“Medicare is fining a record number of hospitals because they readmitted too many patients within 30 days for more treatment, according to federal records released this week.
During the next year, 2,610 hospitals will see their reimbursement levels reduced and 39 hospitals will be hit with the largest penalty allowed, according to Kaiser Health News.
The federal government’s penalties are designed to make hospitals pay more attention to their patients after they are discharged.”
“When Congress passed the Affordable Care Act, it required health insurers, hospitals, device makers and pharmaceutical companies to share in the cost because they would get a windfall of new, paying customers.
But with an $8 billion tax on insurers due Sept. 30 — the first time the new tax is being collected — the industry is getting help from an unlikely source: taxpayers.
States and the federal government will spend at least $700 million this year to pay the tax for their Medicaid health plans. The three dozen states that use Medicaid managed care plans will give those insurers more money to cover the new expense. Many of those states – such as Florida, Louisiana and Tennessee – did not expand Medicaid as the law allows, and in the process turned down billions in new federal dollars.”
“The top executive for H&R Block, the nation’s largest tax preparer, on Wednesday said he expected President Obama’s health care law to add “significant complexity” to next year’s tax season.
Speaking on H&R Block’s quarterly earnings conference call, CEO William Cobb said that the company was already taking steps to train its tax preparers based on the draft forms that the Internal Revenue Service has released to comply with Obamacare.
“As expected, the forms are very detailed and can present significant complexity, depending on a filer’s coverage status during the year, income level, and household composition,” Cobb said. “Depending on their situation, there are instances where filers may need to file multiple new tax forms and complete additional worksheets.””
“Last week, the Department of Health and Human Services announced that the number of insurers participating in state marketplaces was on the rise. But it didn’t say whether that improved competition was taking place everywhere, or just in the urban markets that already had a lot of insurance carriers.
The week before, it announced that 7.3 million Americans were currently enrolled in marketplace plans created by the Affordable Care Act. But it didn’t share a breakdown by health plan, state, age or income.”
“Who’s up for the latest batch of bad Obamacare-related news?
(1) Consumers brace for the second full year of Obamacare implementation, as the average individual market premium hike clocks in at eight percent — with some rates spiking by as much as 30 percent.
(2) “Wide swings in prices,” with some experiencing “double digit increases.”(Remember what we were promised):
Insurance executives and managers of the online marketplaces are already girding for the coming open enrollment period, saying they fear it could be even more difficult than the last. One challenge facing consumers will be wide swings in prices. Some insurers are seeking double-digit price increases…”
“Last month’s launch of the Apple Watch is indicative of the big potential that companies are seeing in digital health. And the market is buying into digital health in a big way, judging by the record amount of money these firms have been raising this year.
Through the first nine months of 2014, digital health companies have raised $5 billion, almost double what they did in all of 2013, according to publicly reported data compiled by StartUp Health. The actual number of deals are on a slower pace this year, which StartUp Health says is an indication that the relatively young market is maturing.”
“One year ago, every network, every member of Congress and certainly HHS and CMS watched or tried to log into HealthCare.gov. It proved to be a long, long wait. The collective frustration at the end of the day was the site did not work.
Despite repeatedly assuring both Congressional committees and the American public that the new marketplace and this bold new experiment on shopping for government controlled health insurance was to be smooth as silk and easy as pie, the rollout was a colossal failure for the HHS Secretary and her team. Ultimately, she admitted being responsible for the ‘debacle’ but not much has been done to eliminate the problems and clean up the process. HealthCare.gov is still broken.
The rollout was a failure, but my hope is the bureaucracy has learned some lessons. Here are five things I hope we can file away as lessons learned.”
“During the Patient Protection and Affordable Care Act’s first period of open enrollment October 2013 – March 2014, an estimated fourteen million people enrolled for health coverage through the new private insurance Marketplaces (8 million) and through Medicaid (6 million). To facilitate this substantial volume of enrollment and enrollment-related activities, approximately 4,400 Marketplace Assister Programs employing more than 28,000 full time-equivalent staff and volunteers served consumers nationwide. All Assister Programs were expected to help consumers understand their coverage options, apply for financial assistance, and enroll (see Appendix 1). Additional functions undertaken by many assisters included outreach and education; help with post-enrollment questions and problems; assistance with appeals of eligibility determinations; and help applying for other public benefits and services.
The emergence of Marketplace Assister Programs around the country is a significant health policy innovation. The majority of programs that were operational in 2013-14 needed to organize, launch and scale up quickly to be ready for the ACA’s first open enrollment period. Because so many programs were new or substantially expanded their scope during this first year, this period was also characterized by both the need and opportunity for widespread “learning by doing.” Several surveys conducted during or just at the close of 2013-14 Open Enrollment have already begun to assemble valuable data about: consumers’ experiences with assisters; assisters’ self-reported experiences; and best practices and lessons emerging from specific states or assister-related initiatives.1”
“Former HHS insurance oversight chief Jay Angoff has filed a lawsuit against the department for not making 2015 rate filings public, arguing the administration is not abiding by its own regulations on disclosing the information.
Responding to the lawsuit, an HHS official said the agency will publish the rate information prior to the beginning of open enrollment. HHS Spokesperson Ben Wakana told Inside Health Policy late Wednesday (Oct. 1): “We are readying the rate change information. The department is committed to providing consumers accurate information so they can make informed decisions, and therefore, before the beginning of Open Enrollment, the agency will publish final insurance rates for all 50 states.””
“Consumer Reports has published an article demanding that we get “mad about the outrageous cost of health care.”
Hey, I’m all for that. The article goes through the usual list of suspects, e.g. $37.50 for a single Tylenol, having two or three MRI scans when one will do, et cetera. The article also asserts that “health care works nothing like other market transactions. As a consumer, you are a bystander to the real action…” I could not agree more. However, I was a taken aback by a statement from George Halvorson, the former Chairman of Kaiser Permanente:
“There is no such thing as a legitimate price for anything in health care,” says George Halvorson, former chairman of Kaiser Permanente, the giant health maintenance organization based in California. “Prices are made up depending on who the payer is.”