More news from the front in the ongoing consolidation wars, insurance vs. provider. This time, it is the American Medical Association expressing its concern about increasing health insurance consolidation. Keep in mind this is one perspective. Insurance companies would say the same about health care system consolidation. As I quoted David Cutler a couple of weeks ago in this space as saying, neither type of consolidation is ultimately in the best interests of those who matter most – our patients.
“Dr. Steven J. Stack, a physician who is president of the American Medical Association, said the Obama administration must carefully review the proposed mergers because ‘a lack of competition in health insurer markets is not in the best interests of patients or physicians.’
Insurers and some economists say that criticism of the mergers is inspired by self-interest — a fear that bigger insurance companies will cut payments to doctors and hospitals.”
Continue reading Health Policy Updates: September 12 2015
First this week, the big big news in the world of health policy was the Supreme Court’s decision in the King vs Burwell case. The ruling results in keeping in place the subsidies for insurance exchanges, one of the central parts of the ACA/Obamacare.
What does this mean? In short, the Obamacare is here to stay. The consensus I have been reading was that this was the last court case with the realistic potential to open up a big hole in the law. If anything is to change from here on out, it will need to go through the legislature, which is much harder to do. Continue reading Health Policy Updates: June 28 2015
The Supreme Court’s decision on the King v Burwell case – determining the future of the ACA’s insurance subsidies – is upcoming. What is going to happen if insurance subsidies get struck down? Besides chaos, or course…the Obama Administration is doubling down and has stated that it is NOT planning for this scenario. Meanwhile, the Republicans have a variety of proposals to fill in the gaps. Here is a (fairly critical) appraisal of the leading 5:
“Most of the plans would extend the availability of subsidies, while dismantling other parts of Obamacare. The result would likely be a world that looks much more like America before Obamacare – where fewer people are enrolled in coverage and are paying higher premiums.”
Continue reading Health Policy Updates: June 13 2015
The Government Accountability Office just released a report on Medicaid, in line with what previous reports had shown; the bulk of Medicaid patients (healthy children and low-income mothers) need little medical care and are therefore very “cheap” to insure, while the bulk (50%) of the program’s spending is taken up by just 5% of its beneficiaries. This is a long report, but most of the info is in the first chart on the first page if you want to take a look.
From the Atlantic, an examination of the trend of hospitals relocating in the pursuit of more profitable markets:
“Hospital officials point to their aging, landlocked facilities and argue it is cheaper to build, rather than renovate. What they don’t say publicly is how geography is often economic destiny for a hospital, especially at a time of increasing financial pressure as a result of Medicare funding cuts, including penalties that may result from new pay-for-performance measures in the Affordable Care Act
Continue reading Health Policy Updates: May 2 2015