Another sign that the economy is mired in muck, with prospects for improvement any time soon being very dim:

A new survey shows a family health plan in 2010 averages $4,000 a year, up 14% from 2009. Meanwhile, the average employer contribution to a family plan hasn’t increased at all. [...] Overall, premium growth slowed slightly this year to 3%, with the average annual cost of a family health plan reaching $13,370. Workers picked up 30% of that bill. The average plan for a single individual cost $5,049.

Slow job growth. Incremental premium increases. Higher out-of-pocket expenses for care. Forget about cost-sharing. This is massive cost shifting, and healthcare consumers are being forced to take the brunt of the cost of that coverage. | LINK

The massive increase in procedures over the past 20 years has added to the cost of providing care, to no one’s surprise. A study in the recent Radiology journal acknowledges this.

Part of the explosion in medical imaging over the past two decades may be attributable to overutilization, and steps need to be taken to cut back … Imaging services and their costs have grown at about twice the rate of other technologies in healthcare including lab procedures and pharmaceuticals…

Part of the problem fueling this growth has been the inclusion of many non-invasive standard imaging techniques as being procedure based — lumping the costs associated with uncomplicated, unenhanced CT imaging with, say, CT-guided renal biopsy — for example. Of course, bordering on the unethical side are the practices of self-referral within large imaging groups in many healthcare markets. | LINK

CMS has informed state Medicaid directors the terms of qualification for federal matching funds for administrative costs toward information technological infrastructures. Specifically, states must comply with the following stipulations: administration of Medicaid incentive payments to Medicaid eligible professionals and eligible hospitals; oversight of the Medicaid electronic health record (EHR) Incentive Program; and the pursuit of initiatives that encourage the adoption of certified EHR technology for the promotion of health care quality and the electronic exchange of health information.

Besides the latter bullet point above, the entrance of individual states into EHR IT initiatives carries with it a commitment to Medicaid funds in this era of reform. Some states are already on board, like California — whose governor couldn’t be more excited to get the ball rolling.

“What we are launching today is a new era for healthcare,” Schwarzenegger said. “Through a simple broadband link, this state-of-the-art system will save lives by instantly connecting people from across the state, including under-served and rural areas, with the best and brightest doctors. The California Telehealth Network marks the beginning of a new digital highway that will fundamentally change the future of how healthcare is provided.”

Others, like Minnesota, are leaving some state government agencies — and patients they serve — in a lurch.

Millions of dollars in health care funds seemingly destined for Minnesota after last week’s emergency session of Congress have yet to clear a final hurdle: the signature of Gov. Tim Pawlenty, an outspoken critic of the new federal spending.

UPDATE: In an unsurprising PR move, leading Dem candidate for Pawlenty’s job come November — former one-term U.S. Senator Mark Dayton — wants Pawlenty to just accept fed funds. | LINK

It has already happened in the Minneapolis/St. Paul metro. Now Duluth is in the midst of a nurses strike.

Nurses in Duluth voted overwhelmingly to reject a new labor contract, setting the stage for a 24-hour strike.

More than 90 percent of nurses who voted from St. Mary’s Medical Center and SMDC Medical Center, and more than 86 percent of those from St. Luke’s Hospital voted to reject the contract offer primarily because it did not include language that would allow them to close a unit to new admissions if they felt overwhelmed.

Again, the issue appears to be faulty staffing (nurse:patient) ratios. | LINK

The state of Massachusetts has reached a deal with the fifth of six insurers initially denied rate hikes for coverage in that state. While nowhere near the massive increases sought in other high-profile states, Massachusetts’ most recent settlement involved a company’s requests for hikes in the 10% to 25% range for policyholders. Over 90% of coverage in Mass. has been positively affected by settlement negotiations with those five insurers which includes the individual market and small-business purchasers. The process of rate hike negotiations is just another factor in the long history of closely observed operations in a state which guarantees coverage to all of its citizens. | LINK

The initial impact of the new healthcare reform law won’t begin until late September/early October. But how much do Americans really know about the legislation’s benefits and changes? President Obama has embarked on some PR jaunts to remind the public of the virtues of reform, but is the White House’s awareness campaign really enough to get the word out that reform is actually imminent? Apparently not.

Many key parts of the new law, signed by President Obama in March, take effect in several stages beginning next month and continuing through 2015. Because it’s so complex, consumer advocates worry that people won’t take advantage of its benefits, so they have embarked on a nationwide education campaign. [..]

“People are still afraid that there are death panels . . . or that Medicare is going to go away,” says Cheryl Matheis of AARP, the nation’s largest seniors organization. “We have an obligation to get the information out there…”

It’s the new reality. Focus groups, polls, lobbies. To bad reform won’t cover the cost of these mechanisms of information dissemination. | LINK

Critics of President Obama’s rosy outlook on Medicare reform as part of the Affordable Care Act are pointing to the entitlement’s chief actuary as proof that his sudden realization of Medicare’s fiscal virtues under reform are peppered with politics. As recently as last weekend, Obama praised the almost half a trillion in savings over the next decade to the federal budget as not only the most fiscally responsible action the government has implemented as part of reform, but also as part and parcel of the overall commitment to the nation’s seniors with respect to the affordable access to healthcare.

Read the rest of this entry »

Two thousand ten just may go down as the year that Medicare is finally getting the recognition it deserves. Well, perhaps in a half-perverse way, anyway. The government entitlement program, which has just celebrated 45 years as the godfather of all payers in healthcare, continues to gain ink in an otherwise unrelated news cycle. President Obama appears to be taking credit for saving the program’s solvency singlehandedly, as his vision of healthcare reform would be far less vital without a provision to forming a leaner, meaner CMS.

In his weekly address to the American people, Obama reiterated his commitment to a program that is more “secure” than ever, a “commitment to America’s seniors” — never wavering from that core point. Obama will likely continue that same tenor as he campaigns for (some of the more vulnerable) Democrats in this year’s midterms, highlighting Medicare’s fiscal leanness with such tenacity, that to acknowledge that the country is still mired in a recession flirting with across-the-board double digit unemployment and ever-spiraling jobless claims is completely tangential.

At this stage, it is not clear how this gambit of Obama’s will play out in November, especially when wide swaths of the general population demographic — not just seniors — need the reassurance he continues to express on health reform as generalizable and essential to economic recovery in this country. All the while, the GOP will continue to hold up Obama’s enthusiasm for government’s role in Medicare as reason that 16% of this country’s GDP is one of the prime causes of the current economic disarray.

President Obama had yet to deal with sinking approval ratings; had yet to encounter such outrage over Arizona’s lukewarm SB1070 law; and had yet to consider how his actions over the previous 18 months of his presidency may impact midterms. Nope. This time last year, the most powerful 48 year-old in the world had to contend with the initial inklings of voter discontent with the looming vote on reform. Late summer 2009 — in the span of the healthcare debate/debacle — represented the germination of alternative voices to his heretofore mostly respected push for guaranteed access to heatlhcare.

Read the rest of this entry »

On Monday, Medicare (and Medicaid) turn 45. And to celebrate, the government will be touting its annual open enrollment. Well, okay, the feds will also be throwing in a plug for government’s role in health reform and what benefits are in store for those who were spring chickens when Medicare became law. Who better to message than the avuncular Andy Griffith?

Clearly targeted at those seniors who still think “death panels” are an essential creation of the Obama plan for reform, the ad — which begins airing in some markets today — will mostly focus on the benefits for seniors inherent in standalone or the program’s supplemental plans under reform. There will be no mention, however, of the major way the new reform law will maintain Medicare solvency well into the next couple of decades: trimming the fat from Medicare Advantage payouts from plans which originally saw benefit under the George W. Bush administration’s 2003 Medicare Modernization Act. | LINK

Republicans and Dems are waiting to see just exactly how public opinion continues to be shaped on the issue of healthcare reform in this country in the run-up to the 2010 mid terms. If the results of a new tracking poll [PDF] are any indication, there is comfort for the latter party.

The July Health Tracking Poll indicates overall public support for the health reform law is steady from June, while unfavorable views of the law have trended downward.  Half the public (50%) now expresses a favorable view of the law, while 35 percent say they have an unfavorable opinion (down from 41% in June).

The results don’t exactly show that misconceptions do exist, however.

[L]arge shares of seniors mistakenly believe the law includes provisions that cut some previously universal Medicare benefits and creates “death panels.”

Results are over at the Kaiser (kff.org) website, a link from this blog in the Blogroll.

No matter the moniker (beneficiary, patients-as-consumers, healthcare consumers, policyholders), the economics-speak of healthcare reform places the person at the very center of it — the patient — left to assess two very basic questions with each care encounter: (1) Did I get my reason for access to a mode of care addressed? and (2) [How much] will I have to pay for it? Seems as though this poor soul is not too happy about having to acknowledge this bit of healthcare cognitive dissonance.

“Why am I being billed for services I never wanted to get?? Because health care providers think they can simply do what they want and people will have to pay for it, or their insurance company will. That is wrong.”

Sometimes the meaning of life is easier to come up with. | LINK

In a reform environment in which appearances are everything, providers could be looking to the AMA for some help. Some physician groups/health systems, the AMA says, could be unfairly targeted by insurers’ quality ratings to steer patients toward systems they deem more “efficient”, creating a somewhat dubious practice reputation for those health systems cited as “inefficient”. Insurance companies counter that, in this age of reform, the delivery and coverage marketplace will have to adapt to measures, they say, are being mandated by the Obama administration as necessary mechanisms of reform and quality.

The AMA is particularly worried about individual physicians being rated by insurers. The doctors’ group says physicians who are deemed expensive may be looking after sicker patients, or the claims data may simply be inaccurate.

A very simplistic view by the AMA, as the 21st century patient and healthcare consumer is able to make informed decisions on provider networks based upon resources unavailable to them just a few years ago. Patient advocacy groups, disease advocacy organizations, support groups, and … even insurance companies themselves are sources of care informatics designed to “steer” patients to where they should be seeking care based upon the best available data matching their unique chronic care needs. Healthcare quality doesn’t just appear out of nowhere; it must be earned. Patients cannot benefit from it without physicians who are capable of providing it.| LINK