After much anticipation and an outpouring of feedback on the proposed rule released last March, the Department of Health and Human Services (HHS) released its final rule on the Accountable Care Medicare Shared Savings Program late last week. This program was created by one of a few key delivery system reform provisions in the health care reform law, to better align financial incentives in Fee-For-Service Medicare to strive for cost savings while protecting and improving quality of care. Provider groups had many concerns with the proposed rule, largely stemming from the lack of flexibility in initial funding that is required to develop a new ACO model and keep it running. The general analysis was that the potential upside offered through the program would not be sufficient to support the development of ACOs in the Medicare Fee-For-Service market – and the potential downside risk too great. Continue reading ‘HHS Releases Final ACO Rules’
Archive for the 'Health Care Reform' Category
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In a national survey of primary care physicians that the Archives of Internal Medicine published last month, nearly half agreed: Their own patients are getting too much care.
The study drew widespread attention as Americans struggle with health care’s drag on our economy. At Group Health’s Annual Membership Meeting, Commonwealth Fund President Karen Davis, PhD, said the United States is paying twice as much per capita for health care as other industrialized countries. Yet 15 nations outrank us in quality of care. Clearly, we could do better with less. But how do we decide which care to eliminate? Continue reading ‘If less is more, which health care should be cut?’
King County made the recent stunning announcement that it will save $60 million in health care costs in the next two years over earlier projections. The single biggest reason for the savings? Healthier employees.
With seven years of health care cost data to support the report, King County Executive Dow Constantine delivered a treasure trove of information that provides insight into best practices for managing healthcare costs across an organization. The data shows encouraging trends for King County and points at what may be possible nationally to make health care reform work. Continue reading ‘King County has the data that shows the way’
Americans are drowning in data while starving for transformational ideas. So writes Neal Gabler in his August 13 New York Times piece, “The Elusive Big Idea.”
Think Albert Einstein’s theory of relativity, Marshall McLuhan’s “medium is the message,” and Betty Friedan’s “feminine mystique.” Concepts like these let us “get our minds around our existence and attempt to answer the big daunting questions of our lives,” wrote Gabler, of the University of Southern California. Such visionary ideas could once “ignite fires of debate, incite revolutions, and fundamentally change the way we look at and think about the world.” Continue reading ‘Health care’s elusive big idea: Less is more’
Parents’ concern about the safety of the immunizations given to their children has been rising steadily for the past decade-and-more. Although immunization against selected infectious diseases has long been an important element of health care for children – and has, in fact, truly changed the face of illness-in-childhood in sweeping ways – there is a growing concern among some parents that the risks associated with immunization may exceed their substantial benefits. Continue reading ‘IOM report confirms immunizations are safe’
For the fifth report in a row, Group Health’s group practice received the most top ratings on quality care measures in the Puget Sound Health Alliance (PSHA) Community Checkup, which was released last week.
The Community Checkup reports on performance related to the treatment of asthma, diabetes, depression, prevention of certain diseases, and the use of antibiotics and generic medications. Continue reading ‘Group Health still #1 in PSHA Community Checkup’
After weeks of debate, the White House and Congress have agreed to increase the U.S.debt ceiling while ultimately cutting federal spending by $2.4 trillion, according to the Congressional Budget Office’s assessment.
The House approved the Budget Control Act on Monday evening by a vote of 269-161 (in a wonderful, apolitical moment, Representative Gabrielle Giffords, injured in the shooting in Arizona last January, returned to work for the first time in eight months to cast her vote on this bill). The Senate approved it 74-26 on Tuesday, and it was signed by the President soon thereafter. The last minute deal averted what would have been the first default in U.S.history, but the politically fraught process leading up to yesterday’s default deadline will likely yet have economic and political implications, and the hardest work of identifying specific cuts, revenues, and program changes to reduce the deficit still lies ahead. Continue reading ‘Debt ceiling and deficit reduction (semi) end-game’
Section 1001 of the Affordable Care Act (ACA) establishes women’s preventive health benefits as a category of mandatory preventive services for all new fully insured and self-funded plans. The ACA, however, provides no specifics about what should be included in this general category. In order to meet some very tight timelines under the law, and likely to mitigate the anticipated controversy over inclusion of reproductive health services, the Secretary of Health and Human Services (HHS) tasked the Institute of Medicine (IOM) to “review what preventive services are necessary for women’s health and well-being and should be considered in the development of comprehensive guidelines for preventive services for women.” Continue reading ‘Changes to women’s preventive health benefits’
A message from Group Health President and CEO Scott Armstrong to members and staff:
In the last few years, Group Health has gotten a lot of attention for our cooperative roots. While some of that attention was misinformed by heated political debates, market research reveals that our consumer-governed structure gives us great credibility and differentiates us from our competitors. A growing number of people think co-ops are “cool.” Continue reading ‘The Board of Trustees affects your life as a member and an employee’
Last month, the federal government disclosed—then quickly abandoned—a plan to unleash “mystery shoppers”on 4,000 primary care practices across the United States. The goal? To see just how many providers refuse to take new Medicare and Medicaid patients. Continue reading ‘Of mystery shoppers, country doctors, and a meeting with Bill Clinton’
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