by Kevin Roche on Friday, January 18, 2013
Allow drug spending growth has slowed, it is still a significant category of cost and adding drug benefits to Medicare and Medicaid has caused concern about how those drugs are paid for. A report to the Centers for Medicare and Medicaid Services discusses new methods for reimbursing for drugs.
Tags: Drugs, Government, Health Care Costs
by Kevin Roche on Thursday, December 13, 2012
The Congressional Budget Office releases a presentation on how it calculates long-term projections fro Medicare and Medicaid spending. More than a little frightening, and the absence of serious bipartisan discussion about reducing this spending is disturbing in its economic implications.
Tags: Government, Health Care Costs, Medicare
by Kevin Roche on Friday, July 20, 2012
Our Potpourri finally returns, including items on duplicate payments in federal health programs, EHR use and malpractice claims, venture capital statistics, consumer use of online self-service applications, and a new statistical method for predictive modeling.
Tags: Consumers, Financings, Government, Health Care Costs, Health Care Quality, Malpractice
by Kevin Roche on Monday, July 9, 2012
The Medicare Payment Advisory Commission delivers an annual report to Congress on what it views as the pressing issues for the Medicare program. This year’s report touches on several issues, which have relevance for health care in general.
Tags: Government, Health Care Costs, Medicare
by Kevin Roche on Wednesday, July 4, 2012
The New England Journal of Medicine contains an article on the relative review process and outcomes for the FDA, Health Canada, and the European Medicines Agency, with the surprising finding that the FDA is faster than its corresponding agencies.
Tags: Drugs, Government, Regulation
by Kevin Roche on Thursday, May 3, 2012
Pay-for-performance programs have enough problems demonstrating that they actually work to improve outcomes and now the Government Accounting Office has identified another potential problem for these initiatives–the federal fraud and abuse regulations.
Tags: Government, Pay For Performance, Regulation
by Kevin Roche on Tuesday, November 15, 2011
Massachusetts Special Commission on Provider Price Reform has released its momentous report on how to address the surging health care costs in the state, which appear to be largely caused by “excessive” provider prices and price increases. Someday regulators might learn that the more you regulate, the more you regulate.
Tags: Government, Health Care Costs, Health Care Reform, Providers
by Kevin Roche on Friday, October 28, 2011
Another brilliant Potpourri, with scintillating health care gems, including revising the FDA’s 510(k) process, the essential benefits package for health exchanges, the future of Medicare Advantage, the lack of labor productivity in health care, variation in elective procedure rates and the OIG’s work plan.
Tags: Care Management, Devices, FDA, Government, Health Care Costs, Health Care Reform, Health Insurance, Medical Care, Medicare, Physicians
by Kevin Roche on Thursday, September 22, 2011
A Kaiser Family Foundation report surveys state managed care Medicaid programs, finding a surge in utilization of health plans and addition of eligibility categories to the plans. A great variety of features are used in different states, but the trend toward more managed care is clear.
Tags: Government, Health Care Costs, Health Care Reform, Medicaid
by Kevin Roche on Tuesday, July 5, 2011
Deloitte issues the results of a global and a United States consumer survey on perceptions of health and health care system. Most Americans have a gloomy outlook, but so do the citizens of most of the surveyed countries.
Tags: Consumers, Government, Health Care Costs, Health Care Quality
by Kevin Roche on Thursday, April 21, 2011
A study of the VHA’s care for chronic disease patients finds generally good compliance with treatment recommendations, but not necessarily the best patient outcomes, reflecting the complexity of improving quality.
Tags: Care Management, Chronic Disease, Disease Management, Government, Health Care Quality
by Kevin Roche on Thursday, April 14, 2011
Medicaid and the Childrens Health Insurance Programs provide coverage for a very substantial portion of the nation’s children. The GAO issues a report on the adequacy of some aspects of the care they receive.
Tags: Care Management, Government, Health Care Costs, Health Care Quality, Medicaid
by Kevin Roche on Tuesday, March 29, 2011
A review article of high quality studies on the VHA’s telemedicine initiatives suggests that those interventions had positive health outcomes and may also lower overall health care utilization and cost.
Tags: Government, Telemedicine
by Kevin Roche on Friday, February 25, 2011
A positively presidential set of health care data points for your edification in today’s Potpourri, including examining correlations between hospital volume, quality and costs, improving quality program adherence, creating good insurance markets, the physician gender pay gap, the effects of the health reform law, and potential inconsistencies in HHS’ HIT incentive programs.
Tags: EHRs, Government, Health Care Quality, Health Care Reform, Health Insurance, HIT, HITECH, Hospital, Physicians
by Kevin Roche on Friday, January 7, 2011
Off we go into 2011, with more snippets of health developments including the OIG’s 2011 work plan; an international survey of internet usage for health purposes, physicians’ understanding of patients’ belief systems, medical tourism and care management for persons with multiple chronic conditions.
Tags: Chronic Disease, Consumers, Government, HIT, Medical Tourism, Physicians
by Kevin Roche on Saturday, November 6, 2010
There was a big change in the balance of power between the parties in this week’s midterm election but that change may or may not have a significant effect on the health reform law. Changes in government at the state level may have more of a near-term effect.
Tags: Government, Health Care Reform
by Kevin Roche on Wednesday, October 27, 2010
The Department of Defense and the Veterans Administration spend a lot of money on health care and health information technology, sometimes earning kudos. But there are a lot of problems. The GAO puts out a report on DOD’s Electronic Health Record Initiative, which should make the agency blush with shame.
Tags: Government, HIT
by Kevin Roche on Thursday, September 16, 2010
The meaningful use provisions of the stimulus bill provide incentive payments to providers who implement EMRs, and ultimately penalties for those who don’t or who don’t use those systems in certain ways. A pair of new briefs outline challenges for providers to meet the meaningful use requirements.
Tags: Government, HIT, Providers
by Kevin Roche on Monday, September 13, 2010
The Office of Actuary publishes its current estimate of national health spending in the wake of health reform. It finds that the law will slightly increase spending, but there is a big caveat because the projections assume Medicare payment cuts will stay in place.
Tags: Government, Health Care Costs, Health Care Reform
by Kevin Roche on Saturday, September 11, 2010
Fall is a lovely time of year and what could be better than relaxing with a Potpourri, featuring health insurance increases, the true costs of EHRs, hospital pay-for-performance programs and quality, the impact of social networks on health behavior, and unenrolled Medicaid-eligible children.
Tags: Consumers, Government, Health Care Costs, Health Care Quality, HIT, Hospital, Medicaid, Pay For Performance, Workplace
by Kevin Roche on Thursday, September 2, 2010
Medicaid programs, and other third-party payers, can save a lot of money by requiring use of generics when available. Some state laws, however, can significantly inhibit generic use, according to new research in Health Affairs.
Tags: Drugs, Government, Medicaid, Regulation
by Kevin Roche on Friday, August 13, 2010
In a sign that the media is less willing to accept some of the Administration’s misleading pronunciations about health care, when HHS claimed that the Medicare Trustee’s report showed the new health law extended Medicare solvency by several years, most sources noted that the CMS Actuary disagreed.
Tags: Government, Health Care Costs, Medicare
by Kevin Roche on Thursday, August 5, 2010
Every year Medicare puts out very lengthy and detailed proposed, and ultimately final, rules updating the reimbursement for all of the classes of providers–physicians, hospitals, etc. While reading these is a tough slog, it gives a good sense of issues which affect all payers, and of Medicare’s mindset.
Tags: Government, HomeCare, Medicare
by Kevin Roche on Friday, July 30, 2010
There has been no more gnarly health care problem for Congress than how to deal with physician reimbursement. At some point, as a Health Affairs article points out, it will have to come up with a better solution than the temporary fixes it has used for years.
Tags: Government, Health Care Costs, Medicare, Physicians
by Kevin Roche on Friday, July 23, 2010
More commentary on MedPAC’s Annual Report, focusing on the care of dual-eligible beneficiaries and the use of shared decision-making in the Medicare population.
Tags: Government, Medicare
by Kevin Roche on Thursday, July 22, 2010
MedPAC’s annual report always contains many useful analyses of health care issues, complete with research citations. This year’s report covers several topics of general interest, including effective benefit designs and improving quality efforts.
Tags: Government, Medicare
by Kevin Roche on Wednesday, July 21, 2010
For several decades drug companies have taken a beating over their pricing and many governments have limited how those companies charge for their products. A new study suggests that such regulation does limit development of new medicines.
Tags: Drugs, Government
by Kevin Roche on Monday, July 19, 2010
HHS has issued its draft regulation on what preventive services health plans must cover without cost-sharing by the patient. Someone, of course, has to pay for all these “free” services, and it usually is the consumer.
Tags: Government, Health Insurance, Wellness and Prevention
by Kevin Roche on Saturday, July 10, 2010
Sitting indoors seeking relief from the summer heat? Here’s a montage of cool and refreshing health care items, including CPOE systems, accountable care organizations, Massachusetts’ reform experience, reducing imaging, and medical management trends.
Tags: Care Management, Government, Health Care Reform, HIT, Hospital, Medical Care
by Kevin Roche on Saturday, July 3, 2010
We light up the sky with a scintillating selection of health care bombshells. Okay, maybe not that great, but some hopefully useful info on the VA’s health information system, MRIs and emergency cardiac care, business method and process patents, end-of-life care, actuaries’ views on how to control costs and, of course, more issues in Massachusetts.
Tags: Government, Health Care Costs, Health Care Reform, Health Insurance, Medical Care
by Kevin Roche on Friday, July 2, 2010
A critical component of personalized medicine is various molecular diagnostic tests. AHRQ has issued a lengthy report on the state of these tests, examining their quality and clinical utility.
Tags: Government, Medical Care, Personalized Medicine, Regulation
by Kevin Roche on Thursday, July 1, 2010
The Commonwealth Fund issues one of its regular reports designed to demonstrate how bad the US health system is compared to those of other developed countries. Unfortunately, the report is based almost exclusively on subjective survey data and fails to provide any adjustments to create a truer picture of the status of our system vis-a-vis others.
Tags: Government, Health Care Costs, Health Care Quality, Health Care Reform
by Kevin Roche on Friday, April 9, 2010
States that supposedly led the way on health care reform are finding out it was the bleeding edge that they were on. Insurers are always the easy target, but bashing them won’t solve the underlying cost problem. If the federal bill actually is implemented, the experience of these states will likely be replicated nationally.
Tags: Government, Health Care Costs, Health Care Reform, Health Insurance
by Kevin Roche on Tuesday, March 2, 2010
The Centers for Disease Control issues a massive compendium of health facts and information called Health United States 2009. In addition to basic information regarding health care, it has some description and analysis of particular issues such as use of medical technology.
Tags: Devices, Government, Health Care Costs, Health Care Quality
by Kevin Roche on Friday, February 19, 2010
Much concern has been expressed about whether the FDA may make changes to the 510(k) and other regulations that hinder speed to market for medical device companies. A recently finalized guidance may actually help those firms.
Tags: Devices, Government
by Kevin Roche on Thursday, February 18, 2010
Personalized medicine is widely promoted as the future of health care. Several government agencies are examining the implications of growth in genomic knowledge and its application to medical practice. CDC and NIH are intending to create a Genomics Knowledge Synthesis Center.
Tags: Government, Personalized Medicine
by Kevin Roche on Monday, November 30, 2009
The Senate takes up its version of the health reform bill, creating an opportune moment to revisit what the goals of reform are and whether this bill will actually widen access, lower cost or improve quality. The answer is likely not.
Tags: Government, Health Care Costs, Health Care Reform
by Kevin Roche on Tuesday, November 24, 2009
The CBO released a brief report looking at the potential impact of various changes in federal policies on research and development spending for drugs. Current and future policies are not likely to encourage more R & D.
Tags: Drugs, Government, Pharmaceutical
by Kevin Roche on Friday, November 6, 2009
The Office of Inspector General issues a work plan every year which gives guidance on potential areas of mismanagement, fraud and abuse in federal programs. This year’s plan reveals continuing focus on hospital and nursing home payments and drug reimbursement.
Tags: Government
by Kevin Roche on Monday, November 2, 2009
The Congressional Budget Office releases its preliminary analysis of the House health care reform bill, finding it will expand coverage to most legal citizens and reduce the deficit.
Tags: Government, Health Care Reform
by Kevin Roche on Friday, October 30, 2009
Net neutrality sounds good to some but a Brookings commentary indicates it may cause problems for health care users.
Tags: Government, HIT, Telemedicine
by Kevin Roche on Wednesday, October 28, 2009
The Center for Health Care Strategies release an updated report on Medicaid enrollees with chronic disease, reaffirming how a relatively few patients account for well over half the total program spending.
Tags: Chronic Disease, Government, Medicaid, Medical Care
by Kevin Roche on Monday, October 26, 2009
An analysis from the CMS Office of Actuary examines the effects of the current House of Representatives health care reform bill and finds that while it would substantially reduce the number of uninsured persons, it would also likely significantly increase not only the federal deficit, but total health spending.
Tags: Government, Health Care Reform
by Kevin Roche on Saturday, October 24, 2009
A miscellany of interesting items for your weekend browsing pleasure.
Tags: Care Management, Government, Health Care Costs, Health Care Reform, Telemedicine
by Kevin Roche on Tuesday, October 20, 2009
The latest survey on the impact of reform in Massachusetts indicates that employers are continuing to offer good coverage, but costs, especially to small firms and their employees, are going up.
Tags: Government, Health Care Reform, Health Insurance
by Kevin Roche on Thursday, October 15, 2009
AHIP commissioned PriceWaterhouseCoopers to do an analysis of the Baucus bill’s impact on insurance premiums. The report, which has been strongly attacked by reform proponents, concludes that the weak individual mandate and light penalties will drive costs higher; costs which will be borne by consumers and employers through higher insurance premiums.
Tags: Government, Health Care Reform, Health Insurance
by Kevin Roche on Friday, October 9, 2009
The American College of Physicians presents its reform ideas.
Tags: Government, Health Care Reform, Physicians, Providers
by Kevin Roche on Thursday, October 8, 2009
The CBOs initial score of the Baucus bill suggests it will reduce the deficit, but there are many caveats, especially on physician payments.
Tags: Government, Health Care Reform
by Kevin Roche on Thursday, October 8, 2009
Having taken heat on drug safety, the FDA has issued a new draft guidance on risk mitigation efforts by drug companies.
Tags: Drugs, Government, Pharmaceutical, Regulation
by Kevin Roche on Wednesday, October 7, 2009
A Nature article explains how Britain’s NICE (National Institute for Health and Clinical Excellence) works.
Tags: Comparative Effectiveness, Government, Medical Care
by Kevin Roche on Friday, October 2, 2009
Another study demonstrates quality performance and better cost benefits from Medicare Advantage plans.
Tags: Care Management, Government, Health Insurance, Medicare
by Kevin Roche on Thursday, October 1, 2009
A review of what money is spent on which children for Medicaid and CHIPS yields insights on possible cost-saving and quality improvement opportunities.
Tags: Government, Health Care Costs, Medicaid/CHIPS
by Kevin Roche on Monday, September 28, 2009
While the United States is often portrayed as having the most troubled health system among developed nations, every country has serious issues, including Canada.
Tags: Government, Health Care Reform
by Kevin Roche on Friday, September 25, 2009
AHIP presents evidence on the value of Medicare Advantage plans in delivering more efficient and effective care.
Tags: Government, Health Care Costs, Health Care Reform, Health Insurance, Hospital
by Kevin Roche on Thursday, September 17, 2009
Everybody says we need cost control and expanded access, but nobody wants to pony up.
Tags: Government, Health Care Costs, Health Care Reform
by Kevin Roche on Tuesday, August 25, 2009
USA Today published an article on the federal end-stage renal disease program. The problems are typical of most government health programs.
Tags: Care Management, Chronic Disease, Government
by Kevin Roche on Tuesday, August 18, 2009
While Massachusetts is the state health care reform example most often referred to in the discussion over federal reform efforts, Tennessee’s earlier program to extend coverage may also offer lessons.
Tags: Government, Health Care Reform
by Kevin Roche on Monday, August 10, 2009
In a letter to a Congressman, the CBO gives its rationale for how it attributes costs and savings to prevention and wellness programs.
Tags: CBO, Government, Medical Care, Wellness and Prevention
by Vita Advisors on Friday, August 7, 2009
Healthways’ Center for Health Research put our a report estimating that Medicare could save over $100 billion a year if beneficiaries entered the program in better health and maintained good health status.
Tags: Government, Medical Care, Medicare, Wellness and Prevention
by Kevin Roche on Tuesday, July 21, 2009
As health reform heats up, the public needs to be careful about what politicians say; they seldom are completely accurate.
Tags: Government, Health Care Reform
by Kevin Roche on Thursday, July 16, 2009
The CBO examines the House Tri-Committee health reform bill.
Tags: Government, Health Care Reform, Legislation
by Kevin Roche on Tuesday, July 14, 2009
Patient cost sharing reduces utilization, but appears to limit use of appropriate as well as inappropriate care.
Tags: Consumers, Government, Health Care Costs, Incentives
by Kevin Roche on Thursday, July 9, 2009
A number of reports and commentaries have recently been issued on comparative effectiveness research.
Tags: Comparative Effectiveness, Government, Health Care Reform, Health Insurance
by Kevin Roche on Wednesday, July 8, 2009
A new UnitedHealth Group report identifies $332 billion over ten years in administrative cost savings.
Tags: Administrative Costs, Government, Health Care Costs, Health Care Reform, Health Insurance
by Kevin Roche on Tuesday, July 7, 2009
Common Cause has issued a report detailing the amounts health groups are spending on campaign contributions and lobbying.
Tags: Government, Health Care Reform, Legislation, Politics
by Kevin Roche on Thursday, July 2, 2009
A recent Kaiser Foundation data note looks at attitudes on paying for health reform.
Tags: Consumers, Government, Health Care Reform
by Kevin Roche on Wednesday, July 1, 2009
A recent JAMA commentary gives a concise summary of the cost control problems.
Tags: Government, Health Care Costs, Health Care Reform, Medical Care
by Kevin Roche on Friday, June 26, 2009
Unhappy with its projections, Democrats have beginning disparaging the CBO’s estimates on health reform.
Tags: CBO, Government, Health Care Costs, Health Care Reform
by Kevin Roche on Wednesday, June 24, 2009
Reality appears to have hit the health reform train head-on in the form of the costs of expanding coverage. Maybe we should focus on getting costs under control and then coverage extensions would be affordable.
Tags: Government, Health Care Costs, Health Care Reform, Health Insurance, Legislation
by Kevin Roche on Monday, June 22, 2009
The CBO’s June 16th letter to Senator Conrad is an excellent summary of health reform and cost control ideas and implementation issues.
Tags: CBO, Comparative Effectiveness, Government, Health Care Costs, Health Care Reform, Health Insurance
by Kevin Roche on Thursday, June 18, 2009
Congressional Budget Office has responded briefly to the proposals by several health industry segments to create cost savings of up to two trillion dollars over ten years.
Tags: CBO, Government, Health Care Reform, Health Insurance
by Kevin Roche on Thursday, June 18, 2009
The Congressional Budget Office’s initial assessment of Senator Kennedy’s Affordable health Choices Act is that it would increase deficits by about one trillion dollars over the next ten years, but only increase the number of covered citizens by about a net 16 million people.
Tags: CBO, Government, Health Care Reform, Health Insurance, Uninsured
by Kevin Roche on Wednesday, June 17, 2009
Republican Senators have now introduced a bill to essentially gut federal funding or use of comparative effectiveness research, continuing an attack on the proposed expansion of such research for the purpose of controlling costs
Tags: Comparative Effectiveness, Government, Health Care Reform, Medical Care
by Kevin Roche on Friday, June 12, 2009
One of the controversial provisions in some health care reform proposals has been creation of a public plan, often analogized to Medicare, which would be an option offered alongside private insurance plans.
Tags: AMA, Government, Health Care Reform, Health Insurance, Payor
by Kevin Roche on Tuesday, June 9, 2009
Several prominent health industry segments have issued a follow-up statement identifying more specifically where they believe health care cost savings can be achieved.
Tags: AdvaMed, AHA, AMA, Government, Health Insurance, Medical Care, PhRMA
by Kevin Roche on Tuesday, June 2, 2009
A not-for-profit group that has been a vigorous proponent of health care reform has released a report, Hidden Health Tax, on the costs of the uninsured and who ultimately bears that cost.
Tags: Cost Shifting, Government, Health Insurance, Uninsured
by Kevin Roche on Tuesday, June 2, 2009
The American Hospital Association and the American Medical Association, in conjunction with a number of physician specialty organizations, have each released statements regarding proposals to help control health care costs by changing, even reducing payments to providers.
Tags: AHA, AMA, Government, Medical Care
by Kevin Roche on Monday, June 1, 2009
Massachusetts has become such a bellweather for health reform that every report analyzing the program’s outcomes is eagerly anticipated. Health Affairs, vol. 28, page w578 (May 2009), looks at some of the results as of the fall of 2008.
Tags: Government, Health Care Reform, Health Insurance
by Kevin Roche on Friday, May 29, 2009
The Congressional Budget Office’s most recent missive on health reform (available here) discusses the budgetary treatment of health care reform proposals.
Tags: CBO, Government
by Kevin Roche on Thursday, May 21, 2009
In informal responses to inquiries about the use of health risk assessments and wellness incentives, the Equal Employment Opportunity Commission has indicated that it will use the Americans with Disabilities Act and its general powers to limit the ability of employers to enact programs designed to improve the health of employee populations and control health care costs.
Tags: Government, Health Insurance, HRAs, Incentives
by Kevin Roche on Thursday, May 21, 2009
The Los Angeles Times ran an article on May 17, 2009, regarding Cesarean births. Birth services are a microcosm of the problems in the broader health system.
Tags: Government, Health Care Costs, Hospital