July 13, 2010
3:57 pm
An organization of health industry chief executives today applauded federal regulators for being responsive to the concerns of hospitals and physicians in constructing the final “meaningful use” regulations that will determine the allocation of health information technology (HIT) incentive funds. But, said the president of the Healthcare Leadership Council (HLC), the newly-released rules leave some critical issues still unaddressed.
HLC president Mary R. Grealy said that, even though her organization was still analyzing the regulations, “it’s clear that federal regulators paid close attention to the more than 2,000 comments they received on the proposed rule, and that they have been responsive to concerns that the initial regulations placed the “meaningful use” bar so unrealistically high that the health technology revolution would have been slowed instead of accelerated.”
The “meaningful use” regulations establish standards that health providers must meet in order to qualify for a share of the more than $27 billion authorized by Congress in last year’s economic stimulus legislation.
The Healthcare Leadership Council is a coalition of chief executives from all sectors of American healthcare.
Ms. Grealy said, “An example of this responsiveness is seen in the fact that the rules no longer require that, in the initial stage of implementation, all of a health provider’s administrative transactions must be included in an electronic health record. That simply wasn’t realistic. Those requirements are now in Phase 2 of implementation, which is achievable.”
She said, though, that legitimate concerns remain. For example, the regulations should consider each campus of a multi-campus hospital system as a separate entity in qualifying for HIT incentive payments. And, she said, health providers who have built and succeeded with their own information technology systems should be grandfathered into the universe of successful “meaningful use” qualifiers, but that doesn’t appear to be the case based on an initial review of the rules released today.
Nonetheless, Ms. Grealy said, “we’re seeing important progress with these regulations. Clearly, the administration saw there was a gap between the theoretical standards they initially wanted to apply and the real-world challenges that physicians and hospitals face in achieving HIT advancement. We all want the benefits that come from information technology – enhanced patient safety, more cost-efficient operations, greater use of evidence-based medicine – but to make strides forward, regulators and providers need to be moving at a coordinated pace.”
July 09, 2010
2:44 pm
Let’s begin with a couple of basic truths.
First, that government-imposed price controls are antithetical to genuine, consumer-focused health reform. The only way to achievable sustainable reform that improves health outcomes and contains cost is through medical innovation, developing new treatments, technologies and medications to keep people healthier and making healthcare more cost-effective.
The second truth is that the health reform process taking place right now will not follow a simple linear path. Regulators and lawmakers will face a number of forks in the road and will have to make decisions that will determine the ultimate course of reform and the way patients and health providers will be affected.
With those premises in mind, it’s becoming increasingly clear that health reform at the national level must avoid some of the paths being taken by the state of Massachusetts.
A Wall Street Journal op-ed piece this week by Joseph Rago points out that while the Bay State has succeeded in its goal of achieving an insured populations (not counting those who are gaming the system by buying insurance, keeping it long enough to avoid state penalities, and then dumping it), cost containment has not been accomplished. Consequently, state politicians are trying to force costs down through government controls.
Governor Deval Patrick’s insurance commissioner has rejected the vast majority of requested premium increases submitted by state insurers. These increases are deemed necessary to cover expected claims, with health costs rising at eight percent annually. With these artificial price caps in place, insurers are essentially being forced to sell their products at a financial loss.
A state appeals board has reversed many of these price controls, saying they ignored “economic realities” – “economic realities” being the fact that three major insurers are now under administrative oversight because of concerns about their financial viability.
And now, the governor wants to extend this rate review process to cover hospitals and physician groups, which could effectively impose the same price controls on providers that are currently undermining health insurers. Also, as Rago points out, the state is using its “determination of need” process to restrict the use of certain medical technologies.
At a time when our population needs improved access to insurance, a growing supply of healthcare providers and medical innovation that can achieve long-term quality improvements and cost reductions, government price controls take us farther away from all of those goals.
What we’re learning from the Massachusetts experience is that there are certain roads that deserve to be less traveled.
July 08, 2010
10:48 am
According to statistics released yesterday by the American Cancer Society, cancer death rates have continued what is now an almost two decade decline.
The Society tells us that, since 1991, cancer mortality rates among men have dropped 21 percent, while women’s rates have declined 12 percent since 1992.
This success can be attributed to a number of factors. Healthier lifestyles and a reduction in the number of people who smoke have certainly contributed. But so has the ability to detect the signs of disease earlier before it has had a chance to progress. And improvements in treatment have meant that a cancer diagnosis is, more often than in the past, not a death sentence.
The promise of health reform is that more people will have health coverage and, thus, have access to early diagnosis and treatment. The reality is that we need to make sure that coverage does indeed equal increased health access, and that we strengthen support for healthcare innovation so that the future will see more development of treatments and technologies that will eventually defeat this disease for good.
July 07, 2010
7:49 am
We’re not going to comment in this space on the political wisdom of President Obama’s decision use a recess appointment to install Dr. Donald Berwick as head of the Centers for Medicare and Medicaid Services, thus bypassing the Senate confirmation process. What was certain to be a contentious confirmation debate will now be a contentious debacle on cable talk shows over the merits of using recess appointments for controversial nominees.
We’ll elect not to engage in that particular crossfire. Instead, we want to offer Dr. Berwick not only best wishes in his new position but, more importantly, the advice, counsel and support of leaders from all sectors of American healthcare.
Dr. Berwick has a big job in front of him. Not only has CMS been without a permanent head for far too long, since 2006, but Dr. Berwick will find himself as a point person in the implementation of health reform. CMS will be in the center of one of the most essential components of reform, achieving progress in changing our healthcare delivery and payment systems to focus on quality and value. Fortunately, as HLC members know from our meetings with him, this is a topic on which Dr. Berwick has profound expertise and unbridled enthusiasm.
Making headway on healthcare delivery reform will depend, in large part, on building upon the successes that private sector health providers have already achieved. We stand ready to share these examples with Dr. Berwick and his CMS team and to collaborate with him in moving toward an innovative, consumer-centered, results oriented healthcare system.
July 02, 2010
1:37 pm
I’ve never believed for a second that it’s easy to be a reporter covering the healthcare beat. Whether it’s new HIPAA privacy requirements or a seemingly arcane topic like medical loss ratios that will actually affect a whole range of healthcare activities, these journalists have to absorb a great deal of complex material and make it understandable and interesting for their readers, viewers and listeners.
One of the best at doing this is Marilyn Werber Serafini of the National Journal. I’ve known Marilyn for several years and have not only found her to be impeccably fair and accurate in her reportage, but she has that rare ability to dive down into the murky waters of health policy minutiae and emerge with compelling and insightful pearls for her readership.
I’m sharing my admiration for her work because Marilyn was just selected by the Kaiser Family Foundation as its first Robin Toner Distinguished Fellow, an honor named after the talented New York Times health policy reporter who passed away from cancer in 2008. As part of her selection, Marilyn will be working with the Kaiser News Service on articles surrounding health policy and politics and the implementation of health reform.
It’s a fine choice by the Kaiser Family Foundation and a benefit to the readers of Kaiser News Service, which has already assembled a very talented and experience staff of healthcare journalists.
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