AHIP Proposes Reform Plan
The United States could reduce total health care spending by $145 billion in the next 7 years while improving the quality of patient care by implementing five proposals, according to a plan from industry group America's Health Insurance Plans. The plan endorsed a combination of measures, including better disease management and care coordination, prevention, a move to electronic transactions, a transition to a value-based payment system, and new technology. The group also called for replacing the current medical liability system with a dispute resolution process consisting of an independent administrative process to provide quick and fair resolution to disputes. AHIP president and CEO Karen Ignagni said most aspects of the proposal are already used by health insurance companies. “The nation needs a coordinated approach across the public and private sectors to maximize the impact of these strategies,” she said in a statement.
ACP Provides Framework
The American College of Physicians has reiterated its 2002 message that all Americans should have access to affordable health insurance coverage. In an update to its position paper, ACP reviewed its key reform recommendations and said they remain, with some revisions, a viable approach to making coverage available universally. The paper said reforms to expand coverage should be done in concert with changes in health care financing and delivery to improve outcomes and efficiency of care. “Expanding health insurance coverage to all Americans is a moral imperative,” said Dr. Jeffrey Harris, president of ACP. The paper advised expanding Medicaid coverage, creating tax credits, adding options for small employers, and measures to ensure all participate. It also asked for federal government support for states to redesign health care delivery programs to expand coverage and organize care around patient-centered medical homes.
Mass. Uninsured Rate Cut
In the first year after Massachusetts implemented its health insurance coverage expansion and reforms, the uninsured rate in the state's adults dropped by almost half, from 13% to just over 7%, according to an Urban Institute study published online in Health Affairs. The study also showed that access to care for low-income Massachusetts adults has increased, and the share of adults with high out-of-pocket health care costs and problems paying medical bills has dropped. In addition, it found no evidence that the expansion of publicly subsidized coverage has “crowded out” employer-sponsored coverage. The reforms, enacted in April 2006, included an expansion of Medicaid, state subsidies for low-income residents to purchase health insurance, and a new purchasing arrangement for private health insurance. Under the reforms, most uninsured individuals must purchase insurance or pay a penalty to the state.
Consumer Reports Eyes Hospitals
Consumer Reports has begun grading hospitals and plans to add ratings for other health care providers. The ratings, which include nearly 3,000 hospitals, are at
CMS Outlines Hospice Rights
The Centers for Medicare and Medicaid Services has finalized regulations that give Medicare beneficiaries with terminal illnesses the right to determine how they receive end-of-life care. The provisions, contained in an overhaul of regulations governing the hospice industry, include explicit language on patient rights that had not existed under the previous regulations, CMS said. With the new rule, patients who choose hospice, or palliative care, over curative treatment are entitled to such things as participation in their treatment plan, the right to effective pain management, the right to refuse treatment, and the right to choose their own physician. CMS noted that although many hospice patients already are active in their own treatment plans, this regulation is the first to set out a detailed list of patient rights. “It is time to update our regulations to reflect advances in medicine and hospice industry practices as well as patient rights,” said CMS Acting Director Kerry Weems in a statement.
Florida Expands Coverage Options
Florida Gov. Charlie Crist, a Republican, has signed legislation that will allow the state to negotiate with health insurers to develop affordable health coverage for the 3.8 million uninsured Floridians aged 19–64 years. The legislation focuses on primary and preventive care to discourage unnecessary emergency room visits. Private insurers have said the plan will allow them to create benefits packages for about $150 a month or less. All benefit plans will include, at the very least, coverage for preventive services, screenings, office visits, outpatient and inpatient surgery, urgent care, prescription drugs, durable medical equipment, and diabetic supplies, according to the governor's office. Approved insurance companies also would have to offer consumers a plan that includes catastrophic and hospital coverage. The law includes provisions for all families to buy into the Florida Kid Care program and creates a clearinghouse where small businesses can choose from a variety of health care plans and services for their employees.