Gainsharing, or the splitting of cost savings between hospitals and physicians, has been prohibited since 1999. But a new opinion from the Office of the Inspector General (OIG), in the Department of Health and Human Services, opens the door a crack to very limited kinds of gainsharing. At the same time, the opinion illustrates the legal difficulties that various kinds of payment bundling will...
Health Care Industry Archive
June 2009
Perhaps because the Republicans are now in the minority, their favorite reform idea—consumer-directed health plans (CDHPs)—has not attracted much attention lately. But a new proposal in the U.S. Senate to put new limits on health savings accounts (HSAs) might revive this debate. As you’ll recall, CDHPs combine high-deductible policies with HSAs, which are tax-favored bank accounts that...
The great magicians on the Senate Finance Committee have pulled the rabbit out of their hat to reduce the 10-year cost of their reform plan to $1 trillion. And what have they come up with? According to Senator Kent Conrad (D-ND), they’ve cut the cost mainly by reducing eligibility for government subsidies. For example, the income limit at which a family of four would receive federal subsidies...
Eminent Economist Speaks - Alain Enthoven, a professor emeritus of management at Stanford University, has weighed in against the public option that many Democrats espouse. In a New York Times op-ed piece cowritten with David Riemer, director of the Community Advocates Public Policy Institute in Milwaukee, Enthoven, who supplied much of the intellectual firepower for the Clinton reform plan,...
The Commonwealth Fund, one of the principal sources of health policy ideas for the Obama Administration, has estimated the potential savings of three different insurance reform scenarios from 2010 to 2020. Assuming that unspecified Medicare reforms and delivery system changes were implemented within a framework of universal coverage, the report predicts that an approach that includes a...
President Obama today rebutted insurance industry claims that the proposed “public option”—a government-sponsored plan that would compete with private insurers—would lead to the end of the employer-based insurance system. “If private insurers say that the marketplace provides the best quality health care … then why is it that the government, which they say can’t run...
If some of the paranoia about health IT that I heard last week at the American Medical Association annual meeting really is representative of practicing physicians — and not just the protectionist Medical Establishment — this country is in trouble. As much as the AMA purports to speak for all doctors, only about one in five U.S. physicians is a dues-paying member these days, and the...
A little canary is tweeting in the coal mine of Massachusetts. Despite the availability of supposedly affordable insurance in that state, increasing numbers of its insured citizens are calling patient-assistance hotlines. They say they are having trouble paying their medical bills and are not getting the care they need. That should be of great interest to Congressional committees that are...
Does changing the way physicians are paid hold the key to effective healthcare reform? The New York Times held an online roundtable discussion on this topic, engaging a wide range of thought leaders, most of them physicians. Their widely varying responses show how little agreement there is on this topic, even as Congressional leaders try to craft reform legislation. Elliott Fisher, director of...
Once again, a major healthcare system has sent letters to patients warning that it may terminate its relationship with an insurance company. This time, it’s Atlanta’s WellStar Health System, which has mailed letters to 14,000 patients saying that it may not renew its contract with Aetna. As always, the fight is over money. An Aetna spokesman said WellStar is asking for too much, and a...
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