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
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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.”
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