Region’s ER facility expansion will drive up costs

The Seattle Times shed important light on a disturbing development in the region’s health care market with its November 29 story, “ER building boom is wrong prescription, critics say.” Experienced ethics reporter Carol Ostrom describes how large hospitals have recently built many new, aggressively marketed emergency facilities—many as free-standing facilities in affluent areas of Puget Sound. Continue reading ‘Region’s ER facility expansion will drive up costs’

Supercommittee fails to reach an agreement — what now?

After many committee meetings and much speculation whether the bipartisan Joint Select Committee on Deficit Reduction (“Supercommittee”) would come to an agreement to cut the United Stated deficit by $1.2 trillion, the deadline has unfortunately past. Despite the fact that the Supercommittee had full authority to essentially cut from any government budget to reach the $1.2 trillion goal, the Democrats and Republicans could not agree on exactly how to reform certain programs for savings nor develop creative ways to raise revenue without increasing taxes for everyone. Our own Senator Patty Murray, a co-chair of the Supercommittee, stated that the group worked up to the wire to strike a deal, but in the end, no recommendation could be agreed upon by both parties. Continue reading ‘Supercommittee fails to reach an agreement — what now?’

The Supreme Court to hear arguments on the Affordable Care Act

On Monday, the Supreme Court of the United States decided it would hear the challenge to major provisions of the Patient Protection and Affordable Care Act (ACA) in its upcoming session. Specifically, the Court will hear arguments contained within the suit filed by 26 states and the National Federation of Independent Business that came through the U.S. Court of Appeals for the 11th Circuit. It is important to note this is the only appellate court to find the law to be unconstitutional. Continue reading ‘The Supreme Court to hear arguments on the Affordable Care Act’

School-based health centers make a difference

 

Today I joined Mayor Mike McGinn at West Seattle High School to encourage the community to vote “Yes” on the Families & Education Levy so the City can continue providing successful “wrap around” services, including student health centers, to Seattle’s public school students.

Some 1,748 students made 11,066 visits to the seven health centers that Group Health operates in the 2010 school year. Group Health receives grant funds from Seattle’s Families and Education Levy and provides in-kind resources to operate the health centers.  Continue reading ‘School-based health centers make a difference’

Performance Matters

Only nine Medicare Advantage plans in the country earned 5 stars overall, and Group Health Cooperative’s plan is one of them.

Numbers are the currency of the land—the best way we have to demonstrate accountability and transparency regarding how we take care of people. But over the years our concept of quality has evolved beyond just scores and numbers. Continue reading ‘Performance Matters’

HHS Releases Final ACO Rules

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’

If less is more, which health care should be cut?

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?’

IOM releases report on the essential health benefits package

 

The Institute of Medicine (IOM) released its recommendations for the essential health benefits (EHB) package this morning.  Continue reading ‘IOM releases report on the essential health benefits package’

IOM report on essential health benefits expected this week

The Institute of Medicine (IOM) announced that its report on recommended essential health benefits will be released October 7. The Affordable Care Act (ACA) requires the Department of Health and Human Services (HHS) to delineate the essential health benefits that must be offered by all carrier participants in the state health insurance exchanges. All health plans must cover these health benefits to be certified and offered in the proposed state health insurance exchanges. In addition, Medicaid state plans must cover these services by 2014. Continue reading ‘IOM report on essential health benefits expected this week’

King County has the data that shows the way

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’