Finally, we may be seeing the beginning of the end of fee-for-service payment.
In an announcement Monday, the federal Department of Health and Human Services set two goals for changing how Medicare will pay for care, making the most significant change in payment in its 50-year history. First, HHS Secretary Sylvia Mathews Burwell said that next year, 30 percent of all payment to Medicare providers would be in alternative payment programs that reward hospitals and physicians for how well they care for patients rather than how much care they provide.
By 2018, 50 percent of payments would go into alternative payment programs, such as accountable care organizations, patient-centered medical homes and bundled payments, she wrote.
“In alternative payment models, providers are accountable for the quality and cost of care for the people and populations they serve, moving away from the old way of doing things, which amounted to, ‘the more you do, the more you get paid,’” Burwell added. Continue reading
Reporters facing unreasonable delays or inadequate responses from media officials at an agency of the U.S. Department of Health and Human Services (HHS) can bring their complaints to one of three deputy assistant secretaries for public affairs.
In a phone conference on Wednesday between top HHS media officers and AHCJ board members, these officials were named as contacts for reporters having difficulties. Their names and the agencies whose media offices they oversee are listed below.
The phone conference was one in a regular series in which leaders of AHCJ’s Right to Know (RTK) Committee work with the HHS public affairs office to improve government transparency and access to information and experts.
As chair of the RTK committee, I joined board President Karl Stark and RTK Vice Chair Felice J. Freyer in representing AHCJ. We spoke with Dori Salcido, assistant secretary for public affairs, News Division Director Bill Hall, and Deputy Assistant Secretary Mark Weber. Continue reading
Photo by Len Bruzzese
Louis Sullivan, M.D., recounted his decades of service to medicine to attendees of Health Journalism 2014 on Thursday at the Grand Hyatt in Denver.
In a conversation with Andrew Holtz, Sullivan touched on his experience as the only African American student in his Boston University School of Medicine class in the 1950s, the founding dean and president of the Morehouse School of Medicine in Atlanta and the secretary of the Department of Health and Human Services under President George H. W. Bush.
“Racism is really such a complex thing,” he said. “There’s no easy way to define it,” Sullivan told Holtz when asked about the doctor’s upbringing in the segregated south.
“I think we’re a much better country now than we were 30 to 40 years ago,” he added. Continue reading
The recently released 2014 work plan sets up how the Inspector General’s office of U.S. Department of Health and Human Services will scrutinize claims CMS pays to hospitals, nursing homes, and home care agencies, as well as for prescription drugs, medical equipment and other care services. Continue reading
The U.S. Department of Health and Human Services has released the much-anticipated numbers for the first month of enrollment in the ACA’s insurance marketplaces.
A quick breakdown from the press release:
- 975,407 customers have gone through the process but have not yet selected a plan
- 106,185 Americans selected health plans
- 396,261 assessed or determined eligible for Medicaid or CHIP
The 28-page issue brief (PDF) from HHS has plenty of other numbers, including those for individual states and draws comparisons between the healthcare.gov rollout and the launch of other programs, including the Federal Employees Health Benefits Program, Medicare Part D, Massachusetts’ Commonwealth Care, and the Children’s Health Insurance Program.
Image by Eric Allix Rogers via flickr.
So you have a great medical study to cover – interesting topic, compelling results. All you need is an interview with the study’s authors to help bring the research home to readers.
That’s where things get tricky. The researcher you need to connect with before your oh-so-tight deadline has letters in his or her affiliation that don’t bode well for timely interviews: FDA, HHS, USDA, CMS.
Scoring an interview with a scientist who works for a government agency can be frustrating and full of dead ends. It shouldn’t be. AHCJ’s Right to Know Committee is working on improving reporters’ access to a number of government agencies.
But change is slow. And your deadlines won’t wait. What can you do today for a story that’s due tomorrow? Continue reading
Despite the Obama administration’s focus on cutting health care costs and fraud in the Medicare and Medicaid systems, the office charged with investigating such things plans to cut 400 staffers by the end of 2015.
Fred Schulte at The Center for Public Integrity reports that the news came to light during a June 24 congressional hearing about prescription drug abuse in Medicare.
The Department of Health and Human Services’ Office of Inspector General is responsible for investigating fraud and abuse in the system. Last year the office shut down investigations into 1,200 complaints because of a lack of resources, according to Gary Cantrell, deputy inspector general for the OIG Office of Investigations.
Cantrell blames the cuts on “a mix of budgetary issues which he called ‘expiring funding streams.’” Schulte reports that no one at HHS would discuss the situation.
Schulte has previously reported on electronic health records and linked them to higher health care costs. He points out one potential impact of the cuts:
One major project that’s likely to be scaled back is an ambitious plan to “identify fraud and abuse vulnerabilities” in electronic health records. The federal government is spending about $36 billion in economic stimulus funds to help doctors and hospitals purchase the digital technology in the hopes that it will ultimately reduce waste from duplicative tests and make health care more efficient and less costly.
The OIG’s 2013 Work Plan outlines the office’s focus and new and ongoing projects, including reasonableness of Medicare payments, coding of medical equipment claims, questionable billing patterns, review of claims submitted by “error-prone” providers and more. Meanwhile, ProPublica, the Center for Public Integrity, The Wall Street Journal and other publications have documented fraudulent and wasteful practices in Medicare.
For some Friday fun … Sarah Kliff did a blog post for The Washington Post’s Wonkblog on “99 things” that have to happen in the 99 days between her post and Oct 1. OK, she cheated a little:
2. Washington state must launch a health insurance exchange
3. Oregon must launch a health insurance exchange
4. California must launch a health insurance exchange
5. Idaho must launch a health insurance exchange
6. Hawaii must launch a health insurance exchange
7. Colorado must launch a health insurance exchange
Image by Peter Kaminski via flickr.
But she’s still got some useful information on what’s on the states’ and the feds’ to-do list which helps you understand the technical complexity of this undertaking.
And don’t forget to check out number 99. Which, quite frankly, has nothing to do with health care but we can all learn about baby otters.
A headline in The New York Times recently confused some people – initially including me.
“States Will Be Given Extra Time to Set Up Health Insurance Exchanges,” the paper said on Jan. 15.
Initially I thought the Department of Health and Human Services had delayed the start of the exchanges – which would have been really big news (and I couldn’t imagine how I missed it).
But the exchanges aren’t being pushed back (despite the periodic spates of rumors in Washington that they will be…) Enrollment starts in October 2013. The exchanges will have to be up and running on Jan. 1, 2014 – although I don’t think any of us will be surprised if some states’ exchange debuts are bumpier than others. What the states ARE getting is extra time to make a decision about their exchange – or maybe to reconsider their decision. For states that are running their own exchanges, nothing changed. The deadline was in December and, with a very few exceptions (more below), those decisions are made.
The extra flexibility is for the rest of the states – most of which are letting the federal government run the exchange, and some of which will have a “partnership” exchange, with the federal government doing most of it but the state assuming some functions. The deadline for that decision – fully federal or partnership – is Feb. 15. That’s where HHS is giving them wiggle room. Continue reading
The Department of Health and Human Services has revised its media guidelines, in response to some of the issues raised by AHCJ members. The revisions take effect today.
The changes, which all appear on page 5 of the guidelines for HHS staff (PDF), are as follows:
- In the section prohibiting nonemployee contractors from speaking for the agency, HHS has added the sentence, “Exceptions to this practice may be considered on an individual basis.” This was in response to a member’s complaint that she had been barred from speaking with a contractor who was the only person knowledgeable about the subject of her story.
- This sentence was added: “Meetings that are open to the public are, by definition, open to the media.” This was in response to AHCJ’s complaints about a series of “listening sessions” held last fall across the country from which the news media was excluded.
- The paragraph concerning attribution was clarified. It now says: “As a matter of routine, media interviews should be on the record and attributable to the person speaking to the media representative, unless an alternate attribution arrangement is mutually agreed upon in advance. HHS recognizes the following types of attribution: …” The document then provides definitions for “on the record,” “not for attribution,” “on background” and “off the record.” The previous version, which lacked the definitions and the phrase “As as matter of routine,” had led some to conclude that not-for-attribution interviews were barred.
HHS declined to remove one clause that has troubled some members: The requirement that employees “coordinate with the appropriate public affairs office/personnel” before doing an interview.
The guidelines were first issued in September, after AHCJ requested written ground rules. Journalists were told then that the document was final and in effect, but could be changed in response to questions or complaints. AHCJ members responded with their concerns and AHCJ shared them with the agency, resulting in these changes.
The same applies to the revisions. Dori Salcido, assistant secretary for public affairs, said she welcomed input from AHCJ members about the guidelines. Please send your reactions to the chair of AHCJ’s Right to Know Committee, Felice Freyer (firstname.lastname@example.org), so any new concerns can be conveyed to HHS.