In a packed and stuffy boardroom, a procession of speakers vigorously urged the Eden Township Healthcare District's directors to keep San Leandro Hospital open. The crowd overflowed into the lobby of the Hayward Area Recreation and Park District administration building. The hospital is run by Sutter Health, which last summer exercised an option to purchase the hospital from the healthcare district. Sutter, which says the hospital is losing millions every year, plans to turn it over to the Alameda County Medical Center, which wants to close the emergency room and acute care facility and convert the hospital into a rehabilitation facility with an urgent care clinic. In August, when the healthcare district board voted to reject the purchase, Sutter sued the district demanding that it fulfill its contract. An audit is expected to be completed in January, which should clarify the hospital's finances.
For years, the federal government has spent billions to entice senior citizens into private Medicare Advantage plans run by private insurers that offer bonus care for low premiums. Now that nearly a quarter of Medicare patients have enrolled in these health plans, including 350,000 in South Florida, Congress is poised to pass legislation that would yank billions of dollars from them. Many patients resent this turnabout and want to preserve the program, which offers extras, such as vision care and gym memberships. On the other hand, patients who pay for care in other ways say they resent subsidizing those who get gold-plated treatment at bargain rates. The controversy over Medicare Advantage is one of the thorniest issues complicating final passage of landmark legislation to overhaul the nation's healthcare system. Republicans have turned potential cutbacks into a rallying cry against reform.
HHS is providing $60 million in grants for researchers to develop so-called Strategic Health IT Advanced Research Projects to target "breakthrough advances" that overcome barriers to the adoption and meaningful use of health IT.
"Innovative research and approaches are required to overcome some of the foremost challenges we face in achieving our vision of a transformed healthcare system enabled through health IT," said David Blumenthal, MD, HHS' National Coordinator for Health Information Technology.
"The SHARP program will bring together some of the best and brightest minds in the nation to find breakthrough solutions and innovations that will eliminate barriers to adoption and, over time, increase the meaningful use of health IT to improve the health and care of all Americans," Blumenthal said.
Funding for the four-year research period will target:
Security of health IT research to develop security and risk mitigation policies and the technologies to build and preserve the public trust as health IT systems become ubiquitous.
Patient-centered cognitive support research to align health IT with the day-to-day practice of clinicians as they provide care.
Healthcare application and network platform architectures research to achieve electronic exchange and use of health IT securely, privately, and accurately.
Secondary use of electronic health record data research to improve the overall quality of healthcare, population health, and clinical research, while protecting patient privacy.
Each project will create a research agenda addressing the specific goals of the Health Information Technology for Economic and Clinical Health Act and identify the barriers to adoption and meaningful use of heath IT. HHS expects to award qualified applicants cooperative agreements to support research efforts in these four project areas.
The researchers will implement a collaborative, interdisciplinary program addressing short-term and long-term challenges in their focus area. Additionally, the projects will develop and implement a cooperative program between researchers, healthcare providers, and other health IT sector stakeholders to incorporate results into health IT practices and products.
The funding is authorized under the $787 billion American Recovery and Reinvestment Act. Applications are due January 25, with awards anticipated in March 2010. Information about the SHARP program can be found at http://HealthIT.HHS.gov/ and at www.grants.gov.
After a long day of acid, partisan debate, Senate Democrats held ranks early Monday in a dead-of-night procedural vote that proved they had locked in the decisive margin needed to pass a far-reaching overhaul of the nation's healthcare system. The roll was called shortly after 1 a.m., with Washington still snowbound after a weekend blizzard, and the Senate voted on party lines to cut off a Republican filibuster of a package of changes to the health care bill by the majority leader, Harry Reid of Nevada. The vote was 60 to 40—a tally that is expected to be repeated four times as further procedural hurdles are cleared in the days ahead, and then once more in a dramatic, if predictable, finale tentatively scheduled for 7 p.m. on Christmas Eve.
A compromise on the healthcare overhaul that the Senate reached this weekend offered some relief for insurance companies, specifically for nonprofits that could win exemption from a new $6.7 billion tax. Part of the deal was an exemption for nonprofit insurance companies that met several requirements. One way to qualify is to spend an average of 92% of premiums on healthcare expenses. That spending measure, called a company's medical-loss ratio, is closely watched to determine how much insurers take in profits. Few companies, though, would qualify for that exemption. Goldman Sachs analyst Matt Borsch says just four insurers reached that threshold in 2008. America's Health Insurance Plans, the industry trade group, said federal data show that plans on average spend 87% of premiums on care.
The Senate nudged its health bill toward tighter restrictions on abortion coverage, a change that left advocates on both sides of the issue unsatisfied. Under a deal with Sen. Ben Nelson, women who receive a new tax credit to buy insurance would write a separate check with their own money for abortion coverage, and states would explicitly have the option of barring such coverage from plans sold on new insurance exchanges. However, the language is less sweeping than that adopted by the House in November, which abortion-rights groups interpreted as the most significant setback in Congress for their cause in many years. As it did in the House, abortion threatened to sink the healthcare bill at the last minute in the Senate. Nelson, an antiabortion Democrat, vowed to withhold his vote unless the bill included more stringent requirements to ensure no federal money goes toward paying for abortion. The debate centered around the insurance exchanges, where people who don't have coverage elsewhere will be able to comparison-shop for plans. The House language prohibits anyone who gets a tax credit from enrolling in a policy that covers abortion. The Senate would allow states in effect to match that restriction if they choose, but in other states the Senate language wouldn't be as restrictive. It says women can get the coverage if they write two checks to their insurer, one for abortion and one for everything else. The change in the Senate bill is expected to be adopted this week.