Physicians still largely control the levers of the health care system. Their perceptions of the system and their role in it therefore carry outsized importance. A detail survey by The Physicians Foundation reveals deep dissatisfaction among many doctors.
The Physician Group Practice Demonstration conducted by Medicare has largely wrapped up , to be supplanted by the accountable care organization programs. The PGP demo appears to have led to slightly improved quality and has led to slightly lower cost savings over traditional fee-for-service Medicare.
The Health Care Cost Institute releases a report on spending and utilization in the employer-based health care coverage market for 2011. Spending continues to rise faster than inflation or economic growth and is largely driven by higher prices charged by providers, not by increases in utilization.
The Center for Public Integrity has pointed out what was an obvious unintended consequence of greater use of electronic health records–providers will use the additional clinical information to feed billing systems that use the data to maximize coding for reimbursement. Medicare is already feeling the effects and other payers are likely to do so also.
Yet another report on hospital readmission work, this one from the Northeast Business Group on Health. Basically a puff piece full of obvious recommendations and bland nostrums, it purports to provide recommendations to addressing the readmissions “crisis”.
Bundled payments are designed to change the incentives for providers so that they manage patient care in a more cost-effective manner, hopefully without negatively affecting quality. A report from the Agency for Healthcare Research and Quality examines the research evidence to date on the effect of bundled payment approaches, finding that spending and utilization are probably lower, with an uncertain effect on quality.
The Government Accounting Office weighs in on the ongoing controversy over the effects of the Affordable Care Act on employment-based health insurance, reviewing a number of microsimulation models and employer surveys, finding that there is a wide range of estimates of a decrease or increase in the number of covered persons and substantial uncertainty in the accuracy of the predictions.
Yet another survey of the employer market, this one from Aon Hewitt, which also reflects views of employees covered under their companies’ health plans. Aon Hewitt finds that employers are stepping up their level of action in regard to designing and operating health plans and other programs to encourage better health.
We, among many others, have been harsh critics of Medicare’s misguided hospital readmissions penalty program, which begins this year. MedPAC has weighed in with its views on how to “refine” the program, but its recommendations will only exacerbate the flaws in the current regulations.
The Kaiser Family Foundation published its annual survey on Employer Health Benefits. While the rate of growth in both single and family health insurance premiums has slowed, it is still well above inflation, wage growth or GDP growth and while employee cost-sharing is relatively flat, the amount spent on health insurance by the average employee continues to grow far faster than income.
Another brilliant edition of our Potpourri, focusing on individual health insurance rate reform, variation in traumatic care costs, genetic counseling and diabetes, small business and health care costs and savings from wellness programs.
Research based on data from UnitedHealth Group’s commercial health plans finds wide variation in episode of care costs across both selected procedures and chronic diseases. The research also showed that for care provided by physicians meeting certain quality and efficiency benchmarks, episode of care costs were generally lower than for care provided by other physicians.
The Employee Benefit Research Institute has released a survey on consumers attitudes toward their health care coverage. Among three types of coverage, traditional, high deductible with no savings account and high deductible with a savings account, enrollees in high-deductible plans had similar overall levels of satisfaction to those in traditional plans, but greater dissatisfaction relating to cost-sharing.