TOP STORIES

Gentiva to Buy Odyssey Health Care for Nearly $1 Billion; The Wall Street Journal – May 24, 2010

Gentiva Health Services Inc. agreed to acquire Odyssey HealthCare Inc. for nearly $1 billion, a combination that will create the largest U.S. home-health and hospice provider.

INSURANCE

Health Care Law Faces Test as Regulators Settle Which Plans Must Do What; The Washington Post – May 24, 2010

In keeping with Obama’s promise that you can hold on to your insurance if you like it, the new law leaves it to regulators to decide how much a health plan can change without giving up its grandfathered status. In other words, when does a health plan cease to be the same health plan?

TRANSPARENCY/SAFETY

Bishops Note Way Forward with Health Care, Clarify Misconceptions; United States Conference of Catholic Bishops – May 21, 2010

The U.S. Conference of Catholic Bishops is trying to clarify where they stand, or stood, on health reform in an open letter. 

STATE NEWS

Emmer vs. Others in Health Care Feud; The Pioneer Press – May 23, 2010

Last week, as the 2010 session deadlocked over a proposed expansion of health care for the poor, Minnesota lawmakers on both sides of the aisle made a decision with a potentially profound impact on the 2010 governor’s race – they hand the next governor the option of making the final decision.

Insurers May Slash Rates to Hospitals; The Boston Globe – May 24, 2010

Massachusetts health insurers say they want to freeze or slash payments to some hospitals and large physician groups this year, a move that could create tough contract negotiations and the potential for disruptions where patients get their care.

Candidates for Insurance Clash; Rome Tribune News – May 22, 2010

Federal health reform has raised the role of every state’s insurance commissioner, heating up the nine-way GOP primary for Georgia’s open seat.

Health Reform is Proving Quite Expensive; Charleston Daily Mail – May 24, 2010

President Obama and Democratic congressional leaders said their ‘Patient Protection and Affordable Care Act’ of American health care would extend coverage to 31 million more people while reducing health care costs. Every armchair economist in the country knew that doing the first would make the second impossible.

MEDICARE/MEDICAID

Millions of Medicaid Kids Don’t Get Medical Exams; Chicago Tribune – May 24, 2010

Almost three-quarters of children on Medicaid in nine states are not getting all of their legally required medical, vision and hearing examinations, including immunizations, according to a new government study.

IMPLEMENTING THE LEGISLATION

The Gaming Begins; The New York Times – May 23, 2010

Few Americans know what a “medical loss ratio” is, but a fierce struggle over how to calculate it under the new health care reform law will determine how much insurers must spend on patient care and how much they can retain for administration and profits.

A Practical Guide Forward for Progressive on Health Care; Salon – May 24, 2010

Progressives’ post-health care reform funk is playing right into the hands of the GOP.

Health Reform Law Extends, Enhances Adoption Credit; Minnesota Public Radio News – May 23, 2010

Tucked into the 2,000-page federal health care law is a provision designed to defray adoption costs, about $1,000, to more than $13,000 for the costs of finalizing a domestic or foreign adoption.

EMPLOYERS

Plan to Seek Retiree Care Subsidy?  Don’t Delay; Business Insurance – May 24, 2010

A $5 billion federal program to partially reimburse private and public employers for retirees’ health care costs is about to begin, but employers who don’t act on the offer quickly may come away empty handed.

Study Points to Health Law’s Penalties; The New York Times – May 24, 2010

About one-third of employers subject to major requirements of the new health care law may face tax penalties because they offer health insurance that could be considered unaffordable to some employees. 

HEALTH INFORMATION TECHNOLOGY

High-Tech Alternatives to High-Tech Care; The New York Times – May 24, 2010

There is another broad transformation in health care under way, a powerful force for decentralized innovation. It is fueled in good part by technology – low-cost computing devices, digital sensors and the Web.

Medical Devices Drive Up Heart-Care Costs; The Philadelphia Inquirer – May 24, 2010

A study by researchers at the University of Pennsylvania and the Philadelphia VA Medical Center found that newer medical devices are a major reason why heart care costs are rising dramatically.

Visit the Health Policy News blog for archived Health Policy Reform News articles.

Even though the Mayo Clinic Health Policy Center did not take a position of support or opposition to the final legislation, we believe that the new health care reform law contains provisions that are aligned with our principles for reform, principles that will begin to move us toward a system that provides all Americans with quality care at affordable costs. Some of these provisions include:

• Provisions to pay more for value – better health care outcomes at lower cost,
• Insurance reforms, including elimination of pre-existing condition exclusions,
• An insurance exchange, rather than an expansion of Medicare or a government-run public option,
• Subsidies for people with financial need to purchase health insurance,
• An independent payment advisory board, and
• Pilot projects on accountable-care organizations, medical homes and bundled payments.

The Mayo Clinic Health Policy Center continues to articulate our areas of agreement and areas of concern. We believe the pay-for-value provisions are a good start, but not comprehensive or aggressive enough to have an immediate impact on lowering the cost and improving the quality of health care.  We are also concerned about the continued approach of funding reform through the use of across-the-board payment cuts.

With the passage of the bill, the specific work of HealthCare REPAIR is coming to a close, but our desire to keep the public engaged in the ongoing process continues.  In the next few months we will be launching a new initiative called Americans for Better Health Care. Americans for Better Health Care (ABHC) will help the public understand how a value-based health care system can improve the lives of patients and their families by improving outcomes and lowering health care costs. As with HealthCare REPAIR, we will organize people to advocate publicly for the expansion of patient-centered care based on the idea of value in health care.

We’re currently developing the specifics of ABHC, and we’ll keep you posted as we progress. We might ask for your input as we develop the new program, so please keep an eye out for emails from us.

Once again, thank you very much for all your help and participation in HealthCare REPAIR. We look forward to working with you again as Americans for Better Health Care.

TOP STORIES

Congressional Dems Push ‘Doc Fix’; Politico – May 21, 2010

Democrats in Congress have proposed easing a planned cut in payments to doctors under Medicare in an effort to stem an expected shortage of primary care doctors and address the top issue for physicians who backed health reform. 

House Poised To Consider COBRA Subsidy Extension, Medicare Payment ‘Fix’ ; Kaiser Health News – May 21, 2010

Caught up in the congressional politics swirling around a pending tax bill are two proposals to extend — once again — subsidies for COBRA health insurance and a “fix” of Medicare payments to doctors. Without action by the end of the month, those laid off after June 1 would have to pay the entire cost of continuing their health insurance and doctors could see their Medicare payments slashed by 21 percent.

Transparency/Safety

NIH Proposes New Funding Rules to Prevent Conflicts of Interest; The Washington Post - May 21, 2010

The National Institutes of Health proposed new guidelines Thursday to prevent financial conflicts of interest among thousands of researchers who receive federal funding, a move long sought by watchdogs of scientific research concerned about the influence of the drug industry and others.

Wellness/Chronic Care

When Patients Don’t Fill Their Prescriptions; The New York Times – May 21, 2010

As Dr. Pauline Chen writes in her Doctor and Patient column, the issue of “nonadherence” with medication is a growing problem in medicine.

The Vermont Accountable Care Organization Pilot: A Community Health System to Control Total Medical Costs and Improve Population Health; The Commonwealth Fund – May 21, 2010

This report describes the efforts of three health care provider organizations in Vermont that are planning pilot tests of accountable care organizations, to be launched next year as part of a national learning network.

Two Drugs Can Make Cancers Less Fatal ; The Wall Street Journal - May 21, 2010

New uses for two established cancer drugs significantly increased the time patients survived without their disease progressing, in studies that provide fresh evidence of how cancer is often becoming a chronic disease.

State news

FL: Medicaid Pilot Hearings Begin; Health News Florida – May 21, 2010

A massive overhaul of Florida’s Medicaid system is on the shelf — at least for now. But get ready for three more years of debates over the pilot managed-care program that former Gov. Jeb Bush left behind, with hearings starting Friday. 

MA: Doctors in Texas to Aid Area Hospitals; The Boston Globe – May 21, 2010

A group of community hospitals in Southeastern Massachusetts has taken the unusual step of partnering with doctors from an out-of-state academic medical center to provide cancer treatment — instead of one of Boston’s prestigious hospitals. Southcoast Health System has signed an affiliation agreement with doctors from MD Anderson Cancer Center in Houston.

Medicare/Medicaid

Health Reform’s Changes In Medicare; Health Affairs – May 20, 2010

An overview of the Medicare provisions that will take effect over the next five years.

Implementing the Legislation

Poll: Schedule Fails to Sway Public; Politico – May 21, 2010

A new poll, released this morning by the Kaiser Family Foundation, suggests the accelerated implementation schedule has failed to sway a skeptical public — or even keep health reform’s most ardent supporters on board.

The Prevention Dilemma ; Kaiser Health News – column by Robert Gould, President & CEO, Partnership for Prevention – May 21, 2010

There will never be enough federal money to address every prevention need.  What Secretary of Health and Human Services Kathleen Sebelius needs to decide is whether there is sufficient political courage to concentrate early prevention funding to deliver a knockout blow to the leading cause of premature death in the country: tobacco. 

The Impact of Health Reform on Health System Spending; The Commonwealth Fund – May 21, 2010

New estimates released today by The Commonwealth Fund and the Center for American Progress (CAP) show that the health reform law passed in March could reduce annual growth in health care spending from 6.3 percent to 5.7 percent over the next decade—a savings of $590 billion—while lowering annual premiums by nearly $2,000 for the typical family and extending coverage to 32 million previously uninsured individuals by 2019. Click here to read the issue brief.

Employers

Survey: Employers See Health Care Hikes in 2011; AP/Google News – May 20, 2010

More than 40 percent of employers surveyed by the consulting firm Mercer expect health care reform to raise health care costs by a modest 2 percent or less next year.

National Restaurant Association, UnitedHealth Team Up on Insurance for Restaurant Workers; The Chicago Tribune – May 21, 2010

The National Restaurant Association and insurance giant UnitedHealth Group Inc. are teaming up in an attempt to make coverage more accessible to millions of restaurant workers without health benefits, three years ahead of when the health care overhaul would require everyone to have insurance.

Goodbye, Employer-Sponsored Insurance ; The Wall Street Journal – op-ed – May 21, 2010

John Goodman, president and CEO of the National Center for Policy Analysis, writes that “Millions of American workers could discover that they no longer have employer-provided health insurance as ObamaCare is phased in. That’s because employers are quickly discovering that it may be cheaper to pay fines to the government than to insure workers.”

Visit the Health Policy News blog for archived Health Policy Reform News articles.

TOP STORIES

Democrats Try to Calm Doctors’ Lobby on $88.5B Medicare Plan ; The Hill - May 20, 2010

House Democrats are seeking to assuage doctors worried about looming cuts to Medicare rates. The effort comes one day after the American Medical Association declared its opposition to a proposed five-year fix to the payment system, which it said only serves to kick the problem down the road. AMA supports repealing the Medicare payment formula. 

Insurance

Study: Uninsured Don’t Go To the ER More Than Insured ; USA Today – May 20, 2010

Those with health insurance are just as likely to use the emergency room as people without insurance, according to a new report by the Centers for Disease Control and Prevention.

Transparency/Safety

FDA Urged to Make Public More Company Data; AP/Yahoo News – May 20, 2010

U.S. Food and Drug Administration should make more information public, including its reasons for refusing to approve a drug or device, an agency task force recommended on Wednesday.

State news

FL: Jackson Health System Consultant Fees Subject of Fierce Debate; The Miami Herald – May 20, 2010

Experts and politicians debate whether cash-strapped Jackson should spend $10 million for consultants.

MN: Twin Cities Nurses Reject Contract Offer, Setting the Stage for a Strike; The Minneapolis Star-Tribune – May 20, 2010

Minneapolis-St. Paul nurses voted overwhelmingly to authorize a one-day strike at 14 hospitals, raising the stakes for both sides in the struggle to reach a new contract.

Medicare/Medicaid

Disabled Face Hard Choices As States Slash Medicaid ; The Wall Street Journal - May 20, 2010

Home health care—funded largely by Medicaid—generally costs less money than institutionalizing developmentally disabled people. But the political reality is that it’s easier to cut back home services than to close a 24-hour facility, which can leave people with nowhere to go. Thus, some of the biggest cuts around the country are happening in the basic services that help the disabled cope at home.

Prescription drugs

Medco Report Finds Big Jump in Child Prescriptions; AP/ABC News – May 20, 2010

Prescription drug use among children grew several times faster than for adults last year, due in part to swine flu drugs and Type 2 diabetes medications, according to Medco Health Solutions Inc.

Employers

FACT CHECK: Tax-Cut Math Doesn’t Add Up For Some; AP/Google News – May 20, 2010

Tax credits to help small business pay for employee health coverage fall short of the “broad eligibility” White House officials promoted, The Associated Press reports.

Health Information Technology

MGMA Tells HHS New EMR Disclosure Requirements ‘Onerous’ ; HealthLeaders Media – May 20, 2010

The Medical Group Management Association told HHS this week that new HIPAA disclosure requirements for electronic medical records are burdensome, unnecessary, costly, and may discourage physicians from adopting the new technology.

Miscellaneous

Chip Pioneer, Genentech Vet Bring High-Tech Sensibility to Medicine ; The Wall Street Journal – May 20, 2010

The University of California-San Francisco is collaborating with the University of California, Berkeley to offer a two-year master’s degree in “translational medicine,” the discipline of transferring lab breakthroughs to the marketplace. A Q&A with

Visit the Health Policy News blog for archived Health Policy Reform News articles.

Insurance 

Report: 2-Million Person Increase in Health Savings Account Enrollment; America’s Health Insurance Plans – May 2010 

A new AHIP report shows a 2-million person increase in Health Savings Account enrollment. Most notable: the increase largely comes from employer-based plan that have generally been a smaller player in this arena. Why the boom? Because of the economic downturn-HSAs are a generally a whole lot cheaper for employers and often for employees, particularly younger workers with lower health costs.

Transparency/Safety 

Florida Hospitals Take Aim at Infections; The Miami Herald – May 19, 2010 

Florida hospitals and surgeons have kicked off a new effort to find and prevent system problems that cause needless complications from surgery. The $800,000 program will try to find even simple errors that cause patients to develop infections and other problems that keep them in the hospital longer or force them to return with relapses. 

Academic Hospitals Team Up to Stop Catheter-Related Infections ; HealthLeaders Media – May 19, 2010

With Medicare threatening to reduce payments for hospital-acquired conditions, a consortium of academic medical centers is ramping up the effort to track and stop catheter-related bloodstream infections, a growing acute care concern. University HealthSystem Consortium, an alliance of 107 academic medical centers with 234 affiliated hospitals in the U.S., wants to reduce the number of catheter-related bloodstream infections, or CRBSIs, by streamlining systems of care and hospital practice cultures that cause them.

Wellness/Chronic Care 

The Battle Over Taxing Soda; The New York Times – May 19, 2010 

Sugary drinks cost much less than they used to and Americans drink more of them, raising costs for society as it copes with the obesity epidemic. 

State news 

AZ: State OKs Sales Tax Increase to Balance Budget; AP/Google News – May 19, 2010 

Arizona voters have approved a temporary sales tax increase designed to help the state avoid hundreds of millions of dollars in spending cuts to schools, health care and law enforcement.

FL: Miami-Dade Adds Tools for Possible Takeover of Jackson Health System; Miami Herald – May 19, 2010

Miami-Dade commissioners took a step toward removing the current Public Health Trust on Tuesday, approving a measure that allows them to sweep away the hospital’s governing board and replace it with a new seven-person panel if Jackson Health System’s finances worsen.

MA: Senate Approves Bill to Contain Health Costs; AP/Google News – May 18, 2010 

Wealthier hospitals would be required to make a one-time $100 million contribution to ease insurance premiums for smaller businesses under a bill approved Tuesday by the state Senate.

MN: Twin Cities Nurses Take Strike Vote on 14 Hospitals; The Minneapolis Star-Tribune – May 19, 2010 

Thousands of Minneapolis-St. Paul nurses from 14 hospitals are voting on whether to strike over a contract dispute centered on staffing levels and their pension plan. The voting by the 12,000 Twin Cities nurses will take place today. 

OK: House Overrides Health Care Bill Veto; Businessweek – May 19, 2010

The Oklahoma House has overridden Gov. Brad Henry’s veto of legislation to allow Oklahomans to opt out of a new federal health care overhaul law.

Medicare/Medicaid 

AMA Opposes ‘Doc Fix’ in Tax Legislation; The Hill – May 19, 2010 

The American Medical Association is opposing the Medicare “doc fix” included in the tax extenders bill House Democrats are preparing.

Four New Board Reps Named to MedPAC ; HealthLeaders Media – May 19, 2010 

Four new members have been appointed and two members reappointed to the 17-member Medicare Payment Advisory Commission: Scott Armstrong (president and CEO of Group Health Cooperative); Katherine Baicker, Ph.D. (professor of health economics in the Department of Health Policy and Management at the Harvard School of Public Health); Mary Naylor, Ph.D., R.N. (Marian S. Ware Professor in Gerontology and director of the New Courtland Center for Transitions and Health at the University of Pennsylvania School of Nursing); and Cori Uccello, a senior health fellow of the American Academy of Actuaries.

Implementing the Legislation 

Talk of the Nation: How The Health Care Law Affects You; NPR – May 18, 2010 

Kaiser Health News staff writer Mary Agnes Carey and The Wall Street Journal’s Janet Adamy discussed the many ways the health overhaul law will affect health care consumers young and old, and especially people with Medicare coverage on NPR’s Talk of the Nation.

Employers 

WSU Survey: Health Care Reform May Cause Decrease in Coverage; The Seattle Business Journal - May 17, 2010

About a third of Seattle-area executives said it may be cheaper for their businesses to stop offering health care benefits and pay fines in the wake of national health care reforms enacted earlier this year, a Washington State University survey discovered. 

Health Information Technology

Are Electronic Health Records Distracting to Your Doctor?; The Columbus Dispatch – May 19, 2010 

A new study finds that electronic medical records can both help and hinder doctor-patient relationships. 

Miscellaneous

Moody’s Predicts More Bad News For Nonprofit Hospitals; HealthLeaders Media – May 19, 2010

Non-profit hospital chiefs who think they’ve been dragged through the wringer with the credit crunch and the recession should not think the worst is over, according to a new Moody’s Investor Service report, which could be summed up in short: Brace yourselves for more bad news and changes for many years ahead.

Tough Medicine; The Minneapolis Star-Tribune – May 19, 2010

Nursing, once a job for life, runs headlong into wrenching changes in the hospital industry.

Zipnosis: Online Medicine in a Hurry; The Minneapolis Star-Tribune – May 19, 2010 

MinuteClinic entrepreneur Rick Krieger’s new venture, Zipnosis, lets patients get diagnoses online, for $25. The company started a pilot program at Park Nicollet this month.  

Chicago Readies Health Care High School; The Chicago Business Journal - May 19, 2010

In the fall, Chicago will open its first charter high school specializing in health care, a move local hospitals hope will help relieve chronic workforce shortages. Juniors and seniors will be able to earn credits by shadowing hospital workers and interning as assistant nurses and in other professions. 

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WellPoint CEO Is Grilled

The Wall Street Journal
May 19, 2010

Pressure is mounting on WellPoint Inc. Chief Executive Angela Braly, who faced tough questions about the health insurer’s practices at its annual shareholders meeting Tuesday, before the gathering ended abruptly after a director collapsed.

Ms. Braly is trying to quell concerns about her company’s highly public feud with the Obama administration over its pricing practices and allegations, which Wellpoint disputes, that the company drops coverage for women with breast cancer .

The feud came to a head May 9 when Ms. Braly sent a sharply worded letter to President Barack Obama chastising him for attacks on the health-insurance industry. Over the ensuing week, Ms. Braly has been navigating a public-relations crisis, battling fresh worries from investors, employees and brokers.

The sudden finish of Tuesday’s annual meeting came during a question-and-answer session after most of the meeting’s business was done. It followed the collapse of William H.T. Bush, a WellPoint director and the brother of former President George H.W. Bush. Mr. Bush was sent to an Indianapolis-area hospital, where he is “stable, alert and being evaluated,” according to WellPoint spokeswoman Kristin Binns.

One of the session’s first questions came from Arlene Zarembka, who owns a small law firm in St. Louis, and asked the company to explain a 41% rate increase the company originally said she would face, but which she says it later reduced to a 28% increase. She said she asked Ms. Braly, “What are you doing about these high rates of increase and how are you making sure what happened to me won’t happen to others?”

Ms. Braly answered the question by pressing her company’s broader message that it is merely passing on rising costs from other parts of the health-care system. “The recently passed [health overhaul] legislation does little to address the underlying cost issue,” Ms. Braly said, according to a spokeswoman. She expressed concern that “these soaring costs would challenge affordability for many.”

That stance could continue to put WellPoint at odds with Democrats, however, since rising prices could undercut President Obama’s signature domestic initiative. The administration is keeping a close eye on premium increases to make sure insurers don’t use the new law as an excuse to raise prices, according to an administration official.

Rob Stone, who owns 15 WellPoint shares and proposed that WellPoint study how to convert to nonprofit status, called Tuesday’s meeting “tense.”

After the meeting ended, about 100 protesters gathered outside WellPoint’s Indianapolis headquarters. The Main Street Alliance, a group of small-business owners that includes Ms. Zarembka, called on Ms. Braly to end the company’s “public-relations death spiral.”

The insurance industry’s price increases have become a lightning rod for criticism since WellPoint planned to raise prices on individual policies in California by as much as 39%.

In April, WellPoint, the national’s largest health insurer by membership, withdrew its California rate increases after errors were discovered in its filings. The company is now scrutinizing its calculations to resubmit the filing to the state’s regulator.

Bill Ryan, one of WellPoint’s outside directors, reiterated his support for Ms. Braly, saying, “She is the perfect person to have in these difficult times.” He added that the board has pressed the company about whether it could have anticipated some of its challenges. “We didn’t expect the administration to come at us in such an aggressive style,” said Mr. Ryan

A week ago, President Obama said his administration had recently asked an insurer to stop systematically dropping coverage of women with breast cancer. The president didn’t name the insurer, but WellPoint has been fending off accusations that it targets such women.

Ms. Braly denied the allegations and shot back at Mr. Obama for spreading “false information.” Health and Human Services Secretary Kathleen Sebelius has called on states to investigate WellPoint’s pricing practices. And last Thursday, the Senate Finance Committee asked Ms. Braly for a detailed account of how the errors occurred. Ms. Braly is frustrated by the flap with the administration, and is working to quiet fears and get back to running her company. “The goal is to have a positive relationship with the government at all times,” she said in an interview at her offices.

Last week, Ms. Braly met with the company’s managers in Brooklyn, N.Y., where several hundred gathered to ask questions and a few thousand tuned in to a television feed. There, she was grilled about the company’s reputation and why it was being singled out by the government.

A day later, Ms. Braly faced another round of questions from the company’s top brokers, who gathered for an annual meeting and pressed her on how it would repair relations with the administration. The same day, Ms. Braly dispatched her strategy lieutenant, Bradley Fluegel, to New York to handle queries from institutional investors.

WellPoint’s stock fell almost 10% on April 30, the day after the company disclosed mathematical errors in its California rate filing, and it hasn’t rebounded.

Jay Nogueira, vice president at one of the company’s top 10 shareholders, T. Rowe Price, said the stock won’t bounce back until investors were convinced that there isn’t another chapter in the hostility with the government. “These guys are not dealing well with the public limelight,” said Mr. Noguiera.

WellPoint and the administration are now trying to downplay the recent fracases. Ms. Sebelius gave a speech Friday about a mile from WellPoint’s headquarters, and said at a press conference that she will continue to keep the pressure on insurers and that WellPoint “has been a leader and a major player and we look forward to working with them.”

Visit the Health Policy News blog for archived Health Policy Reform News articles.

TOP STORIES

$35M for Dartmouth Health Care Delivery Center; AP/San Francisco Chronicle – May 18, 2010

Dartmouth College will establish the Dartmouth Center for Health Care Delivery Science, which will study ways to offer low-cost, high-quality health care, using a $35 million gift from an anonymous donor.

Related: In a Washington Post opinion piece, Dartmouth President Jim Yong Kim and Dartmouth-Hitchcock Clinic President James Weinstein write that studying health care delivery can help “tackle the twin problems of how to provide high-quality health care while lowering costs.” Click  here to read “Health Reform’s Next Test.”

Insurance

MA: Insurers Blame Rate Increase Cap for Losses Topping $150 Million; The Boston Globe – May 18, 2010

The four major Massachusetts health insurers posted first-quarter losses totaling more than $150 million, with three of them blaming the bulk of the losses on Gov. Deval Patrick administration’s decision to cap rate increases for individuals and small businesses.

Two Tiered Medical Care for Haves and Have Nots; The Fiscal Times – May 18, 2010

A small but growing number of physicians are abandoning traditional insurance-based practice to offer VIP treatment, including more time with patients, in return for upfront fees. Some health care experts view this as an ominous trend that could exacerbate socioeconomic disparity in the health care system in light of a looming doctor shortage.

Insurance Affects ICU Survival Rate in U.S.: Study; Reuters/Yahoo News – May 18, 2010

Intensive care patients who did not have health insurance were 21 percent more likely to die than insured patients, U.S. researchers reported on Monday.

Wellness/Chronic Care

Food Firms Pledge to Cut Calories in Fight on Obesity ; The Wall Street Journal – May 18, 2010

Sixteen food makers on Monday pledged to cut 1.5 trillion calories from their products by 2015 as part of a White House campaign to combat childhood obesity. But it will be difficult to measure whether food companies meet the goal, and many of the industry’s biggest players haven’t signed on.

Dramatic Surge Seen in Kids Hospitalized With MRSA; AP/Google – May 18, 2010

The number of children hospitalized with dangerous drug-resistant staph infections surged 10-fold in recent years, a study found.

State news

FL: Change in the air over control of troubled Jackson Health System; The Miami-Herald – May 18, 2010

After months of debate, the Miami-Dade Commission will vote Tuesday to give itself the option to do away with the current Public Health Trust and create a new board if Jackson’s finances worsen.

MA: Hospitals Report Hefty Reserves; The Boston Globe – May 18, 2010

Massachusetts hospitals are sitting on billions of dollars in reserve funds, according to a report released yesterday by the Patrick administration.

MN: Budget Deal: Nobody’s Cheering; The Minneapolis Star-Tribune – May 18, 2010

DFLers and Gov. Tim Pawlenty ended an exhausting legislative session Monday, patching the state’s ailing budget by delaying $2 billion in school payments and adopting $1 billion in largely one-time cuts. The deal gives Pawlenty or his eventual successor the power to decide whether to shift thousands of low-income Minnesotans from a state health-care plan to Medicaid ahead of a federal timetable.

MN: Twin Cities Nurses’ Union Eyes 1-Day Walkout; Minneapolis Star-Tribune – May 18, 2010

The union that represents 12,000 Minneapolis-St. Paul nurses said that it will limit any potential strike to one day, removing at least for now the specter of an open-ended walkout.

Utah: Increase in Health Tests, Procedures is Raising Costs in Frugal State; The Washington Post – May 18, 2010

Until recently, Provo, Utah seemed to be a model for the nation. But spending on Medicare patients here has accelerated rapidly, as it has in many other areas of the country that are known for cost-efficient care.

The culprit: a swift increase in the number of procedures and tests being performed — a trend that has coincided with the additions of new surgical and cancer treatment suites and diagnostic machines at hospitals and clinics throughout the growing region.

Medicare/Medicaid

Waste in Health Care? For Some, It’s Profit; The Boston Globe – May 18, 2010

Globe columnist Joanna Weiss writes that “Anybody who has experience with our Medicare system knows that cheaper, more patient-friendly options exist than its rules permit. The problem is that changing those rules would mean less profit for the health care industry.”

Texas Doctors Opting Out of Medicare at Alarming Rate; The Houston Chronicle – May 18, 2010

Texas doctors are opting out of Medicare at alarming rates, frustrated by reimbursement cuts they say make participation in government-funded care of seniors unaffordable.

Implementing the Legislation

In Health Law, a Clearer View of Coverage; The New York Times – May 18, 2010

Starting in 2014, insurers will be required to offer a clearly defined package of essential health benefits comparable to the comprehensive coverage ordinarily provided by employer plans.

Amid Concern, White House Speeds Up Health Care Benefits; Politico – May 18, 2010

President Barack Obama and his Democratic allies are using the levers of government to speed up and promote what they consider the most popular aspects of the new health care law before a highly skeptical public passes judgment in November. 

New Health Law Allows Uninsured to Receive Medical Care Via High-Risk Pools; The Washington Post – May 18, 2010

If you’re sick — or have ever been sick — and can’t get insurance, the new health-care law promises fast relief: access to guaranteed coverage through a special federally funded insurance program starting in July. The goal is to provide comprehensive and affordable coverage to more people. But as the starting date approaches, uncertainties abound.

Firms Put Limits on Mental Therapy; The Boston Globe – May 18, 2010

Spiraling medical costs have driven many employers to place new limits on coverage for mental health care, raising concerns that the rules may violate federal regulations intended to make it as easy for patients to see therapists as other doctors.

Prescription drugs

Brand-Name Drug Prices Rose 9.7% Last Year, AARP Says; The Wall Street Journal – May 17, 2010

The AARP says that manufacturer prices for brand-name prescription drugs commonly used by people on Medicare rose 9.7% for the year ending in March — the biggest annual jump since the group started tracking prices in 2002.

Employers

W.H. Issues Health Care Tax Guidelines; Politico – May 18, 2010

The Obama administration on Monday issued rules allowing potentially millions of small businesses to claim tax credits in the health care overhaul, a move that could help incite support for the reforms among small businesses. Related: Millions of Small Businesses Could be Eligible for Health Care Tax Credits, The Washington Post

The Small Business Tax-Credit Gap; The Los Angeles Times – May 17, 2010

Under health reform, businesses with fewer than 25 employees are eligible for tax credits to help pay premiums. And, come 2014, those with more than 50 employees will be fined if they don’t provide insurance. But what about businesses in the middle, with between 25 and 50 employees? The Los Angeles Times on the dilemma this creates for one company.

Health Information Technology

Resisting the Push to Digitize; Politico – May 18, 2010

Numerous medical groups say that the aggressive government push to digitize is too much, too soon. Health information technology in the United States remains highly fragmented, so any large overhauls, experts warn, must work on a timeline that stretches years into the future.

Miscellaneous

Nobelist Is Chosen to Fill Cancer Post; The New York Times – May 18, 2010

Dr. Harold E. Varmus, in a return to Washington, will lead the National Cancer Institute and is expected to shake up the much-criticized federal cancer program.

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Health Overhaul Hits Sales Commissions
The Wall Street Journal
May 18, 2010

Among the first to feel the effects of the nation’s health-care system overhaul are insurance salespeople, whose commissions for selling policies to individuals and small groups are themselves getting overhauled.

The new law requires that insurers use at least 80% of the premiums to pay for medical care for patients rather than administrative costs and profit-taking. But many companies that sell health insurance to individuals and small businesses maintain a lower “medical loss ratio” because they use more of the premium to cover administrative expenses, including sales commissions.

The commissions typically run between 4% and 6% of a policy’s premium, but can be as high as 30% for the first year.

A recent Senate report found that companies targeting the market for individual policies paid only 74% of their premiums for medical expenses in 2009, while firms that target large employers generally met the law’s required ratio.

Companies are already starting to change how they pay salespeople. Starting on May 1, Independence Blue Cross of Philadelphia, Pa., stopped paying small-group agents a percentage commission and instead switched to a monthly flat fee for each contract sold.

The company’s small-group medical loss ratio is 85%, which is comfortably in line with the new regulations. But it wants to keep agent outlays flat amid rising medical costs, said Jim O’Connor, director of small group sales at the insurer, which covers about 380,000 small-group members.

Janet Trautwein, CEO of the National Association of Health Underwriters, which represents insurance agents and brokers, predicted that “eventually there won’t be any more percentage commissions.”

Commissions come in a dizzying variety of structures; a common flat fee is $15 per person.

“We do anticipate that agent and broker compensation will go down,” said Jeff Smedsrud, co-president of health insurance operations for Independence Holding Co., which takes in about $600 million annually in premiums sold through three subsidiaries, Standard Security Life Insurance Co. of New York, Madison National, and Independence American Insurance Co.

Insurers that target individuals and small businesses rely more heavily on agents than those that target large employers. What’s more, commissions per policy tend to be lower for large-group sales than for individual and small-group sales.

This June, American Family Insurance Co., a property and casualty insurer based in Madison, Wis., will hand over the administration of its individual insurance policies to American Enterprise Group Inc., because American Family decided it can’t shoulder the administrative costs, said a spokesman.

American Enterprise, based in Des Moines, Iowa, currently has 60,000 major medical policyholders and sells through 29,000 agents. That company is also re-evaluating its future.

“Subject to pending regulations, American Enterprise likely will need to reduce sales-related costs, such as commission percentages,” said spokeswoman Mary Durand.

Humana Inc., a large insurer with one million individual and small-group policyholders, also sees change coming. In a first-quarter earnings report to Wall Street on April 26, its chief executive, Michael McCallister, said that “there is going to be pressure on commissions; there is just no question about it.”

In Idaho, major insurers instituted flat fees between three and four years ago, according to Scott Leavitt, who runs the a three-agent firm in Boise. Initially, he suffered about a 20% drop in income on individual policies, he said, but he has been able to make that up.

The main reason: Mr. Leavitt had many older customers whose premiums—and therefore his percentage commission—were high because of their age. The flat fee on those customers was less than the old commission. But for young customers, the flat fee was higher, especially if they had children, on whom agents also earn a fee. Selling to such young families is the main way Mr. Leavitt said he has made up the initial loss.

In the small-group market, however, Mr. Leavitt now gets paid a flat fee per employee, regardless of how many dependents that employee has. He estimated that he has suffered a 25% loss in that market, which he hasn’t made up. Overall, he said, income on his health-insurance book of business is down about 15%.

Mr. Smedsrud, of Independence Holding, said another option would be for insurance companies to stop paying commissions altogether, and to have agents and brokers charge their customers instead.

The model, he said, would be “fee for service as a consultant, much in the same way that your financial adviser might charge 1% of each transaction for his advice.”

Given the complexity of the insurance market, he said, consumers might be willing to pay for advice when purchasing, and for help when filing or appealing claims.

Visit the Health Policy News blog for archived Health Policy Reform News articles.

TOP STORIES

Health Reform’s Next Test; The Washington Post – May 17, 2010

Health insurance reform is now law, giving millions of Americans access to the full resources of our health care system for the first time. The question becomes: How can we ensure that they, and all of us, receive value-based and high-quality care?

Rivals Unite to Mull Reform’s Next Steps; Politico – May 17, 2010

Some of the most powerful industry groups that battled against each other during the health care debate have now teamed up and raised $450,000 to explore the idea of creating a national nonprofit that would help implement key parts of the law – the idea for the organization is tentatively named Enroll America.

INSURANCE

A Scrappy Insurer Wrestles With Reform; The New York Times – May 17, 2010

In the last several months, Ms. Braly, the chief executive of WellPoint, has tangled with state regulators, Congress and the Obama administration over concerns that it charges customers too much or engages in questionable tactics to avoid paying claims.

Health Insurers Try to Shape Rules; The New York Times – May 15, 2010

Insurance lobbyists are trying to shape regulations that will define “unreasonable” premium increases and require them to pay rebates to consumers if the companies do not spend enough on patient care.

TRANSPARENCY/SAFETY

Consumer-Friendly System Emerges; Politico – May 17, 2010

Less than two months after President Barack Obama signed landmark legislation to give Americans more control over their health insurance, the American people are already seeing benefits.

WELLNESS/CHRONIC CARE

Abortion Foes Fought Obama Health Care, Now Use New Law; The San Francisco Examiner – May 16, 2010

Abortion opponents fought passage of President Barack Obama’s health care overhaul to the bitter end, and now that it’s the law, they’re using it to limit coverage by private insurers.

STATE NEWS

In the Middle in Arkansas, And Hit From Both Sides; The New York Times – May 17, 2010

Senator Blanche Lincoln is discovering with the overheated political passions battering incumbents this year, being in the middle only gets you hit from both sides.

Arizona Officially Joins Suit Against Health Reform; Arizona Central – May 17, 2010

Arizona is now officially among the plaintiffs in a lawsuit challenging the federal health reform law.

High-Risk Illinois Patients May Be Stuck Paying High Rates; Pantagraph – May 17, 2010

For thousands of Illinois residents who pay high health insurance premiums because of medical problems, the new federal health care legislation won’t offer relief.

MEDICARE/MEDICAID

In Berwick, Obama Chooses Innovative Leader for Medicare; The Boston Globe – April 17, 2010

Donald Berwick is well-qualified to make the many crucial decisions surrounding Medicare and Medicaid and could end up being one of the most significant appointees in the administration.

IMPLEMENTING THE LEGISLATION

Insurers, Commissioners Hammer Out Details of Health Care Reform; The Washington Post – May 17, 2010

The National Association of Insurance Commissioners is helping the government translate a new requirement that health insurers use at least 80 or 85% of their premium dollars to pay medical bills or otherwise improve consumers’ health into detailed rules.

Dems to Tout Reform’s Early Benefits; Politico – May 17, 2010

Congressional leaders opted for another, more reliable strategy: front-loading their legislation with consumer-friendly, insurance industry reforms and other fixes they hope will generate support for the new law in the run-up to the pivotal midterm elections.

EMPLOYERS

N.F.I.B. Joins Suit Against Health Reform; The New York Times – May 17, 2010

The National Federation of Independent Business has announced that it will join the 20 states that are suing to have the health care reform law invalidated.

Workplace Remains Key Source of Health Coverage; The Wall Street Journal – May 17, 2010

The share of Americans who get health coverage through their jobs has been declining gradually for years, dropping to 63.3% of working-age adults in 2008. The question now is whether the new health law will accelerate that trend, and induce more employers and workers to turn to government coverage options.

Administration Releases New Guidance on Small Business Health Care Tax Credit; Politico – May 17, 2010

A link to the full document outlining key facts regarding the new Small Business Health Care Tax Credit.

Health Care Overhaul’s Tax Provisions Have Small Firms Crying Foul; The Los Angeles Times – May 17, 2010

Small businesses fear they may face expensive new payroll paperwork requirements as part of a little-known tax provisions in President Obama’s health care overhaul.

Visit the Health Policy News blog for archived Health Policy Reform News articles.

Top stories

Small-Business Lobby Joins Challenge to Health Law; AP/Google News – May 14, 2010

The nation’s most influential small business lobby is joining a court challenge to President Barack Obama’s health care overhaul, arguing that Americans cannot be required under the Constitution to obtain insurance coverage.

Dems Feel Health Care Fatigue; The Hill – May 14, 2010

Healthcare reform fatigue has set in among Democrats, casting doubt that Congress will move much health-related legislation the rest of this session.

Insurance

High-Risk Insurance Pools Will Cost Eight Times More Than Forecasted, Expert Predicts; Fierce Healthcare – May 13, 2010

The federal government’s $5 billion plan for creating state-based high-risk insurance pools for uninsured patients could cost five times that amount, according to one healthcare analyst’s calculations.

Transparency/Safety

Doctors More Likely to ‘Cut Corners’ When Interrupted, Impacting Patient Safety; Fierce Healthcare – May 14, 2010

Physicians are more likely to cut corners to “catch up for lost time” when they’re frequently interrupted, putting patient safety at risk, according to a study published online today by Quality and Safety in Healthcare. The study comes on the heels of similar research showing that medication errors increase as nurses experience more interruptions.

Wellness/Chronic Care

He’s the Poster Child for Patient Empowerment; The Minneapolis Star-Tribune – May 14, 2010

“e-Patient Dave” turned his battle against cancer into a call for patient empowerment.

Medicare/Medicaid

Deficit Worries Make It Tough for Democrats to Move the ‘Doc Fix’; The Hill – May 14, 2010

House Democrats are struggling with how to prevent cuts to physician payments under Medicare.

D.C. Jumps at Health-Care Savings in Expanded Medicaid; The Washington Post – May 14, 2010

The District asked the federal government Thursday for permission to add thousands of low-income adults to the Medicaid program, becoming one of the first jurisdictions to respond to an expansion of Medicaid eligibility in the new federal health-care law.

Implementing the Legislation

GOP Pushes Back on Health Reform; Politico – May 14, 2010

After weeks of letting Democrats try to take control of the health care message, Republicans have gotten back into the game in recent days, threatening to hold up a Medicare nominee and challenging White House claims that reform’s start-up is going smoothly. 

Lobbyists Have Long Wish List For New Health Rules; Kaiser Heath News – May 14, 2010

Now that the health care bill is law, an array of groups — representing doctors, insurers, small businesses and others — have switched to their post-passage game plans. Among their top goals: Helping shape the all-important regulations being written by the Obama administration. Kaiser Health News has a sampling of their priorities and who will be pushing them.

Insurers, Commissioners Hammer Out Details of Health-Care Reform; The Washington Post – May 14, 2010

In comments submitted to the National Association of Insurance Commissioners (NAIC), which is helping the government translate the new requirement into detailed rules, members of the insurance industry have asked for permission to count a wide range of expenses.

Delivering Better Primary Care; The New York Times – May 13, 2010

A Q&A with Dr. Richard J. Baron, a general internist and geriatrician who leads the Greenhouse Internists, a five-physician primary care practice in urban Philadelphia, who has published two papers, both of which address the present and the future of primary care from the perspective of a community physician.

New Administration

Kerry Comes to Defense of Nominee to Run Medicare, Medicaid Programs; The Boston Globe  – May 14, 2010

Senator John F. Kerry rose to the defense of Harvard professor Donald Berwick yesterday, deriding Republicans who have used what Kerry called “phony assertions’’ to damage Berwick’s nomination to run the country’s Medicare and Medicaid programs.

Miscellaneous

Doctor Pooling Plan Sparks Fear ; The Wall Street Journal – May 14, 2010

A hospital trade association is developing a plan for hospitals around southern California to form a foundation that would supply them with doctors. The proposal by the Hospital Association of Southern California to create a joint medical foundation for its members is just one sign of the growing alignment between doctors and hospitals, a trend expected to be accelerated by the health overhaul.

Visit the Health Policy News blog for archived Health Policy Reform News articles.

TOP STORIES

GOP: Medicare Pick Favors ‘Rationing’; Politico – May 13, 2010

Senate Republicans revived their health care “rationing” theme Wednesday evening as they fired their first salvo in what’s expected to be a fierce battle over the confirmation Donald M. Berwick to be administrator of the Centers for Medicare and Medicaid Services.

Orszag: Healthcare Law Doesn’t Include More Spending Than Previously Reported; The Hill – May 12, 2010

A letter released by the Congressional Budget Office on Tuesday “simply updates” the calculation of the size of discretionary authorizations included in the legislation, says Office of Management and Budget Director Peter Orszag. 

Transparency/Safety

Regional Variations in Diagnostic Practices; The New England Journal of Medicine – May 12, 2010

The newly passed health care reform legislation includes substantial increases in funding for comparative-effectiveness research programs and establishes major initiatives that will move Medicare and Medicaid toward bundled payment systems. The writers of this report believe their findings underscore the need for additional efforts to advance risk-adjustment methods as reform proceeds.

Report: Health Claims for Food, Drugs Deserve Same Scrutiny; The Wall Street Journal - May 13, 2010

A report by the Institute of Medicine now says the FDA should be able to apply “the same degree of scientific rigor” to claims about cholesterol-lowering or immunity-boosting foods and nutritional supplements as it does to drugs and medical devices.

New Defibrillator Avoids Wires in Heart ; The Wall Street Journal - May 13, 2010

Researchers developed a new type of implantable defibrillator that avoids the traditional technique of connecting directly to the heart with wires that are associated with complications.

How Quality Will Pay for Hospitals Under New Reform Measures ; HealthLeaders Media – May 13, 2010

Hospitals will feel the pressure to maintain continuous quality improvement or risk being penalized under reform incentives scheduled over the next several years, according to a PricewaterhouseCoopers’ Health Research Institute report.

New Frailty Test Could Improve Surgical Outcomes, Reduce Cost Discrepancies ; HealthLeaders Media – May 13, 2010

A team at Johns Hopkins has created a simple, 10-minute “frailty” evaluation tool for doctors to use in their offices to much more accurately gauge whether elective surgery is more likely to help or harm a patient.

Wellness/Chronic Care

MA to Force Stores to Post Graphic Signs vs. Smoking; The Boston Globe – May 13, 2010

Massachusetts is poised to become the first state in the nation to force retailers to prominently display graphic warnings about the perils of smoking right where cigarettes are sold — at tobacco sales racks and next to cash registers.

State news

CA: Schwarzenegger’s Revised Budget Plan is Expected to Eliminate Health Programs; The Los Angeles Times – May 13, 2010

Gov. Arnold Schwarzenegger is expected to present a revised budget plan that would dismantle some of California’s healthcare programs after efforts to scale them back have been reversed by federal courts.

FL: Official Questions Auditors’ Silence on Jackson Health System; The Miami Herald – May 13, 2010

The treasurer of Miami-Dade’s public health system is pressing for answers over a disputed ‘famous $50 million’ charge at Jackson.

MN: Agreement Reached on Health Bill; The Minneapolis Star-Tribune – May 13, 2010

Minnesota House and Senate conferees reached agreement on a bill that would preserve the state’s core health and human services programs while cutting $114 million in the current budget cycle and another $155 million in 2012-13.

Medicare/Medicaid

Clarifying Sources of Geographic Differences in Medicare Spending; The New England Journal of Medicine – May 12, 2010

Although geographic differences in Medicare spending are widely considered to be evidence of program inefficiency, policymakers need to understand how differences in beneficiaries’ health and personal characteristics and specific geographic factors affect the amount of Medicare spending per beneficiary before formulating policies to reduce geographic differences in spending.

Implementing the Legislation

Feds Defend Health Reform’s Legality; Politico – May 12, 2010

The Obama administration has previewed its legal defense of health care reform in its response to a case in Eastern Michigan that sought to declare the individual mandate unconstitutional.

Health Law Guarantees Protections For Emergency Room Visits ; Kaiser Health News – May 13, 2010

Under the new health law, insurance companies must extend several new protections to patients who receive emergency care. One of the biggest guarantees: Patients who need emergency treatment will have their costs covered at the same rate, regardless of whether they are treated at “in-network” or “out-of-network” hospitals.

New England Journal of Medicine; May 2010

The New England Journal of Medicine has posted several articles related to health care reform, including:

The Cost Implications of Health Care Reform, Jonathan Gruber, Ph.D.
Health Insurance Exchanges — Key Link in a Better-Value Chain, Jon Kingsdale, Ph.D.
Health Insurance Reform and the Tensions of Federalism, Christopher C. Jennings, and Katherine J. Hayes, J.D.

Miscellaneous

How the Dakotas Keep Their Doctors: Sanford Merit Says: ‘We Grow Our Own’ ; HealthLeaders Media – May 12, 2010

It is well-documented that rural areas throughout the U.S. are provider-poor, and with the coming shortage of doctors estimated at 150,000 over the next 15 years, these areas may be especially challenged to find qualified practitioners. But apparently, Sanford Merit Care has overcome the physician recruitment challenge.

Visit the Health Policy News blog for archived Health Policy Reform News articles.

TOP STORIES

Health Overhaul Law Potentially Costs $115B More; AP/The Washington Post – May 11, 2010

President Barack Obama’s new health care law could potentially add at least $115 billion more to government health care spending over the next 10 years, congressional budget referees said Tuesday. Click here to read the CBO’s letter.

Related:

CBO Ups Health Care Cost Projections, Politico

Republicans Jump on New CBO Score to Blast Health Reform Bill, The Hill

Dems Sell Health Law Benefits; Politico – May 12, 2010

The Obama administration Tuesday night gave more shape to its health reform selling strategy: focus on the early roll-out of tangible benefits and, if all goes as planned, win over a skeptical public more than any argument ever could.

Insurance

Insured Workers’ Health Costs Still Rising; CNN Money – May 12, 2010

Out-of-pocket costs for the millions of Americans with employer-based health coverage rose again in the past year, although at a slower pace than the year before, according to a new industry report released Tuesday.

Transparency/Safety

Is Transparency a Price of Reform?; Politico – May 11, 2010

Some House Democrats are not content with the transparency requirements in the health care overhaul and say they’re committed to trying to force hospitals, pharmaceutical companies and other industries to reveal their price tags. 

Wellness/Chronic Care

White House Task Force Issues Report on Fighting Childhood Obesity; The Washington Post – May 12, 2010

Cabinet officials stood on stage with Michelle Obama on Tuesday to reveal the results of the White House Task Force on Childhood Obesity: The task force defined success by the numbers: returning this country to a childhood obesity rate of 5 percent by 2030.

Rachael Ray and Senator Lobby for School Lunch; The New York Times – May 12, 2010

Rachael Ray sounded off to lawmakers about what she considers to be the stingy reimbursement rates in the Child Nutrition Act.

When Incentive Payments to Doctors End, Quality of Medical Care Declines; The Los Angeles Times – May 12, 2010

One of the best ways to improve the quality of medical care is to give doctors a financial stake in their health of their patients. Studies show that targeting monetary incentives prompt doctors to focus on specific clinical outcomes. But what happens when those incentives are removed?

State news

Health-Care Overhaul is Up Against Long Campaign Across U.S.; The Washington Post - May 12, 2010

Efforts to block a key provision of the new health-care overhaul law are underway in 33 states, as a growing roster of mostly Republican officials have mounted legal and legislative challenges to an eventual requirement that virtually all Americans buy health insurance or pay a penalty tax.

Missouri Voters May Be Voting on the New Federal Health Insurance Mandate; The Kansas City Star – May 11, 2010

The Missouri House gave final approval to a measure that will appear on the Aug. 3 ballot stating that people and employers cannot be compelled to have health insurance nor penalized for paying for healthcare on their own.

Medicare/Medicaid

CMS Awards $9M to Four States for Medicaid EHR Incentives; iHealth Beat – May 11, 2010

On Tuesday, CMS announced that it has awarded over $9 million in federal matching funds to help four state Medicaid programs (including Minnesota’s) prepare to implement the electronic health record incentive program included in the 2009 federal economic stimulus package.

Medical Fraud Expert: ‘Unless You’re Very, Very Aggressive, You’re Going To Lose A Lot Of Money’ ; Kaiser Health News – May 12, 2010

Every year, the Centers for Medicare and Medicaid Services loses an estimated $65 billion to criminals who defraud the health care system, according to Lou Saccoccio, executive director of the National Health Care Anti-Fraud Association. And it’s his mission to stop it.

Implementing the Legislation

Washington Post Event: Health Reform And Its Implications (video); Kaiser Health News – May 12, 2010

Washington Post staff writers, David Hilzenrath, Amy Goldstein, Ceci Connolly, Alec MacGillis and David Brown discuss the new health care law and its implications.

Prescription drugs

FDA Urges Docs to Report Misleading Drug Ads; AP/Google News – May 12, 2010

The Food and Drug Administration said Tuesday it will begin asking doctors to keep an eye out for misleading drug advertisements as part of the agency’s latest effort to police the pharmaceutical industry’s multibillion-dollar marketing machine.

Employers

Bribe Your Workers to Be Healthy; CNN Money – May 12, 2010

Provisions in the new reform law offer aid, and even some cash, to small businesses that run wellness and prevention programs for their employees.

Miscellaneous

SEIU’s Henry Keeps Focus on Health Care; The Wall Street Journal - May 12, 2010

Mary Kay Henry, the new president of the Service Employees International Union, plans to keep recruiting health care workers to the union and expects the health-care overhaul bill will help SEIU do just that.

“I think we’ll see more workers wanting to join a union so they can have a say” in how their employers implement provisions of the health-care bill, Henry said in an interview with Washington Wire. Henry, who headed SEIU’s health-care division, said the legislation makes SEIU more important to workers, who’ll need the union’s help in sorting through complicated changes.

New SEIU President Eyes Leadership Shake-Up; CQ Politics – May 12, 2010

Major changes to the Service Employees International Union’s downtown operations could be under way soon.

Visit the Health Policy News blog for archived Health Policy Reform News articles.