AHIP Proposes Reform Plan
The United States could reduce total health care spending by $145 billion in the next 7 years while improving the quality of patient care by implementing five proposals, according to a plan from industry group America's Health Insurance Plans. The AHIP plan endorsed a combination of measures, including better disease management and care coordination, prevention, a move to electronic transactions, a transition to a value-based payment system, and new technology, to improve the U.S. health care system and save money. The group also called for replacing the current medical liability system with a dispute resolution process consisting of an objective, independent administrative process. AHIP President and CEO Karen Ignagni said that most pieces of her group's proposal are in use now by health insurance companies. “Plans have made measurable progress, but the nation needs a coordinated approach across the public and private sectors to maximize the impact of these strategies,” Ms. Ignagni said in a statement.
ACP Provides Framework
The American College of Physicians has reiterated its 2002 message that all Americans should have access to affordable health insurance coverage. In an update to its 6-year-old position paper, ACP reviewed the key reforms recommended and said they remain, with some revisions, a viable approach to making coverage available universally. The paper emphasized ACP's belief that reforms to expand coverage should be done in concert with changes in health care financing and delivery to improve outcomes and efficiency of care. “Expanding health insurance coverage to all Americans is a moral imperative,” said Dr. Jeffrey Harris, ACP president. The paper recommended expanding Medicaid coverage, creating tax credits, and adding options for small employers. It also asked for federal government support for states to expand coverage and organize care around a patient-centered medical home.
Consumer Reports to Grade Hospitals
Consumer Reports has begun grading hospitals, and plans to eventually add ratings for other health care providers. The ratings, which include nearly 3,000 hospitals, are available at
Florida Expands Coverage Options
Florida Gov. Charlie Crist, a Republican, has signed legislation that will allow the state to negotiate with health insurers to develop affordable health coverage for the 3.8 million uninsured Floridians aged 19–64 years. The legislation focuses on primary and preventive care to discourage unnecessary emergency department visits. Private insurers have indicated that the plan will allow them to create benefits packages for about $150 a month or less. All benefit plans will include, at the very least, coverage for preventive services, screenings, office visits, outpatient and inpatient surgery, urgent care, prescription drugs, durable medical equipment, and diabetic supplies, according to the governor's office. Approved insurance companies also would have to offer consumers a plan that includes catastrophic and hospital coverage. In addition, the new law creates a centralized clearinghouse where small businesses can choose from a variety of health care plans for their employees.
CMS Outlines Hospice Rights
The Centers for Medicare and Medicaid Services has finalized regulations that give Medicare beneficiaries with terminal illnesses the right to determine how they receive end-of-life care. The provisions, contained in an overhaul of regulations governing the hospice industry, include explicit language on patient rights that had not existed under the previous regulations, CMS said. According to the new rule, patients who choose hospice, or palliative care, over curative treatment are entitled to such things as participation in their treatment plan, the right to effective pain management, the right to refuse treatment, and the right to choose their own physician. CMS noted that although many hospice patients already are active in their own treatment plans, this regulation is the first to set out a detailed list of patient rights. “End-of-life care has changed markedly in the past 25 years and it is time to update our regulations to reflect advances in medicine and hospice industry practices as well as patient rights,” said CMS Acting Administrator Kerry Weems in a statement.
Mass. Uninsured Rate Cut
In the first year after Massachusetts implemented its health insurance coverage expansion and reforms, the uninsured rate among adults in the state dropped by almost half, from 13% to just over 7%, according to an Urban Institute study published online in Health Affairs. The study also showed that access to care for low-income Massachusetts adults has increased, and the share of adults with high out-of-pocket health care costs and problems paying medical bills has dropped. In addition, the study's author found no evidence that the expansion of publicly subsidized coverage has “crowded out” employer-sponsored coverage. The reforms, enacted in April 2006, included an expansion of Medicaid, state subsidies for low-income residents to purchase health insurance, and a new purchasing arrangement for private health insurance. Under the reforms, most uninsured individuals must purchase insurance or pay a penalty to the state.