Timely Information From Around the Country that Impacts the Way You Work!

AHRQ Issues Health Care Performance Data by State - March 2008

The Agency for Healthcare Research and Quality today issued its annual “state snapshots” summarizing data on health care quality by state. Based on data from the agency’s 2007 National Healthcare Quality Report, the snapshots summarize state performance by health care setting and type of care, and rank the states on 15 measures ranging from cancer deaths, vaccination and prenatal care rates to recommended heart attack care. New to the snapshots this year are data on state health status and progress toward the Department of Health and Human Services’ Healthy People 2010 health goals.

(Source: AHA - March 27, 2008)

Group Asks White House to Convene Conference on Nurse, Physician Supply - March 2008

The Council on Physician and Nurse Supply has called on the White House to convene a conference to address the national shortage of nurses and physicians. “The shortage of nurses and physicians is a serious matter that should be addressed at the highest levels,” said Linda Aiken, council co-chair and professor of nursing at the University of Pennsylvania. The council estimates 30% or 30,000 more nurses must graduate annually to address projected shortages, and calls for increased public financing for bachelor’s level nursing programs so more nurses can proceed to graduate education and become teachers. It notes that more than 30,000 qualified applicants to bachelor’s nursing programs were turned away in 2006, largely due to a faculty shortage. The council also recommends expanding medical schools and graduate medical education positions at teaching hospitals to address an anticipated shortage of 100,000-200,000 physicians over the next 15 years.

(Source: AHA - March 27, 2008)

AAMC: Medical Home Model Holds Promise - March 2008

The Association of American Medical Colleges views the medical home model as promising and supports further research on how to best implement it, the association announced this week. In a position statement, AAMC said every patient should have access to a medical home, meaning a continuous relationship with a health care provider or team of providers to help them navigate the health care system. The association indicated it would work with medical schools and teaching hospitals to develop a better understanding of how the medical home model can be adopted in academic and community settings. It said payment for the model should appropriately recognize and reward providers for prevention, care delivery and coordination; and that providers should be trained to understand and implement the model within a team environment.

(Source: AHA - March 27, 2008)

Report: Economic Cost of Uninsured is High - March 2008

The poor health and shorter lifespan of the uninsured cost the U.S. economy between $102 billion and $204 billion in 2006, the New America Foundation estimates in a new report. That’s at least as much as the public cost of covering them, and does not include the cost to society when medical bills go unpaid, the authors said. The report updates estimates reported by the Institute of Medicine in 2000 to reflect growth in the economy and the number of uninsured.

(Source: AHA - March 27, 2008)

Report: States Testing New Medicaid Care Management Strategies - March 2008

States are experimenting with a variety of innovative care models, financing structures and performance measurement strategies to lower costs and improve care for chronically ill and disabled Medicaid patients, according to a new study by the Center for Health Care Strategies. The new models “embody a core set of care management elements that are not unlike those of traditional managed care but give states different ‘levers’ to achieve accountability for both quality and cost,” the authors said. They expect states will continue to explore new approaches to caring for Medicaid beneficiaries with complex and costly health care needs due to growing budget pressures and the momentum for health care reform. The study looked at programs in California, Indiana, Minnesota, Mississippi, New York, North Carolina, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Texas and Washington.

(Source: AHA - March 27, 2008)

CDC’s Early 2007 Estimates Show Rise in Uninsured - March 2008

An estimated 43.7 million U.S. residents were uninsured when interviewed during the first nine months of 2007, up from 43.6 million in 2006, the Centers for Disease Control and Prevention reported today. Based on the CDC’s National Health Interview Survey, the estimate includes 6.8 million children. An estimated 54.5 million residents were uninsured for at least part of the year prior to the interview, and 31.2 million were uninsured for more than a year, up from 30.7 million in 2006. An estimated 17.5% of privately insured respondents were enrolled in a high-deductible plan and 4.5% were enrolled in a consumer-directed plan, a high-deductible plan with an account to pay for medical expenses.

(Source: AHA - March 27, 2008)

To Mandate, Or Not? - March 2008
By: Grace-Marie Turner

The issue of achieving universal coverage for health insurance has dominated the health reform debate in the Democratic presidential campaigns. In order to achieve universal coverage, Senator Hillary Clinton says, the government must require everyone to have health insurance.

But what a slippery slope that is!

As we have learned from the first experiment in this country with an individual mandate for health insurance in Massachusetts, this proposal has dramatic and far-reaching consequences for individuals, businesses, and the health insurance market. Read more

The Consumer Health Care Engagement Report, Vol. 1, Issue 1

The Single-Payer Remedy Is Worse Than the Disease - March 2008

Source: The Galen Insitute

No one denies that America's health sector faces problems. Costs continue to rise, and 45 million people lack insurance. Even worse, many politicians think they've discovered the cure in a single-payer system. But that remedy would be worse than the disease. Read more

The Consumer Health Care Engagement Report, Vol. 1, Issue 1

Humana Offers Members Gift Cards for Participating in Health Practices - March 2008
Source: Kaiser Network

Humana last month launched a program, called "Healthy Returns," that provides its Medicare plan beneficiaries with gift cards to Macy's, CVS, Lowe's and Borders as an incentive to adopt healthier lifestyles, Florida Health News reports. Read more

The Consumer Health Care Engagement Report, Vol. 1, Issue 1

Fines for Bad Health Set Off Employee Backlash - March 2008
Source: Wall Street Journal

Employers are eager to try wellness programs for their employees to restrain health-care costs. Who could argue with the idea that the best way to avoid medical bills is to keep from getting sick in the first place? Try the employees at Clarian Health in Indianapolis. Read more

The Consumer Health Care Engagement Report, Vol. 1, Issue 1

Report Examines Tax Incentives to Ease Retiree Health Care Costs - March 2008

Tax incentives to help working Americans save for post-retirement health care costs would only partly address out-of-pocket costs for low-income Medicare beneficiaries, according to a new study by the Commonwealth Fund. “Because their pre-retirement incomes are low on average, helping low-income individuals to save will not fully address the problem of out-of-pocket medical costs for the low-income elderly,” the authors said. Low-income people also are more likely to lack retiree benefits and typically cannot afford Medigap coverage, the study adds. The authors suggest limiting tax incentives to individuals with incomes up to 300% of the federal poverty level to reduce the tax revenue loss to the federal budget.

(Source: AHA - March 24, 2008)

Report: Consumers may need help directing Medicaid personal care - March 2008

States that allow disabled Medicaid beneficiaries to direct their own personal care services should be careful to provide sufficient support to help beneficiaries find quality direct care workers and back-up assistance when needed, according to two new reports from the Kaiser Commission on Medicaid and the Uninsured. In 2006, 42 states offered programs allowing Medicaid beneficiaries to direct their own personal assistance services. Based on a study of programs in California, Colorado, New York and Virginia, the commission said beneficiaries highly value the ability to choose their own direct care workers and set their own schedules, but that some may need more support than the consumer-directed model has to offer. Beneficiaries who choose to continue using an agency-directed program cited the need for reliable back-up assistance as the primary reason.

(Source: AHA - March 24, 2008)

AHA Opposes Medicaid Cost-Sharing Provision - March 2008

The AHA today voiced opposition to a Deficit Reduction Act provision that would allow state Medicaid programs to require hospital emergency departments to impose cost-sharing for non-emergency services. Commenting on the Centers for Medicare & Medicaid Services’ proposed rule implementing the DRA provision, AHA said congressional sponsors intended the provision to deter individuals from using hospital EDs for services that can be provided in lower-cost settings. “However, the sponsors failed to understand that a growing number of physicians do not take Medicaid patients because of inadequate payment, and the hospital ED is often the only source of primary medical care for Medicaid beneficiaries,” AHA said. The letter notes that the Congressional Budget Office concluded that co-payments will cause fewer individuals to seek care. “Putting up barriers to primary and urgent care in the ED will lead to poorer health and higher costs for many Medicaid beneficiaries in terms of more costly ED visits or avoidable hospitalizations,” AHA said.

(Source: AHA - March 20, 2008)

A Comments on LTCH Proposed Rule - March 2008

In a comment letter today, the AHA expressed support for the Centers for Medicare & Medicaid Services’ proposal to return the long-term care hospital prospective payment system to the fiscal year calendar in 2009. However, the association expressed concern with several other changes to the LTCH PPS included in the proposed rule. Specifically, it said a proposed coding offset “would inappropriately push Medicare payments even further below the cost of care for LTCH patients” and should be withdrawn to allow for a full market basket update. In addition, it said the market basket update for rate year 2009 should be applied to the standard amount for rate year 2008, not rate year 2007. AHA also urged CMS to drop future plans for a one-time budget neutrality adjustment, which it said was unnecessary. The association also suggested that CMS develop a comprehensive set of standards for all LTCH patients rather than targeting a narrow segment.

(Source: AHA - March 20, 2008)

Study: Nurses Key to Care Improvement Efforts - March 2008

Hospitals face growing trade-offs when allocating nurses between direct patient care and quality improvement efforts, according to a new study by the Center for Studying Health System Change. Hospital leaders in Detroit, Memphis, Minneapolis-St. Paul and Seattle who were interviewed for the study stressed the importance of engaging nurses and other staff in quality improvement activities. However, they said hospitals committed to including nurses in quality improvement often face a shortage of nurses; growing demand to participate in more, often duplicative quality improvement activities; and shortcomings in traditional nurse education. The study was commissioned by the Robert Wood Johnson Foundation.

(Source: AHA - March 20, 2008)

Supreme Court Hears Arguments on Labor Organizing - March 2008

The U.S. Supreme Court today heard arguments in a case attempting to overturn a California law forbidding employers to use any state funds, including Medicaid dollars, to influence employees about whether to select a union as their bargaining representative. The arguments generally focused on whether the state law is preempted by the National Labor Relations Act. The court is expected to rule on the case, Chamber of Commerce v. Brown, later this year. The AHA in January filed an amicus brief supporting the effort to overturn the law. The case’s employer free-speech controversy concerns hospitals because they rely on state funding programs and are frequent subjects of union organizing drives.

(Source: AHA - March 19, 2008)

NJ Hospitals Support Effort to Expand Children’s Health Coverage - March 2008

The New Jersey Hospital Association this week voiced support for legislation introduced by state Sen. Joseph Vitale that would provide free or low-cost health insurance to 250,000 uninsured children. “This bill will provide thousands of New Jersey children with access to high quality health care when and where they need it,” said Betsy Ryan, NJHA president-elect and chief operating officer. “We look forward to working with Sen. Vitale and to receiving additional details regarding the second phase of Sen. Vitale’s bill and any future legislative efforts to reduce the financial crisis faced by our hospitals and the patients they serve.” New Jersey hospital groups oppose more than $108 million in proposed cuts to state hospital charity care funding for uninsured residents. Nearly 20 New Jersey hospitals have closed in the past 10 years and several others are in bankruptcy or filing for closure as hospitals struggle against chronically low payments from Medicare, Medicaid and other programs.

(Source: AHA - March 19, 2008)

Supreme Court Hears Arguments on Labor Organizing - March 2008

Hospitals planning to participate in Cover the Uninsured Week April 27 to May 3 can visit the campaign’s online Event Planning Center to register as an event planner. The first 500 planners who register their events will receive a free promotional banner. Participants also can order free bookmarks, lapel stickers and other materials to promote their events, or download a fact sheet to help educate community leaders about the uninsured. The AHA is a national partner in the annual campaign, led by the Robert Wood Johnson Foundation, to raise awareness about the 47 million Americans without health insurance and help those who are eligible enroll in low-cost or free health coverage programs.

(Source: AHA - March 18, 2008)

AHA Section Honors Federal Hospital Leaders - March 2008

The AHA's Section for Federal Hospitals today presented two hospital leaders with awards for outstanding service. "Lives have been saved and the quality of life for many soldiers has been vastly improved thanks to their hard work and commitment," said Barbara Lorsbach, AHA's senior vice president of member relations. Lieutenant Colonel Dawn Garcia, head nurse for the combined intensive care unit at Landstuhl (Germany) Regional Medical Center received the section's 2007 Special Achievement Award. Colonel Jimmie Keenan, chief of staff for the Army Medical Action Plan, Army Medical Department, Office of the Surgeon General in Falls Church, VA, received the section's 2007 Award for Excellence. For more, see the AHA news release.

(Source: AHA - March 13, 2008)

Universal Screening Fails to Reduce MRSA Infections - March 2008

A study to be reported in tomorrow's Journal of the American Medical Association found that screening patients for methicillin-resistant staphylococcus aureus on admission to the hospital did not reduce the MRSA infection rate. The study of more than 21,000 surgical patients at a Swiss teaching hospital compared the use of rapid screening plus standard infection control measures with infection control measures alone. "Overall, our real-life trial did not show an added benefit for widespread rapid screening on admission compared with standard MRSA control alone in preventing nosocomial MRSA infections in a large surgical department," the authors conclude.

(Source: AHA - March 11, 2008)

Health Affairs Focuses on Health Disparities - March 2008

The March/April issue of Health Affairs focuses on health disparities research, including studies ranging from minority perceptions of physician care quality to non-medical influences on health disparities. The issue was funded by the Robert Wood Johnson Foundation, which recently launched a commission to consider solutions outside the medical system for reducing health disparities. For more on the issue, see the press release.

(Source: AHA - March 11, 2008)

Committees Pass Budget Plans That Exclude Medicare, Medicaid Cuts - March 2008

The House Budget Committee yesterday voted 22-16 to approve a fiscal year 2009 budget resolution that excludes the president's proposed Medicare and Medicaid cuts. However, the budget blueprint includes reconciliation instructions directing the House Ways and Means Committee, which has jurisdiction over Medicare, to report legislation that decreases spending or increases revenues by $750 million over five years.

The resolution also includes reserve funds for budget-neutral legislation to improve Medicare and the State Children's Health Insurance Program and prevent or delay Medicaid regulations. This afternoon, the Senate Budget Committee voted 12-10 to approve a budget resolution that excludes Medicare cuts to hospitals, assumes the cost of extending the moratoria on several Medicaid regulations, and provides reserve funds for budget-neutral legislation to improve SCHIP and physician reimbursement. The House and Senate resolutions, expected to go to their respective floors next week, eventually must be reconciled in conference. The president's budget plan proposed more than $182 billion in cuts to Medicare over the next five years, of which $135 billion would come from hospitals; as well as $18 billion in Medicaid cuts.

(Source: AHA - March 6, 2008)

AHA, YMCA Promote Partnerships to Improve Community Health - March 2008

Addressing the Association for Community Health Improvement's (ACHI) annual meeting today in Atlanta, AHA President and CEO Rich Umbdenstock and YMCA President and CEO Neil Nicoll discussed their commitment to building on existing hospital-YMCA partnerships to make better health and health care a reality for everyone. "The fact is the most efficient health care system is one that prevents disease," Umbdenstock said, noting that a focus on wellness is one of the five components of the AHA's health reform framework: Health for Life: Better Health. Better Health Care. He said hospital-YMCA partnerships like Team Lean in Bainbridge, GA, a 12-week community competition to lose weight and lower cholesterol and blood sugar, "is a perfect example of that idea. Simply put, the community is healthier because of the creativity and dedication of the local YMCA chapter and hospital." ACHI is a program of the Health Research and Educational Trust, an AHA affiliate.

Hospitals: No Charge For Mistakes - March 2008

The board of trustees for the Oregon Association of Hospitals and Health Systems has unanimously adopted guidelines to ensure that no patient or payer foots the bill for hospital care related to adverse medical events.

Click here to read more.

CMS Posts HIPAA Compliance Review Information - February 2008

The Centers for Medicare & Medicaid Services’ Office of E-Health Standards and Services has issued a document to help health plans, healthcare clearinghouses, and certain healthcare providers understand the types of information that may be requested of them for potential Health Insurance Portability and Accountability Act security rule violations. The document details which personnel may be interviewed and which documents may be reviewed by the contractors responsible for conducting onsite investigations.

Click here to read more.

CMS: Health Spending Will Double by 2017 - February 2008

The Centers for Medicare & Medicaid Services today projected that annual U.S. spending on healthcare will double to $4.3 trillion by 2017, nearly one-fifth of the gross domestic product. A slowdown in private spending is expected to be offset by faster growth in public-sector spending, partly due to the baby boom generation enrolling in Medicare, CMS said. CMS Acting Administrator Kerry Weems said the projection “reminds us that we need to accelerate our efforts to improve our healthcare delivery system to make sure that Medicare and Medicaid are sustainable for future generations.” Annual growth in spending for hospital care is expected to slow from 7.2% in 2008 to 6.4% by 2017, CMS said. The report was published online by Health Affairs.

Click here to read more.

New Guidance Improves Appeals Process for Medicare Denials - February 2008

The Centers for Medicare & Medicaid Services has, as required by law, issued guidance effective July 1 for hospitals that are appealing payment denials by the agency and its contractors. Authorized by the 2003 Medicare Modernization Act and long advocated by AHA, the guidance affects all Medicare appeals activity, including appeals of medical necessity review denials by fiscal intermediaries and Medicare administrative contractors, and appeals of payment denials by recovery audit contractors. It prevents funds from being recouped during the first two stages of the five-stage appeals process. Interest on denied payment will continue to accrue, but will not be assessed if the denial is overturned in favor of the provider. The vast majority of appeals are concluded during the first three levels of the appeals process.

Click here to read more.

Successful Clinical Integration Initiatives in Physician Organizations: How to Build a FTC Compliant Program - February 2008

The FTC and Department of Justice have described a clinically integrated network as one that implements "an active and ongoing program to evaluate and modify practice patterns by the network's physician participants and creates a high degree of interdependence and cooperation among the physicians to control costs and ensure quality."

During the past five years there has been a significant increase in enforcement activity by the FTC in response to complaints alleging that physician networks are engaging in the suppression of price competition and utilizing structures that fail to meet FTC guidelines.

Click here to read more.

Need To Increase Signatures On House and Senate Letters Opposing Medicare/Medicaid Hospital Cuts - February 2008

As Congress returns from its President's Day recess, budget committees are getting ready to mark up their versions of a fiscal year 2009 budget. As of today, 161 House members and 16 senators have signed letters urging budget committee leaders to reject the president's proposed $135 billion in Medicare and Medicaid hospital cuts.

We expect both letters to be closed to signatures this Friday, Feb. 29, so please contact your senators and House members to make sure they sign. The letters are being distributed by Sens. Blanche Lincoln (D-AR) and Pat Roberts (R-KS), and Reps. Richard Neal (D-MA) and Phil English (R-PA).

Please help our champions demonstrate solid opposition to the cuts!

Click here to see the Lincoln-Roberts letter and the list of signers

Click here to see the Neal-English letter and the list of signers.

Quality of care; Medicare Cutbacks are Key Issues Driving Healthcare IT - February 2008
Delivery of quality healthcare is driving investments in clinical technology, including electronic medical records (EMR) and technology that reduces medical errors, such as computerized practitioner order entry (CPOE), suggest results of the 19th Annual Healthcare Information and Management Systems Society (HIMSS) Leadership Survey, sponsored by Cisco. Medicare cutbacks and managed care fee reductions are creating uncertainty about the ability to fund such investments, the survey also reveals.

Click here to read more.  

Now Accepting Orders for the 2008 Federal Employees Almanac - Introducing an All New, Easier-to-Read Size! - February 2008

Since 1953, the Federal Employees Almanac has been the leading publication of career information for federal employees. The Almanac contains more than 500 pages of guidance on federal employee benefits, compensation, policies, procedures, perks and programs and is published annually.

Paperback Edition
Traditional bound copy.
$16.95 (plus shipping & handling) for a single copy

Spiral-Bound Edition
Enhanced bound copy lays flat when open for easier reading.
$19.95 (plus shipping & handling) for a single copy

The Almanac includes sections on:

• 2008 Pay and Leave Tables
• Per Diem Rates
• Insurance
• Retirement
• Post-Retirement
• The latest policies on leave, hiring programs, compensatory time and other benefits 
• Thrift Savings Plan
• Divorce, Legal Separation, and Annulment
• New developments in personnel rules including the alternative systems
  at Homeland Security and Defense
• Employment Procedures and Policies
• Downsizing Policies
• Agency Roles and Responsibilities
• Taxes
• Travel, Transportation, and Relocation
• Postal Service

Order your copy of the 2008 Federal Employees Almanac today! Go to www.FederalDaily.com/2008almanac.htm or call (800) 989-3363 (Mon. - Fri. 9:00 a - 5:00p,  EST)

Please Note: The 2008 Federal Employees Almanac will be rushed to you directly from the printer in February 2008.

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