When Competitive Bidding Hurts Patients – NYTimes.com

medical-equipment suppliers send a technician to the patients’ homes to explain what can go wrong and to show them and their families how to use the device properly. But I know from experience that some suppliers are better at this than others. Some CPAP suppliers’ technicians will spend an hour making sure the families understand everything. Others (whom I no longer use) spend no more than 15 minutes. I found this out after patients showed up in my clinic, days after their machines had been delivered, still unable to use them.

This extra care takes time, and time costs money. But sicker patients and unnecessary hospital visits cost far more. And competitive bidding doesn’t take these subsequent costs into account.

via When Competitive Bidding Hurts Patients – NYTimes.com.

The United States Senate Committee on Finance: Newsroom – Ranking Member’s News

Three members of the Senate Finance Committee are concerned that the new Center for Medicare and Medicaid Innovation (CMMI) within the Center for Medicare and Medicaid Services (CMS) will place unnecessary financial strains on the nation’s health care entitlement programs, further threatening their future solvency.

Ranking Member Orrin Hatch (R-Utah) along with U.S. Senators Mike Enzi (R-Wyo.) and Tom Coburn (R-Okla.) today wrote two separate letters to the Government Accountability Office (GAO) Comptroller General and the U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius calling for a full examination of the activities being undertaken by CMMI and its fiscal impact on the Medicare and Medicaid programs.

“We are concerned that at a time of significant uncertainty for the fiscal health of the U.S. government, funds are being expended by the Innovation Center with little to no actual value provided,” the senators wrote to HHS Secretary Kathleen Sebelius. “Reducing health care costs is vital to preserving the solvency of the Medicare and Medicaid programs, but we are concerned that the Administration’s current approach, operating within the fee-for-service system, will not achieve the spending reductions necessary to meet this goal.”

Established under the $2.6 trillion health law, CMMI was created to test new payment and service delivery models under Medicare and Medicaid. To date, the program, which was appropriated $10 billion in federal funding, has yet to produce recommendations or implement a single systematic change or reform to the programs.  In their letters, the Senators requested Comptroller General Gene Dodaro conduct an extensive study regarding the implementation of several new Centers and Offices created with CMS, including CMMI. They further asked Secretary Kathleen Sebelius to outline CMMI’s operating strategy and detail how the $10 billion in funding is being used.

via The United States Senate Committee on Finance: Newsroom – Ranking Member’s News.

Fidelity: Retired couple needs $240,000 for health costs, up 4 percent from 2011 estimate – The Washington Post

Couples retiring this year can expect their medical bills throughout retirement to cost 4 percent more than those who retired a year ago, according to an annual projection released Wednesday by Fidelity Investments.The estimated $240,000 that a newly retired couple will need to cover health care expenses reflects the typical pattern of projected annual increases.

via Fidelity: Retired couple needs $240,000 for health costs, up 4 percent from 2011 estimate – The Washington Post.

My Way News – Medicare disruptions seen if health law is struck

Last year, in a lower court filing on the case, Justice Department lawyers said reversing the Medicare payment changes “would impose staggering administrative burdens” on the government and “could cause major delays and errors” in claims payment.

Medicare payment policies are set through a time-consuming process that begins with legislation passed by Congress. Even if Obama’s overhaul were completely overturned, the government still would have authority under previous law to pay hospitals, doctors, insurance plans, nursing homes and other providers.

“There is an independent legal basis to pay providers if the Supreme Court strikes down the entire law,” said Thomas Barker, a former Health and Human Services general counsel in the George W. Bush administration.

But reversing the new law’s payment changes from one day to the next would be a huge legal and logistical challenge, raising many questions. How would the government treat payments made over the last two years, when the overhaul has been the law of the land? Would providers have a right to refunds of cuts that had been made under the legislation?

Former program administrators disagree on the potential for major disruptions, while some private industry executives predict an avalanche of litigation unless Congress intervenes.

via My Way News – Medicare disruptions seen if health law is struck.

Blahous and Capretta: Exposing the Medicare double count – Health – AEI

One of the enduring mysteries of President Obama’s health law is how its spending constraints and payroll tax hikes on high earners can be used to shore up Medicare finances and at the same time pay for a massive new entitlement program. Isn’t this double counting?

The short answer is: Yes, it is. You can’t spend the same money twice. And so, thanks to the new health law, federal deficits and debt will be hundreds of billions of dollars higher in the next decade alone.

via Blahous and Capretta: Exposing the Medicare double count – Health – AEI.

Nine million reasons for reform: Mending the Medicare-Medicaid misalignment – Health – AEI

At an AEI event on Tuesday morning, health policy experts joined Joseph Antos to discuss how to improve care for dual eligibles, defined as people enrolled in Medicare due to age or disability status and Medicaid due to low incomes. Melanie Bella of the Medicare-Medicaid Coordination Office began the discussion with a report of the Centers for Medicare and Medicaid Services CMS efforts to coordinate care for the dually eligible population, most notably the Financial Alignment Initiative. The initiative — currently underway in 27 states — moves dual eligibles into state-run plans supported by federal funds. Judith Feder of Georgetown University’s Public Policy Institute went on to question CMS’s decision to cede responsibility of dual eligibles to the states, given that the federal government currently spends about four times more on these individuals  than the states do. Alan Weil of the National Academy for State Health Policy framed this issue as a culture clash between the two programs: while Medicare strives to preserve choice for its beneficiaries, Medicaid often limits choice in an attempt to contain costs. Tim Schwab of SCAN Health Plan demonstrated that when designed appropriately, special needs plans for dual eligibles can play a large role in improving integration between Medicare and Medicaid.

via Nine million reasons for reform: Mending the Medicare-Medicaid misalignment – Health – AEI.

Health Care Reform Isn’t Entitlement Reform – Reason.com

All this assumes that the law’s Medicare savings will actually pay off. Yet that is no sure thing either. Those projected savings are based in large part on targeted payment cuts to health industry players and providers. Those cuts, however, are already facing heavy opposition, and the White House has already backed down at least once.

On the same day that the Medicare Trustees report was released, the Government Accountability Office published a critical report on the administration’s decision to override planned payment cuts to private insurers in the Medicare Advantage program—cuts that played a big part in generating ObamaCare’s alleged Medicare savings. A week earlier, progressive champion and Massachusetts Senate hopeful Elizabeth backed scrapping ObamaCare’s tax on medical device makers. In this sort of political environment, it is hard to see how all of ObamaCare’s savings will stick.

via Health Care Reform Isn’t Entitlement Reform – Reason.com.

Obama’s Senior Swindle | The Weekly Standard

Anticipating a senior revolt, the administration took action. It ran millions of dollars’ worth of taxpayer-funded TV ads featuring Andy Griffith saying things like, “That new health care law sure sounds good for all of us on Medicare!” It mailed out full-color, taxpayer-funded propaganda brochures singing the same tune. It repeatedly claimed (and continues to claim) that money taken out of Medicare to fund Obamacare would—magically—also stay in Medicare and be used to extend its solvency.

But the administration didn’t stop there. Instead, it launched an $8.35 billion “demonstration project” to postpone the vast majority of Obamacare’s Medicare Advantage cuts until after what Obama likes to call his “last election.” In truth, this isn’t really a demonstration project at all. It’s something closer to the opposite: an attempt to keep Obamacare’s effects from being demonstrated until it’s too late for voters to respond.

via Obama’s Senior Swindle | The Weekly Standard.

President Obama’s Medicare slush fund—Benjamin E. Sasse & Charles Hurt – NYPOST.com

This political ticking time bomb could become the biggest “October Surprise” in US political history.

But the administration’s devised a way to postpone the pain one more year, getting Obama past his last election; it plans to spend $8 billion to temporarily restore Medicare Advantage funds so that seniors in key markets don’t lose their trusted insurance program in the middle of Obama’s re-election bid.

The money is to come from funds that Health and Human Services is allowed to use for “demonstration projects.” But to make it legal, HHS has to pretend that it’s doing an “experiment” to study the effect of this money on the insurance market.

That is, to “study” what happens when the government doesn’t change anything but merely continues a program that’s been going on for years.

via President Obama’s Medicare slush fund—Benjamin E. Sasse & Charles Hurt – NYPOST.com.

Independent Payment Advisory Board Will Help Reduce Health Costs — Center on Budget and Policy Priorities

Contrary to critics’ claims, IPAB will not usurp the role of Congress in setting Medicare policy, nor will it limit Medicare beneficiaries’ access to care.  Efforts to repeal IPAB are misguided.  If successful, such efforts could lead to more draconian steps, such as replacing guaranteed Medicare benefits with a premium support system, or voucher, whose value would fall farther behind the cost of health care each year.

via Independent Payment Advisory Board Will Help Reduce Health Costs — Center on Budget and Policy Priorities.