A couple of today's clippings show an ominous trend toward increasing the number of for-profit health care systems, even in places that have been bastions of not-for-profit medical, such as Massachusetts.
I have long been an advocate of managed care systems, since I believe they hold the hope for better coordination of health care services and, therefore, improved quality and for "bending the cost curve" downward through improved efficiency. But if for-profit systems become managed care systems (aka "Accountable Care Organizations), those efficiencies could simply go to their bottom line, not to reducing the cost of care.
Caveat Emptor!
SPC
Ranks of for-profit hospitals may grow
Caritas owner pursuesdeals in Taunton, Lowell
Cost control the next step for Massachusetts health reform
All eyes will monitor the effort as national reform unfolds, but experts expect payment revisions to vary depending on the state.
By TANYA ALBERT HENRY, amednews correspondent. Posted March 28, 2011.
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Already a pioneer of health coverage expansion, Massachusetts is beginning to tackle the critical next phase of its health system reforms: containing costs. There may be debate about the best way to accomplish that, but observers agree it is the necessary next step if universal coverage is to be successful.
The Model of the Future?
The health-care law promoted accountable-care organizations. But it's hard to know what they are.
http://online.wsj.com/article/SB10001424052748703300904576178213570447994.html?KEYWORDS=medicare
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1,000+ pages of health-care rules? | |
| Health care lobbyists and advocates are bracing for six pages of the health care reform law to explode into more than 1,000 pages of federal regulations when the Department of Health and Human Services releases its long-delayed accountable care organization rules this week. “What, you expected less than a thousand pages for legislation that only took a page and half?” a staffer with one of the current proto-ACOs asked. http://dyn.politico.com/printstory.cfm?uuid=39296B51-1086-4367-ACC9-9C30CBB9FC63 Health Insurance Exchanges Already Making WavesThis story was produced in collaboration with  It seems like a simple idea: create new marketplaces, called "exchanges," where consumers can comparison shop for health insurance, sort of like shopping online for a hotel room or airline ticket. But, like almost everything else connected with the health overhaul law, state-based insurance "exchanges" are embroiled in politics. Some Republican governors are threatening to refuse to set up exchanges unless they get more flexibility over Medicaid, the state-federal health program for the poor. Others say they don't want to implement any part of the federal health care law. As Medicaid Budgets Squeezed, States Consider Eccentric Ideas On Cutting CostsWhen New York's Medicaid director asked the public for money-saving ideas, the most popular suggestion - as measured by the sheer volume of e-mails raising the idea - left him a bit red-faced. End payments for routine circumcisions, e-mailers advised. Though the idea didn't make the final list for New York's cost-curbing plan, it's just one example of how interest groups, such as Intaction.org, which opposes circumcision, businesses and other policy proponents are pushing to capitalize on states' dire Medicaid shortfalls. A single-payer health care system would work for OregonPublished: Tuesday, March 29, 2011, 7:00 AM Updated: Wednesday, March 30, 2011, 7:42 AM By Samuel Metz Am I crazy, a physician embracing legislative efforts to create a single-payer health care system in Oregon? You be the judge. It would create thousands of jobs. It would provide health care to people whether they work full time, part time or are retired, disabled, sick or unemployed. It would stimulate Oregon business. It would reduce our state deficit. And it would provide comprehensive care to every Oregonian without spending more than we do now. Where would the money come from? Oregon businesses and families already spend this money. But Oregon wastes $4 billion annually in private insurance administration. That's premium money that never goes toward health care. Half is the insurance company overhead. The rest is what hospitals and providers like me waste collecting payments from insurance companies. Princeton economics professor Uwe Reinhardt, speaking recently before the Senate Finance Committee, said of Duke University's 900-bed hospital: "We have 900 billing clerks at Duke. I'm not sure we have a nurse per bed, but we have a billing clerk per bed. It's obscene." Study Finds Raising Medicare Age Would Shift CostsRaising Medicare's eligibility age by two years would save the federal government $7.6 billion but those costs—and more—would shift to others, according to a report out today. The analysis by the Kaiser Family Foundation says that increases in total costs for people 65- and 66-year-olds, employers and the state governments in 2014 would outpace the federal savings. (KHN is an editorially independent program of the foundation.) The report assumed full implementation of the health law and an increase in Medicare eligibility to 67 in 2014. The shift in costs include added out-of-pocket expenses for people who are 65 and 66 that year, higher retiree costs for employers and increased Medicaid costs for states. The total out-of-pocket costs for 65- and 66-year-olds would increase by $5.6 billion while employer retiree health care costs would rise $4.5 billion, according to the report. Aetna pushes back and sues doctorsPosted by Don McCanne MD on Friday, Mar 25, 2011This entry is from Dr. McCanne's Quote of the Day, a daily health policy update on the single-payer health care reform movement. The QotD is archived onPNHP's website.http://pnhp.org/blog/2011/03/25/aetna-pushes-back-and-sues-doctors/ |
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