Tuesday, May 24, 2011

Tuesday Tidbits

The AMA News reports about the continuing confusion created by the interim final regulations governing the Affordable Care Act's co-pay free preventive care mandate. Unfortunately, as public commenters, including the AMA and AHIP, have pointed out the rules are based on medical treatment guidelines not health plan coverage. rules. The AMA News highlights the problem as follows:
Physicians, health plans and consumer advocates hailed the new rules as a way to promote prevention and cut down on chronic illness. But so far, the reality has been mixed at best, as few patients seem to be either aware of the benefit or able to take advantage of it. Physicians also are confused about when to collect a co-pay, leaving some practices with refunds due to patients and others short on cash they could have collected rightfully.
A final rule clarifying the the ambiguities inherent in the interim rule is not expected soon.

Healthday, via the AHIP Hi Wire, reports about "a new report [in the Archive of Internal Medicine that promotes]  a "Top 5" list of action items for each of the primary care disciplines -- family medicine, internal medicine and pediatrics -- to help save money and conserve health resources." Perhaps health plans should exclude from coverage inconsistent actions as not medically necessary.

In an interesting development, Fierce Healthcare is reporting that the Mayo Clinic is now "sharing its hefty brand with health facilities around the U.S. that it doesn't own. The Clinic already covers 70 hospitals and clinics in Minnesota, Michigan and Iowa under its Mayo Health System umbrella. Going forward, Mayo will affiliate with more centers like Altru [Health System of Grand Forks, N.D.], and eventually build a nationwide group of partners, David Herman, a medical director at Mayo, told the [Rochchester, Minnesota, Post Bulletin] newspaper".

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