Monday, June 25, 2012

Health care policy news from campuses on the campaign trail

The Supreme Court is expected to deliver its decision on the constitutionality of the Affordable Care Act AKA "Obamacare" tomorrow. Although I'm hoping they'll rule that it's constitutional, I'm not optimistic. While I'm waiting, I'll share these news items about health care policy with you, which were originally posted in Overnight News Digest: Science Saturday (Venus Transit, Partial Eclipse, and Total Recall edition), Overnight News Digest: Science Saturday (Global Tipping Point edition), and Overnight News Digest: Science Saturday (Turing at 100 edition) on Daily Kos.

First, two news items that are explictly about the Affordable Care Act.

Rutgers University: Rutgers-Camden Law Professor says Congress has Authority to Protect Viability of Private Health Insurance
May 25, 2012
CAMDEN — While health care policy continues to be debated across the nation, a Rutgers–Camden law professor says Congress has the authority to ensure the viability of private health care insurance in the United States.

David M. Frankford, a professor at the Rutgers School of Law–Camden, is a widely published expert on health law and policy who has spent 28 years researching and teaching health care finance and regulation.

Much of the current debate on health care reform surrounds the Affordable Care Act, now under review by the U.S. Supreme Court to determine the constitutionality of the law’s requirement of Americans to buy health insurance or pay a penalty.

Opponents of the act say Congress lacks authority to force people to buy a product, but Frankford challenges that notion.

“The idea that the federal government, that Congress, lacks authority to maintain the viability of a private insurance system is quite surprising,” says Frankford, of Wynnewood, Pa. “A private insurance system is commerce under the constitution. Without these sorts of reform, it will continue to spiral downward. It has been eroding now over the course of a number of decades, a trend that accelerated over the last ten years. Congress has authority to protect the continued viability of this commerce and it has the discretion to choose among reasonable means of doing so.”
SUNY Buffalo: Report: Health Care Reform Must be Local, Regardless of Court Decision
"Communities of solution" that integrate primary care and public health are key to creating healthy neighborhoods, says UB family medicine professor and co-author
June 20, 2012
BUFFALO, N.Y. -- Even with an imminent Supreme Court ruling on the health care overhaul law, it's still the primary care physician and the local community that will determine the path of true health care reform. That's the message from "Communities of Solution: The Folsom Report Revisited," a policy paper published online in the May/June issue of Annals of Family Medicine.

"The Folsom Report, published in 1967, called for a closer alliance between public health and primary care," says corresponding author Kim S. Griswold, MD, MPH, associate professor of family medicine in the University at Buffalo School of Medicine and Biomedical Sciences. "Now, nearly 50 years later, we're calling for the same thing. We need to inject -- and maintain -- the public ingredient in medical care."

The original Folsom Report grew, in part, out of the social justice movements of the 1960s and 1970s. It was responsible for several important advances, including the establishment in 1969 of a new medical specialty called family medicine.
Here's to hoping my pessimism about the decision is unfounded.

For the rest of the health care policy news, continue over the jump.

American Medical News: Most doctors headed for penalty over Medicare quality reporting
Growing numbers of physicians are earning reporting bonuses, but hundreds of thousands still have not participated in a program that turns punitive in 2013.
By Charles Fiegl, amednews staff.
Posted May 28, 2012.
Absent a significant change in the trajectory of Medicare’s physician quality reporting system, a large majority of doctors will set themselves up for future rate cuts by failing to report enough quality measures to the federal government in 2013.

A recent trends report from the Centers for Medicare & Medicaid Services shows that fewer than 200,000 physicians, out of the more than 600,000 who were eligible for the incentive program, reported PQRS measures in 2010. More than 125,000 physicians reporting as individuals met enough of the requirements to share a total of nearly $400 million in bonuses, but hundreds of thousands of eligible doctors did not attempt to meet the pay-for-reporting criteria. More than 50,000 tried for the bonuses but did not report enough quality measures to hit the minimum.

The lack of participation has physician organizations concerned that a huge segment of those caring for Medicare patients soon will take a hit when CMS begins not only withholding bonuses from doctors who don’t participate in the PQRS but also cutting their pay rates. Physicians can consider 2012 to be their final year to try reporting risk-free: A 1.5% noncompliance penalty won’t be assessed until 2015, but that payment adjustment will be based on whether physicians report quality measures in 2013.
University of California: Specialized elder care could significantly cut costs
June 8, 2012
SAN FRANCISCO — Creating specialized hospital units for elderly people with acute medical illness could reduce national health care costs by as much $6 billion a year, according to a new study by UCSF researchers.

The team assessed a program called “Acute Care for Elders,” or ACE, which offers individualized care for older patients in specially designed hospital units. It is being piloted in 200 hospitals nationwide, serving an estimated 100,000 patients annually.

“The Medicare proportion of the health care budget is going up faster than anything else, and the cost of hospital stays is one of the fastest growing components of that care,” said senior author Seth Landefeld, M.D., chief of the UCSF Division of Geriatrics. “This was really an opportunity to look at how you can deliver higher value care while maintaining or improving quality and reducing cost.”
University of California: Health experts named to statewide task force
June 5, 2012
Ten health policy experts from the University of California system have been appointed to a task force that will develop a 10-year plan to help make the state's residents healthier.

California Health and Human Services Agency Secretary Diana S. Dooley made the appointments Monday (June 4) to the Let's Get Healthy California Task Force, formed under an executive order from Gov. Jerry Brown to make recommendations to improve the delivery of health care in the state.

The task force and a panel of expert advisers will work together to gather, evaluate and prioritize the best ideas and practices and organize them into a 10-year plan to improve quality, control costs, promote personal responsibility for individual health and advance health equity.


  1. I take it one thing you are saying is if providers don't need to shuffle with health care policy, this would reduce total costs. One consideration: an insurer should pay the provider unless the patient already did, to avoid a sometimes non-payment to providers of paid benefits.

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