House Approves GOP Budget Proposal

A divided House approved a $3.6 trillion Republican budget yesterday recasting Medicare and imposing sweeping cuts in domestic programs.

But partisan divisions over the measure, which is dead on arrival in the Democratic-led Senate, also underscores how tough it will be for lawmakers to achieve the cooperation needed to contend with a tsunami of tax and spending decisions that will engulf Congress right after this fall’s elections.

The fiscal plan the House passed by a near party-line 228-191 vote would reshape and squeeze savings out of Medicare and Medicaid, the federal health insurance programs for the elderly and poor. The proposal would not change Medicare for retirees and those near retirement, letting the government continue paying much of their doctors’ and hospital bills.

For those under age 55, Medicare would be reshaped into a voucher-like system in which the government would subsidize people’s health care costs, which Republicans say would drive down federal costs by giving seniors a menu of options that would compete with each other. Democrats say government payments won’t keep up with the rapid inflation of medical costs, leaving many beneficiaries struggling to afford the care they need.



Health IT Gets $200M For Big Data Project

The Obama administration is putting $200 million behind a big data effort that will benefit a number of industries, including healthcare and health IT. The project will focus on a wide variety of areas, from biomedical research to crowd-sourced data gathered, in real time, from social media sites such as Twitter and Facebook.

The National Science Foundation (NSF), one of several agencies that will support the initiative, has published a long list of solicitations for different big data projects that support its overall objectives, including:

  • Creating a complete health, disease and genome knowledge bases to enable biomedical discovery and patient-centered therapy
  • Ensuring a full complement of health and medical information is available at the point of care for clinical decision-making
  • Giving students and researchers intuitive real-time tools to view, understand and learn from publicly available large scientific data sets, including genome sequences and public health databases
  • Supporting research in particular domain areas–especially areas of national priority, including health IT
Click here to read more.


DSS Announces Higher Medicaid Physician Reimbursement

The Connecticut State Medical Society (CSMS) has announced after providing comments to the state Department of Social Services (DSS) on how to increase physician reimbursement for adult services under Medicaid, DSS has released a new fee schedule.

The new fee schedule, which is retroactive to January 1, 2012, raises physician fees an average of close to 15% for adult office consultations, office and outpatient procedures and some psychiatric service codes. At a time when most states are freezing or reducing physician payments under Medicaid, these increases raise rates to around 75% of Medicare in Connecticut — a far cry from the 48% in place just a few years ago.

Click here to view the new fee schedule.

AMA Urges CMS To Re-Evaluate Timelines

The American Medical Association (AMA) joined with other physician specialty groups to urge the Centers for Medicare & Medicaid Services (CMS) to consider the “imminent storm” of overlapping regulations going into effect next year.

In a letter to acting Administrator Marilyn Tavenner, the groups expressed concern that the timeline for transitioning to ICD-10 overlaps with other program deadlines, such as e-prescribing, electronic health records and the physician quality reporting system.  Click here to read the groups letter in its entirety.

“We urge CMS to re-evaluate the penalty timelines associated with these programs and examine the administrative and financial burdens and intersection of these various federal regulatory programs,” said the letter. “We also urge CMS to use its discretionary authority provided by Congress under these programs to develop solutions for synchronizing these programs to minimize burdens to physician practices, and propose these solutions in the physician fee schedule proposed rule for calendar year 2013.”

Scribes Improve Practice Productivity

With Congress dedicating $30 billion in economic stimulus to help doctors create electronic records, physicians who convert to electronic records can receive bonus payments from Medicare and Medicaid beginning in 2011; those who aren’t using them by 2015 will face penalties.  Yet the U.S. Centers for Disease Control (CDC) estimates only 43.9% of doctors are using full or partial EHR systems.

A growing number of U.S. practices are hiring medical scribes, individuals trained to assist physicians with medical documentation, to enter patient information into electronic health record systems, allowing physicians to spend more time with patients and increasing productivity.

Physician scribes work alongside physicians and provide them with any assistance they may need.  They serve as a personal assistant to the doctor to help make them more efficient and productive.  Though physicians can choose how they would like to work with scribes, the ultimate goal is to allow doctors to see more patients without being bogged down by the administrative functions of a doctor visit.

The scribe works one on one with the physician to document the history, physical exam as well as the diagnoses for each patient a physician sees.  By the end of the patient workup, the scribe has written the final diagnoses, after care plan and prescribed meds in accordance with the prescription(s) as dictated and co-signed by the physician.

Scribes, who must have excellent listening, spelling and typing skills in addition to a working knowledge of medical terminology, can expedite routine intake steps and ensure quality patient care because they allow doctors to focus on patients.  Their focus on data entry and record completion also help physician practices earn meaningful use incentive payments from the government.

Costs For Long Term Care Insurance On The Rise

Just as aging Baby Boomers are realizing they may need long-term care insurance, the marketplace is shrinking, the cost of premiums is soaring, and providers are altering the policies they offer.

Long-term care insurance helps cover expenses that typical health insurance doesn’t, such as nursing homes, in-home care and assisted living.

Insurance companies have been making major adjustments because the claims on long-term health care policies have exceeded their predictions The reason: People are living longer and developing long-term illnesses. Meanwhile, near-record-low interest rates have depressed what the industry earns on the premiums it collects.

Click here to read more.

Experts Rate This Week’s Supreme Court Healthcare Arguments

After three days of oral arguments concluded this week, four constitutional law experts weighed in on the strengths and weaknesses of the cases made by the administration’s top lawyers and the attorney representing the 26 states challenging the 2010 Patient Protection and Affordable Care Act (PPACA).

The justices are expected to rule later this summer, a decision which will either uphold President Obama‘s landmark healthcare overhaul or scrap at least the most controversial part; the requirement that most Americans have health insurance.

Click here to read more.

CMS To Host Provider Call On Meaningful Use Basics Today

The Centers for Medicare & Medicaid Services (CMS) will offer a national provider call at 3p.m. today March 29 at 3 p.m. ET to discuss the basics of the Medicare and Medicaid EHR (Meaningful Use) Incentive Programs. Eligible professionals (EPs) can qualify for up to $44,000 over five years under the Medicare program and up to $63,750 under Medicaid. This year is the last chance EPs have to begin the Medicare meaningful use program and receive full incentive payment. Topics to be discussed on the call include:

  • Program eligibility determination
  • Available incentives
  • Registration process
  • Major milestones for participation and payment
  • Reporting meaningful use data
  • Resource identification
  • Question and answer

The 90-minute CMS educational program event is free but registration is required.  Click here to sign up.

Study Finds Hospital Pay For Performance Did Not Improve Mortality Rates

A new study has found Medicare’s largest effort to pay hospitals based on how they perform — an inspiration for key parts of the health care law — did not lead to fewer deaths.  The study casts doubt on  a central premise of the health law’s effort to rework the financial incentives for hospitals with the aim of saving money while improving patient care.

But the study published in the New England Journal of Medicine yesterday found that the mortality rate at the participating hospitals was virtually the same as the mortality rate for the 3,363 hospitals that were not part of the project. While the mortality rate dropped slightly over the course of the project among the participating hospitals, it also dropped for the other hospitals.

Medicare will start altering payments to more than 3,000 hospitals based on how patients rate their stays and how completely hospitals follow a handful of clinical guidelines for basic care this fall.

Storm Response Bill Clears Committee

Governor Dannel P. Malloy’s proposal to impose minimum standards for electric and gas utilities for emergency preparation and restoring services to customers has cleared a key legislative committee.  Earlier this week, Malloy announced the General Assembly’s Energy and Technology Committee approved the bill. It awaits further action by the Senate.

The new standards will cover minimum staffing and equipment for each utility, based on the number of customers it services. They also include recovery and service restoration targets in emergencies, and plans for deploying mutual aid crews and private contractors.

Malloy’s bill is one of several proposed in response to the lengthy power outages following the remnants of Hurricane Irene in August and the October snow storm.  Many healthcare facilities across Connecticut lost power and had to develop contingency plans for patients in light of the lengthy outages.