Read HCR Monthly
Retribution…
January 31st, 2012Earlier this week, I read with interest a report detailing a heated exchange between a leading House Republican and representatives of the American Hospital Association…
It seems that during the last Sustainable Growth Rate (SGR) battle in December 2011, Republicans decided that a reasonable way to pay for the cost of SGR was to dun the hospital industry for an additional $15 billion dollars in reduced Medicare/Medicaid reimbursements. According to Republicans, this would cover the two year window Congress was trying to resolve during this latest scramble to manage the unmanageable SGR. Read the rest of this entry »
The IRS: Healthcare Reform “Enforcers” and More…
January 17th, 2012So it’s 2012 and a year of consequence for healthcare reform is ahead of us. Aside from the ten key elements of the law that are scheduled to kick in this year (http://tinyurl.com/5u2f8e6), a slew of ongoing HCR programs and actions are about to become very important to all Americans in 2012. Here’s a quick list of some key HCR Developments for the next twelve months… Read the rest of this entry »
The ‘S’ Word in Healthcare Reform
December 20th, 2011In little more than two years, the main elements of the HCR will take hold across the nation. As implementation continues to ramp up, one of the more intriguing questions surrounding its activation is, is the “S” word being realized?…That is, “S” as in “savings.” Are the much publicized “savings” that were projected in early 2010 actually occurring as we head towards January 1, 2014?
The savings, according to the final 2010 CBO estimate, would provide a “net reduction in federal deficits of $143 billion…over the 2010–2019 period as result of changes in direct spending and revenues.”
Further, in August 2010, an NEJM article co-authored by Peter Orzag and Ezekiel Emanuel, MD, estimated that by 2030, total HCR savings would be up to $1 trillion.
Now, however, as various HCR elements meet the real world, many of the “savings” have proved illusory, if not completely unachievable.
To illustrate these difficulties, let’s take a look at the current status of “savings” in three key programs — Medicare Advantage, the CLASS Act, and ACOs. Read the rest of this entry »
Individuals in the Roiling Seas of HCR
November 22nd, 2011As the implementation of healthcare reform continues to ebb and flow, occasionally a name, an individual, is brought to our attention in the roiling seas of HCR. These are unusual moments because so much of healthcare reform’s activation feels so massive and impersonal. But in the midst of the waves of hyperbole and political spin, these names stick with us. Why? Because somehow these folks manage to convey simple truths to the public. And frequently these truths both delight and shock us.
PCORI and the Lessons of History…
October 27th, 2011While nasty wars continue to rage around the failed CLASS Act, and hearing after hearing on IPAB threatens to generate major legislative confrontations, one of the new HCR regulatory panels that you probably haven’t heard much about is PCORI, the Patient Centered Outcomes Research Institute.
There’s a lot of health theory tied up in this new bureaucracy, and if history is once again predictive of the future, we do need to study PCORI carefully. Read the rest of this entry »
The Great CLASS Act Caper
September 29th, 2011
(*Definition: ca·per noun – a prank or trick; harebrained escapade)
Eight days ago, late on the morning of September 22nd I was sitting at my desk, quietly reading emails, when suddenly, my computer began spewing:
- 11:06 EDST – “CLASS office at HHS closing down!” …
- 11:49 EDST – “CLASS closing ‘flat out false’ says Administration”…
And on it went, for the rest of the day, message after message…“CLASS is dead!”; “No it’s not.”; “Yes it is!”… You get the picture. Read the rest of this entry »
The HCR Taxman Cometh
September 14th, 2011As the country struggles with the current economic malaise, and the pharmaceutical industry enters into yet another difficult quarter of “trying to make the numbers,” one matter that I doubt many Rx execs are thinking about today is the HCR Taxman. That’s too bad. They probably should. That’s because he’s coming for the entire industry on September 30th. Read the rest of this entry »
HCR v. Supreme Court: On this matter, there will be no Equivocation
September 1st, 2011What a wild summer of HCR activity this has been! The pushing and shoving over IPAB, State Exchanges, ACOs, SGR, health insurance waivers, and all the rest of the HCR alphabet soup has washed over us time and again these last three months. And what to conclude from all of this? Read the rest of this entry »
America’s Poorest, Sickest, Least Educated, Cognitively Impaired Citizens Versus “Super Committee” Cuts
August 4th, 2011In reviewing the multitudes of old and newly entitled individuals who are having their healthcare impacted by the new HCR law, one designation which I commend to everyone for your deeper understanding is the so called “Dual Eligibles” category. Read the rest of this entry »
So, Where Are We with ACOs?
July 18th, 2011Tom Norton gets to grips with what an Accountable Care Organization is … and what it is not.
Sixteen months into the new Healthcare Reform law, many continue to wonder about the status one of the most confused aspects of the new HCR — the elusive Accountable Care Organization, or ACO. And why are ACOs viewed this way? Simply stated, the heated debate over exactly what an ACO is … and what it is not … has not been resolved as of this writing. (http://tinyurl.com/3nydsqj).
