The Health Care Blog

"The possible" vs "what we want," resumed

By Matthew Holt Not so long ago (actually less than 2 weeks), there was quite the spat on THCB between the Four Horseman (Klepper, Kibbe, Lazewski & Enthoven) and Maggie Mahar. Essentially it came down to this question: Is there...
November 17, 2009 in Matthew Holt, Medicare, Policy, Policy/Politics | Permalink | Comments (4)

Medicare’s Biggest Change in 40 Years on the Horizon?

By Vince Kuraitis Earlier this week CMS issued a typically cryptic Announcement indicating that they were shelving the Medicare Medical Home Demonstration (MMHD) and instead would focus on the recently announced Multi-Payer Advanced Primary Care Initiative (MAPCI). My blog post...
November 11, 2009 in Medicare | Permalink | Comments (1)

CMS Reinstates Paying for Avastin Used Off-Label for Macular Degeneration

MERRILL GOOZNER Medicare has reinstated payment codes for eye specialists who use Genentech's Avastin to treat wet macular degeneration. A tiny amount of Avastin, which is sold for cancer treatments, successfully treats the condition at about $100 per shot. Genentech...
October 29, 2009 in CMS, Medicare, Merrill Goozner | Permalink | Comments (2)

Hiding In Plain Sight: Using Medicare To Solve The ‘Public Option’ Conundrum

By JEFF GOLDSMITH As Senate and House Committee versions of health reform move toward unified legislation and floor votes, the most complex political challenge is how to resolve the “public option” controversy. While one would have thought weightier issues such...
October 21, 2009 in Jeff Goldsmith, Medicare, Public Option, Reform | Permalink | Comments (53)

Pop the Cost Bubble: Unallot Medicare

By Victor M. Sandler, MD Here’s a dirty little secret: Cutting health care costs is not that difficult, nor will it harm patients. That’s because it only involves giving up unnecessary medical care—tests and treatments patients may want but really...
October 5, 2009 in Costs, Medicare | Permalink | Comments (7)

Health Reform and Medicare: Part I

By THOMAS L. GREANEY Here’s a pop quiz on health reform: Which prominent Republican said the following: And if you don’t [oppose this health care legislation] and if I don’t do it, one of these days you and I are...
September 30, 2009 in Medicare, Public Option, Reform | Permalink | Comments (9)

Medicare Policy Might Discourage Proper Care for Hospital-Acquired Infections

By MAYA SEQUEIRA Medicare's recent policy of refusing to pay hospitals' additional costs to treat hospital-acquired infections fails to adequately incentivize prevention and proper treatment of these complications, associated with 99,000 deaths annually. A recent analysis by Peter McNair and...
September 29, 2009 in Medicare, Quality | Permalink | Comments (3)

Obama’s Medicare Half-Truth

By AUSTIN FRAKT Obama was called a liar during his recent address to a joint session of Congress. Actually, he was not fully truthful about the implications of cuts to Medicare. Obama repeated that his health reform plan includes payment...
September 20, 2009 in Economics, Medicare, Medicare Advantage, Obama, The Speech | Permalink | Comments (43)

Is an IOM v. CBO Smackdown Looming on Health-Reform Costs?

By TIM MULLANEY The U.S. can cut health-care spending by $250 billion a year within a decade, a congressionally chartered panel will say this month in a bid to show costs can be contained even if all Americans are insured....
September 15, 2009 in CBO, Economics, IOM, Medicare, Reform | Permalink | Comments (8)

Ornish Alienates HuffPo's Class Warriors

By MERRILL GOOZNER Ariana Huffington recently anointed diet-and-exercise guru Dean Ornish as her chief medical correspondent. With all the guff her site had taken from the science-based medicine crowd for giving free rein to anti-vaccinists, faith healers and the no-evidence-needed...
September 1, 2009 in Media, Medicare, Merrill Goozner, prevention | Permalink | Comments (3)

Time for a Closer Look (and Lower Costs)

By ROGER COLLIER One of the effects of the exaggerations, misinterpretations, distortions, and downright lies about Congressional health care reform proposals—mostly from far-right politicians and their hangers-on—has been to deter more objective analysis. In fact, two key features of the...
September 1, 2009 in Congress, Medicaid, Medicare, Public Option, Reform, Roger Collier | Permalink | Comments (3)

The Health Care Cost Shifting Myth

By AUSTIN FRAKT There is a pervasive notion that providers of health care can make up for lower payments received from one set of payers (e.g. Medicare, Medicaid, uncompensated care) by increasing prices charged to other payers (e.g. private insurance...
August 31, 2009 in Medicaid, Medicare | Permalink | Comments (53)

Expect to hear a whole lot about this...

By Matthew Holt Seniors care about death panels (apparently) but they usually really care about drug prices and costs. Part of the political rationale for the Republicans passing Medicare drug coverage in 2003 was to deny the Democrats the ability...
August 30, 2009 in Matthew Holt, Medicare, Medicare Advantage, Policy, Policy/Politics | Permalink | Comments (10)

Will Hospital Stocks’ Rally Continue?

By DON JOHNSON Since early July, most hospital companies’ stocks have been rallying in anticipation of relief from uncompensated care costs under proposed health insurance reform bills. On Wednesday, however, profit taking hit the stocks in a small way. The...
August 15, 2009 in Health Plans, Hospitals, Medicaid, Medicare | Permalink | Comments (4)

The Case for Price Ceilings for Health Services

BY DAVID HANSEN Most in the current health reform debate agree on the need to curtail health care costs. Despite this, few discuss directly how health services are priced, though clearly this a central issue. Prices have both immediate impacts...
July 27, 2009 in Costs, Managed Care, Marketplace, Medicare, Reform | Permalink | Comments (48)

The Case for Home Health Care

By Dr. George Taler While Congress is debating health reform and struggling to accomplish the apparently competing goals of reducing costs while improving quality, I am part of a program that does both. As co-director of the Washington Hospital Center’s...
July 25, 2009 in Chronic conditions, Congress, Costs, Home Health Care, Long Term Care, Medicare, Physicians, primary care, Reform | Permalink | Comments (8)

Can HR 3200 Be Fixed?

By ROGER COLLIER Health care reform looks like it’s stalled. And rightly so, based on the provisions of the House Democrats’ health care reform bill. The grossly misnamed America’s Affordable Health Choices Act (HR 3200) combines the worst of all...
July 23, 2009 in Congress, Medicare, Policy/Politics, Public Option, Reform, Roger Collier | Permalink | Comments (54)

Op-Ed: The Unintended Consequences of “No Pay for Errors”

By BOB WACHTER Medicare’s policy to withhold payment for “never events” – the first effort to use the payment system to promote patient safety – remains intriguing and controversial. To date, most of the discussion has focused on the policy...
July 21, 2009 in Bob Wachter, evidenced-based medicine, Medicare, Patient Safety, Quality | Permalink | Comments (3)

A Wild Pitch: HR3200 Brushes Back Health Reform

By JEFF GOLDSMITH On May 12, the flame throwing Chicago White Sox pitcher Bobby Jenks was fined for throwing behind an opposing player, Texas Rangers second baseman, Ian Kinsler. When Jenks, who can throw a 102 MPH fastball, was asked...
July 20, 2009 in Congress, Economics, Hospitals, Jeff Goldsmith, Medicaid, Medicare, Physicians, Policy/Politics, Reform | Permalink | Comments (24)

Eliminating Medication Waste in Long-Term Care Can Help the White House Pay for its Health Plan

By CARLA CORKERN The news of an $80 billion White House deal with drug companies to lower Medicare drug costs targets $30 billion in savings for consumers covered by Medicare Part D, but the sources of the remaining $50 billion...
July 14, 2009 in Costs, Long Term Care, Medicare, pharmaceuticals | Permalink | Comments (26)

No Country for Old Men

By JEFF GOLDSMITH As we enter summer, the health reform process is moving into its Newtonian phase: irresistible forces meeting immovable objects. In both health cost and access, the trend is not our friend. There is ample evidence not only...
July 6, 2009 in Jeff Goldsmith, Marketplace, Medicare, Obama administration, Policy/Politics, Reform, The Industry | Permalink | Comments (57)

Careful What You Wish For

By THE INCIDENTAL ECONOMIST On the left are those who would like health reform to include a strong public plan, one that could negotiate large provider discounts, driving down the cost of medical care. On the right are those who...
July 4, 2009 in AMA, CMS, Congress, Economics, Medicare, Reform | Permalink | Comments (25)

McAllen: A Tale of Three Counties

By DANIEL GILDEN Introduction The challenge of constraining costs while maintaining or enhancing the quality of medical care is vividly brought to life by Atul Gawande in his recent widely-read New Yorker essay. The anecdotal evidence presented in the article...
June 25, 2009 in Chronic conditions, Dartmouth Atlas, Medicare, Medicine, Policy, Policy/Politics, prevention | Permalink | Comments (55)

Op-Ed: It's the Waste, Stupid.

By MICHAEL PAINTER A recent Wall Street Journal editorial strongly challenged the notion that there is enormous waste in American health care. In the article the editors acknowledge that dramatic variation in health care spending exists across the country--but point...
June 12, 2009 in Costs, Medicare, Wall Street Journal | Permalink | Comments (6)

MedPac on Steroids

By MAGGIE MAHAR Maggie Mahar is an award winning journalist and author. A frequent contributor to THCB, her work has appeared in Barron's and Institutional Investor. She is the author of Money-Driven medicine: The Real Reason Why healthcare costs so...
June 5, 2009 in Congress, Medicare, Obama administration, Policy, Reform, Senate Finance Committee | Permalink | Comments (13)

Disruption breaking out over at Scott Shreeve's place

Clayton Christensen's publisher is pressing me to read The Innovators Prescription and then interview him. Sadly I haven’t had the time to pay the book the attention it deserves. Messrs Kuraitis & Kibbe already did a review on THCB and...
February 21, 2009 in Economics, HHS, Marketplace, Matthew Holt, Medicare, Scott Shreeve | Permalink | Comments (2)

Viciously Vladeck

The new Health Affairs is out and with it a lovely piece of vintage Vladeck. In a review of a new book on Medicare by old Brookings warhorse Henry Aaron and fast rising UT Longhorn star Jeanne Lambrew, Bruce Vladeck...
January 6, 2009 in Medicare, Medicare Advantage, Policy, Policy/Politics | Permalink | Comments (0)

Is Massachusetts a model for national reform?

By Charlie Baker I get asked this question a lot these days, which shouldn’t be that surprising. Harvard Pilgrim is headquartered in Massachusetts, and the Massachusetts health care reform plan is already a couple of years old. More importantly, it...
December 30, 2008 in Charlie Baker, Medicare, Obama administration | Permalink | Comments (18)

The Medicare Ponzi Scheme

By Eric Novack Just today, our next President spoke out against the largest investment swindle in US history. The alleged behavior of Bernard Madoff may have cost investors up to $50 billion. “In the last few days, the alleged scandal...
December 19, 2008 in Economics, Medicare, Policy/Politics | Permalink | Comments (19)

Now, Sleepless in San Francisco

By Matthew Holt Having returned from Seattle, the persistent itching from the sand-fly bites of Roatan has awakened me at 5 a.m. So I’m commenting on three pieces of news, which I've commented on before here and at Spot-On. First,...
December 5, 2008 in Health 2.0, Health Plans, Hillary Clinton, Marketplace, Matthew Holt, Medicare, Medicare Advantage, Policy, Policy/Politics | Permalink | Comments (1)

A Fantasy Brought to You by the New York Times: Medicine Without Risk

By Maggie Mahar Sometimes I agree with New York Times’ editorials. Sometimes I don’t. But I rarely learn much from them. To my mind, the problem with the form is that it encourages opining without evidence. So, I admit, I...
October 27, 2008 in Maggie Mahar, Medicare, Policy | Permalink | Comments (10)

Private Medicare plans face uphill battle to prove efficiency

By Robert Laszewski I have been struck by the optimism regarding private Medicare presented by health plan executives during the recent earnings season and the analysts failure to press them on just how their numbers will add-up to sustain the...
September 9, 2008 in Health Plans, Medicare, Medicare Advantage, Robert Laszewski | Permalink | Comments (2)

Medicare hospital quality reporting steps up in sophistication

By Bob Wachter Medicare is now reporting actual risk-adjusted mortality rates for pneumonia, MI, and heart failure. The topic must be important because NPR's "Talk of the Nation" spent 30 minutes interviewing Don Berwick and me about it -- on...
September 2, 2008 in Bob Wachter, Hospitals, Medicare, Quality | Permalink | Comments (2)

Pay doctors for the value they offer patients

By Maggie Mahar A frequent contributor to THCB, Maggie Mahar's work has appeared in the New York Times, Barron's and Institutional Investor. A fellow at the Century Foundation, Maggie is also the author of the increasingly influential HealthBeat blog, one...
August 19, 2008 in Economics, Maggie Mahar, Medicare, Physicians, Policy | Permalink | Comments (12)

Medicare could pave the way for national reform

By Maggie Mahar A frequent contributor to THCB, Maggie Mahar's work has appeared in the New York Times, Barron's and Institutional Investor. A fellow at the Century Foundation, Maggie is also the author the increasingly influential HealthBeat blog, one of...
July 25, 2008 in Maggie Mahar, Medicare, Policy | Permalink | Comments (8)

Health Systems' Ferocious Challenges

By Brian Klepper Lately, I've had interesting discussions with a thoughtful exec. at a major Western health system about the ferocious challenges facing hospitals and health systems. Her organization's internal conversations at the moment are centered, in part, on what...
July 22, 2008 in Brian Klepper, Economics, Hospitals, Medicare, The Industry, Transparency | Permalink | Comments (3)

Already counting down to the next physician fee cut

By Robert Laszewski Robert Laszweski has been a fixture in Washington health policy circles for the better part of three decades. He currently serves as the president of Health Policy and Strategy Associates of Alexandria, Virginia. You can read more...
July 14, 2008 in Economics, Medicare, Policy/Politics, Robert Laszewski | Permalink | Comments (3)

Ted Kennedy shows up to vote; McCain absent

By Maggie Mahar Maggie Mahar is an award winning journalist and author. A frequent contributor to THCB, her work has appeared in the New York Times, Barron's and Institutional Investor. She is the author of Money-Driven Medicine: The Real Reason...
July 10, 2008 in Maggie Mahar, McCain, Medical Devices, Medicare, Policy/Politics | Permalink | Comments (7)

The problem with Medicare Advantage

By Maggie Mahar Everyone understands why Congress was so reluctant to cut physicians’ fees. Reimbursements for primary care physicians are very low—so low that 30 percent of Medicare recipients who are looking for a new medical home can’t find one....
July 10, 2008 in Maggie Mahar, Medicare, Medicare Advantage, Policy/Politics | Permalink | Comments (13)

Senate votes to reign in private Medicare

By Robert Laszewski Robert Laszweski has been a fixture in Washington health policy circles for the better part of three decades. He currently serves as the president of Health Policy and Strategy Associates of Alexandria, Virginia. You can read more...
July 9, 2008 in Medicare, Medicare Advantage, Policy/Politics, Robert Laszewski | Permalink | Comments (5)