Wednesday, September 7, 2011
Competition and Health Care Savings
Can someone point me in the direction of an article or any evidence (at all) that competition lowers health care cost? Where does this idea come from? Who shops around for the best price? Who clips coupons and scours the "ads" for a "cheap" doctor - no one. So why do the republican candidates keep talking about competition lowering the cost of health care.
Here is my alternative for the "unfair" public mandate that has come out of the Afordable Care Act - lets just have medicare for all.
Sunday, March 13, 2011
Know your FRAX risk; Docs -- USE the FRAX
On March 1 the USPSTF presented new guidelines on osteoporosis screening (1.). Yea, these were helpful. This guidelines states that women should look at a risk calculator called the the FRAX (Fracture Risk Assessment) tool (World Health Organization Collaborating Centre for Metabolic Bone Diseases, Sheffield, United Kingdom; www.shef.ac.uk/FRAX/) Women who are over 65 should get screening, we knew that. But women who are under 65 and have a risk equal to or greater than those that are 65 (based on other risk factors) should be screened.
In addition, a recent study from Canada confirmed that treatment based on 10-year risk of osteoporosis, ie., not treating women with low or intermediate risk did not result in higher rates of fractures. Yea for comparative effectiveness training.
So patients can take this FRAX test at home or be directed to take it while waiting for those physicals!
1. Screening for Osteoporosis: U.S. Preventive Services Task Force Recommendation Statement
U.S. Preventive Services Task Force, Ann Intern Med March 1, 2011 154:356-364
2. A Before-and-After Study of Fracture Risk Reporting and Osteoporosis Treatment Initiation, Leslie WD, et al Ann Intern Med November 2, 2010 153:580-586
In addition, a recent study from Canada confirmed that treatment based on 10-year risk of osteoporosis, ie., not treating women with low or intermediate risk did not result in higher rates of fractures. Yea for comparative effectiveness training.
So patients can take this FRAX test at home or be directed to take it while waiting for those physicals!
1. Screening for Osteoporosis: U.S. Preventive Services Task Force Recommendation Statement
U.S. Preventive Services Task Force, Ann Intern Med March 1, 2011 154:356-364
2. A Before-and-After Study of Fracture Risk Reporting and Osteoporosis Treatment Initiation, Leslie WD, et al Ann Intern Med November 2, 2010 153:580-586
Thursday, January 20, 2011
Why medicare advantage plans will be cut - From Don McCanne
U.S. Department of Health & Human Services
Office of Inspector General
January 18, 2011
Rollup Review of Impact on Medicare Program for Investment Income That Medicare Advantage Organizations Earned and Retained From Medicare Funds in 2007
If Federal requirements had been established to delay prepayments to Medicare Advantage organizations (MA organizations) until after the beginning of the beneficiary's coverage period by the same number of days that we estimated that MA organizations held Medicare funds, the Medicare Part A and Part B trust funds (which finance the Medicare Advantage program) could have earned approximately $450 million of interest income in calendar year (CY) 2007. Alternatively, if Federal requirements had been established to require MA organizations to reduce their revenue requirements in their bid proposals to account for anticipated investment income, the Medicare program could have saved an estimated $376 million that the 457 MA organizations that were included in our sampling frame earned in CY 2007.
We recommended that CMS evaluate these audit results and either (1) pursue legislation to adjust the timing of Medicare's prepayments to MA organizations to account for the time that these organizations invest Medicare funds before paying providers for medical services or (2) develop and implement regulations that require MA organizations to reduce their revenue requirements in their bid proposals to account for anticipated investment income. CMS did not concur with our recommendation.
http://oig.hhs.gov/oas/reports/region7/71001080.asp
Comment: Simply stated, the private Medicare Advantage plans receive hundreds of millions of dollars by investing advance payments of taxpayer funds used to pay their health care claims. This is not unusual since all insurers work the float. The longer they can hold on to premiums before they pay out benefits, the greater the returns from investing those funds. It is so commonplace that the Centers for Medicare and Medicaid Services did not concur with the Inspector General's recommendation to pursue changes to recover that investment income.
The opportunity cost of interest-free cash advances to private insurers is yet one more cost of our flawed system of health care financing. It is a very real cost, amounting to hundreds of millions of dollars just for the private Medicare Advantage plans alone. This is just one more reason that we should establish our own public insurance program - an improved Medicare for all.
_______________________________________________
Quote-of-the-day mailing list
Quote-of-the-day@mccanne.org
http://two.pairlist.net/mailman/listinfo/quote-of-the-day
Office of Inspector General
January 18, 2011
Rollup Review of Impact on Medicare Program for Investment Income That Medicare Advantage Organizations Earned and Retained From Medicare Funds in 2007
If Federal requirements had been established to delay prepayments to Medicare Advantage organizations (MA organizations) until after the beginning of the beneficiary's coverage period by the same number of days that we estimated that MA organizations held Medicare funds, the Medicare Part A and Part B trust funds (which finance the Medicare Advantage program) could have earned approximately $450 million of interest income in calendar year (CY) 2007. Alternatively, if Federal requirements had been established to require MA organizations to reduce their revenue requirements in their bid proposals to account for anticipated investment income, the Medicare program could have saved an estimated $376 million that the 457 MA organizations that were included in our sampling frame earned in CY 2007.
We recommended that CMS evaluate these audit results and either (1) pursue legislation to adjust the timing of Medicare's prepayments to MA organizations to account for the time that these organizations invest Medicare funds before paying providers for medical services or (2) develop and implement regulations that require MA organizations to reduce their revenue requirements in their bid proposals to account for anticipated investment income. CMS did not concur with our recommendation.
http://oig.hhs.gov/oas/reports/region7/71001080.asp
Comment: Simply stated, the private Medicare Advantage plans receive hundreds of millions of dollars by investing advance payments of taxpayer funds used to pay their health care claims. This is not unusual since all insurers work the float. The longer they can hold on to premiums before they pay out benefits, the greater the returns from investing those funds. It is so commonplace that the Centers for Medicare and Medicaid Services did not concur with the Inspector General's recommendation to pursue changes to recover that investment income.
The opportunity cost of interest-free cash advances to private insurers is yet one more cost of our flawed system of health care financing. It is a very real cost, amounting to hundreds of millions of dollars just for the private Medicare Advantage plans alone. This is just one more reason that we should establish our own public insurance program - an improved Medicare for all.
_______________________________________________
Quote-of-the-day mailing list
Quote-of-the-day@mccanne.org
http://two.pairlist.net/mailman/listinfo/quote-of-the-day
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