April 30, 2013
The most destructive Obamacare tax increases are just around the bend
Asked about Senator Max Baucus’s (D-Mont.) recent “train wreck” comments, President Obama today said, “A huge chunk of it [Obamacare] has already been implemented.” Unmentioned was the wave of destructive Obamacare tax increases that will begin to hit Americans during the next tax filing season and beyond:
via ATR Mobile: Obamacare’s Tax Hike Train Wreck.
April 30, 2013
We propose a framework for health care reform that focuses on supporting person-centered care. With continued innovation toward more personalized care, this is the best way to improve care and health while also bending the curve of health care cost growth.
Our health care system holds great promise. As a result of fundamental breakthroughs in biomedical science, improvements in data systems and network capabilities, and continuing innovation in health care delivery, care is becoming increasingly individualized and prevention-oriented. The best treatment for a patient involves not just specific services covered under traditional approaches to health insurance financing, but also includes new technologies and new kinds of care and support at home and beyond traditional health care settings. These advances require health care providers to work with patients and their caregivers to target increasingly sophisticated treatments and to coordinate care effectively ways that works best for each patient.
via Bending the curve: Person-centered health care reform – Health – AEI.
April 30, 2013
According to consultants from Oliver Wyman who wrote on the issue in the January issue of Contingencies, the magazine of the American Academy of Actuaries, around six million of the 19 million people with individual health policies are going to have to pay more—and this even after accounting for the government subsidies offered under the law. For example, single adults age 21-29 earning 300% to 400% of the federal poverty level will be hit with an increase of 46% even after premium assistance from tax credits.
via Daniel Kessler: The Coming ObamaCare Shock – WSJ.com.
April 29, 2013
BACKGROUND: Ongoing efforts to profile physicians on their relative cost of care have been criticized because they do not account for differences in patients’ socioeconomic status (SES). The importance of SES adjustment has not been explored in cost-profiling applications that measure costs using an episode of care framework. OBJECTIVES: We assessed the relationship between SES and episode costs and the impact of adjusting for SES on physicians’ relative cost rankings. RESEARCH DESIGN: We analyzed claims submitted to 3 Massachusetts commercial health plans during calendar years 2004 and 2005. We grouped patients’ care into episodes, attributed episodes to individual physicians, and standardized costs for price differences across plans. We accounted for differences in physicians’ case mix using indicators for episode type and a patient’s severity of illness. A patient’s SES was measured using an index of 6 indicators based on the zip code in which the patient lived. We estimated each physician’s case mix-adjusted average episode cost and percentile rankings with and without adjustment for SES. RESULTS: Patients in the lowest SES quintile had $80 higher unadjusted episode costs, on average, than patients in the highest quintile. Nearly 70% of the variation in a physician’s average episode cost was explained by case mix of their patients, whereas the contribution of SES was negligible. After adjustment for SES, only 1.1% of physicians changed relative cost rankings >2 percentiles. CONCLUSIONS: Accounting for patients’ SES has little impact on physicians’ relative cost rankings within an episode cost framework.
via Impact of Socioeconomic Adjustment on Physicians’ Relative Cost of Care | RAND.
April 29, 2013
President Obama has nominated Howard Shelanski, the top economist at the Federal Trade Commission, to direct the White House office overseeing all federal regulations.
If confirmed, Mr. Shelanski will direct the Office of Information and Regulatory Affairs, a branch of the Office of Management and Budget
via Obama Nominates F.T.C. Economist to Top Regulatory Post – NYTimes.com.
April 29, 2013
Medicare is referring to the newly created Center for Medicare and Medicaid Innovation, which gives the program power to create and expand projects without congressional authorization. This authority could also be used to create projects based on HQP’s lessons. It’s not. Instead, Medicare has created a raft of projects and experiments meant to move the system from fee-for-service toward pay-for-quality — with the hope that if they can get the payment incentives right, then the market will have reason to support programs like HQP.
To Health Quality Partners and its defenders, Medicare’s decision is ludicrous. “We’re spending tens of billions of dollars now on Medicare innovation where Medicare already discovered something amazing and now they’re forgetting what they discovered?” Brenner says. “It’s an amazing government moment.”
via If this was a pill, you’d do anything to get it.
April 27, 2013
It’s an attractive political principle, but it would come at a price. Putting all federal employees on the exchanges would obliterate the most market-oriented insurance program run by the government, the Federal Employee Health Benefits Program, or FEHBP. Indeed, the FEHBP has long been considered a model for market-based reform of the Medicare and Medicaid programs.
In the FEHBP, employees get to choose amongst a wide variety of plans offered by private insurers. The employer–the government–then subsidizes about three-fourths of the cost to the employee. The employee can choose a more generous or expensive plan if he wants, but he has to pay for a portion of the difference in price, and vice versa. As a result of this approach, FEHBP plans have organically evolved to contain the benefits and financial features that consumers want. By contrast, any minor change to Medicare requires an act of Congress.
via GOP’s Dave Camp: Why Not Put All Federal Employees Onto Obamacare’s Exchanges? – Forbes.
April 26, 2013
In the years since the health care law’s passage, we’ve seen businesses and states seeking waivers from ill-conceived provisions of the health care law, business owners contemplating demoting full-time workers to part-time status to avoid fines, and recently, even a union calling for the law’s repeal. The reality is that the law puts many Americans in their own unique binds.
Perhaps OPM will find a way to resolve this particular issue facing members of Congress and their staffers. But it’s saying something that with all the senators, representatives, lawyers, legislative gurus and health care policy experts floating through Capitol Hill, there’s still utter confusion about what the proper application of this particular provision is. How are tens of millions of Americans and millions of businesses supposed to make sense of the law and determine how it will affect their special circumstances?
via Obamacare’s uncertainty strikes Congress | WashingtonExaminer.com.
April 26, 2013
The White House sums up the central idea behind the health care exchanges in the new federal health law with a simple motto: “more choices, greater competition.”
But even some stalwart supporters of the Affordable Care Act worry that in many states, people won’t have a lot of health insurance choices when the exchanges launch in October.
via Affordable Care Act Health Exchanges May Lack Competition When They Launch in October.
April 26, 2013
Last Thursday, the Bipartisan Policy Center’s (BPC) Health Care Cost Containment Initiative released a comprehensive plan to increase efficiency and reduce costs while reorienting the nation’s health care system to become more patient-centered. That combination would ideally lead not only to a more sustainable fiscal future but to better health care as well.
The plan targets the largest health care levers that federal policymakers have: Medicare and the tax code — specifically the exclusion of employer-provided health care from taxation. The plan, as scored by health policy experts, would reduce budget deficits over the next 10 years and then continue to lower the trajectory of the federal debt.
Medicare would be transformed into a system that rewards value and coordination instead of the quantity of services, and the tax code would no longer encourage overspending on health care. Furthermore, these changes at the federal level are meant to encourage and incent a more rational private health care system.
These lofty goals were heralded by BPC’s health care leaders: former Senators Tom Daschle, Bill Frist and Pete Domenici, along with Dr. Alice Rivlin. Their agreement after a year of discussion, painstaking research and stakeholder outreach suggests that their scrupulously bipartisan conclusions might be more than just a legislative pipe dream.
via Might Health Care Reform Be the ‘Grand Bargain’? | The Concord Coalition.