Two years after Congress enacted a sweeping healthcare reform measure, lawmakers are still battling over how to rein in the rising cost of medical care. On Thursday, the House voted to eliminate one of the main cost controls in the 2010 law: the Independent Payments Advisory Board, whose purpose is to keep a lid on the growth of Medicare's budget. The board may be a blunt instrument, but it's not the threat that its detractors claim.
While some public hospitals do well on measures of patient care, many get lower ratings because of the added challenges they face, such as caring for more uninsured people, said Bruce Boissonnault, CEO of the Niagara Health Quality Coalition. Starting in October, hospital payments for Medicare patients will undergo a historic change. Using Hospital Compare scores, Medicare, the largest single payer of hospital services, will reward hospitals based on the quality of care they provide, not just on the quantity of services they deliver. Many states, including Texas, are overhauling their Medicaid programs for the poor in a similar way.
California insurance officials are seeking new limits on a controversial form of health coverage insurers are selling to small employers. At issue is a new type of self-insurance for small businesses with as few as 25 workers. Critics said insurers such as Cigna Corp. are using these new plans to game the system and cherry-pick companies with healthier workers. They said this could undermine a key goal of the federal Affordable Care Act to lower premiums by pooling together more healthy and sick Americans into insurance exchanges. Premiums could continue to escalate without a diverse pool of consumers.
The Pittsburgh region uses "substantially" more healthcare services than comparable cities, costing the region an extra $187 million a year, according to a report released today. With competition for medical services likely to heat up between the region's two healthcare titans, UPMC and Highmark, the Pittsburgh Business Group on Health commissioned the study to better understand how hospital capacity might affect health care spending. The organization is a nonprofit coalition of more than 80 companies that seeks to find ways to lower costs and increase value in health care.
Two bidders competing to buy struggling Christ Hospital were told on Friday to revise and resubmit their proposals. After a week of closed-door meetings, both bidders are still waiting to learn which of them will be permitted to acquire the hospital. A source close to the proceedings could not confirm whether this request came from the judge presiding over the hospital's bankruptcy or the hospital's Board of Trustees. The development climaxed—or anti-climaxed, if you prefer—a dramatic week for the hospital.
For the first time in nearly 12 years, patients insured by UnitedHealthcare of Illinois Inc. will have access to Rush University Medical Center and three other regional hospitals that belong to The Rush System for Health network. The multiyear agreement, to be announced Monday, reunites the state's No. 2 insurer, a division of Minnetonka, Minn.-based UnitedHealth Group Inc., and Rush, Chicago's fourth-largest hospital based on patient revenue, after the two parted ways in December 2000 over a dispute about reimbursement rates and other issues. Beginning on May 1, UnitedHealthcare's 1.2 million customers in Illinois will gain in-network access to Rush's hospital network and the Rush Health physicians group.