Tuesday, December 30, 2014
Monday, December 29, 2014
Sunday, December 28, 2014
Friday, December 26, 2014
Wednesday, December 24, 2014
Tuesday, December 23, 2014
Monday, December 22, 2014
Grim outlook for healthcare, hospital sector in 2015: rating agencies
Grim outlook for healthcare, hospital sector in 2015: rating agencies
BY ROBIN RESPAUT Tue Dec 16, 2014
(Reuters) - The outlook for non-profit healthcare remains dour for 2015, as hospital operating margins continue to face pressure from rising costs and weaker reimbursement.
The three major credit ratings agencies gave the healthcare and hospital sector a negative outlook next year, citing anticipated downgrades, declining operating cash flows, and on-going uncertainties surrounding the implementation of the Affordable Care Act.
"The negative pressures facing most providers are widespread," said Martin Arrick, services analyst with Standard & Poor's Ratings. "Many providers will not be able to adapt."
S&P forecasted more downgrades than upgrades among not-for-profit healthcare providers for a third consecutive year, as operating margins are pinched by rising costs. "There would likely have been more downgrades in 2014 if not for the high level of merger and acquisition activity which often precluded downgrades and in many cases led directly to upgrades," S&P said in its 2015 outlook.
Moody's Investors Service anticipated another 12 to 18 months of weak performance, with large hospital systems faring better from economies of scale and the ability to drive revenue growth through expanded services.
"The largest hospitals are getting stronger, while the smaller hospitals get weaker," Moody's senior analyst Daniel Steingart said.
Many hospitals have exhausted the low-hanging fruit for cost-cutting. At the same time, hospitals are expected to shift away from the traditional fee-for-service models, in which more patient services led to more revenue. The Affordable Care Act and purchasers of healthcare are now emphasizing preventative care and reduced hospital stays.
That trend might be good news for the 43 million Americans grappling with overdue medical debt, according to the U.S. Consumer Financial Protection Bureau, but not so for hospitals that historically counted on healthcare spending to balance operating budgets.
Fitch Ratings said more uncertainty is on the way, as Republicans with Congressional control vow to repeal or defund parts of the Affordable Care Act. That would "hamper the sector's ability to adapt and plan," Fitch said.
The rating agency was closely following an upcoming U.S. Supreme Court decision in the King vs. Burwell case, in which the court could effectively invalidate insurance coverage purchased through federally operated state exchanges.
"The hospital sector has navigated many challenging environments in the recent past, but the upcoming years represent a true transition as the core model of healthcare delivery and reimbursement is undergoing redesign," said James LeBuhn, Fitch senior director.
Enrollment in Medicaid Managed Care Grows Faster Than Fee-For-Service
Enrollment in Medicaid Managed Care Grows Faster Than Fee-For-Service
By Rebecca Adams, CQ HealthBeat Associate Editor
The number of Medicaid beneficiaries enrolled through private managed care plans is growing faster than the number of people entering the traditional program, according to an analysis released Wednesday by a trade group representing health plans.
The study, done by the PricewaterhouseCoopers accounting firm for the Medicaid Health Plans of America, found that 9.3 million more Medicaid beneficiaries were in managed care plans in 2014. The number in Medicaid fee-for-service programs fell for the first time, dropping by 300,000 enrollees, according to the report.
The total increase in the number of Medicaid beneficiaries from 2013 to the end of September was about 9 million people, according to the report and federal statistics.
Forty states, up from 37 last year, use private Medicaid plans to deliver services to beneficiaries, according to a presentation on Capitol Hill Wednesday by PwC Health Industries Payer Strategy Director Ari Gottlieb. The jurisdiction with the highest percentage of Medicaid enrollees in managed care is Washington, D.C., followed by New Mexico. The states with the lowest percentage in managed care are Utah, followed by Virginia.
The total number of plans grew from 176 Medicaid plans last year to 184 plans this year, according to Gottlieb. Of those, 166 plans serve just one state. The average number of people in the plans is 134,000 beneficiaries. However, 10 large companies oversee care for more than a million people. The largest Medicaid health plans are UnitedHealthCare, with more than 4.4 million members in 21 states, and Anthem, with 4.3 million members in 17 states. Other companies with a Medicaid population of more than 1 million people include Centene, Molina, WellCare, LA Care, Aetna, HealthNet, Care Source and AmeriHealth Caritas.
“As more states like Tennessee, Indiana, and Utah endorse Medicaid expansion, it only make sense that they do so with the help of Medicaid managed care,” said Jeff Myers, president and CEO of Medicaid Health Plans of America, in a statement. “The risk-based capitated model brings the budget predictability that is key to managing the influx of new Medicaid beneficiaries
Myers had indicated in a talk in early November that 9 million people had joined Medicaid over the past year and that managed care was a growing part of the program. The study provides additional details.
Federal officials are working on a proposed rule that will make changes to policies for Medicaid managed care.
Thursday, December 18, 2014
Wednesday, December 17, 2014
Tuesday, December 16, 2014
Monday, December 15, 2014
Sunday, December 14, 2014
Friday, December 12, 2014
Wednesday, December 10, 2014
Tuesday, December 9, 2014
Monday, December 8, 2014
Sunday, December 7, 2014
Thursday, December 4, 2014
Wednesday, December 3, 2014
Tuesday, December 2, 2014
Monday, December 1, 2014
Sunday, November 30, 2014
Friday, November 28, 2014
Tuesday, November 25, 2014
Monday, November 24, 2014
Poll: Majority says universal healthcare is not government role - The Hill
Poll: Majority says universal healthcare is not government role
By Sarah Ferris - 11/20/14 The Hill
Slightly more than half of Americans believe that the federal government is not responsible for providing universal healthcare, according to a Gallup poll released Thursday.
The survey reflects a different national attitude than just eight years ago, when nearly 70 percent of people believed the government should provide healthcare coverage for all.
The shifting viewpoint spans the election of President Obama, who entered office with a pledge to expand insurance coverage. The reversal of opinion suggests a “significant backlash” of the government’s far greater role in healthcare now, Gallup's Editor-in-Chief Frank Newport wrote.
Since Obama passed his signature healthcare law, the number of people who said universal healthcare is not a government role climbed from 41 percent in 2008 to a high of 56 percent in 2013.
That number partly declined this year, which marks the first year after the healthcare exchanges went into effect and millions of people gained insurance for the first time.
Unsurprisingly, people were far more likely to say government should provide healthcare if they supported the Affordable Care Act, which aimed to widely expand coverage though not universally.
Overall, support for ObamaCare remains on par with the president’s low favorability ratings nationally, though a growing number of people have said they are pleased with their healthcare coverage without specifically mentioning the still unpopular law.
Thursday, November 20, 2014
Wednesday, November 19, 2014
Tuesday, November 18, 2014
Monday, November 17, 2014
Thursday, November 13, 2014
Wednesday, November 12, 2014
Tuesday, November 11, 2014
Monday, November 10, 2014
Thursday, November 6, 2014
Wednesday, November 5, 2014
Monday, November 3, 2014
Sunday, November 2, 2014
Friday, October 31, 2014
Thursday, October 30, 2014
Georgia Insurance Commissioner Ralph Hudgens has required Blue Cross Blue Shield of Georgia to immediately rescind recent amendments to their existing physician contracts.
Georgia Insurance Commissioner Ralph Hudgens has required Blue Cross Blue Shield of Georgia to immediately rescind recent amendments to their existing physician contracts.
Commissioner Hudgens’ action comes in response to numerous complaints from physicians regarding the insurer’s amendments to existing contracts. Complaints focused on lack of clarity in the terms of the contract, including the actual amount doctors would be reimbursed for providing medical services.
“This action resets the process while at the same time preserving the existing physician agreements without the amendments,” Hudgens said. “Georgia consumers will have continuous access to their Blue Cross contracted doctors and will not be impacted by this action.”
Please read Commissioner Hudgens’ news release for complete information. The Georgia Society of the American College of Surgeons (GSACS) will keep you updated on further developments as they occur.
www.oci.ga.gov/ExternalResources/Announcements/NewsReleaseInsurance-10292014-173.pdf
Wednesday, October 29, 2014
Tuesday, October 28, 2014
Monday, October 27, 2014
Thursday, October 23, 2014
Tuesday, October 21, 2014
POLITICO poll: Alarm, anxiety as election looms
POLITICO poll: Alarm, anxiety as election looms
By ALEXANDER BURNS | 10/20/14
An overwhelming majority of voters in the most competitive 2014 elections say it feels as if events in the United States are “out of control” and expressed mounting alarm about terrorism, anxiety about Ebola and harsh skepticism of both political parties only three weeks before the Nov. 4 midterms.
In a POLITICO poll testing the hardest-fought states and congressional districts of the year, two-thirds of likely voters said they feel that the United States has lost control of its major challenges. Only 36 percent said the country is “in a good position to meet its economic and national security” hurdles.
If no individual issue has come to define this election — like health care in the 2010 
campaign or the Iraq War in 2006 — the accumulation of disparate fears has created a sense of pessimism and frustration across the midterm landscape.
The public distress manifests itself across a range of issues:
- Terrorism: Eighty-four percent of voters say the Islamic State of Iraq and the Levant poses a “serious” threat to the U.S. homeland, including 43 percent who say it poses a “very serious” threat. Just 12 percent said the Islamic State, also known as ISIS, is not a serious concern.
- Health care: Most voters believe their health care costs will go up under the Affordable Care Act. Fifty-seven percent said they believe their personal costs will increase, while only 7 percent said they will decrease. A third said their costs would remain the same. (At the same time, support for repealing Obamacare has continued to drop, now down to 41 percent.)
- Presidential management: Voters in the midterm battleground states are evenly split on whether President Barack Obama or George W. Bush was more effective at managing the federal government. Thirty-eighty percent named Bush, while 35 percent preferred Obama. A quarter of respondents said the two men were equally competent.
- Ebola: Only 22 percent of respondents said they had a lot of confidence that the government is doing everything it can to contain the contagious disease. Thirty-nine percent they had some confidence, while a third said they had little or no confidence. The poll concluded Oct. 11, before the hospitalization of the second nurse who treated an Ebola patient in Dallas.
Virginia voter Amaris Landecho, 33, said her main concerns this year were largely about the “economy and the housing market” until Ebola came along, raising questions about “whether the government is prepared to handle issues like this.”
“My mind tells me they are not prepared for this, but my heart is filled with hope that they are,” said Landecho, who works at a military hospital and expects to vote Democratic. She added: “I’m upset with Congress — the whole thing, Democrat or Republican. It doesn’t matter.”
Charlene Pierson, a retired church secretary in Michigan, said she thinks the Ebola scare is “very, very hyped up,” but has concerns about Obama’s leadership style overall. “The man has spent most of his time not knowing what’s going on in his own government, and he’s supposed to be commander in chief,” said Pierson, 68, who plans to vote Republican.
The atmosphere of fear and anxiety has not produced a decisive advantage for either party on the congressional ballot. Forty-four percent of voters said they would vote for Democrats next month, while 41 percent said they preferred Republicans. That represents a tiny shift in the Democratic direction since POLITICO’s last poll, in early September, well within the margin of error.
The new poll, designed by SocialSphere Inc. and conducted by the research firm GfK, tested 840 likely voters in competitive U.S. House and Senate races. The poll was conducted online using GfK’s KnowledgePanel methodology, which is also employed by The Associated Press. The poll ran from Oct. 3 to 11 and has an overall margin of error of plus or minus 4.2 percentage points.
Republicans appear likely to prevail in many of the hardest-fought races of the year and stand a good chance of taking control of the Senate. In the bigger picture, however, there is little to indicate that the GOP has rehabilitated itself in the eyes of voters since its setbacks in the 2012 presidential election.
The Republican Party continue to trail heavily among young and nonwhite voters, losing Hispanics by 25 points, African-Americans by 74 points, women by 5 points and every age group of voters under 65.
But the GOP maintains important leads among whites (12 points), voters over 65 (12 points) and men (4 points) — advantages that are likely to prove decisive on a midterm electoral map tilted toward less diverse and more conservative states in the South and Mountain West.
Voters disapprove of congressional Republicans by a 40-point margin, 70 percent to 30 percent, including 38 percent who strongly disapprove of the Hill GOP. For Democrats, the numbers are only a bit better: 61 percent disapprove and 38 percent approve.
Asked which party is closer to big business and Wall Street, 39 percent of respondents said it was Republicans versus only 9 percent who said it was the Democrats. Fifty-one percent said both parties were equally close to big business and the financial sector.
Malcolm Carter, a retired schoolteacher in Kentucky, said he planned to vote Republican — and support Senate Minority Leader Mitch McConnell for another term — as “the lesser of two evils.” “I think the Democratic Party is leading us down a road that we can never recover from,” said Carter, 73. “Not that Mitch McConnell is my favorite.”
While the economy and other domestic issues still reign supreme, voters have shifted their attention noticeably toward national security since POLITICO began polling the midterm battleground races earlier this year.
In May, half of likely voters named economic issues as their chief concerns, while only 6 percent named national security, foreign affairs or terrorism.
Now, those numbers are 40 percent for the economy and 22 percent for national security, foreign affairs and terrorism.
And the same pool of voters that expressed intense resistance to U.S. military intervention overseas in a July POLITICO poll now say they are more concerned about terrorism against the homeland (60 percent) than the possibility of another “drawn-out U.S. war in Iraq” (39 percent.)
Elizabeth Ivey, an insurance agent in Panama City Beach, Florida, said she feels that national security issues have become “a constant” in U.S. politics. “If it’s not one thing, it’s another that’s coming up,” said Ivey, 48, who intends to vote Republican. “I am worried about ISIS; I think it’s something that we need to keep over, away from our country. I do support us going over there and fighting in the Middle East.”
Changes Pondered in How to Pay Accountable Care Organizations
Changes Pondered in How to Pay Accountable Care Organizations
By Rebecca Adams, CQ HealthBeat Associate Editor
A top Medicare official suggested Monday that federal officials planning to release a proposed rule soon may be rethinking the way that accountable care organizations are paid.
Centers for Medicare and Medicaid Services Deputy Administrator Sean Cavanaugh said at a Brookings Institution forum that “the new rule will be out shortly” and officials will “hopefully have a final rule early next year.”
One complaint that current Medicare ACO participants have is that the health care alliances must save a certain amount of money before they can share in the savings.
Another concern is that the cost targets that ACOs are expected to hit are tied to national increases in Medicare spending. Some ACOs say that costs in their communities are rising higher than the national average.
If ACOs significantly reduce their costs in the short run, providers can share in the savings. But it may make it more difficult to reap long-term savings if federal officials expect even deeper reductions in the future.
If an ACO has saved a lot of money, its federal budget target could be lowered. Hitting that lower target may be difficult, and providers fear that they may not be able to reduce costs further in order to get bonus payments in the future.
The task of meeting lowered spending targets may be even more difficult in the current era, when Medicare costs are growing at a historically low rate.
Cavanaugh recognized the challenges.
“We need to improve the incentives that the ACOs receive, improve the information and help build the capacity of the ACOs,” he said.
Cavanaugh said that federal officials are listening to the concerns of providers that are part of ACOs.
“We heard quite a bit of talk about changing the payment rules for the ACOs,” he said.
The ACOs want to get rid of or narrow the minimum savings thresholds they have to meet before they can share in the savings, he said.
“Many ACOs balked at that, feeling like they did generate change and it wasn’t a statistical anomaly and would like to be paid for that,” he said.
The health care law stated that CMS officials should have a national benchmark so that ACOs would have to reduce the costs of beneficiaries based first on the patients’ historical spending, and then get an adjustment based on how much national fee-for-service program costs go up.
“The fee-for-service program has essentially been not growing at all, so that’s a very difficult benchmark to meet,” said Cavanaugh —especially in communities where costs may be growing faster than the national average.
“The only thing I would say is we have been listening very closely to these, but this was a point of contention in the drafting of the Affordable Care Act and it is very delicate regional balances that come out in those discussions,” he said. “But we are hearing quite a bit about whether the benchmarking methodology is the one we should stay with.”
Cavanaugh also said federal officials are taking seriously the concerns about how much CMS should lower the spending targets of groups that have already reduced costs.
And he said some ACOs have asked to provide care differently, such as by providing more generous home health benefits or waiving certain hospitalization rules.
Some ACOs want to use a capitated model so that they would get a flat fee for each member — an idea that Cavanaugh said “raises some conceptual challenges” because the ACO might be acting more like a health plan that has a network.
But he said, “These are all ideas we’re taking seriously and considering as we propose a new rule.”
Subscribe to:
Posts (Atom)