The American Hospital Association's response to "Bitter Pill". Judge for yourselves.Umbdenstock Addresses Time's "Bitter Pill" | |
| By Rich Umbdenstock | March 01, 2013 |
In an open letter to the field, AHA President and CEO Rich Umbdenstock seeks to "clarify some particularly misleading statements" in Time magazine's recent cover story, "Bitter Pill."
As a former hospital system CEO, I know that hospitals and health system leaders face challenges and issues as tough as anywhere in America. That's why we feel it's so important to clarify some particularly misleading statements in the March 4 Time magazine article "Bitter Pill."
Let's start with the article's assertion that nonprofit hospitals should not be allowed to make a "profit." The fact is, all hospitals need a positive margin to help finance the facilities and equipment needed to keep pace with advances in care and meet the demands of our aging population.
Then there is the statement about nonprofit hospitals employing their "region's most richly compensated executives." Nowhere does the article mention the rigorous process prescribed by the Internal Revenue Service for setting executive compensation, or that an impartial panel of a hospital's board usually is charged with setting CEO compensation.
This board relies on benchmark data from similar organizations to determine the compensation for, what is in my view, one of the most difficult jobs imaginable — helping to improve your community's health, while navigating the often-conflicting priorities of the public, government, business and insurers. The value hospitals bring to the community goes beyond the care that they provide, and we must make sure others understand this important fact.
Policy experts, health care leaders offer landmark roadmap for better health care at lower cost
BERKELEY —
An unprecedented, year-long collaborative effort involving policy experts from UC Berkeley, CEOs of major health insurers and health care delivery systems, and leaders from California’s public sector has produced a detailed roadmap that would transform the state’s health care system and improve care and outcomes while saving billions of dollars in the process.
The members of the Berkeley Forum for Improving California’s Healthcare Delivery System have agreed to support a risk-adjusted global budget model of paying for coordinated care, and today (Tuesday, Feb. 26), will issue a detailed report on specific actions that would save the state of California $110 billion – about $800 per household annually – over the next decade.
Global budgets, whereby physicians and hospitals optimize care under pre-determined expenditure targets, are a major shift from today’s predominantly fee-for-service environment. The current system, in which providers are paid for each treatment or procedure rendered, leads to the provision of more and duplicative services rather than efficient care that promotes good health, the report authors said.
Posted March 01, 2013, at 6:29 p.m.
Republican governors in Florida, New Jersey, Arizona, Ohio and elsewhere who have railed against the Affordable Care Act, the Obama administration’s health care reform law, have softened their opposition recently and endorsed the reform law’s major expansion of Medicaid.
But in Maine, Republican Gov. Paul LePage is giving no indication he plans to change his mind and allow Maine’s Medicaid program to grow.
The governor’s reluctance comes down to the fact Maine already has a generous Medicaid program that’s often running over budget and doubts that the federal government will stick to its promise of increased Medicaid funds, LePage spokeswoman Adrienne Bennett said.
“We already know that we were an early expander, and can we afford to expand more?” she said. “Right now, we can’t even pay for our welfare programs that we have.”
Meanwhile, Democrats have called for the state to participate in the expansion, which takes effect at the start of 2014. Rep. Linda Sanborn, D-Gorham, has submitted legislation that would sign Maine up.
“If Maine chooses not to do it, we basically are sending our tax dollars to other states for those folks rather than doing it here,” she said.
The Affordable Care Act’s Medicaid expansion — one of the measures in the law aimed at reducing the ranks of the uninsured — spreads Medicaid coverage to groups not traditionally covered under the public health insurance program for the low-income and disabled: able-bodied parents and adults without children who earn up to 133 percent of the federal poverty level ($20,628 for a two-person household).
Under the health care law, the federal government will cover 100 percent of costs for newly eligible Medicaid recipients for three years. The 100 percent funding will gradually drop to 90 percent in 2020, and states will have to make up the remaining share.
The Kaiser Family Foundation estimates that 21.3 million more people nationwide would receive Medicaid coverage if all states expanded their programs. But the end result is likely to be more complicated. By Kaiser’s count, 27 states so far are planning to participate while 16, including Maine, are not. Eight more are weighing their options.
For Maine, the decision is more complicated than in most states, said Jeff Austin, vice president of government affairs and communications for the Maine Hospital Association.
GOP leaders don’t grasp Obama’s willingness to give ground on Medicare, Social Security
WASHINGTON — On Thursday, I attended a background briefing with one of the most respected Republicans in Congress. The rules on these gatherings is you can’t name those involved, but you can quote them. That gives the lawmaker room to be a bit more honest without fear of immediate public reprisal. The discussion was frank and, in a way, encouraging: It suggested that some of the gridlock in Washington is simply the result of poor information.
Would it matter, one reporter asked the veteran legislator, if the president were to put chained-CPI — a policy that reconfigures the way the government measures inflation and thus slows the growth of Social Security benefits — on the table?
“Absolutely,” the legislator said. “That’s serious.”
Another reporter jumped in. “But it is on the table! They tell us three times a day that they want to do chained-CPI.”
“Who wants to do it?” said the legislator.
“The president,” replied the reporter.
“I’d love to see it,” laughed the legislator.
You can see it. If you go to WhiteHouse.gov, the first thing you’ll see is an invitation to read the president’s plan to replace the sequester. That plan is only a page. “Savings from Superlative CPI” — another way of saying chained-CPI (consumer price index) — is one of the items in bold type.
Reason, not bluster on hospital debt
Gov. Paul LePage undermined his efforts to use liquor revenue to pay back the hospitals when he went too far during a radio appearance on Friday morning and said he would veto all bills, including his own, until he has the payment deal he wants.
This situation, with hundreds of millions of dollars in play, amid many competing priorities, calls for grounded negotiation, not threats. Though LePage later explained he would not sign legislation that doesn’t have “broad, bipartisan support or promote job creation until the hospital debt is paid,” it’s too bad LePage made the issue a power struggle because, to date, he’s mostly offered a reasonable public policy argument about using revenue from a renegotiated liquor contract to pay the debt.
Maine residents already knew LePage’s priorities. He campaigned on paying the debt owed. He’s already held off on issuing $105 million in voter-authorized bonds, saying he will release them only when the Legislature agrees to his plan to repay the hospitals. By going further, andpromising to veto bills that come across his desk until the Legislature caves to his proposal to pay down the hospital debt, he may have strengthened his opposition.
So far, the Legislature has two proposals to review. LePage wants to use the proceeds from a renegotiated wholesale liquor contract to pay $186 million in debt the state owes its hospitals, triggering a $298 million federal match. Sen. Seth Goodall, D-Richmond, is sponsoring a bill that is silent about how the money would be used but lays out threshold requirements for companies seeking to operate the state’s wholesale liquor business.
Court rejects restraining order to halt Medicaid cuts set for March 1
Posted Feb. 28, 2013, at 6:27 p.m.
BANGOR, Maine — A federal judge on Thursday denied a request for a temporary restraining order filed by the advocacy group Maine Equal Justice Partners seeking to block Medicaid cuts for disabled and elderly recipients scheduled to take effect March 1.
The group filed its request on Feb. 20, in cooperation with the National Health Law Program and the Center for Medicare Advocacy, on behalf of five Maine residents whose health care coverage through MaineCare, the state’s Medicaid program, would be terminated. In January, the U.S. Department of Health and Human Services approved some Medicaid cuts proposed by the LePage administration to balance the state budget.
“It bears emphasis, however, that this decision is based largely on the procedural posture of the motion and the underdeveloped state of the record,” U.S. District Judge John A. Woodcock Jr. wrote in denying the request, adding that the parties will have an opportunity to further develop their evidence and arguments and the decision does not eliminate the possibility of some preliminary injunctive relief.
In denying the temporary restraining order, Woodcock wrote that such orders are intended to be used in emergency situations and are “an extraordinary equitable measure used to forestall irreversible consequences and preserve the status quo for a fuller deliberation of the merits of the case.”
The court decided the case didn’t meet that emergency standard.
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Saturday, March 2, 2013
Health Care Reform Articles - March 2, 2013
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