Two fellow AHCJ core topic leaders, Susan Heavey and Joseph Burns, have looked at aspects of the recent census report that documents a sharp decline in the uninsured rate. (Susan’s look at poverty and gender is here and Joe’s overview is here).
About 25 Washington, D.C., area journalists met on Sept. 30 to learn about how the Affordable Care Act was affecting a local brewery and discover how the district’s health insurance exchange was working to help such small employers gain coverage for their employees. Continue reading
There’s a lot of speculation about what outgoing House Speaker John Boehner may or may not accomplish in his last weeks in office.
Ending the acrimony about the Affordable Care Act is not one of them.
Not only is the House now rapidly moving ahead with another attempt to gut key sections of the law through a budget tool known as reconciliation (which President Obama would veto), Boehner has another ACA legacy. He was pivotal in filing the House of Representatives lawsuit charging that President Obama and his administration overstepped their authority in implementing the health law. Continue reading
In 2016, the definition of “small business” or “small group” market was supposed to change under the Affordable Care Act. Instead of covering businesses with up to 50 workers, the small group market would encompass businesses with up to 100.
But in a rare bipartisan move on ACA-related legislation this week, the House of Representatives, followed by the Senate, swiftly and quietly voted to make this change optional for states as part of what has become known as the Protecting Affordable Coverage for Employees Act (PACE). The House voted on Sept. 29 and the Senate on Oct. 1. Continue reading
For the past two months, new data on the rate of the uninsured in the United States have reached what appear to be historic levels.
Last week, the U.S. Census Bureau released the latest numbers, reporting that the percentage of Americans who were uninsured last year dropped by 2.9 percentage points from 2013, the largest percentage-point decline since 2008.
In an article for Kaiser Health News, Julie Rovner went further, quoting Paul Fronstin, director of health research for the Employee Benefit Research Institute. The decline of almost 3 percent is, “probably the biggest drop ever,” Fronstin said. Continue reading
We don’t usually post two consecutive items by the same health care reporter on different topics. But when I was trying to double-check a link on the last item based on Bruce Japsen’s work, I stumbled on another interesting post by him. This one is about how health reform is encouraging primary physician pay to rise more quickly than that of specialists.
Japsen reports in Forbes that primary care physician compensation rose nearly 3.6 percent last year to $241,273, according to the Medical Group Management Association (MGMA), an association of physician practice administrators.
Specialists make nearly twice that much – on average $411,852 in 2014 – but their rate of increase was a lower 2.39 percent from 2013.
And the gap was even wider in the prior year. In 2012, he writes, “pay of primary care doctors, which include family physicians, internists and pediatricians (rose) more than 9 percent while specialist total compensation rose just 3.9 percent.”
This isn’t going to close the gap. But it clearly is telling us something about how the shift away from fee-for-service to value-based medicine is taking root. Primary care is often at the center of these new models, which emphasize coordination, prevention, management of chronic conditions, and team-based care. In addition, hospitals are hiring more primary care doctors to capture outpatient revenue – which is also part of the “value-based” picture. And there is a shortage of primary care physicians.
“It’s a buyer’s market,” Dr. Halee Fischer-Wright, a pediatrician and MGMA’s chief executive officer, was quoted as saying. “Every system needs primary care physicians as they shift to value based care models.”
And that trend is likely to heighten amid the coming consolidation of health insurers who are pushing for more rapid transformation into value-based models.
A recent post by Bruce Japsen at Forbes makes a quick supplement to a post we did recently highlighting how hospitals are faring in Medicaid expansion states vs. nonexpansion states.
Japsen knows a lot about the business side of the hospital industry and has written about the ACA’s impact on hospital finance. Recently he’s been paying attention to second-quarter earnings reports of publicly traded hospital companies. (As he notes, it’s the sixth quarter since ACA coverage expansion began.) Continue reading
President Barack Obama’s trip to Alaska this week is aimed at highlighting climate change and the environment, but his health care overhaul has turned up in the news, too.
This particular story by Alaska Public Media’s Annie Feidt paints the Alaskan health landscape in full relief, profiling the state’s top health official amid wrangling over the expansion of Medicaid under the Affordable Care Act, or so-called Obamacare. Continue reading
Fred Schulte of the Center for Public Integrity took a look at the Patient-Centered Outcomes Research Institute (PCORI). Created by the Affordable Care Act, it’s supposed to spend $3.5 billion by the end of the decade to fund research to figure out what medical treatments work, or don’t work. That would be useful information as we try to figure out how to tame the nation’s $3 trillion health care bill. [Note: PCORI helps fund some of AHCJ’s health journalism training programs. See more at the bottom of this post.]
Late last month we wrote about criticism leveled at the federal government’s latest bundled payment proposal.
Since then, other experts have come forward to criticize not only the Comprehensive Care for Joint Replacement (CCJR) proposal announced last month, but also the Bundled Payments for Care Initiative (BPCI) program that began in April 2013. Both programs come from the federal Centers for Medicare & Medicaid Services.
You can find detailed criticism of CCJR from Harold Miller, president of the Center for Healthcare Quality and Payment Reform, on the CHQPR’s blog, and from Suzanne Delbanco, executive director of Catalyst for Payment Reform, and Francois de Brantes, executive director of the Health Care Incentives Improvement Institute (HCI3), on the Health Affairs blog. For an explanation of how CMS can improve the BPCI program, see this HCI3 blog post from de Brantes. Continue reading