The proposed rules, issued June 22 by the IRS, would apply to the nearly six in 10 U.S. hospitals that operate as tax-exempt, nonprofit charitable hospitals. They would be required to provide additional consumer protections and services to patients who qualify for charity care and medical financial aid. If finalized, the rules would bar the hospitals from using the most aggressive debt collection tactics against low-income patients who don't pay their medical bills.
Massachusetts had the nation's highest rate of health coverage even before passage of a pioneering 2006 law requiring most residents to have insurance. Yet tens of thousands of people like Francisco Machado go uncovered each year and pay a fine. Starting in 2014, when much of the national Affordable Care Act kicks in, millions of other Americans could face a similar fine, putting Massachusetts in the spotlight as a possible indicator of what lies ahead for the country. The federal plan mimics the state's law in its basic approach to expanding coverage: Make health insurance more affordable through new subsidies and a state-run insurance market. Then compel most people to buy plans and penalize those who do not.
Louisiana hospital officials are taking a wait-and-see attitude toward Gov. Bobby Jindal's refusal to expand Medicaid eligibility as called for in President Barack Obama's health insurance overhaul. In contrast to other states, where hospital officials are lobbying their governors and legislatures to move forward with the Medicaid expansion, Louisiana hospital administrators and representatives are being cautious. Still, hospitals are worried the expanded Medicaid participation authorized under the health overhaul law would lead the federal government to significantly reduce compensation to hospitals for providing care to the uninsured.
In the first part of the Health Insurance's $4.4 Billion Bunker Buster two-part series, I highlighted how the Medical Loss Ratio and Direct Primary Care facets of Obamacare would have far-reaching impacts beyond what most commentators have observed. Now comes the news that CalPERS considers scrapping health plans to lower its medical tab from the latimes.com. As the third largest purchaser of health insurance in the country, they are a bellwether. Even with their buying power, CalPERS is seeing their rates increase nearly three times the rate of medical inflation and are looking for new ideas.
Texas ranked dead last in the federal government's latest report card on the delivery of health services, falling short in areas ranging from acute hospital care to home treatment of the chronically ill. Texas scored 31.61—less than half of top-ranked Minnesota's 67.31—out of a possible 100 points in the Agency for Healthcare Research and Quality annual rankings. Rated "weak" or "very weak" in nine of 12 health delivery categories, Texas dropped from 47th place in 2010 to 51st in 2011, behind all other states and Washington, D.C.
Healthcare providers have yet to agree on the best way to protect the privacy of personal health information (PHI) in health information exchanges (HIEs), but John Halamka, MD, has an opinion. As CIO at Beth Israel Deaconess Medical Center (BIDMC) in Boston, Halamka recently announced in a blog post that BIDMC will have all of its 1,800 affiliated ambulatory care providers ask their patients to "opt in for data sharing among the clinicians coordinating their care." This would allow data exchange, not only within BIDMC, but also with outside clinicians who provide care for those patients. The patients who opt in now will still be able to opt out later.