The healthcare bill proposed by the Senate Finance Committee would pare tax-free health expense accounts. The legislation would limit flexible spending account contributions to $2,000 a year beginning in 2013, and it would standardize the expenses that are qualified. Some health plan administrators are distressed that Congress may scale back such accounts, and administrators have started a campaign to preserve the flexibility in the plans.
New Census data for the first time confirm unusually high rates of uninsured in Florida's Miami-Dade and Broward counties, and reveal wide disparities in coverage among local communities. Fifty-three percent of adults ages 18-64 in Hialeah lack health insurance—almost three times the national average. Meanwhile, only 13.8% of that age group in Weston are uninsured, the lowest rate in South Florida.
Senator Bill Nelson of Florida wants to expand health insurance coverage because one in five Floridians is uninsured. And as a member of the Senate Finance Committee, he can help shape legislation. But the bill taken up this week by the committee would cut Medicare payments to insurance companies that care for more than 10 million older Americans, including nearly one million in Florida. Nelson said he had received 56,000 telephone calls, letters and e-mail messages on the legislation since June.
Last week, the population health management industry paused to consider the implications of a bankruptcy filing by LifeMasters Supported SelfCare, a long-time leader in disease management and population health management. Health Plan Insider readers were asked to consider whether the event represented an isolated case or a barometer for an entire industry. But the question reflects an out-of-date perspective on the services that innovative companies in the industry provide and left a false impression on casual observers.
Certainly, those who follow the industry closely recognize that events leading to LifeMasters' Chapter 11 filing were both unfortunate for, and unique to, that organization. But one unique and unfortunate occurrence does not a trend make.
Only those not directly involved in the development, implementation or evaluation of population health management programs would fail to recognize the industry's evolution to one that bases services on the needs and resources of the populations and providers served. Close observers of the industry recognize its significant transformation through adoption of multiple intervention modalities in addition and complementary to the traditional call center model.
Today, leading industry organizations are deploying proven health promotion, prevention and chronic care management services spanning an entire populations' continuum of health—the well, at-risk, and chronically ill. Organizations throughout the industry have developed more collaborative and innovative models of care delivery to fully integrate services with practicing physicians to support individuals in adherence to physician-led care plans.
Further, significant new opportunities for the population health management industry are contemplated by ongoing federal activities to enact healthcare reform legislation. Congressional leaders and the Obama administration have strongly emphasized the importance of prevention and wellness activities, sought to improve access to care coordination and coaching support programs to targeted beneficiaries, and promoted the widespread adoption of health information technologies to collect, share, and analyze health-related data.
These proposals and others, including a proposal to establish an "Innovations Center" within the Centers for Medicare and Medicaid Services to test a variety of care models and interventions in Medicare fee-for-service, were included in a proposal put forward last week by Sen. Max Baucus, D-MT, chair of the powerful Finance Committee.
The industry's strength and diversity is best seen in the membership of its leading voice, DMAA: The Care Continuum Alliance, which continues to expand its reach across many healthcare industry segments. This week, more than 700 leaders in population health management convened in San Diego for DMAA's 11th annual meeting, The Forum 09. Attendees heard industry leaders speak about a variety of successful interventions, collaborative delivery models, and innovative approaches to care.
The Forum attendees and the broader DMAA membership would identify a clear trend in the population health management industry: A trend of continuing innovative evolution and expansion, built on both past successes and lessons learned, to provide health promotion, prevention, and chronic care management services to all in a continuing effort to significantly improve the health of the nation and reduce the costs of care.
Tracey Moorhead is the president and CEO of DMAA: The Care Continuum Alliance.
Vice President Joe Biden said new data showing health-insurance premiums rising faster in every state than wages or inflation highlight the need for healthcare legislation. The administration released a report with new figures showing the growth in premiums state-by-state over the last decade. Compiled by the National Economic Council, the report says that from 1999 to 2009 premium growth ranged from 88% in Michigan to 145% in Alaska. During the same period, wages and inflation rose in the U.S. by 38% and 28%, respectively.
A healthcare union trying to organize workers at Boston-based Beth Israel Deaconess Medical Center has assailed the hospital's physicians group for charging a late-night fee for patients who come to the emergency room after 10 p.m. Local 1199 of the Service Employees International Union drew on Medicare claims data that show patients treated by the Harvard Medical Faculty Physicians at five hospitals in the state were billed a surcharge of $30 if they were seen between 10 p.m. and 8 a.m. The doctors group and Beth Israel representatives said the fee was a common practice in Massachusetts and nationwide.