Whitehouse to Prez: Dude, You’re Copying My Ideas! Keep it Up!

From the Whitehouse Press office:

New Obama Administration Goals for Medicare Mirror Sen. Whitehouse Recommendations

Senator Whitehouse has Been Urging Administration for Years to Set Clear Goals to Improve Care and Reduce Costs

Goals Resemble the Whitehouse-Steinberg Compact in Rhode Island

Washington, DC – Today the Obama Administration announced that it is setting clear goals and a specific timeline for reforming the way doctors and hospitals are reimbursed when treating Medicare patients. The goals announced today come after U.S. Senator Sheldon Whitehouse (D-RI) has been urging the Administration for years to set clear targets for health care delivery system reforms, arguing as early as 2011 that, “we can and must have a clear challenge to strive toward.”

In 2013 Whitehouse co-authored an opinion piece urging President Obama to set specific goals for reforming payment systems, noting that “at least 75 percent of Medicare payments should be assessed in some way other than fee-for-service” by 2020. Whitehouse also released a report in 2012 chronicling the Administration’s progress in implementing the delivery system reform provisions within the Affordable Care Act, and identifying payment reform as one of five key areas for reform.

“As we continue working to improve the delivery of care and lower costs in our health care system, it’s vital that we set clear, accountable goals,” Whitehouse said today. “Vague calls to ‘bend the cost curve’ will never galvanize our nation’s health care providers and insurers in the same way that specific goals with a number and date will. Today’s announcement by the Obama Administration reinforces the reforms already taking place under the Affordable Care Act and could accelerate the shift to a system that works better for everyone.”

More specifically, the U.S. Department of Health and Human Services (HHS) today set a goal of tying 30 percent of traditional fee-for-service Medicare payments to alternative payment models by the end of 2016, and tying 50 percent of payments to these models by the end of 2018. HHS also set a goal of tying 85 percent of all traditional Medicare payments to quality or value by 2016 and 90 percent by 2018. Whitehouse was briefed by HHS Secretary Sylvia Mathews Burwell in advance of today’s announcement.

Since 2011, Senator Whitehouse has been calling on the Administration to set a specific cost-savings target to drive health care delivery system reform efforts, and has identified payment reforms as one of the key areas in any such effort. More recently, he and Rhode Island Foundation President Neil Steinberg brought together a coalition of Rhode Island health care leaders to develop recommendations on how the state can improve care and lower costs. Among the recommendations they agreed to was to establish specific payment reform goals this year.

Senator Whitehouse has long been a leading voice for health care delivery system reforms. He founded the Rhode Island Quality Institute during his time as the state’s Attorney General, helped secure new investments in Health Information Technology in the American Recovery and Reinvestment Act, and was a strong advocate for the inclusion of delivery system reforms in the Affordable Care Act.

Despite expanded coverage, hospitals may see more bad debt – Nashville Business Journal

I definitely don’t want to harsh on anyone’s mellow about Obamacare, but this is the part that worries me:  the bad debt that hospitals are going to take on.  This issue is going to have to be reconciled somehow.

Despite expanded coverage, hospitals may see more bad debt – Nashville Business Journal.

Mississippi GOP Leaders Say They Will Resist Expanding Health Care

In case you wonder what Obamacare will look like in some states, here is an example of a state, Mississippi, that is already saying “Whoa, horsie!” when it comes to implementation.

Miss. Medicaid expansion unlikely, GOP leaders say – The Dispatch.

I wonder about the implementation here in Rhode Island and whether we will be able to extend health care coverage to all, given our sagging economy. As I said in an earlier post, I see health care as a potential economic driver, and I hope Rhode Island will find ways to make this happen.

As a health care practitioner, I am particularly interested in changes specific to children and families. For more on how the law specifically impacts children and families, the Children’s Mental Health Network has a page that gives a helpful breakdown of all the changes.

[Ninjanurse butts in to Kiersten’s post]
Lt. Governor Elizabeth Roberts sent an email with this–

Rhode Island has been implementing the federal health reform law for over two years, beginning with Lt. Governor Roberts’ early efforts in 2010 to ensure Rhode Island had a clear path ahead toward achieving universal coverage for Rhode Islanders. With the Supreme Court’s ruling, that path has been cleared for the state to move forward in partnership with the federal government and continue to benefit from its support and funding.

The Supreme Court decision means up to 120,000 uninsured Rhode Islanders will be able to enroll in healthcare coverage starting October 1, 2013 and will have access to the coverage by January 1, 2014. Rhode Island families and small businesses soon will have an online marketplace known as the RI Health Benefits Exchange where they can easily buy and compare health insurance options. Some residents will even qualify for free or low-cost insurance depending on their income. Rhode Islanders will begin to hear more about this marketplace in the coming months.

These are not empty words, but a work in progress. As much as I wish we could speed it up, I know that good people are working overtime to meet these goals.

One of those good people is a Republican, Christine Ferguson, who has been appointed by Governor Chafee as head of the new Rhode Island health insurance exchange. Ms. Ferguson has a long resume of health management experience in Rhode Island and Massachusetts and is a passionate and effective advocate for people in need of access to basic healthcare. We’re lucky to have her on our team at this point in time.

My Conscience Clause

I’m thinking about how my tax dollars are going to buy proton pump inhibitors for people who not only don’t have ulcers, don’t have raging gastric reflux– but people who tell me their stomachs are just fine!

I’m outraged. My religion, which I re-name weekly, forbids over-prescription of drugs of dubious benefit to people who don’t actually have a disease. My philosophy is called ‘evidence based’. It’s a minority religion, I’ll admit, but reality does have a way of sticking around whether it fits our narrative or not.

I demand that insurance companies stop funding proton-pump inhibitors for people who would do just fine with an occasional Tums. I demand that the secular authorities bow down to my authority as High Priestess (self-ordained) and re-arrange everyone’s insurance immediately.

Don’t whine to me that your stomach hurts. I have conscience, and I’m exercising it on you.

Toxic Debt Ceiling Collapses on US Elderly

AARP released a statement about the newly passed legislation on the debt ceiling. While in the first two paragraphs, it’s clear they are trying to be nice, by the third paragraph, they are getting down to business about what is wrong with this legislation. From the statement:

“We are relieved that Congress has acted on a bipartisan agreement to address the debt ceiling and prevent default to ensure that seniors will continue to receive their Social Security checks and have access to health care. We are also gratified that after hearing from millions of AARP members, the President and Congress did not cut Social Security, Medicare and long-term care in the first round of deficit reduction.

“Going forward, we are pleased that Social Security, Medicaid and Medicare benefits are protected if the so-called “super committee” fails to reach an agreement later this fall, but we will remain vigilant in our efforts to protect the health and retirement security of seniors and future retirees. We are concerned that a fast-track committee process will deny Americans a voice in the discussion about critical tax, health and retirement issues. We also are concerned about the potential use of a trigger that would arbitrarily cut provider payments under Medicare, which could unfairly shift costs to seniors.

“Seniors have worked their entire lives to achieve a level of health and economic security in retirement. As the deficit debate continues, AARP will continue to impress upon Congress the need to protect Medicare and Social Security from harmful cuts. With the compounded effect of loss of retirement savings and home equity, high unemployment and rising health care costs, cuts to the benefits seniors have earned could undermine the standard of living of not just those with limited incomes, but middle class seniors who have median incomes of only $18,500.

“AARP will continue to raise the voices of millions of Americans who rely on their Social Security and Medicare benefits and oppose benefit cuts for deficit reduction. Americans want a broader conversation around health and economic security, not one focused solely on deficit reduction.

“AARP believes that the American public deserves a seat at the table in any forum, including the newly created super committee, that discusses potential changes to these critical programs. We believe that our nation’s leaders should work together to strengthen health and retirement security for current and future generations.”

Who is going to be on this “Super Committee”? Is this “Super Committee” going to supplant Congress? How many seats on the Super Committee are going to be reserved for the already-super-influential corporations?