Sunday, November 15, 2009

Weekend update / Miscellany

Reuters reports Senate Minority Leader Mitch McConnell's prediction made today that the health care reform bill, once introduced in the Senate, "will be on the floor for quite a long time." Senate Majority Leader Harry Reid has indicated that the bill which combines the Senate Finance Committee and Senate Health Education Labor and Pensions Committee approved bills will be submitted this coming week.

The Chief Actuary of the Centers for Medicare and Medicaid Services ("CMS"), Richard S. Foster, has issued his estimate of the financial effects of the health care reform bill (H.R. 3962) approved by the House of Representatives on November 7. He projects that the national health insurance coverage provisions of the bill would cost about $935 billion in order to extend coverage to 34 million people. Medicare savings would offset about $571 billion of this amount. However, those Medicare savings would be cut just about in half if the AMA gets its way and Congress repeals the sustainable growth rate formula for calculating Medicare reimbursement to doctors (H.R. 3961). He predicts that the health care system would not be able to handle the initial surge of new insureds, leading to price increases and cost shifting. He does not believe that the devices in the bill to bend the health care cost curve would be fruitful.

On Friday, CMS announced that

the results for the 2008 Physician Quality Reporting Initiative (PQRI). More than 85,000 physicians and other eligible professionals who satisfactorily reported quality-related data to Medicare under the 2008 PQRI received incentive payments totaling more than $92 million, compared to $36 million in 2007.

The number of eligible professionals who earned an incentive payment increased by one-third from 2007, when 56,700 eligible professionals earned an incentive payment. In 2007, eligible professionals could only participate in the program during a 6-month reporting period. In 2008, the program expanded to allow reporting for either a 6-month or a 12-month period.

Eligible professionals who participated in the 2008 PQRI can access confidential feedback reports that aggregate the data they submitted across all practices with which they are associated. The reports also show eligible professionals how they compare with other participants across the country who have submitted the same measures. CMS redesigned these reports for 2008 based on feedback from national stakeholder focus groups. Features in the new report include additional data formats and more information about reporting and performance rates per measure.

I think that I'll ask my doctor amigos whether they participate in PQRI.

Speaking of Medicare, the Medicare Advantage (Part C) and Prescription Drug Plan (Part D) open enrollment period starts tomorrow and runs through December 31 according to a CMS press release. "Beginning on November 15th, beneficiaries can go to www.medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to make changes in their Medicare prescription drug and health coverage. People in Original Medicare without prescription drug coverage can enroll in a drug plan or health plan that offers drug coverage during Open Enrollment."

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