HHS Secretary Highlights its 2010 Accomplishments.

http://www.hhs.gov/news/press/2010pres/12/20101230a.html

View the video here.

They did a lot and have a long road ahead but with Secretary Sebelius at the helm, lots will be done.

VA Judge rules on Keystone provision in health reform law

According to NBC breaking news, a federal judge in Virginia has found part of the Obama care law (the keystone provision), unconstitional. The keystone provision mandates that starting in 2014, everyone must have health insurance. According to observers, this should not have any impact on the implementation on the law.

Read more about the challenges to the health care reform law at wsj health blog and the new ruling at Kaiser news brief.

Click here for the text of the ruling courtesy of wsj.com

Also in related health reform challenge news :this coming thursday, a Florida court is scheduled to hear arguments regarding a separate challenge to the health overhaul.

Doc payment for cut for medicare patient delayed.

Physician payment cuts for medicare patient scheduled for Jan 1, 2011 has been delayed. According to NPR, this issue is dated to the early eighties and has nothing to do with the health care overhaul.

This delay will come as a relief for some medicare recipient as they do not have to be concerned with losing their doctors as some might have to get rid of some medicare patient to keep their practices afloat.
From more information:
http://news.yahoo.com/s/ap/20101208/ap_on_bi_ge/us_medicare_deal_5

HHS announces Healthy People 2020

Today HHS unveiles a new 10year objective aim at tackling preventive health measures.

Please read the press release below:


News Release
FOR IMMEDIATE RELEASEThursday, December 2, 2010
Contact: OASH Press Office(202) 205-0143
HHS announces the nation’s new health promotion and disease prevention agenda
The U.S. Department of Health and Human Services today unveiled Healthy People 2020, the nation’s new 10-year goals and objectives for health promotion and disease prevention, and “myHealthyPeople,” a new challenge for technology application developers.
For the past 30 years, Healthy People has been committed to improving the quality of our Nation’s health by producing a framework for public health prevention priorities and actions.
“The launch of Healthy People 2020 comes at a critical time,” said HHS Secretary Kathleen Sebelius. “Our challenge and opportunity is to avoid preventable diseases from occurring in the first place.”
Chronic diseases, such as heart disease, cancer and diabetes, are responsible for seven out of every 10 deaths among Americans each year and account for 75 percent of the nation’s health spending. Many of the risk factors that contribute to the development of these diseases are preventable.
“Too many people are not reaching their full potential for health because of preventable conditions,” said Assistant Secretary for Health Howard K. Koh, M.D., M.P.H. “Healthy People is the nation’s roadmap and compass for better health, providing our society a vision for improving both the quantity and quality of life for all Americans.”
The Healthy People initiative is grounded in the principle that setting national objectives and monitoring progress can motivate action, and indeed, in just the last decade, preliminary analyses indicate that the country has either progressed toward or met 71 percent of its Healthy People targets.
Healthy People 2020 is the product of an extensive stakeholder feedback process that is unparalleled in government and health. It integrates input from public health and prevention experts, a wide range of federal, state and local government officials, a consortium of more than 2,000 organizations, and perhaps most importantly, the public. More than 8,000 comments were considered in drafting a comprehensive set of Healthy People 2020 objectives. Based on this input, a number of new topic areas are included in the new initiative, including:
Adolescent Health
Blood Disorders and Blood Safety
Dementias, including Alzheimer’s Disease
Early and Middle Childhood
Genomics
Global Health
Health-Related Quality of Life and Well-Being
Healthcare-Associated Infections
Lesbian, Gay, Bisexual and Transgender Health
Older Adults
Preparedness
Sleep Health
Social Determinants of Health
Healthy People is also issuing a special challenge to encourage developers to create easy-to-use applications for professionals who are working with the new national health objectives and state- and community-level health data.
“This milestone in disease prevention and health promotion creates an opportunity to leverage information technology to make Healthy People come alive for all Americans in their communities and workplaces,” said Chief Technology Officer Todd Park. “The ‘myHealthyPeople’ apps challenge will help spur innovative approaches to helping communities track their progress using Healthy People objectives and targets as well as develop an agenda for health improvement.”
HHS is also launching a newly redesigned Healthy People Web site that allows users to tailor information to their needs and explore evidence-based resources for implementation. The Web site is located at: www.healthypeople.gov. For more information about myHealthyPeople, go to www.challenge.gov/

WORLD AIDS DAY

Today on this world AIDS day, I would love us to observe a moment of silence for all those who have died from the disease including those without it that worked to eliminate it.

To those living with this disease, I am so sorry you have to and to those working to find a cure, thanks for all your efforts.

To everyone else out there please be careful, remember, “prevention is better than cure”. Know your health status because according to the U.S department of Health and Human Services (HHS), about 1.1 million people are living with HIV in the U.S and 33 million are living with it worldwide and also about one out of five people living with HIV is not aware of it.

Here is HHS's Secretary Kathleen Sebelius thoughts on World AIDS DAY. She also mentions the steps that the US is taking to help eradicate the HIV epidemic.

Here is WHO's Director General, Dr. Margaret Chan thoughts on the HIV epidemic. She is happy that the epidemic is becoming stabilizes in some regions of the world but concerned that certain regions do not have access to treatments. She wants the rights of people living with HIV protected and to end discrimination against them.

To find out more about AIDS CHECKOUT:

http://www.aids.gov/

http://www.who.int/hiv/en/index.html

Happy Thanksgiving!

I am Thankful that my shoulder is getting better and if anything for health insurance.

Happy Thanksgiving all.

Deficit committee recommendation for Medicare payments

The nation’s debt must be reduced and one way the debt reduction task force has propose to do so is by making Medicare beneficiaries pick up more of their health care cost. Now they pay 25% of the cost of Medicare part B and if the task force’s recommendation is granted, the beneficiaries cost share will be 35%.

Read the full article from Kaiser news here:

On the global front

From World Health Organization press release:
Giving that more than half of the world’s population is living in urban areas; Countries around the world are working on initiatives increase public health in their respective cities. This week leaders from around the world are meeting in Kobe, Japan to trade ideas for improving the health of urban area residents.

Find out more about this initiative and the Kobe conference by clicking on the link below:
http://www.who.int/mediacentre/news/releases/2010/cityhealth_20101115/en/index.html

Medicare-for 2011 starts Today 11/15/2010

Medicare open enrollment starts today, if you are eligible or to find out if you are visit the following resources:

Sources
http://www.hhs.gov/news/press/2010pres/11/20101115a.html

Resources for Medicare BeneficiariesPeople with Medicare, their families and other trusted representatives can review and compare current plan coverage with new plan offerings, using many proven resources, including:

Visiting www.medicare.gov, where they can get a personalized comparison of costs and coverage of the plans available in their area. The popular Medicare Plan Finder and Medicare Options Compare tools have been enhanced for an efficient review of plan choices. Multilingual Open Enrollment information and counseling is available.

Calling 1-800-MEDICARE (1-800-633-4227) for around-the-clock assistance to find out more about coverage options. TTY users should call 1-877-486-2048.
Reviewing the 2011 Medicare & You handbook. It is also accessible at www.medicare gov and has been mailed to the homes of people with Medicare benefits.

Getting one-on-one counseling assistance from the local State Health Insurance Assistance Program (SHIP). Local SHIP contact information can be found:
At http://www.medicare.gov/contacts/organization-search-criteria.aspxor
On the back of the 2011 Medicare & You handbook or;
By calling Medicare at 1-800-MEDICARE (1-800-633-4227; TTY, 1-877-486-2048)
Through a listing of national stand-alone prescription drug plans and state specific fact sheets can be found at: http://www.cms.hhs.gov/center/openenrollment.asp

Sources

http://www.hhs.gov/news/press/2010pres/11/20101115a.html

Employees will see increase to their health coverage

The open enrollment for 2011 health insurance coverage is upon and because of the new provision of health care reform law employees will need to scrutinize the plans offered by their employer as their cost will increase for some services and decrease for others.


Employees will see the following:

There will not be co-payment for preventive services such as mammogram (which means increase cost to insurer who might pass it on to the insured in form of high insurance cost.)

Some plans will see higher deductible and plans that previously did not carry any deductible will see one.

Employee might also see an increase in cost for spousal coverage.

Employees will not be able to use money in the flexible spending account to cover the cost of over the counter medication.

Children up to the age of 26 can be covered by their parents health insurance, and
The new health care reform law also eliminates the lifetime cap for essential services than hospital stay.

Source:

• Kaiser daily health news (11/15/2010)
• http://www.ajc.com/business/check-your-insurance-packets-741985.html

New York's Health care Fraud Summit

On November 5 in Brooklyn, NY, the department of Health and Human Service’s Secretary Kathleen Sebelius and U.S Attorney General Eric holder participated in a health care fraud prevention summit. The summit is one of a series of summit organized by the health care fraud prevention and enforcement action team (HEAT), a fraud prevention team created by HHS and the attorney general’s office, to build further support in preventing health care fraud. The team hopes “to work with patient to protect the patient’s medical information, to work with providers to strengthen screening standards and to work with private insurers to share strategies about how to prevent fraud”

In her speech to the summit participants, Secretary Sebelius mentioned two things that will be useful in combating fraud; the first is a new center for program integrity that was created at the Centers for Medicare and Medicaid services earlier this year and the accordable care act, which she calls one of the strongest fraud prevention laws in American history.
To combat health care fraud they hope to do the following by:

*Making it easier for law enforcement officials to see health care claims data from around the country,

*Combining all Medicare-paid claims into a single searchable database and analyzing claims in real time to flag potential scams,

* Targeting overpayments, which can be an appealing target for criminals by,
- establishing competitive bidding for medical equipment,
- running television advertisements asking everyone to stay wary and to monitor their
medical bills,
- strengthening the Senior Medicare Patrol which empowers senior citizens to protect
themselves,
- and by providing new physicians with a copy of a green packet titled “ A Roadmap for new Physicians”, a packet explains the health care laws that applies to physicians so that the can comply with federal laws and be able to spot fraud.

Source:
http://www.hhs.gov/secretary/about/speeches/sp20101105.html

Financing Health care

With the enactment of the health care reform bill, cuts to state health care budget and hopes of increasing revenues, hospitals in Florida and New York are trying new ways to operate in the black and boost finances.

The Miami herald reports that Jackson Health Systems in Florida plans to use cost accounting, the hospital is in a process of buying software that will give them accurate information of which procedure makes them money and which ones do not.

In Syracuse New York, according to web site syracuse.com, St Joseph hospital hopes to boost finances by buying up doctor’s practices to create one health care network and have adequate supply of doctors.
Source: Kaiser Health News : http://www.kaiserhealthnews.org/Daily-Reports/2010/November/05/Hospitals.aspx

States Budget Cuts and health care

After reading the Department of Health Human Services Strategic Plans for 2010-2015, I was excited to see that they have many quality improvement initiatives scheduled as well as plans to extend the health care workforce. Then Tuesday’s election came and gave me a reality check, which is more budget cuts are coming to States around the country, and health care will not be spared.

States budget cuts will negatively affect patient care, an area that needs improvement and service providers’ income and jobs. In hopes of balancing their budget New York state has propose more cuts that I can infer will not benefit anyone, it will instead end put a strain on other areas of the state’s budget such as unemployment.

Health care is not a demand business it is a needs business, and we need a health care system that is capable of addressing medical issues when they arise, not three months later due to back order of supply. When funding is cut, it will lead to cuts in programs, and services for patients, training programs for staff, quality and process improvement programs and jobs.

To keep health care spending from rising astronomically, lawmakers must encourage and help health care entity to be more efficient and to seek out process improvement initiatives that will save cost and improve care in the future, cutting funds must be the last straw. I have first of experience from working as a health care service provider that cuts to the budget will not help anyone and quality improvement initiatives will.

Source:

http://www.hanys.org/communications/

http://www.helpyourhospital.org/

Republicans are now in control of the house, what does it mean for health reform.

Now that the democrats have lost the house to the republicans, what does it mean for the health care reform bill? Will the look to replace all of it or just part of it, or will they seek to add to it or delete from it? Will they be able to do anything?
Like many Americans, I only like part of the health reform bill, I support coverage for the uninsured, and I support not exempting those with pre-existing conditions from coverage, but I cannot support is forcing everyone to have health insurance. It is difficult for me to support such a measure because I see it having an adverse effect on the economic.

John Goodman has some Idea for the Republicans to consider such as Health care Portability, Affordability, and fairness.
http://healthblog.ncpa.org/the-morning-after/?utm_source=newsletter&utm_medium=email&utm_campaign=HA#more-14333


Kaiser Health news : While unable to overturn the federal law, the newly elected officials will be under pressure to act. They could lean on congressional delegations to repeal or change the legislation, seek waivers from some of its provisions, veto state legislation related to it and appoint like-minded people to important positions, such as insurance commissioner slots.

http://www.kaiserhealthnews.org/Stories/2010/November/03/states-health-law-governors-election.aspx

WSJ Healthblog: The insurance industry wants to roll back a tax taking effect in 2014, but is worried about a possible threat to the individual mandate.
Drug makers want to get rid of an independent committee charged with reducing the per-capita rate of Medicare spending, since it could hurt sales of pharmaceuticals, the paper says

http://blogs.wsj.com/health/2010/11/03/am-vitals-health-care-industry-has-a-wish-list-for-republicans/

Protesting Rep. Paul Ryan's plan for Medicare

Kaiser Health news reports that The Alliance for Retired Americans is staging union-backed protests throughout aiming to get seniors not to vote certain republican candidates into office on November 2nd. They are especially targeting Representative Paul Ryan of Wisconsin who has plans to privatize Social Security and turn Medicare into an income-adjusted voucher program.

In their book titled “Young Guns”, by Ryan and his co-authors republicans Eric Cantor of Virginia and Kevin McCarthy of California, Ryan explain his plans for Medicare and Social Security as part of his “Road Map for America”. Ryan’s plan preserves Medicare as it is for those currently eligible and those within 10years of the eligibility age and proposed that those under 55 upon reaching the eligibility age will receive an initial voucher averaging of $11,000 which will be adjusted for inflation, and income; low income earner he proposed will receive more support and high income earners less.

Source:

http://www.kaiserhealthnews.org/Stories/2010/October/26/Ryan-Medicare-plan.aspx

http://www.roadmap.republicans.budget.house.gov/Issues/Issue/?IssueID=8520

CO pays for some preventive care to go away

The Chicago Tribune reported today that starting January 1st 2011, employees would not be required to pay a co-payment for preventive services as required by the Affordable care act. The act hopes that by eliminating the co-pays for preventive care more people will be encouraged to go seek preventive care.

From Kaiser weekly update-10/15/2010

I was excited to here the terms Pace (program for all inclusive care of the elderly) programs and accountable care organization(ACO) from head of the Center for Medicare and Medicaid Services (CMS), Dr. Don Berwick as he highlights his organization plans for improving Long-Term facility, during the Kaiser Family Foundation Weekly update.

According to CMS, ACO are entities establish by providers who agree to be responsible for the improving care, cost, for medicare beneficiaries enrolled in the traditional fee-for-service plans.

The Pace program according to medicare.gov an optional benefit under both Medicare and Medicaid that focuses entirely on older people, who are frail enough to meet State's standards for nursing home care and it features comprehensive medical and social services that can be provided at an adult day health center, home, and/or inpatient facilities.

Healthcare reform and the upcoming elections

Health care reform


In a recent article titled “Health care and the mid-term elections”, The Economist discusses the role the Health care reform will play on the upcoming mid-term election in the U.S. Many people are in favor of parts of the reform such as the one that stops insurers from excluding those with pre-existing condition from coverage but some are wary of parts such as the “individual mandate” option that requires everyone to carry health insurance.
This uncertainty regarding the individual mandate and the other unpopular pieces of the reform is a “useful weapon” for the Republicans in the campaign. The article goes on to say that, most of the democrats running are “staying mum and are not apologizing for their votes for the reform, whilst the Republicans are vocal.

Not only are the Republicans vocal about their disdain for the reform they can do whatever they can except repeal (can be vetoed by the president) to stop the law. They could not fund the program, which will prevent agency from administering it, they could attach a vital bill (a common practice by both parties) to the law, which will forbid its implementation, and they can just not implement the programs. Already, as I reported last week, 20 states have been given approval to precede their lawsuit charging that the reform is unconstitutional.
http://www.economist.com/node/17259055

news.

Health care reform news: 10/14/2010
According to the Wall Street Journal’s news hub, a Florida judge ruled that the lawsuit from by 20 states challenging the constitutionality of the health care bill that requires that effective 2014 everyone must carry health insurance would move on.

Medicare crackdown news: 10/14/2010
According to NPR’s Morning Edition program, a dozen people in New York were charged for committing Medicare Fraud. The FBI is cracking down on Medicare fraud around the country prosecute doctors and patient bleeding the Medicare fund.

Recently in Brooklyn, New York, the FBI arrested three doctors for submitting false claims to Medicare; how dumb are these doctors really, why did not think performing 85 hemorrhoidectomies on one patient in 20 months will raise a red flag?

These scammers would pay patients for allowing them to submit false claim to Medicare, and because of such frauds, which is prevalent though out the country, the Medicare program has lost billons.

According to the Wall Street Journal’s news hub, a Florida judge ruled that the lawsuit from by 20 states challenging the constitutionality of the health care bill that requires that effective 2014 everyone must carry health insurance would move on.

According to NPR’s Morning Edition program, a dozen people in New York were charged for committing Medicare Fraud. The FBI is cracking down on Medicare fraud around the country prosecute doctors and patient bleeding the Medicare fund.

Recently in Brooklyn, New York, the FBI arrested three doctors for submitting false claims to Medicare; how dumb are these doctors really, why did not think performing 85 hemorrhoidectomies on one patient in 20 months will raise a red flag?

These scammers would pay patients for allowing them to submit false claim to Medicare, and because of such frauds, which is prevalent though out the country, the Medicare program has lost billons.

More physicians opting for hospital instead of private practice.

10/14/2010

According to NPR’s morning edition, physicians are giving up private practices and are going to work for hospitals and hospitals are very pleased with it because it means more revenue.
The high cost starting a business, which includes high malpractice insurance rates, makes going to work for a hospital very attractive to physicians who can now focus on caring for their patients instead on the balancing act of patient-care and practice management.
The hospitals will benefit because the physicians can bring their patients with them because patients are what hospitals need.

Health Risk Assessment-for whose benefit/

If I want to choose the type of health insurance coverage I want, I will have to answer some health risk assessment questions, if I do not answer I will be defaulted into a high deductible hra medical plan.

I have been told this information will provide me with necessary information to identify risk factor early on, well thank you for your concern, but what are your other reason for requesting this information?

Comparative Effectiveness Research- What do people think about it.

I am scared of the one-size-fit-all approach to medicine and I hope that the comparative effectiveness research does not go there, it will not work, it does not work for me just ask my physicians.
It will be helpful to doctors as a starting point of how to treat an ailment or disease but they must not loose sight of the fact that what works for one person will not work for another.
According to a study by Health affairs, I am not the only one weary about this.



Source: WSJ Health blog, Health Affairs

Insurance returning unused premium to insured? a good idea.

This article by the Cato institute got me thinking. I have to agree with this article, refunding money not will be bad for the sick since the money not spend on the healthy is used on the care for the sick. I know the law is trying to prevent insurance company from using too much money for administrative cost but hope they set guidelines because insurance companies with more sick people than healthy people might have to limit care to stay afloat.

getting health insurance

Last week, Governor Schwarzenegger made California the first state to board the health insurance purchasing pool train by signing two bills into law. His goal is to provide health care to Californians without relying on the state’s general fund. The new bill is set to be effective in 2014.

It is that time of the year for many companies around the nation as insurance open enrollment period is upon them, what should employees expect? When the law that mandates everyone to have health insurance goes into effect, most people will be comparing government plans, to their companies plans and choosing the one that offers them the most for their money.

The Fed's response to Mcdonald's Mini-health worry

According to WSJ, the Department of Health and Human Services (HHS) says that the secretary will exercise her discretion in enforcing the new minimum medical loss ration requirement. The requirement puts the minimum cap of annual benefit payout at $750,000 and the law requires plan to spend between 80% and 85% of premium on medical benefits. For plans that charge enrollee $14 a week, this is not feasible.
However, the nearly good news is that HHS might extend waivers to employers facing similar issues as to prevent the disrupting of health care coverage for employees that exempt them from meeting the $750,000 cap.


Source: The World Street Journal.

End of mini-med plans?

According to the Wall Street Journal McDonald told the federal government it could drop health insurance coverage for 30,000 of its hourly-employees. The plan in question is one of those limited health care plan coined mini-med plans, and it cost each employee $14 a week, with a deductible is $2000.
So who is next?
If these plans cost less than the penalty the government imposed penalty for not offering health insurance to employees, companies will keep them, if not a lot of people will have to move to the government program.

Standardizing EHR - Stage on.

9/29/2010

According to health affair’s Health Policy Brief, Doctors, Hospitals and Clinicians will soon be receiving incentives under Medicare/Medicaid to make meaningful use of electronic health record but first certain objectives must be met by their systems, they must adopt “strict technical standard and be certified in meeting them”.

The goal of the Department of Health and Human Service (HHS) is to have a Nationwide Health information network, but in order for this to happen the Electron Health Systems must be standardized so that records can be shared securely between health entities. Before the current systems are adopted and or upgraded to be secure and remotely accessible someone has to come up with a set of criteria that all health care entity using the electronic health record must meet.

Well, Health Affairs and the Robert Wood Johnson Foundation (RWJF), in this article about “Standardizing Electronic Medical Records” discuss this. The article also talks about the objectives set by HHS, in order for the incentives to be paid.

After the standards are set and the certification criteria are create then the actual challenge will begin, how many of the existing systems out there can be upgrades successfully, how much money will this all cost, and how long will this all take, will Doctors and hospitals agree to share information, will the patients agree?

I think creating standards and criteria is a good start because a standardized system will be a good value to patients, especially those patients who have and continue to see multiple clinicians and have to constantly list every ailment they have had and every drug and treatment they are on.
With technology there are always early and late adopters and people, who will never adopt it, but when all the kinks have been ironed out and the incentives stops, this will be the norm.

source: Health Affairs, Health Policy Briefing. http://www.healthaffairs.org/healthpolicybriefs/brief_pdfs/healthpolicybrief_26.pdf