February 05, 2010
9:19 am
Ron Williams, the chief executive officer of Aetna and a member of the Healthcare Leadership Council executive committee, is a co-chair of the prestigious Davos Economic Summit. While in Davos, Mr. Williams took the time to sit down with Fox Business News and discuss the current state of health reform and what’s missing from the current legislation that is stalled on Capitol Hill.
He makes important points about the need to emphasize care coordination between physicians and hospitals, the noticeable absence of medical liability reform which leads to rising defensive medicine costs, and the pressing need to make the financially challenged Medicare program more cost effective.
To watch the full interview go here.
January 08, 2010
1:55 pm
The media got it wrong in reporting about the Mayo Clinic and Medicare patients, but the inaccuracies actually provide a service because it presents an opportunity to discuss the issue of Medicare reimbursement and patient access.
Recent news reports stated that Mayo’s Arizona facilities would no longer be seeing any Medicare patients. As the Clinic pointed out on its health policy blog, that’s not the case. In actuality, the five-physician Mayo family practice clinic in Glendale, Arizona is conducting a trial during which it will no longer be taking Medicare reimbursement for primary care services. Other health services at the Glendale clinic will still be covered by Medicare, but Medicare patients seeking primary care services will have to pay out-of-pocket.
The issue, of course, is low Medicare reimbursement levels that don’t meet the actual cost of providing care. Mayo is not the only health provider pointing out this problem. The Medicare Payment Advisory Commission reported in 2008 that an increasing number of Medicare beneficiaries were having trouble finding a doctor that would take Medicare payments for primary care services. In one of the nation’s largest states, Texas, a survey by the state’s medical association found that only 58 percent of Texas physicians were taking new Medicare patients, and only 38 percent of the state’s primary care doctors were doing so.
One of the mind-boggling aspects of the current health reform debate came when policymakers advocated creating a government-run health insurance option that would pay providers according to current Medicare reimbursement rates. They claimed doing so would save the system money. What they never mentioned was that these cost savings come as a result of not paying doctors and hospitals the actual cost of the care they provide. That’s not greater efficiency. It’s simply underpayment, and those costs get shifted, in large part, over to private payers. Read more
October 29, 2009
11:12 am
Below is my blog post which was featured today on Disruptive Women In Health Care:
If only it were an urban legend that senior citizens in the United States were cutting their physician-prescribed pills in half or ignoring their medications altogether in order to have enough money for food and utilities, but one doesn’t need academic studies to know that this kind of economically-forced non-adherence has too often been the case in our country.
After Congress passed the Medicare Modernization Act (MMA), creating the Part D prescription drug program, the Healthcare Leadership Council – an advocacy group comprised of chief executives of healthcare companies and organizations from all health sectors – literally took its show on the road. Having worked for passage of the MMA, we felt a responsibility to ensure that the new Part D program was implemented successfully and that seniors knew how to take advantage of the new benefit.
In community meetings across the country, I met with scores of elderly men and women who told me heart-wrenching stories of the hard choices they had to make between medications and other necessities, knowing they were putting their health at risk.
Has the Medicare Part D prescription drug program made a difference in drug adherence within this vulnerable population? The results are quite positive but they also show that further improvements remain necessary.
The impact of Part D on drug adherence among the elderly is unquestionable. A survey in April of this year by KRC Research (commissioned by Medicare Today, a coalition of local and national organizations we founded to provide reliable Part D information to seniors) found that three of every 10 Medicare beneficiaries reported that they are now taking medications that they had previously either skipped or rationed. Read more
August 10, 2009
2:44 pm
President Obama has rightly and frequently cited the Cleveland Clinic as one of the health providers in this country that provides the kind of high-quality, cost-effective care that should be emulated nationwide. Given that fact, it makes sense to take note of an interview the Clinic’s CEO, Toby Cosgrove, provided last week to Newsweek Magazine.
As Dr. Cosgrove points out, the debate over health reform during the August congressional recess has focused almost exclusively on the coverage issue. In fact, there has even been a tactical decision by some policymakers to refer to “health insurance reform” instead of “health reform.” This, unfortunately, takes attention away from the issues of quality, delivery reform and cost-effectiveness that will have the greatest impact on the future and sustainability of our healthcare system. Read more
July 28, 2009
2:14 pm
I’m very pleased that the Chicago Sun-Times published my op-ed piece that points out how many of the important components of healthcare reform currently have bipartisan support and we shouldn’t squander this opportunity because of conflict over a controversial, and unnecessary proposal like the government-run health plan.
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