In another sign that Medicare is moving toward a "pay for performance" system, Centers for Medicare and Medicaid Services Administrator Mark B. McClellan trumpeted the preliminary results of a pilot program showing that the lure of higher payments goaded hospitals into improving their quality of care. Separately, federal officials and medical society representatives announced the release of a "starter set" of measures of care given by doctors outside the hospital. In tracking the performance of 270 hospitals on 34 measures of care for five medical conditions, the pilot found "improvements across the board, regardless of a hospital's initial performance on the quality measures," McClellan said. Read more »
House Democrats unveiled a series of initiatives that they said could cut the number of the nation's uninsured Americans by half. The lawmakers' ideas included allowing early retirees to buy into the federal Medicare program and permitting parents of children eligible for Medicaid and the State Children's Health Insurance Program to purchase health care coverage through those programs. The Democrats would also create purchasing pools and provide tax credits to help small businesses purchase coverage. Read more »
Sales of high-deductible health plans sold in connection with health savings accounts (HSAs) have more than doubled in the past six months to the point where they are now covering a total of 1,031,000 people, America's Health Insurance Plans (AHIP) said. "HSAs are steadily gaining momentum in the marketplace" and now are "a valuable part of the suite of products" offered by the nation's health insurers, said AHIP President Karen Ignagni. Sales of HSAs, authorized under the Medicare overhaul law (PL 108-173), totaled 438,000 last September, after making their first appearance on the market in early 2004. President Bush has made the plans a key feature of his vision of an "ownership society" in which individuals have greater control over their health care and their retirement accounts. Read more »
Medicare enjoys higher satisfaction ratings than private insurance plans—but also has disparities from state to state—and could achieve consistently higher performance ratings if quantitative national targets were set for the program, according to speakers at a forum on Capitol Hill. Such targets could include a 75 percent flu vaccination rate, said Sheila Leatherman, a former United HealthGroup executive who now teaches at the University of North Carolina. The co-author of an analysis of 400 studies on Medicare quality, Leatherman said the Medicare Payment Advisory Commission (MedPAC) should be charged with setting those targets. The study was paid for by The Commonwealth Fund. Read more »
Making it tougher for individuals to transfer their assets in order to qualify for Medicaid coverage, increasing the use of "reverse mortgages" to fund long-term care and raising co-payments for medical services are all elements of a National Governor's Association (NGA) draft proposal to overhaul the Medicaid program. The 12-page document also includes a variety of ideas to help increase health care coverage for both current Medicaid beneficiaries and those that may become eligible for the program and to address factors that increase health care costs. Read more »