Contents tagged with health care reform

  • Medicaid expansion: A tale of two states

    Tags: colorado, medicaid, health care reform, kaiser health news, legislature

    Apr 30 2013 9:29 PM
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    It’s no secret that Texas Gov. Rick Perry openly opposes federal health care reform. He has used every opportunity to reiterate that he will veto any effort by the legislature to participate in Medicaid expansion in Texas – an option granted to the states by last summer’s Supreme Court ruling. One source counts 14 states that have fully rejected accepting federal funds to extend health care coverage to low-income adults, while 20 states are fully participating in the expansion and 16 are undecided.

    A state certain to participate in the expansion is Colorado, my new home state. The bill to expand Medicaid to 330,000 Coloradans passed both chambers of the General Assembly last week. Once the Senate approves amendments to the House version of the bill, it will head to the desk of Gov. John Hickenlooper, who has pledged to sign it into law.

    In many respects (to the delight of this Texas native), the two states are very similar. Colorado has its urban capital, several other mid-size cities, and vast expanses of rural space. Residents also have a fierce loyalty to the state. And, until the past decade when control of the House, Senate, and the governor’s mansion has flip-flopped between the parties, Colorado has historically been conservative. The current split in the House is 37 Democrats, 28 Republicans. In the Senate, it’s 20 Democrats, 15 Republicans. And, of course, the governor is a Democrat.

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  • Standardization can relieve administrative burden, if we can get there

    Tags: administrative burden, standardization, health care reform

    Nov 16 2012 7:39 PM
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    The amount of time and money physicians and their staffs spend on the administrative tasks of medicine is astounding. A recent perspective article in the New England Journal of Medicine quantifies it this way: “The average physician spends 43 minutes a day interacting with health plans about payment, dealing with formularies, and obtaining authorizations for procedures,” and physician practices hire coding and billing staff “who spend their days translating clinical records into billing forms and submitting and monitoring reimbursements.”

    That translates to an annual cost of $361 billion spent on health care administration, and half of these expenditures are unnecessary.

    The authors argue that standardization is key to reducing administrative costs, and much of this can be achieved through health information technology and electronic health records. Though they say the only entity with the “clout” to push through standards in medical transactions is the federal government, measures in the Affordable Care Act and the Health Information Technology for Economic and Clinical Health Act (HITECH)—like instituting regulations on payers and providing incentives to physicians and facilities—may start us on the right path when previous efforts have failed.

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  • Money & Medicine: Reflections on the message

    Tags: money, medicine, end-of-life, care, pbs, health care reform, advance directive

    Oct 1 2012 8:00 PM
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    We have known for years that the payment system for health care services provides incentives for hospitals and physicians to run more tests and perform more procedures. Debuting this week, a PBS special “Money & Medicine” examines not only runaway health care spending, but also the danger patients face from over-diagnosis and over-treatment.

    “If you add up medical errors, drug interactions, and hospital-acquired infections, medicine itself is the third leading cause of death in this country,” one expert says in the film. And another, “I’m paid more when I harm my patients; I’m paid more when I do more, even when it’s not beneficial.”

    Contributing to the estimated 30 percent of U.S. health care spending—$800 billion a year—that pays for unnecessary services, the filmmakers identify several forces at play. First, briefly, the providers:  “One person’s waste is nearly always another person’s income, and income turns into strong political defenses of areas that are classic waste.” Next, the patients: Patients’ demands are changing the behavior of providers. And particularly in end-of-life care, the family can demand “full court” care regardless of the odds.

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