Medicare would junk its controversial formula for calculating payments to physicians and instead start paying them in 2007 based on data measuring the efficiency and quality of their care under a proposal floated by Nancy L. Johnson, R-Conn. The plan is tentatively scheduled to be considered before the Ways and Means Health Subcommittee, which Johnson chairs, during a July 21 hearing. But its future is by no means certain, as it faces numerous obstacles, including finding a way to pay its estimated $50 billion five-year cost. Read more »
A House subcommittee approved legislation that seeks to encourage reporting of medical errors with an eye to reducing avoidable mistakes. The bill would establish a database of reports from physicians, hospitals, and other health care providers that could be analyzed to determine patterns and identify problems that can be corrected. Information would be shielded from use in medical malpractice suits. The Energy and Commerce Subcommittee on Health approved the bill (HR 3205), sponsored by Michael Bilirakis, R-Fla., by voice vote. Read more »
Under the new Medicare drug benefit, patients hammered with high drug costs year after year will have to pay bigger percentages of their annual drug bills than patients with relatively low yearly costs, according to a study published in the health policy journal Health Affairs. Congress should consider changing the cost-sharing provision of the benefit "if fairness is judged on the basis of the share of income devoted to out-of-pocket payments," advised the study led by Bruce Stuart, a professor at the University of Maryland Center on Aging. The study suggests incorporating a cap on the proportion of income a patient spends on drugs. Read more »
A bill to extend a grant program for states that create health insurance pools for high-risk individuals was approved by the House Energy and Commerce Health Subcommittee. The bill (HR 3204), sponsored by John Shadegg, R-Ariz., and approved by voice vote, would reauthorize $15 million in leftover grants for fiscal 2005 to states that establish high-risk pools. It also would extend and increase funding for states that already have risk pools, authorizing $50 million a year in operating grants through 2009. Read more »
Their tongues unbound by political considerations and sharpened by the fact that they have client's money on the line, Wall Street analysts often deliver refreshingly direct assessments of the business impact of health policy. They didn't disappoint at a Washington forum. For example, Robert Laszewski, president of Health Policy and Strategy Associates, declared the Medicare Advantage program created by the Medicare overhaul law a short-term "gold mine" for managed care plans. Laszewski also likened the health insurance industry's prospects overall to a "long walk off a short pier." Read more »