Citizens’ Council on Health Care
CCHC HEALTH eNEWS
Tuesday, February 5, 2002
Providing news and commentary on
health care policy, health insurance issues, and medical confidentiality.
·
BUSH ADMINISTRATION PLANS FOR 24/7 HEALTH SURVEILLANCE
·
CAN “QUALITY” BE USED TO RATION CARE?
·
MSA AMENDMENT READY FOR VOTE IN CONGRESS
·
BUSH WANTS $25 MILLION FOR BEHAVIOR MODIFICATION
AND HEALTH PREVENTION STRATEGIES
·
2003 FEDERAL HEALTH BUDGET HEAVY ON BIOTERRORISM
·
HOSPITALIST PROGRAMS RESULT IN SIGNIFICANT COST SAVINGS
·
NEW HHS COUNCIL SIFTS PRIVATE REQUESTS FOR GOV’T
CONTRACTS
·
HEALTH PLANS ENCOUNTER RESISTANCE TO SOCIAL SECURITY
NUMBER
·
CCHC Commentary included
The U.S. Department of Health and Human Services has sent
letters to state governors detailing the portion they will receive of the $1.1
billion slated for bioterrorism response and other public health emergencies.
“The funds will be used to develop comprehensive
bioterrorism preparedness plans, upgrade infectious disease surveillance and investigation,
enhance the readiness of hospital systems to deal with large numbers of
casualties, expand public health laboratory and communications capacities, and
improve connectivity between hospitals, and city, local and state health
departments to enhance disease reporting. The funds come from the $2.9 billion bioterrorism
appropriations bill that President Bush signed into law Jan. 10,” according to
the HHS press release.
States will receive funds from three sources: the Centers
for Disease Control and Prevention, the Health Resources and Services Administration,
and the HHS Office of Emergency Preparedness. States will receive 20 percent of
their apportionment immediately and 80 percent after their plans to use the
funds have been approved. Plans are due
to HHS no later than April 15, 2002.
STATE BY STATE funding levels:
http://www.hhs.gov/news/press/2002pres/states.html
Sixteen criteria must be part of each state plan,
including:
·
Timeline for development of a state-wide plan for
response to a bioterrorist event, infectious disease outbreak, or other public
health emergency.
·
Ability to receive and evaluate urgent disease reports
from all parts of the jurisdiction on a 24 hour a day, 7 days a week basis.
·
Communication systems that provide a 24/7 flow of
critical health information between hospital emergency departments, State and
local health officials, and law enforcement.
Source: “HHS ANNOUNCES $1.1 BILLION IN FUNDING TO STATES
FOR BIOTERRORISM PREPAREDNESS, HHS press release, January 31, 2002, http://www.hhs.gov/news.
CCHC COMMENTARY: The surveillance and reporting
initiatives are part of the CDC’s Model Emergency State Health Powers Act, a
bill being considered in every state legislature that is in session in 2002.
Doctors, hospitals and pharmacists would be required to report on any patient
suspected of harboring a threat to the public’s health. Penalties for
non-compliance would be instituted. We
believe the $1.1 Billion adds incentive for passage of the Act.
Bioterrorism is not the primary purpose of the Act. For
more on
the Health Powers Act: http://www.cchconline.org/pr/pr120401.php3
·
Citizens’ Council on Health Care
·
February 5, 2002
MESSAGE FROM CCHC’s PRESIDENT:
This email publication is free, but it is not free to
produce. Please consider providing CCHC with a tax-
deductible contribution. Online credit card contributions
are taken at: http://www.cchconline.org/donate.php3
Six health plans in California have agreed to join
together to improve patient care and cut costs. They will evaluate provider
performance and provide doctors and hospitals with 5% bonuses of the billed
amounts for providing quality of care and avoiding medical errors. Aetna Inc.,
Blue Cross of California, Blue Shield of California, Cigna Corp., Health Net Inc.
and PacifiCare Health Systems have agreed to a common set of standards by which
to measure performance.
The California Medical Association and consumer groups are
wary of the plan. They are concerned that the dollars saved will end up in the
hands of employers and insurers. Some want government oversight of the plan.
The idea is to create objective standards by which all medications,
hospitals, doctors, and specialists can be judged. Creating the databases is a substantial concern. Henry Aaron, a senior
fellow at the Brookings Institution says, “We must be cautious about labeling
doctors and hospitals as poor providers of care.”
Source: “A Shift to Quality by Health Plans,” Ronald D.
White,
Los Angeles Times, January 14, 2002.
http://www.latimes.com/business/la-000003459jan14.story
·
Citizens’ Council on Health Care
·
February 5, 2002
The evening of Monday, February 4, Senator Craig filed and
offered the Torricelli-Craig Archer MSA amendment to the
Stimulus package on the Senate floor. The amendment would
expand and make permanent Medical Savings Accounts enacted
According to the Republican National Committee, “Absent Congressional
action, the Archer Medical Savings Account (MSA) demonstration program enacted
in 1996 will expire at the end of this year. The Archer MSA demonstration
program offers workers a low-cost, high-deductible private health insurance
policy coupled with a tax-preferred personal medical savings account for
out-of-pocket expenses.
Participants make regular, tax-free deposits into their
MSA to cover routine medical care up to the deductible; the insurance policy
covers expenses above the deductible. Because
the MSA is a personal account, any unspent funds belong to the participant and
continue to grow tax-free.”
1. Archer MSAs aid the economy by encouraging private
savings.
2. Archer MSAs mean health security for dislocated
workers. 3. Archer MSAs are extremely
cost-effective at expanding coverage to the uninsured.
4. Archer MSAs help contain health care costs.
5. Archer MSAs enjoy widespread, bipartisan support.
Source: “The Craig-Torricelli Health Security Amendment:
Five Reasons to Expand the MSA Option, RPC 2001 Policy
Papers
(http://www.senate.gov/~rpc/index99.htm )
http://www.senate.gov/~rpc/releases/1999/hc1020402.htm
·
Citizens’ Council on Health Care
·
February 5, 2002
President Bush’s 2003 budget includes $20 million for a new
“Healthy Communities Innovation Initiative” targeting diabetes, asthma and
obesity.
According to the HHS press release, the initiative “will fund
demonstration projects in five communities to enhance access to services,
encourage positive behavioral changes and improve community health.
The Centers for Disease Control is also slated to receive $5
million for a communications campaign “to teach Americans that even small to
moderate changes in lifestyle can make dramatic differences in health.”
“This year, I intend to ignite a national dialogue about the
state of America’s health,” said HHS Secretary Thompson. “Individuals have the power to protect their
health, and prevention is the key. Through adoption of healthy behaviors, we
can reduce the risk of illness and disease.”
Source: “HHS to Propose New Initiative to Build Healthy Communities,HHS
press release, February 1, 2002, http://www.hhs.gov/news.
·
Citizens’ Council on Health Care
·
February 5, 2002
Big changes are plans in 2003 for health care, according to
President Bush’s budget:
·
$9 Billion less to Medicaid
·
$4.35 Billion to Bioterrorism preparation ($1.5B to
research)
·
$113 billion over next 10 years to modernize Medicare
·
$77 billion over next 10 years to provide 90% of drug
coverage for certain low-income seniors
·
$3.7 billion increase to National Institutes of Health
(Total $27.3B)
·
$127 million increase for a five-year drug treatment
initiative
·
$10 million for a program to reduce medical errors.
The Bush budget requests more than biodefense experts had anticipated.
“The proposed budget seeks $5.9 billion for fiscal year 2003, which begins Oct.
1, up from the $1.4 billion approved for this fiscal year. The increase would “come on top of” a $3.7 billion
supplemental request that Congress has already approved.” according to Kaiser
Daily Health Policy Report.
The $10 million for reducing medical errors would be split
between The Agency for Healthcare Research and Quality and the Food and Drug
Administration. Added to recent appropriations by each agency, FDA spending on
patient safety would increase to $22 million and AHRQ funding for patient
safety would total $60 million.
Previous HHS press releases note that patient safety funds
are directed primarily at data systems and according to the HHS WEEKLY REPORT,
a portion of the funds for bioterrorism are directed at infectious disease
surveillance and “improve[d] connectivity between hospitals, and city and state
health departments to enhance disease reporting.”
Sources: HHS WEEKLY REPORT, 3-9 February 2002, February 4,
2002
http://www.hhs.gov/news/newsletter/weekly,
and KAISER DAILY
HEALTH POLICY REPORT, Monday, February 4, 2002
·
Citizens’ Council on Health Care
·
February 5, 2002
“Hospitalists” are a new breed of physician providing
inpatient care in a hospital in place of primary care physicians. The hospitalist
model of inpatient care is relatively young, and has experienced tremendous
growth over the last few years. This growth has important clinical, financial,
educational and policy implications. To analyze the impact of hospitalists on
the health care system, researchers recently review data regarding the effect
of hospitalists on resource use, quality of care, satisfaction and teaching.
Most of the studies researchers reviewed found that implementation
of hospitalist programs were associated with significant reductions in resource
use:
·
The average decrease in a patient’s hospital costs was 13.4
percent.
·
Average decrease in a patient’s length of stay was 16.6
percent.
·
The few studies that failed to demonstrate reductions usually
used atypical control groups.
·
However, the results were inconsistent for improved outcomes,
such as inpatient mortality and readmission rates.
Patient satisfaction was generally preserved, while
limited data supports the claim that there are positive effects on teaching. Previous research by the authors found some
negative reactions from those who worried about the “purposeful discontinuity
of care” introduced by the hospitalist model when a hospital physician took
over the care of a patient from the patient’s primary care physician. Although concerns about inpatient-outpatient
information transfer remain, recent physician surveys indicate general acceptance
of the model.
Source: Robert M. Wachter and Lee Goldman, “The
Hospitalist Movement 5 Years Later,” Journal of the American Medical Association,
January 23/30, 2002.
Source: Taken directly for Daily Policy Digest, National
Center
for Policy Analysis, February 4, 2002, http://www.ncpa.org/
For companies who want to pitch their security, data
system and health surveillance ideas, the Bush Administration has just set up a
new executive committee to entertain proposals. A one-stop-shop toward a
government contract. The the Council on Private Sector Initiatives to Improve
Security, Safety, and Quality of Health Care held their first meeting on
January 23. The council has already reviewed 18 requests, and met with three companies.
The mission of the new council, according to their web
site is:
“To ensure public health preparedness and the
preparedness, security, safety, and quality of the health delivery system.”
The December 6 letter to the heads of various federal
departments notes: “The Department is receiving a number requests from individuals
and firms seeking our review of their ideas for improving the security, safety,
and quality of our health care delivery system. The Department needs to foster
this creativity by ensuring that we respond systamatically (sic) and
consistently to these requests and provide constructive feedback as
appropriate.”
Council members include heads, or designees of the Centers
for Disease Control and Prevention, the Food and Drug Administration, the
National Institutes of Health, and the Centers for Medicare and Medicaid
Services, the Assistant Secretary for Health, the Assistant Secretary for
Planning and Evaluation, the Office of Public Health Preparedness, the
Department of Defense and the Department of Veterans Affairs.
Sources used: “HHS Creates Council to Review, Respond to
Private
Sector Innovation, HHS press release, February 5, 2002,
Letter from HHS Secretary Tommy Thompson, dated December 6,
2001. http://www.cpsi.ahrq.gov/sec12601.pdf
·
Citizens’ Council on Health Care
·
February 5, 2002
From the Workgroup for Electronic Data Interchange listserv
to CCHC via the Medical Privacy Listserv:
Subject: Obtaining
social security numbers
[....]
Date: Tue,
5 Feb 2002
To: “’privacy@wedi.org’”
<privacy@wedi.org>
Recently, we have been experiencing resistance from
members when we request their social security number and the numbers of their
dependents. Several letters from employees quote The Privacy Act. We are
considering not requiring dependents socials but this could negatively impact
HEDIS [Health Plan Employer Data Information Set] numbers since SSN’s are the
only way to track continuous enrollment.
I am wondering if other health plans are also experiencing
this and if they decided to not require social security numbers or have moved
to using another identifier.
[....]
[a health plan]
Source: med-privacy <med-privacy@venice.essential.org>
Subject: [Med-privacy]
Obtaining social security numbers
Date: Tue,
05 Feb 2002 10:08:49 -0800
NOTE: These news items have been taken directly
from email received by CCHC or from Internet
newspaper publications. Titles in ALL CAPS are
CCHC creations except for those heading articles
from the National Center for Policy Analysis,
the Health Law Pulse, PrivacySecurityNetwork,
and LIST.HEALTHPLAN. Credit to the sending
organization or news service is listed at the
end of each article.
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