The Medicare Payment Advisory Commission delivers an annual report to Congress on what it views as the pressing issues for the Medicare program. This year’s report touches on several issues, which have relevance for health care in general.
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Another excellent Agency for Healthcare Research and Quality has been released, this one examining the state of health information technology that enables patient-centered care. The report summarizes evidence on the utility of HIT for improving care quality and barriers to its further spread.
The New England Journal of Medicine contains an article on the relative review process and outcomes for the FDA, Health Canada, and the European Medicines Agency, with the surprising finding that the FDA is faster than its corresponding agencies.
One of the biggest issues facing retirees is health care costs, notwithstanding the availability of Medicare for many retirees when they retire and for all eventually. Stress over finances can also have a detrimental effect on retiree health. The Employee Benefits Research Institute issues a periodic survey on retirement-related trends which includes health questions. The data paints a bleak picture of retirement for most Americans. (EBRI Brief) Some of the basic findings are astounding, only 14% of Americans believe they will have enough money to live comfortably in retirement. Sixty percent report that the total value of their household’s savings and assets is less than $25,000, meaning they really have nothing to support themselves when they get to retirement. Consequently, it is not surprising that 37% now say they plan to retire after age 65, whereas only 11% said that in 1991.
In regard to health care, only 13 of workers and 24% of current retirees have confidence in their ability to pay medical expenses in retirement, much lower than there confidence in paying for other basic expenses. An even lower number, 9% of workers and 18% of retirees believe they will be able to pay for long-term, or nursing home, care. This uncertainty is a major source of stress, especially for older workers. Compounding these concerns is the finding that a large percent, almost half, of current retirees left the workforce unexpectedly, for health, disability or job loss reasons. These people were probably even more unprepared for retirement and probably have even higher health care expenses. All in all a grim picture, one which will undoubtedly put heavy pressure on policymakers to create some better solutions to prepare Americans to have a comfortable retirement.
The alleged primary spur for passage of the federal reform law was providing insurance for the uninsured, which supposedly would save money in the long run. An Oregon initiative has created an opportunity to see results from a similar effort and a report gives first year outcomes.
A 5 to 4 majority of the Supreme Court has upheld the constitutionality of the individual mandate, but only as a tax, not as an exercise of the Commerce Clause, and has eviscerated the Medicaid expansion. This is likely the worst possible outcome for President Obama, his Administration and the party that supported this ill-advised stab at “reform”.
The Agency for Healthcare Research and Quality has issued a report looking at use of clinical decision support and knowledge management systems, finding some evidence for positive health and cost outcomes, but also large gaps in our understanding of how to maximize the value of these technologies.
Use of emergency rooms is monitored as a potential indicator of access and quality problems. A recent study from the American College of Emergency Room Physicians analyses trends in both emergency room use and crowding.
It is officially the start of summer and our Potpourri is hot, hot, hot, but not steamy! This week we cover why health care IT doesn’t seem to create productivity gains, the use of whole-genome sequencing, the consequences on failure to comply with prescribed drug regimens and the rates of drug misuse and the potential savings for patients in CDHP plans.
The American Medical Association regularly assesses the administrative performance of the large health plans on issues relevant to physicians. This year’s report finds significant improvement in claims payment procedures and results.
About this Blog
The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at [email protected].
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