Clinic Patients Have Less Debt
Patients at “safety-net” clinics in New Orleans have fewer problems affording care and fewer instances of insufficient care than most U.S. adults, even though the clinic patients are disproportionately low-income and uninsured, the Commonwealth Fund reported. According to the group's researchers, this success indicates that the post-Katrina primary care program, which relies on a network of government-funded clinics, could serve as a national model for providing primary care to low-income patients. In a survey of the 27 New Orleans clinics, the nonprofit group found that patients at these facilities were much less concerned about affordability of care than were other U.S. adults and reported less medical debt and fewer unpaid medical bills. They also said they received more efficient care: Only 4% of clinic patients reported getting duplicate medical tests or being told results were delayed or missing, compared with one-third of the general U.S. adult population.
IBM Drops Copays for Primary Care
IBM said it will no longer require copayments or deductibles from U.S.– based employees getting fee-for-service primary care, making it one of the first U.S. companies to cover 100% of primary care costs through health insurance. Visits to in-network internists, family physicians, pediatricians, and general practitioners qualify for full coverage, the company said. The new benefit applies to about 80% of IBM's approximately 110,000 U.S. employees. The remaining IBM employees in this country participate in HMOs that already provide free or low-cost primary care.
MedPAC Pushes for Pay Increases
Most Medicare beneficiaries are able to get a timely appointment when they need one, according to an annual survey conducted by the Medicare Payment Advisory Commission. In fact, Medicare beneficiaries report better physician access than the privately insured population, according to the findings, which were based on a poll of 4,000 Medicare beneficiaries and 4,000 privately insured individuals aged 50-64 years. Of note, both groups reported that finding a new primary care physician was more difficult than finding a new specialist. In related news, MedPAC voted last month to request that Congress approve a 1% increase in the Medicare physician payment rate for 2011.
Concierge Medicine Is Growing
The number of concierge practices has grown to more than 5,000 nationwide, according to a report from the National Center for Policy Analysis. The private primary care delivery model also has expanded from a high-end option for wealthy people to include uninsured patients who pay a flat fee to access primary care services they might otherwise lack, the report said. In addition, physicians have opened concierge practices that supplement Medicare and other insurance coverage. The concierge model allows physicians to experiment with different ways of charging patients, such as billing for telephone and e-mail consultations, the analysis noted. “Innovative practices now offer many different kinds of bundled prices and solutions—for those with or without insurance, for the middle income or the wealthy patient,” report author Devon Herrick said in a statement.
Advantage-Plan Gaffs Are Unclear
The Centers for Medicare and Medicaid Services has little information about the number of beneficiaries who have experienced inappropriate marketing of Medicare Advantage (MA) plans, despite a high number of complaints and questions from lawmakers about the problem, a Government Accountability Office study found. The CMS took compliance and enforcement actions for inappropriate marketing against at least 73 organizations that sponsored MA plans from January 2006 through February 2009, the study said. The government actions ranged from warning letters to fines and suspensions of marketing and enrollment. However, it's not clear how many MA plans engage in inappropriate marketing or how many beneficiaries have been affected, the report said. The GAO recommended that the CMS gather more information on the extent of inappropriate marketing, which can include providing inaccurate benefits information and conducting prohibited marketing practices.
No Smoke, No Device Authority
The U.S. District Court for the District of Columbia ruled that the Food and Drug Administration does not have the authority to regulate so-called e-cigarettes—electronic cigarettes—as a drug-device combination. E-cigarettes are battery-powered devices that deliver vaporized doses of nicotine to be inhaled. The FDA had detained multiple shipments of e-cigarettes imported by one company, Smoking Everywhere, saying that they were unapproved drug-devices. Judge Richard Leon disagreed with the FDA's justification for its action. However, he did not address whether the agency has authority to regulate e-cigarettes under the Family Smoking Prevention and Tobacco Control Act, which President Obama signed into law last June.