2010 Potpourri XIX

HHS has issued a proposed rule which would address problems currently caused for telemedicine practitioners by CMS’ refusal to allow originating sites to accept privileging from distant facilities in regard to physicians doing telemedicine.  It is amazing that it took CMS as long as it did to figure out how stupid their original proposal was; as CMS put it “Upon reflection, we came to the conclusion that our present requirement is a duplicative and burdensome process”.  Well, duh.  In any event, this removes one of the several significant government impediments to greater use of telemedicine, a use which improves access and quality in most cases.  (HHS Proposed Rule)

Towers Watson has published the latest survey on what employers might do as a result of the health “reform” bill.   (Towers Watson Survey) The survey suggests that most employers don’t think the law did much of anything good–90% think it will increase their health care benefit costs; only 14% think it will do anything to help control overall health care costs; 25% think it will help encourage healthier lifestyles and 20% think it will improve quality.  That’s a resounding vote of confidence!  While the vast majority of employers say they will likely keep providing health benefits, they expect to reduce the coverage in the plans and pass the increased costs on to employees.  Finally, many either will or may eliminate their retiree medical coverage as a result of the law.

Gentiva is buying Odyssey Healthcare for about one billion dollars to create one of the largest home health care/hospice companies in the country.   There has been tremendous consolidation among home health care agencies and hospices in recent years.  Some of this is driven by reimbursement and regulatory changes that make it harder for local providers to sustain a profitable business.  Some is likely driven by the desire to create a national brand and economies of scale in operations and marketing.  The home health care and hospice markets are likely to see significant growth as the population ages and as lower cost sites of care are favored by government and private payers.   (WSJ Article)

Researchers at the University of Iowa have developed computer programs that appear to be as effective as humans at identifying which patients with diabetes may have eye problems.  (Science Daily Story) Retinopathy is a common complication of diabetes, but up to 50% of the patients with the disease don’t get an annual eye check, which is recommended.  The computer programs offer a low-cost method for quickly screening a number of patients, and those who may have problems can then be seen by an opthamologist.

John Goodman explains in a Wall Street Journal OpEd why many employers may be dropping health insurance as a result of the health “reform” law.  (WSJ OpEd) He gives several examples of how it will be cheaper for an employer to pay fines for not having coverage than to continue to pay rising health insurance premiums.  This obviously raises the cost of the public subsidies, since most of these workers without insurance would presumably then turn to the individual policies sold through the exchanges.  For most employees, they would actually get a bigger subsidy in the exchange than they currently do for employer-provided insurance.  He points out some likely unintended consequences of how firms might restructure to maximize subsidies for both low and high income workers.