Got a patient who drowned from jumping off burning water skis? Well, there's a new medical billing code for that. Next fall, a transformation is coming to the arcane world of medical billing. Overnight, virtually the entire health care system -- Medicare, Medicaid, private insurers, hospitals, doctors and various middlemen -- will switch to a new set of computerized codes used for determining what ailments patients have and how much they and their insurers should pay for a specific treatment.
The Obama administration announced that people whose insurance plans were canceled this year will "temporarily" be exempted from the law's individual mandate. Here's how they're doing it -- and what it means for the law. 1. The individual mandate includes a "hardship exemption." People who qualify can either ignore the individual mandate altogether or purchase a cheap, bare-bones catastrophic insurance plan that's typically only available to people under 30. 2. According to HHS, the exemption covers people who "experienced financial or domestic circumstances, including an unexpected natural or human-caused event, such that he or she had a significant, unexpected increase in essential expenses that prevented him or her from obtaining coverage under a qualified health plan."
Karen DeSalvo, MD, has been named the new national coordinator for health information technology. DeSalvo is currently New Orleans' health commissioner and senior health policy advisor to Mitch Landrieu, the city's mayor. In announcing DeSalvo's appointment, Health and Human Services Secretary Kathleen Sebelius emphasized DeSalvo's efforts to modernize New Orlean's healthcare system and her pivotal role in rebuilding the city's public health infrastructure after Hurricane Katrina. In the wake of that natural disaster, she pointed out, DeSalvo augmented the city's primary care medical homes for the low-income and uninsured people who were most affected by the storm.
Problems with the government's main health care overhaul website carry a bigger risk than frequent crashes: Higher prices could follow for many Americans if technical troubles scare off young people. The government has touted recent improvements to HealthCare.gov, which millions of Americans are expected to use to sign up for coverage. But enrollment still lags far behind projections, and that has triggered worries that legions of potential customers in their 20s and 30s might not sign up. If that happens — and older, sicker people continue to register in larger numbers — insurers might have to raise future prices to address the imbalance.
Over at Health Affairs, Andrew Steinmetz, Ralph Muller, Steven Altschuler and Ezekiel Emanuel decided to see how health reform looked to hospital executives. They surveyed 74 C-Suite executives from institutions that, on average, employed 8,520 workers and saw annual revenues of $1.5 billion. The survey wasn't scientific by any means, but in a speculative conversation that's proceeding mostly by anecdote, these individuals have a better vantage point on the changes that health reform is making to actual health-care systems than virtually anyone else. The results? Hospital executives think health reform is going to make the health care they deliver a whole lot better.
The White House on Thursday released two "fact sheets" touting early ObamaCare successes, capping a 16-day media blitz intended to promote the healthcare law's benefits. The reports say millions of Americans have already received free preventive services, obtained coverage despite pre-existing conditions, taken advantage of the expanded access to Medicaid, benefited from the closing of Medicare's "donut hole," or been able to remain on their parents' healthcare plans. "The benefits of the healthcare law are real, and the repeal plan pushed by Republicans in Congress would undermine or eliminate them across the board, reversing critical consumer protections and driving up costs for millions of Americans," the White House said in a statement.