Medicare payments to U.S. hospitals for outpatient services would increase 1.9 percent to $41 billion under rules issued by the agency overseeing the federal health program for the elderly and disabled. Payments to cancer hospitals would increase 11.3 percent or approximately $71 million in 2012. Companies such as Tenet Healthcare Corp., which acquired 24 outpatient centers last year, will see modest gains from the rate changes. Dallas-based Tenet, the third-largest publicly traded U.S. hospital chain, made $354 million for Medicare outpatient services in the nine months that ended Sept. 30, a 3.5 percent increase over the corresponding period in 2010, according to a regulatory filing.
The Super Committee has until November 23 to come up with a way to reduce the budget deficit by $1.5 trillion over 10 years. Medicare is expected to bear about $400 billion of cuts to reach that target. It's a few whiskers shy of a 10% annual haircut. The health insurance program for the elderly hasn't been trimmed so short since the Balanced Budget Act of 1997. The BBA cut $112 billion in total Medicare spending over four years, without any measurable negative impact on public health. Still, expect the Committee to get a lot of grief. What "Mediscare" critics fail to recognize is that fiscal austerity has been a blessing for the program in the past.
Highmark Inc. will contribute up to $475 million to West Penn Allegheny Health System in an affiliate agreement that will begin with the reopening of emergency services at West Penn Hospital in Bloomfield. Appointed as WPAHS' interim CEO was Keith T. Ghezzi, a physician and managing director at Alvarez & Marsal Healthcare Industry Group in Washington, D.C. The Alvarez & Marsal website says Dr. Ghezzi specializes in "operational and financial turnarounds." "Our anticipated partnership with Highmark has energized our medical staff and employees," said Jack Isherwood, chairman of the board of WPAHS. The two organizations announced that their boards of directors have approved an agreement, which will soon be filed with the Pennsylvania Insurance Department. The transaction also must be reviewed by the Pennsylvania attorney general and the IRS.
The request by the Wisconsin's insurance commissioner to exempt health insurers from having to spend 80% of premiums on medical care could cost consumers an estimated $14 million over three years. That works out to a savings of 1% or less of what consumers who buy their own insurance would spend in that time period. Insurance Commissioner Ted Nickel asked the federal government to exempt health insurers who sold insurance to individuals and families from the new federal regulation, contending that it could force companies to exit the market. The regulation, part of federal healthcare reform, requires health insurers to spend 80 cents of every dollar in premiums on medical care or pay rebates to consumers. Some 180,000 people in Wisconsin buy insurance on their own.
Longtime Denver Health CEO Dr. Patricia Gabow will retire in September, leaving behind a national reputation for quality and a local legacy of fighting for the poor. Gabow's departure will trigger a wide search for a leader who can take advantage of health care reform's newly insured customers to continue a Denver Health expansion throughout the city. Gabow, who may return part time to help with the transition, transformed Denver Health into an independent agency caring for hundreds of thousands of patients. In her nearly 20-year tenure, Denver Health pushed into more community clinics and school clinics, while expanding its own insurance plan. Gabow's national recognition peaked recently when the hospital was hailed as the best of 114 academic medical centers for lowest mortality rates in its patients.
The National Institute of Standards (NIST), in conjunction with public and private sector stakeholders, has called on the healthcare community to help evaluate electronic health records (EHRs), examine the human factors that are crucial to their design, and assist with guidance on the development of usability engineering practices. An October 27 webcast focused on NIST's recently released Technical Evaluation, Testing, and Validation of the Usability of Electronic Health Records, draft guidelines that review the rationale for an EHR usability protocol (EUP). The guidelines outline procedures for expert evaluation of an EHR user interface from clinical and human factors best-practices perspectives.