Archive for January, 2012


Clinging to Independence in an Age of Interdependence

As hospitals consolidate to protect and amass market share and prepare for accountable care organizations and other perceived threats to their financial health, some are holding out – and trying to hold onto their independence.  Read about the efforts of several Philadelphia-area hospitals to continue flying solo in this Philadelphia Inquirer article.…

Progress Toward Electronic Health Records, But Slowly

The American health care system is moving toward greater use of health care information technology and electronic health records (EHR), but that progress is slow according to a new study from the Bipartisan Policy Center.

The report, Transforming Health Care:  The Role of Health IT, lists six barriers to greater use of health care IT and electronic health records:  misaligned incentives, lack of health information exchange, limited use of consumer engagement using electronic tools, limited levels of EHR adoption, privacy and security concerns, and the need for greater focus and attention for multiple federal priorities.

The Bipartisan Policy Center describes itself as “the only Washington, DC-based think tank that actively promotes bipartisanship…” and says it “drives principled solutions through rigorous analysis, reasoned negotiation, and respectful dialogue.” Its task force on delivery system reform and health information technology is co-chaired by former senators Tom Daschle and Bill Frist.

Read a Washington Post article about the report here and  download the report itself here.…

CMMI Holds Summit, Summarizes Activities

Created by the Affordable Care Act, the Center for Medicare and Medicaid Innovation (CMMI) shared information about the 14-month-old agency’s agenda and achievements to date at a “Care Innovations Summit” in Washington.

The agency is charged with responsibility for pursuing innovation in the delivery of care and payment for care to the Medicare and Medicaid populations as part of the broader health care reform effort.  It pursues its mission by identifying areas in which change is needed and then funding programs designed to test possible improvements.

As part of the summit, the agency published a brief report, “One Year of Innovation:  Taking Action to Improve Care and Reduce Costs.”

CMMI will spend $10 billion supporting such initiatives through 2019.

The summit has its own web site, which you can find here.  A Department of Health and Human Services news release about the summit can be found here and a Washington Post article about the agency and the event is here.  CMMI’s web site is here, and the home page has a direct link to the new report.…

Cardiologists Taking “Regular” Jobs

Fearful of the unknown of health care reform, eroding payments from health insurers, and the need to invest heavily in information technology, more and more physicians are taking jobs working for hospitals.

The Philadelphia Inquirer describes how this trend is playing out in the Philadelphia area among high-earning cardiologists who are giving up their professional independence for the security and certainty of hospital employment.  Read the Inquirer article here.…

Government Overpaying Medicare Advantage Plans, GAO Says

A new report by the U.S. Government Accountability Office (GAO) concludes that Medicare is overpaying Medicare Advantage plans for the services they provide to their Medicare patients.

According to the GAO study titled CMS Should Improve the Accuracy of Risk Score Adjustments for Diagnostic Coding Practices, the overpayments occur because insurers are overstating their members’ health problems and receiving larger Medicare payments as a result.  While Medicare has adjusted its Medicare Advantage rates to reflect this upcoding, GAO maintains, the adjustment has only reduced the degree of overpayment and not ended it.

Based on this report, some House members are urging Medicare to increase its cost adjustments to save money.

GAO’s summary of its findings and the complete report can be found here.…