approve.
Read the full article by Drolet et al, New England Journal of Medicine, May 30, 2012
3. Increase in observation status of Medicare enrollees
Researchers from Brown University examined the frequency that hospitals are placing patients on ‘observation status’ rather than admitting them. Observation status means that they are still getting treated in a hospital, but the stay is covered by Medicare Part B instead of Part A, which can leave the patients with a larger hospital bill. The most affected group are patients who then proceed to a nursing home, as Medicare only covers nursing home care after hospitalization (not observation status). Between 2007 and 2009 the number of observation stays increased 25% while inpatient admissions dropped simultaneously. This rise may be attributed to the payment denial for readmissions and increasingly stringent admission criteria imposed by Medicare.
Source: Health Affairs, June 2012: http://content.healthaffairs.org/content/31/6/1251.abstract
4. US ranks near bottom in adoption of value-based healthcare
Boston Consulting Group (BCG) reports that the United States trails behind eight of twelve developed countries regarding the adoption of value-based purchasing (VBP) (as opposed to volume-based care; for a more detailed explanation see this week’s Health Policy 101). Experts believe that adopting a VBP system will improve health outcomes while reducing expenditures. Countries were assessed on the degree VBP is integrated on a national level (e.g., legal frameworks, IT infrastructure) and the quality of a country’s current disease registries that already track health outcomes.
Sweden was ranked first in their advancement of value-based care, followed by Singapore, Canada, and the United Kingdom. The fragmented nature of the United States’ healthcare system limits the collection of health outcome data as well as the implementation of new standards. While government can play in creating a framework for registries, there is also a role for national medical societies to lead the way in creating standards for data collection and increasing physician participation.
Source: http://www.healthcareitnews.com/news/report-us-ranks-near-last-value-based-healthcare
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
Three of the five largest health insurance companies (United Health, Aetna, and Humana) announced last week that they will continue with the more popular insurance reforms regardless of the Supreme Court Ruling on the Affordable Care Act (ACA) expected to occur at the end of the month. This would include provisions such as allowing children to remain under their parents’ coverage until age 26, having no lifetime limits, and providing preventative health services. The insurance companies have not claimed to continue insuring people with pre-existing conditions.
Critics of the announcement warn that the insurance companies may be signaling to the Supreme Court that even if they overturn the ACA in its entirety, the insurance companies will police themselves and no longer require legislative consumer protections. Conversely the insurance companies maintain that these provisions are low-cost, good for peoples’ health, and keep rising health costs down.
Read the ABC News or New York Times coverage for more information
2. Residents respond to duty-hour regulations
When the ACGME Duty Hours task force implemented the newest duty hours restrictions in July 2011 (80-hour work weeks, 16-hour consecutive work hour limitations, and increased supervision), program directors and residents had mixed feelings about the regulations. In addition to concerns that interns would be less prepared for senior roles, many feared that increasing the number of hand-offs and decreasing continuity would negatively impact patient care as well.
A follow-up study conducted in February 2012 polled 6202 residents regarding the perceived effects of these duty hours regulations. Though the regulations now require interns to have ‘immediately available’ supervision, 73.8% of residents polled believe that the availability of supervision was unchanged. When asked about the effect on education, 40.9% report a worsened education vs. 16.3% who noted an improvement. Additionally a majority (51.5%) believes they were less prepared for more senior roles. In comparing interns to senior residents, 61.8% of interns reported a ‘positive change’ while 49.7% of senior residents believe their quality of life has suffered. Overall 48.4% of residents disapprove of the regulations compared to 22.9% that approve.
Read the full article by Drolet et al, New England Journal of Medicine, May 30, 2012
3. Increase in observation status of Medicare enrollees
Researchers from Brown University examined the frequency that hospitals are placing patients on ‘observation status’ rather than admitting them. Observation status means that they are still getting treated in a hospital, but the stay is covered by Medicare Part B instead of Part A, which can leave the patients with a larger hospital bill. The most affected group are patients who then proceed to a nursing home, as Medicare only covers nursing home care after hospitalization (not observation status). Between 2007 and 2009 the number of observation stays increased 25% while inpatient admissions dropped simultaneously. This rise may be attributed to the payment denial for readmissions and increasingly stringent admission criteria imposed by Medicare.
Source: Health Affairs, June 2012: http://content.healthaffairs.org/content/31/6/1251.abstract
4. US ranks near bottom in adoption of value-based healthcare
Boston Consulting Group (BCG) reports that the United States trails behind eight of twelve developed countries regarding the adoption of value-based purchasing (VBP) (as opposed to volume-based care; for a more detailed explanation see this week’s Health Policy 101). Experts believe that adopting a VBP system will improve health outcomes while reducing expenditures. Countries were assessed on the degree VBP is integrated on a national level (e.g., legal frameworks, IT infrastructure) and the quality of a country’s current disease registries that already track health outcomes.
Sweden was ranked first in their advancement of value-based care, followed by Singapore, Canada, and the United Kingdom. The fragmented nature of the United States’ healthcare system limits the collection of health outcome data as well as the implementation of new standards. While government can play in creating a framework for registries, there is also a role for national medical societies to lead the way in creating standards for data collection and increasing physician participation.
Source: http://www.healthcareitnews.com/news/report-us-ranks-near-last-value-based-healthcare
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