Next year Washington — with the exception of two counties bordering Oregon — will be the only state without a Small Business Health Options Program, or SHOP. That means the vast majority of the state's small employers won't have a shot at federal tax credits that, under the Affordable Care Act, reduce the cost of health insurance for their employees. At the same time, eight insurance companies in the Washington Healthplanfinder exchange are selling dozens of plans in the individual insurance market. Only one, Kaiser Permanente, stepped up to sell health insurance on the small-business exchange, and only in Clark and Cowlitz counties.
Only a few people have tried to hack into the HealthCare.gov website and no one has successfully stolen any information, Democrats in the House of Representatives said Friday. They released parts of a classified briefing they got earlier this week from the Health and Human Services Department saying 32 security incidents had been logged since the website rolled out Oct. 1. Republicans in Congress have been asking questions about website security, since people must enter Social Security numbers and other personal information to enroll in health insurance on the site.
The chief of Augusta's new MaineGeneral Medical Center hospital says demand for services at the facility has been huge. A month after the 192-bed hospital opened, officials say the medical/surgical and critical care units are full at least one day a week and some patients have to remain in the emergency department until beds become available. Chuck Hays, chief executive officer of the hospital's parent organization, tells the Kennebec Journal he is surprised by demand and officials are busy refining the processes to handle it.
The number of people selecting health insurance plans in the federal and state marketplaces increased last month at a brisk pace, bringing the overall figure to nearly 365,000, the Obama administration said on Wednesday. The November number was more than double the one for October, but still well below the administration's goal. The new enrollment data became available as Kathleen Sebelius, the secretary of health and human services, clashed again with Republicans at a hearing of the House Energy and Commerce Committee.
The healthcare industry is in the middle of major and rapid changes being brought about because healthcare costs are a significant part of the total costs incurred by federal and state governments, as well as businesses and individuals. These costs have been increasing for many years and as a result, all healthcare providers are under the microscope, and hospitals find themselves at the center of much of this focus.
>Vincent G. Capece Jr.
The Patient Protection and Affordable Care Act contains many provisions aimed at tempering healthcare costs incurred by the federal Medicare program by reducing payments to hospitals. Many state Medicaid programs have followed suit with similar payment reductions in an effort to balance budgets during a struggling economy, which has negatively impacted tax revenues and increased Medicaid rolls. At the same time, commercial insurers are negotiating extra hard on behalf of employers and individuals to keep rate increases for their health insurance products as low as possible. On top of this, utilization of hospital services is also falling, as all of these payer groups have implemented mechanisms to keep patients out of the hospital.
The impact of all of this activity on the financial health of hospitals has been negative and significant. In response, most hospitals are pursuing aggressive strategies to reduce operating costs. This survey explores the most common areas hospitals are focusing on to achieve cost reductions and the overall benefits that hospital leaders expect to realize from these efforts, as well as the barriers they see to achieving these goals.
Consistent with this trend, we at Middlesex Hospital have embarked on an ambitious effort to significantly improve our operating performance by reducing expenses and optimizing revenue. An effort of this magnitude has an impact on everyone in the organization and requires constant communication and collaboration between and amongst doctors, nurses, and other clinicians and employees. The results of the survey help to validate that our efforts are in step with the majority in the industry.
Continued change in the healthcare industry is a certainty, but whenever there is change, there are also opportunities. From these survey results, we can see that healthcare leaders are being proactive in embracing the need for change in order to thrive in an increasingly difficult economic environment.
Vincent G. Capece Jr.
President and CEO
Middlesex Hospital
Middletown, Conn.
Lead Advisor for this Intelligence Report
House and Senate panels approved legislation Thursday to overhaul how Medicare doctors are paid, although action by the full House and Senate on the bill won't happen until next year. The House Ways and Means committee unanimously approved legislation that would end the way doctors are reimbursed by Medicare and replace it with a system that would reward doctors who meet quality standards. The Senate Finance Committee overwhelmingly approved similar legislation. Lawmakers are looking to replace a payment formula adopted in 1997 to restrain the growth of Medicare payments. The formula tied doctor payments to economic growth and other measures. [Subscription Required]