In this summary, you’ll find info on a new program that awards Medicaid patients, the movement of Medicaid and Medicare-eligible patients into managed care, a study on physician’s salaries, and more!
Health Impacts from Hurricane Sandy
In the wake of Hurricane Sandy, Governor Cuomo has sought significant federal resources to help clean-up and rebuilding efforts in New York. As part of that relief package the state is seeking $3.1 billion for damaged hospitals and other healthcare facilities and more funds to pay for protection against future flooding. This amount does not include a $427.3 million request to Medicaid for emergency cash relief for hospitals and other healthcare facilities with damage or disrupted operations from the storm.
Medicaid & Medicare
Gannett reports that New York will be using a $10 million dollar grant made available under the Affordable Care Act, to begin rewarding Medicaid recipients for engaging in healthy behavior. The program, called the Medicaid Incentives for Prevention of Chronic Diseases, will target 16,700 Medicaid participants who are smokers, have high blood pressure or are diabetic. The program’s participants will receive payments of up to $250 dollars to lose weight, attend smoking-cessation counseling, fill prescriptions related to their illness, and reduce blood pressure levels (Bakeman, 11/26).
Assemblyman Gottfried, the Chair of the Assembly Health Committee, and Assemblyman Hevesi, the Chair of the Assembly Committee on Oversight, Analysis and Investigation will be holding a public hearing on the transition of Medicaid populations into Medicaid Managed Care. The hearing will be held on December 7th in New York City and will explore how the transition of the Medicaid population into Managed Care has impacted patients and services providers.
New York State is in the process of moving the 124,000 people who are eligible for both Medicaid and Medicare into managed care by 2014. A new report from the United Hospital Fund examines the proposed capitation payment method for the new Fully Integrated Duals Advantage (FIDA) program. The report analyzes the features of the FIDA program: eligibility and enrollment, benefits and network adequacy, financing and payment, performance monitoring and quality measurement, and consumer protections. It also lays out a timeline of key milestones for the next two years.
The Wall Street Journal reports that raising the eligibility age for Medicare to 67 from 65 has garnered renewed interest with policy makers looking to avoid the fiscal cliff. Supporters of the concept argue that life expectancies have increased since Medicare was set up in 1965 and that the eligibility age needs to reflect that trend. Proponents of the change also argue that access to insurance coverage under the Affordable Care Act will provide coverage until individuals are eligible for Medicare. Opponents of the measure caution that while raising the eligibility age for Medicare will reduce government costs in the Medicare program it will increase the premium costs for people already enrolled in Medicare. This is because the 65-and 66-year olds are the youngest healthiest people and would be taken out of the Medicare risk pool (Radnofsky, 11/27).
A new report from the Office of the Inspector General in the Department of Health and Humans Services warns that the shift to electronic medical records encouraged by the Affordable Care Act is ripe for fraud and abuse by providers due to a lack of administrative safeguards. Doctors and hospitals can qualify for incentive payments for the switch to electronic medical records if they demonstrate that the new system leads to better patient care and meet a “meaningful use” standard. The report faults Medicare officials, who are responsible for managing the electronic medical record incentive program, for their failure to adopt procedures that would ensure that information being provided by hospitals and doctors about their system is accurate.
Reuters profiles the issue of physician compensation in an article that examines the findings of a study on the salaries of the health care professionals. While physicians who practice in specialty areas continue to garner higher salaries, doctors practicing in the primary care fields have not seen a growth in earnings in the past decade. The researchers who conducted the study have concerns that the lagging compensation will only contribute to the growing shortage of primary care doctors (Pittman, 11/27).
USA Today profiles the rise of deadly drug resistant bacteria infections in health facilities around the country and efforts by hospitals and physicians to stave off infections. The bacteria, known as Carbapenem-Resistant Enterobacteriaceae, or CRE, are able to resist the strongest antibiotics in health care providers’ arsenals. Death rates among patients with CRE infections are high and there is a growing concern that CRE could make its way beyond health facilities and into the general community (Eisler, 11/29).
-Jaime Venditti, 11/30/12