Steward pursues struggling Maine hospital
Mercy Health looking for stronger partner
Pushing forward with its plans to expand out of state, Steward Health Care System LLC, which has amassed a chain of 10 community hospitals in Massachusetts, signed a letter of intent to buy financially struggling Mercy Health System of Maine from a Catholic hospital group.
The letter, which does not spell out financial terms, gives Boston-based Steward exclusive rights to negotiate with Mercy’s owner, Catholic Hospital East, a Pennsylvania-based network of 35 hospitals and other health care facilities operating in 11 states from Maine to Florida.
Investors in Health Care Seem to Bet on Incumbent
By ANDREW ROSS SORKINWho is going to win the presidential election?
You might want to ask Mark T. Bertolini. He just bet $5.7 billion on President Obama.
Mr. Bertolini is the chief executive of Aetna, which on Monday agreed to acquire Coventry Health Care, a huge provider of Medicare and Medicaid programs. His $5.7 billion bet makes a lot of sense if you believe that the Affordable Care Act - otherwise known as Obamacare - will not be repealed.
Mitt Romney has pledged to repeal the act "on my first day if elected," so any gamble that Obamacare stays intact could be fairly described as a wager that President Obama will remain in office.
At a time when so many in the business community appear to be supporting Mr. Romney, it is telling that some businessmen and investors expect a different result - and are wagering more than rhetoric; they are staking their wallet on it.
It may be counterintuitive, but with the Standard & Poor's 500 up 9.5 percent in the last three months and the stock market over all at its highest point since the financial crisis, there is an argument to be made that investors writ large may be helping the incumbent to win. Intrade, an online market that allows investors to bet on political outcomes and other world events, shows that President Obama is favored to win, 57.3 percent to 42 percent.
"The best single predictor of presidential re-election results that we found was the percentage change in the stock market during the three years that preceded Election Day," Deepak Goel of the Socionomics Institute said in February when he released a study that was recently highlighted by Reuters. The study said that recent performance of the stock market was more important than gross domestic product, inflation and unemployment.
At a minimum, the stock market, which is an indicator of future earnings, seems to be in disagreement, at least somewhat, with the steady drumbeat of C.E.O.'s and investors who have said that President Obama's administration, in the words of Daniel Loeb, the outspoken activist hedge fund investor, "is openly hostile to most businesses and unable to articulate or implement policies to spark growth and reduce unemployment."
Patients Would Pay More if Romney Restores Medicare Savings, Analysts Say
By JACKIE CALMES
WASHINGTON — Mitt Romney’s promise to restore $716 billion that he says President Obama “robbed” from Medicare has some health care experts puzzled, and not just because his running mate, Representative Paul D. Ryan, included the same savings in his House budgets.
The 2010 health care law cut Medicare reimbursements to hospitals and insurers, not benefits for older Americans, by that amount over the coming decade. But repealing the savings, policy analysts say, would hasten the insolvency of Medicare by eight years — to 2016, the final year of the next presidential term, from 2024.
While Republicans have raised legitimate questions about the long-term feasibility of the reimbursement cuts, analysts say, to restore them in the short term would immediately add hundreds of dollars a year to out-of-pocket Medicare expenses for beneficiaries. That would violate Mr. Romney’s vow that neither current beneficiaries nor Americans within 10 years of eligibility would be affected by his proposal to shift Medicare to a voucherlike system in which recipients are given a lump sum to buy coverage from competing insurers.
For those reasons, Henry J. Aaron, an economist and a longtime health policy analyst at the Brookings Institution and the Institute of Medicine, called Mr. Romney’s vow to repeal the savings “both puzzling and bogus at the same time.”
Marilyn Moon, vice president and director of the health program at the American Institutes for Research, calculated that restoring the $716 billion in Medicare savings would increase premiums and co-payments for beneficiaries by $342 a year on average over the next decade; in 2022, the average increase would be $577.
Beneficiaries, through their premiums and co-payments, share the cost of Medicare with the government. If Medicare’s costs increase — for instance, by raising payments to health care providers — so, too, do beneficiaries’ contributions.
Rationing Health Care More Fairly
By EDUARDO PORTER
Older adults are understandably anxious about the political sniping over the future financing of Medicare. That is precisely the intention of the presidential campaigns.
Yet the cross-fire over who will cut Medicare by how much sidesteps a critical issue about the future of our medical care: If we must ration our care to hold down costs in the future, how can we do it in a fair, efficient and transparent way?
Mitt Romney’s campaign was brazenly misleading in its charge that the president’s health plan would cut medical services to older adults by reducing Medicare spending by $716 billion. The president’s savings will come mostly from smaller payments to managed care companies, which provide the same services as Medicare at a higher cost, and from slower growth in reimbursement rates to health care providers.
But the response of President Obama’s campaign also aimed to stoke voters’ fears. It stressed — rightly — that the plan to curb Medicare costs proposed last year by Representative Paul D. Ryan, Mr. Romney’s vice-presidential running mate, would add thousands of dollars to older Americans’ out-of-pocket expenditures. Yet it ignored Mr. Ryan’s recent efforts to soften the plan.
Both campaigns claim they are out to protect future health care. Yet the sniping hides the real issue. Protecting federal health programs over the long term, as the population ages and medical costs keep rising faster than economic growth, will require curbing the programs’ spending. And we haven’t quite figured out how to do that.
The federal government’s spending on health care consumes 4.8 percent of the nation’s economic production and is expected to eat up 9.2 percent in 25 years, according to estimates from the Congressional Budget Office. A vast majority of economists agree that restoring a sustainable budget will mean either cuts in Medicare and Medicaid or a tax increase on the middle class.
The Morning Plum: Romney Medicare plan would drive seniors’ costs up
By Greg Sargent
The Romney campaign is up with yet another ad accusing Obama of raiding Medicare of $716 billion to pay for Obamacare, while claiming the Romney-Ryan plan would “restore” Obama’s cuts and strengthen the program. It’s clear that this claim will continue to be central to Romney’s case for the presidency.
For some reason, Jackie Calmes of the New York Times decided it might be a good idea to call up a range of experts and ask them if Romney’s claim is, you know, true. And they say Romney’s plan would actually make Medicare insolvent sooner and drive costs up for seniors:
Would Portland hospital sale to for-profit be the start of more acquisitions?
By Jackie Farwell, BDN Staff
Posted Aug. 21, 2012, at 8:40 p.m.
PORTLAND, Maine — The planned sale of Mercy Health System of Maine to a Massachusetts chain may mark the first time a for-profit company owns a Maine hospital, but the implications for health care go beyond tax status, according to Mercy’s CEO and an observer of the deal.
Mercy, which includes two flagship hospitals in Portland and several health care facilities in southern Maine, has signed a letter of intent to sell the system to Steward Health Care System LLC. Based in Boston, Steward runs 10 community hospitals in Massachusetts.
Terms of the deal have not been disclosed. Mercy, a Catholic organization, and Steward still must reach a final agreement and win approval from the Vatican and the state and federal governments, including the certificate of need unit at the Department of Health and Human Services, which evaluates hospital projects. The entire agreement and approval process is expected to take about six months.
Mercy is a member of Pennsylvania-based Catholic Health East, which operates 35 acute care hospitals across the eastern seaboard.
If the sale goes through, Mercy would become the first hospital in Maine to be owned by a for-profit company.
One exception is the New England Rehabilitation Hospital of Portland, which is jointly owned by Maine Medical Center and HealthSouth. It’s a for-profit, but as a specialty facility it falls under a different category than hospitals such as Portland’s Maine Medical Center or Eastern Maine Medical Center in Bangor.
In Massachusetts, Steward has prided itself on delivering quality health care at lower costs through a system of providers, according to Stuart Altman, a health care economist at Brandeis University in Waltham, Mass. He speculates that the Mercy deal is part of the company’s wider strategy.
“Buying one hospital in Maine doesn’t work,” he said. “So the question is whether this is just the beginning.”
Mercy sale could mean close to $1 million in taxes per year for Portland
By Seth Koenig, BDN Staff
Posted Aug. 21, 2012, at 8:41 p.m.
PORTLAND, Maine — Portland city officials said Tuesday that, while many question marks still hover around the potential sale of Mercy Health Systems to a for-profit entity, shifting the previously nontaxable hospital network onto the tax rolls could generate $865,000 or more in new annual property taxes for the city.
That figure is an early estimate, cautioned city spokeswoman Nicole Clegg, who stressed that it is only based on applying the property tax rate to the land and buildings belonging to Mercy in Portland, which are valued at a total of about $46 million.
Clegg noted that city assessors don’t know if some of the organization’s property will be sold or changed as part of Mercy’s proposed sale to the Boston-based Steward Health Care System LLC; nor do they have an inventory of what hospital equipment the organization owns, which would add personal property tax value to the assessment.
“We don’t know any of the details of the transaction, and we just don’t know what that could mean,” Clegg told the Bangor Daily News. “This is the first time a hospital of this size is going from not-for-profit status to for-profit status in the state, so this could be complicated. We’ll need to see the details of the transaction, we’ll need to understand what equipment is owned and leased by the business before we can really have a true handle on what the financial impact will be.”
Clegg said that while Mercy currently does not pay the city an annual sum in lieu of property taxes, as some nonprofits in Maine do, the organization offers multiple in-kind services, such as free use of the hospital’s X-ray to the city’s health care department potentially worth “hundreds of thousands” of dollars each year.
“Mercy has been a great partner with the city,” she said. “They’ve provided support for our community and minority health outreach programs. They have provided ancillary services for our clinics, and we’ve enjoyed a shared commitment to the poor and vulnerable populations. They’ve provided significant charitable care for these segments of the population, and certainly we hope that as they go through this transition, we’d continue to work together on those shared priorities.”
Clegg also said city officials do not yet know if Mercy’s possible new owners would seek tax breaks.
Why we should all care about MaineCare
By Barbara Shaw, Special to the BDN
Posted Aug. 21, 2012, at 3:56 p.m.
Perhaps you are among the fortunate Mainers with health insurance, either through your employment, the Veterans Benefits Administration or Medicare. Even if you are insured, the debate about who will and will not be covered by MaineCare — Maine’s Medicaid program — will affect you.
The proposed elimination of MaineCare benefits for “childless adults” — nondisabled people ages 20-64 without dependent children — reverses a decade-long effort in Maine to expand coverage to a vulnerable population.
About 10 years ago, with strong bipartisan support, Maine sought and received a waiver from the Centers for Medicare and Medicaid Services to expand MaineCare to include childless adults. Part of a Bush administration initiative, the waiver program aimed to reduce the number of uninsured Americans.
The Maine Hospital Association, Maine Medical Association and members of the business community strongly supported increasing the income eligibility levels in MaineCare as a cost effective strategy to provide coverage to low income adults. As a result of the program, the number of uninsured in this low-income group dropped from 40 percent to 29 percent by 2008.
Plans to eliminate Medicaid coverage to save state dollars are shortsighted and will not end the health care needs of this population. The savings, an estimated $22 million, must be measured against the loss of $37 million federal matching dollars. Elimination of coverage shifts costs to you as a hidden tax on insurance premiums.
Here is how it happens: The uninsured poor and near poor have no access to preventive or primary care to stay well and attend to health problems early. By necessity they delay medical attention until they are forced to seek care through the most inefficient and expensive entry point for health care, the hospital emergency room.
For example, a person with undiagnosed and untreated high blood pressure may show up after having a stroke and will need very costly treatment. Hospitals are obligated to treat the uninsured and then pass on their increased charity care and bad debt to the commercial insurance market. The insurance companies then pass those increases on to the rest of us as higher premiums and reduced reimbursement to providers. We are all paying for the health care needs of the uninsured in the most expensive and least healthful way possible.
But more important than cost containment is enhanced survival. A recent study from Harvard Public Health, published in The New England Journal of Medicine, demonstrates that Medicaid expansion for childless adults saves lives.
Analyzing 10 years of data and nearly 200,000 people, researchers compared three states — New York, Arizona and Maine — that substantially expanded Medicaid eligibility since 2000 with three neighboring states that did not. The study showed a 6 percent drop in death rates in the expansion states compared with neighboring states (Maine was compared to New Hampshire), decreased rates of delayed care because of cost and increased rates of reported “excellent” or “very good” health.
Half of doctors say they’re burned out as workloads rise
By Shannon Pettypiece, Bloomberg News
Posted Aug. 22, 2012, at 9:27 a.m.
About 1 in 2 doctors are burned out, showing signs of emotional exhaustion and little interest in work as patient loads increase, U.S. researchers found.
Doctors working in emergency, family and internal medicine were the most likely to feel drained, according to the study released Tuesday in the Archives of Internal Medicine. Researchers said burnout also was tied to long hours, with 37 percent of physicians working more than 60 hours a week.
The number of doctors reporting feeling burned out is surprising and troubling, said Tait Shanafelt, a professor of medicine at the Mayo Clinic and lead study author. He said the trend may cause physicians to quit or reduce their workload just as demand for doctors is increasing with the aging population. The issue may get worse as 32 million Americans are expected to get health insurance by 2014 under a new U.S. law, increasing the number of people seeking medical care, he said.
“Right at a time when we are trying to provide care to people who are uninsured and projecting workforce shortages we are seeing this burnout rate creep in, which may cause physicians to reduce workloads and consider early retirement,” Shanafelt said.
He added that burnout has also been linked to medical errors and worse patient care in previous studies.
The study found that 46 percent of doctors show at least one sign of being worn out. Shanafelt said the burnout was about 10 percent higher than in the population as a whole. Unlike with other professions, more education isn’t linked to a lower risk of feeling drained among doctors, the study found.
Researchers collected responses from 7,288 doctors across all practice areas to measure levels of emotional exhaustion, depersonalization and sense of professional accomplishment. The data was compared with surveys of the general population.
First, do no harm. Second, nationalize
By Teryl Zarnow, columnist
The Orange County Register, Aug. 17, 2012
The Orange County Register, Aug. 17, 2012
It sounds like a golden age in medical care.
You went to the doctor and received medical care. You didn't jump through hoops such as prior authorization, referrals, or network providers.
"Insurance didn't interfere," recalls Dr. Don McCanne, who practiced family medicine for 31 years in San Clemente before retiring in1997. "You just took care of the patient."
Then in the 1990s came the "managed care revolution."
Suddenly, he says, the private sector "intruded in the relationship between the physician and the patient."
In his practice, McCanne worked evenings and weekends to treat the poor or undocumented without health insurance. Today he sees the same problems getting worse: Medical costs have soared, and many people still don't have access to health care.
McCanne, now 74, volunteers as a policy fellow for Physicians for a National Health Program (PNHP) where he was a past president. His group favors a single-payer national health program often called "Improved Medicare for All."
It's not socialized medicine, just socialized insurance.
I can't decide if the doctor is out of touch with reality or a prophet in blue jeans.
No comments:
Post a Comment