For the second year in a row, iHealthBeat asked a variety of stakeholders to weigh in on health IT progress, disappointments and hopes for the future. Each health IT expert answered via email three questions about the most significant health IT development in 2012, the biggest disappointment in the past year and how the remaining barriers to widespread health IT adoption should be addressed in 2013.
Sue Daugherty is the executive director of the Metropolitan Area Neighborhood Nutrition Alliance (MANNA). MANNA provides medically appropriate meals—three a day, free of charge, meeting very specific dietary needs—to people who are at acute nutritional risk and battling critical illnesses such as cancer, renal disease and HIV/AIDS. It serves 950 patients and 75,000 meals a month in nine counties in the greater Philadelphia region. MANNA provides a crucial, lifesaving service—that's why Daugherty got into the work to begin with. But as she and her team recently learned, MANNA's work could do an even greater good, if given the chance: it could bolster health care's bottom line.
The most important issue facing the next Missouri General Assembly is whether to expand health care coverage for uninsured Missourians who have incomes below 138 percent of the federal poverty level. (Poverty level equals an income of $23,050 for a family of four.) The costs and benefits of expansion have been analyzed in three studies: one by the Missouri Office of Budget and Planning, one by the Kaiser Foundation, and one by the University of Missouri Medical School in cooperation with Dobson, DaVanzo & Associates. The MU study is the most conservative, so I will rely upon it. The projected economic benefits and the number of Missourians covered by the expansion are substantially higher in the other two studies.
The fiscal cliff deal is, obviously, mostly about preventing the fiscal cliff and stopping a wave of huge spending cuts. At the same time, legislators did find ways to make some relatively important health policy changes too. They include everything from raising Medicare doctor's pay, repealing a part of the Obamacare and cutting over a billion from the law's funding. Let's get right to it. Obamacare loses $1.7 billion in funding.
Whether states, hospitals and smaller practices that spend more money on health care provide better treatment is still an open question, according to a new review of past studies. "This is really one of the central issues we're grappling with today in health care," said Peter Hussey from the RAND Corporation in Arlington, Virginia. The topic is especially pressing because although the United States spends more of its budget on health care than any other wealthy nation—and is spending more each year—the World Health Organization ranks its health system 37th.
After opening his bill from UNC Health Care, Charlie Caserta quickly decided that he wouldn't pay. Caserta had paid a $50 co-pay for his visit to a liver specialist, and was hopping mad to see that UNC was trying to collect a $152 facility fee. UNC Health Care collected by pulling the money out of Caserta's state tax refund. It used a little-known law, the Set Off Debt Collection Act, that allows state and local agencies to collect debts by seizing state tax returns and lottery winnings. The law has been good to UNC Health Care. Last year, UNC Hospitals collected $5.7 million, while UNC Physicians and Associates collected $2 million. Together, that accounted for 11 percent of the $72 million of set off debt collected for all state and local agencies that year.