Researchers report that prices for a dozen procedures and tests were 8 to 26 percent higher in counties with the highest level of physicians concentrated in large group practices. (Michelle Andrews, 10/9)
Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Gospel Truth?'" by Nate Beeler, The Columbus Dispatch.
Here's today's health policy haiku:
HEALTH CARE POLICY IN THE BALANCE
Who will be Speaker?
Choice may set tone for budget
And key health issues.
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Almost three out of four beneficiaries are enrolled in medical and drug coverage plans that received at least a four-star quality rating, according to the Centers for Medicare and Medicaid Services. The rankings did show a drop for some companies, especially in regard to prescription drug benefits.
Modern Healthcare: Medicare Advantage Star Ratings Reveal Mix Of High, Low Performers
More Medicare Advantage plans nabbed top quality marks for their 2016 plans than last year, a potential sign that private insurers are trying to meet the federal government's standards for high-quality products and coordinated healthcare for seniors. But the CMS' star ratings, released Thursday, also showed that private Medicare plans are still failing on many levels, particularly when it comes to prescription drug benefits. (Herman, 10/8)
Meanwhile, 2016 Medicare Part D premiums will rise for many -
Reuters: Unwelcome News About Medicare's Rising Drug Costs
Seniors have received some unpleasant news in their mailboxes in recent weeks: premiums for many Medicare prescription drug insurance plans will rise at double-digit rates next year. Premiums for the ten most popular Medicare Part D prescription drug plans (PDPs) will rise an average of 8 percent next year - the fastest clip in five years, according to Avalere Health, a consulting and research firm. And five of the top plans will boost their average premiums anywhere from 16 percent to 26 percent. (Miller, 10/8)
Insurers who hoped to get billions in aid after opening-year losses from their participation in the health law's insurance marketplaces are only getting 12.6 percent of what they requested after the fund to pay them fell short. In the meantime, Obamacare dropouts get picked up by employer coverage in California, and Wyoming loses one of its two health law insurers.
Pittsburgh Post-Gazette: Affordable Care Act Aid Could Take Years To Reach Insurers
Health insurers that lost millions of dollars last year under the Affordable Care Act may wait years for the government to deliver the aid it promised them. Companies, including Downtown-based insurer Highmark, want about $2.87 billion to help cover their first-year losses from online insurance marketplaces — a centerpiece of the landmark health care law. But a federal relief program meant to limit their risk is more than $2 billion short, leaving the companies to collect only 12.6 percent of those requests late this year, the Centers for Medicare & Medicaid Services said this month. (Smeltz, 10/8)
Los Angeles Times: Many Obamacare Dropouts In California Picked Up Employer Coverage, State Says
Nearly half of the estimated 700,000 Californians who have dropped their Obamacare policies during the past two years have enrolled in an employer-based plan, a new report from the Covered California exchange shows. In a news conference Thursday, Lee, the organization’s executive director, said there were about 1.3 million Californians enrolled in the exchange’s plans as of June 30. That was about two-thirds of the 2 million who have enrolled in the exchange since it opened Oct. 1, 2013. (Sisson, 10/8)
The Associated Press: Wyoming Loses 1 Of Its 2 Affordable Care Act Insurers
One of the two companies offering health insurance coverage in Wyoming under the federal health care law has decided to drop out of the program after receiving word that the federal government would be providing drastically less financial help than it expected. The news comes as state leaders debate whether the federal government can be trusted to help pay for expansion of a health insurance program for the working poor. (Moen, 10/8)
Also, lawmakers in New Jersey ask the attorney general there to delay proposed insurance plans from Horizon Blue Cross Blue Shield that are meant to save money --
The Associated Press: New Health Insurance Plan Sparks Debate In New Jersey
Two New Jersey senators have asked the state attorney general to delay the biggest health insurer in the state from offering a set of insurance plans that are being sold as money-saving ways to cover health care. Critics fear the Horizon Blue Cross Blue Shield plans could hurt some patients and hospitals. Democratic Sens. Nia Gill and Joseph Vitale say the state should first set up a way to oversee how health insurers rate health care providers when they set up tiered systems. Here's a look at the issue. (Mulvihill, 10/8)
Colorado's cooperative insurance plan faces an uncertain future over cost concerns, and a patient advocacy group rates California's best HMO and PPO plans --
The Associated Press: Low-Cost Health Insurer In Colorado Faces Uncertain Future
Colorado's biggest nonprofit health insurer faces an uncertain future, and its 80,000 or so customers don't know whether their insurer will be able to offer new polices when next year's enrollment period begins soon. Colorado HealthOP, which emerged from the Affordable Care Act, faces possible insolvency because the U.S. government said it won't be able to cover payments to help stabilize premiums in federal insurance markets. (Wyatt, 10/8)
Los Angeles Times: California Agency Ranks Kaiser As Best HMO, Anthem And Cigna As Best PPOs
Kaiser Permanente was the highest-rated HMO and Anthem Blue Cross and Cigna the top-rated PPOs in a new state report. The California Office of the Patient Advocate released ratings Wednesday of 10 HMOs, six PPOs and more than 200 medical groups, just as Californians prepare to choose their health plans for next year from their employers or Covered California, the state's Obamacare exchange. (Pfeifer, 10/8)
The legislation, introduced in the Senate, would close a loophole in the law that requires public disclosure of such payments to doctors and some other health providers.
ProPublica: Bill Would Add Nurses, Physician Assistants To Pharma Payments Database
A bill proposed Wednesday by two U.S. senators would require drugmakers and medical device manufacturers to publicly disclose their payments to nurse practitioners and physician assistants for promotional talks, consulting, meals and other interactions. The legislation would close a loophole in the Physician Payment Sunshine Act, which requires companies to report such payments to doctors, dentists, chiropractors, optometrists and podiatrists. Companies have so far released more than 15 million payment records, covering August 2013 to December 2014. (Ornstein, 10/8)
And on prices for medical services -
Kaiser Health News: Medical Prices Higher In Areas Where Large Doctor Groups Dominate, Study Finds
Prices for many common medical procedures are higher in areas where physicians are concentrated into larger practice groups, according to a new study. The October Health Affairs study examined the average county prices paid by preferred provider insurance organizations in 2010. It focused on 15 high-volume, high-cost medical procedures across a variety of specialties, including vasectomy, laparoscopic appendectomy, colonoscopy with lesion removal, nasal septum repair, cataract removal and knee replacement. The prices studied reflected the negotiated prices between the PPOs and the physician groups, including payments made by both the plan and the patient. The average price ranged from $2,301 for a total knee replacement to $576 for a vasectomy. (Andrews, 10/9)
With a revolution in U.S. health care -- in both how care is delivered and paid for -- schools that train doctors are scrambling to revamp. Also, a Michigan paper examines the burden on nurses at an understaffed state hospital, and a study analyzes patient attitudes about being discharged from the hospital.
The Washington Post: A Different Kind Of Care Package
U.S. health care is in a revolution that is starting to shake up one of the most conservative parts of medicine: its antiquated model for training doctors. Once paid a la carte for the procedures and services they perform, physicians are beginning to be reimbursed for keeping their patients healthy. ... The AMA is worried enough about the problem that it has been giving out millions of dollars to prod new kinds of teaching, in the hope that doctors’ training can adapt as quickly as the system they will soon join. (Johnson, 10/8)
The Lansing State Journal: Michigan Mental Health Nurses Say OT Hurts Patient Care
The well-being of some 700 patients in state psychiatric hospitals is in the hands of nurses who say they're overworked, overtired and overstressed because of excessively mandated double shifts. Sometimes several days a week, nurses in Michigan's five state-run hospitals end their regular eight-hour shifts only to be ordered to cover staffing shortages by working another eight hours. Against the recommendations of nursing groups and one of the state's own task forces, several current and former nurses at the Michigan Department of Health & Human Services told the State Journal they're worked to the point of exhaustion and ragged nerves, more prone to errors or poor judgment as they deal with unpredictable, sometimes violent patients. (Hinkley, 10/8)
Reuters: Patients Who Feel Ready To Leave The Hospital Are More Satisfied
In a small study of hospitilized patients, those who felt ready to go home when they were discharged were more satisfied with the hospital and their caregivers than those who didn’t feel ready to go. It may be useful to use patient readiness for discharge as one measure of quality of care, the authors write in the Journal of the American College of Surgeons. (Doyle, 10/8)
Chairman of the House Oversight and Government Reform Committee Jason Chaffetz (R-Utah) says his committee's hearings have not found that the reproductive health organization is improperly handling its finances. He says investigations may continue. At a hearing yesterday, a former employee said that Planned Parenthood did bill Medicaid for abortion services. The woman made similar claims in a lawsuit that in 2014 an Iowa appeals court said did not have enough evidence to go forward.