“A key government experiment that set out to lower costs and coordinate care for Medicare patients — now the blueprint for an innovation the Obama administration is trying to move to a national scale — has failed to save a substantial amount of money. The five-year test enlisted 10 leading health systems around the country and offered financial bonuses if they could save enough by treating older patients more efficiently while providing high-quality care.”

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“Despite advice from most free-market analysis, some Republican governors are executing the Patient Protection and Affordable Care Act (PPACA) by establishing Health Benefits Exchanges. These governors dislike PPACA, but they believe that exchanges can be vehicles for more choice than the federal law anticipates.
But I think that the real news is how much difficulty states that want to implement PPACA as fast as possible are having. “

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“Are small-business owners taking advantage of a new tax credit made available last year under the Affordable Care Act?
The Small Business & Entrepreneurship Council, an advocacy group that has been critical of the health-care law, says no – and offers its own research indicating that owners aren’t finding the tax credit useful or applicable to their companies… The SBE Council polled a random sample of 304 small-business owners and found that only 7% have taken advantage of the health-care tax credit.”

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“I’ve predicted that lots of parts of Obamacare will not work the way they’re expected to. But here’s one I wouldn’t have predicted: the high-risk pools, which were meant to tide people over until 2013, have signed up just 18,000 people as of March. There were supposed to be millions of people who were uninsurable because of pre-existing conditions. We heard lengthy testimony about their terrible plight… It was estimated by Medicare’s Chief Actuary that around 400,000 would sign up… The administration is now loosening the requirements (you just need a note from a doctor or nurse saying you’ve been sick in the last year) and lowering premiums. But this doesn’t mean that they’re finally covering more ‘uninsurables’; it just means they’ve decided to use the money allocated for those people to cover someone else. They’re changing the “high-risk pools” to something that looks a lot more like simply subsidizing insurance.”

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“The folks at The Cleveland Clinic, a highly integrated provider organization that has been touted as a model for the sort of team-driven health care that ACOs are supposed to encourage, aren’t buying the promises made by the administration and its backers. Last month, I noted that the Clinic was disappointed with the regulations. Since then, its officials have expanded their criticism in a new letter written to Medicare director and superstar ACO-wonk Donald Berwick.”

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“The feds argue that folks without insurance affect commerce when they consume care without paying for it. Providers then pass along the cost of that uncompensated care to those with insurance.
But requiring everyone to buy insurance will not solve this problem. In fact, the individual mandate will result in higher uncompensated care costs.
The cure, so to speak, is worse than the disease.”

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“Now, with 50 uncompetitive state markets and new federal regulations on what is or isn’t an acceptable insurance plan on top of existing state laws, there will actually be less room for price-cutting competition in health care. You can expect insurance costs to rise as a direct result.”

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“Physician Hospitals of America (PHA) has filed a formal notice of appeal in its ongoing battle against growth restrictions in the healthcare reform law that make it nearly impossible for physician-owned hospitals to expand, according to PHA.
PHA and its coplaintiff, Texas Spine and Joint Hospital in Tyler, Texas, are arguing that provisions that prevent new or expanding physician-owned hospitals from qualifying for Medicare are unconstitutional, as well as limit patient access to high-quality hospitals.”

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“The White House conveniently failed to notice the program’s problems during the health care debate. But last fall, the president’s own fiscal commission officially called for a total repeal of the program. At this point, even Obama’s top health care officials won’t stand behind the program’s worthless fiscal design. ‘While the law outlined a framework for the CLASS Act,’ Health and Human Services Secretary Kathleen Sebelius told members of Congress in February, ‘we determined pretty quickly that it would not meet the requirement that the act be self-sustaining and not rely on taxpayer assistance.’ Whoops!”

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“The law’s spending path depends on making providers pay for all the future Medicare shortfalls. But since no one can force health-care providers to show up for work, short of a health-care provider draft this reform ultimately cannot succeed. The House Republican path, on the other hand, would make a sum of money available to each senior to choose among competing private plans—much the way Medicare Advantage provides insurance today for about one out of every four Medicare beneficiaries.”

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