Boston’s Mayor is outraged at Humana’s decision to raise premiums on it’s basic Part D plan by 130%. Humana’s stockholders should be equally upset.
Jan
4
Insight, analysis & opinion from Joe Paduda
Category: Medicare and Medicaid
Jan
3
Among the health reform plans likely to be considered is an expansion of Medicare, allowing non-seniors to “buy in” to Medicare.
This is a bad idea.
Dec
11
In what will come as no surprise to anyone, Congress will eliminate the pending cut in Medicare physician reimbursement. Not only that, but docs who agree to report certain data to CMS will actually get a 1.5% increase in reimbursement from the Feds.
If you listen very closely, you can almost hear the medical community’s resounding “yippee”.
The reasons docs are not exactly ecstatic about the news are two-fold.
Dec
1
It’s starting.
Rep. Stark (D CA) is already talking about cutting subsidies for Medicare Advantage programs, which he claims are costing taxpayers over 12% more than standard Medicaid programs.
This comes as no surprise to loyal readers and those who are old enough to remember when “Pete” Stark was a major player in national health care policy.
Nov
15
Yawn.
It didn’t take the HHS Secretary Mike Leavitt long to start in with the tired rhetoric about the evils of government-run health care(free reg req). Leavitt does not want the Feds to negotiate drug prices. Heck, he doesn’t even want Congress to give the Feds the power to do so.
Why not? What’s the Secretary scared of?
According to him, it’s the old archenemy of all things good – government-run health care. While I too am a firm believer in the power of the free market, Leavitt’s logic falls apart upon even the most rudimentary exam.
Nov
6
By any accounting, Part D has been a boon to the pharmaceutical industry (free registration required). Revenues and profits at Pfizer, Lilly, and other manufacturers have jumped. This will undoubtedly lead to more research dollars available to search for cures for awful diseases, an effort exclusively funded by the US taxpayer that will benefit the entire world.
Aren’t we generous?
Nov
3
The annual Medicare physician price cut season is on us. Next year’s reduction will average 5%, although payments for office visits (evaluation and management codes) will increase by up to 30%, but reimbursement for other procedures will be slashed up to 20%.
Don’t expect this to actually happen; every year the Medicare reductions are reversed by Congress. And this year will be no different. I’d expect Congress will do something to reverse the cuts, at least in part.
Oct
24
There is quite a bit of interest among private equity and venture capital firms in the work comp managed care “space”. These investors seek to buy into companies that are poised for growth, that have a “sustainable competitive advantage”, solid management, long term contracts with customers, and a profitable business model.
A key to success for these investors is to find these firms before the other investors do, which means identifying good companies quickly. Analysts spend lots of time, energy, and brain power analyzing, assessing, and interpreting data. looking for the wheat among the chaff.
A much faster, and probably more accurate way, is to pick up the phone and call the company. Talk to the receptionist, someone in customer service and someone in billing. What they say doesn’t matter nearly as much as how they say it.
Good companies have energy, enthusiasm, and a desire to help that comes through the phone. Not so good ones have none of the above.
Oct
17
Kudos to USAToday for publishing a pretty good article on variations in practice patterns related to back surgeries. In a front page story today, the paper that has been derided by some as “McNews” explores the issues surrounding the explosion in the number of spinal fusions.
The reporting is balanced, insightful, and thorough, a bit of a surprise coming from a paper that prides itself on short sentences, really short words, and lots of color, not depth and nuance.
Noted throughout the article is the primary problem – no one knows how many spinal fusions are the right number, and there is significant disagreement among stakeholders re when a patient should have surgery. (free registration required) That’s all true, and that’s where workers compensation comes in.
Continue reading Workers’ Comp – the answer to the spinal fusion question
Sep
6
Mark McClellan is leaving his post as head of the Center for Medicare and Medicaid Services. He served long and loyally, sticking to the Administration’s line even when facts indicated otherwise, remaining a calming force when Part D enrollment was going nowhere. McClellan is also known for listening hard to suggestions and criticism from all sides, and working diligently to address problems.
Here’s what’s happened during his tenure.
Part D was passed, implemented, and operational. This was a monumental task, and one McClellan was instrumental in accomplishing. It’s not his fault it is a fatally flawed program; well, maybe it is, in some small part, as he was probably involved in writing/editing/opining on the legislation. Nevertheless, under McClellan the program became reality, with the initial enrollment problems addressed (in large part).