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Health Care Econ-101 For Governor
/0 Comments/in Blog, Blog: Healthcare, Healthcare /byDuring an appearance on WTKK-FM today, Governor Patrick dipped his toe into the uncompensated care pool controversy that has been splashed over the pages of The Boston Herald. Here and here. Some highlights (lowlights) from the Inspector General’s report that sparked the stories have been: $7 million on care for non-Massachusetts residents. Claims were paid out for patients with home addresses in 48 other states, and a handful of foreign countries. $17.8 million for more than 60,000 “medically unlikely” or “medically unnecessary” claims, such as foot X-ray charges for patients suffering from headaches. Suspicious claims for gender-specific procedures for members of the opposite gender. (Such as gynecological bills for men) $6 million for 13,000 duplicate claims. 45% of those seeking […]
CMS Ignites ACO (Accountable Care Organizations) Debate
/0 Comments/in Blog, Blog: Healthcare, Healthcare /byToday the Centers for Medicare and Medicaid Services (CMS) released long awaited proposed regulations for accountable care organizations (ACOs). Under the federal Affordable Care Act (Obamacare), ACOs– which are associations made up of groups of health care providers—can share Medicare savings derived from improvements in care. In CMS administrator Don Berwick’s own words: The creation of ACOs is one of the first delivery-reform initiatives that will be implemented under the ACA [the national Affordable Care Act]. Its purpose is to foster change in patient care so as to accelerate progress toward a three-part aim: better care for individuals, better health for populations, and slower growth in costs through improvements in care. Under the law, an ACO will assume responsibility for […]
Medicaid’s Drug Problem: $329 million a year
/0 Comments/in Blog, Blog: Healthcare, Healthcare /byI have blogged before about the problems that we have here in Massachusetts with our exploding Medicaid costs (here, here, here)– roughly 40% of the budget this year. Alex Brill at American Enterprise Institute (AEI) updated a working paper titled Overspending on Multi-Source Drugs in Medicaid that brings attention to one of those cost drivers –the elevated use of multi-source drugs in Medicaid. Multi-source drugs are prescription drugs that are available in both brand and generic form. While the title may not draw in many readers outside of the health policy community, it highlights a very important issue that does (and will continue) to impact state budgets for years to come. The recently enacted Affordable Care Act (ACA or Obamacare) […]
Teacher pensions: Answering Your Questions
/0 Comments/in Blog, News /byLast week, I blogged on teacher pensions and the piece drew agreement and criticism. In response to critics, I’ll let the numbers speak for themselves. Today, I wanted to continue the conversation by following up on the good questions raised by commenters. How much do teachers’ salaries go up on average? Berkman34 and ChuckinMedford asked about the assumption of a 4.69 percent annual increase in salaries that underpins my average salary number for 2011. There are a few things to say on this which can be helpful. First, the 4.69 percent increase is simply what empirically happened between 2004 and 2009, which were also difficult fiscal years, and years in which municipal aid from the state was not seeing the […]
FactCheck.org: ‘RomneyCare’ Facts and Falsehoods
/0 Comments/in Blog, Blog: Healthcare, Healthcare, News /byA reporter from FactCheck.org visited Pioneer’s office a couple of weeks ago to learn more about the Massachusetts health reform law. Without a doubt this will be a big issue in the 2012 presidential campaign. I give the Annenberg Public Policy Center at UPenn and their FactCheck.org project credit for attempting to get ahead of the curve here. A few thoughts on the article: More Research Needed: There are still a lot of unknowns in Massachusetts. The data in the state is improving but much is still unclear. Pioneer has attempted to capture key metric in its Report Card Series. Interim Report Cards on Massachusetts Health Care Reform A) Increasing Access B) Equitable and Sustainable Financing C) Administrative Efficiency D) […]