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/