Friday, Aug. 10, 2007
The Washington Post on Wednesday published responses from three think tank officials to a recent opinion piece by Post columnist Robert Samuelson. In his piece last week, Samuelson wrote that the "major presidential candidates -- Republican and Democratic -- are dodging one of the thorniest problems they would face if elected: the huge budget costs of aging baby boomers" for Medicare, Medicaid and Social Security, and "Washington's vaunted think tanks -- citadels for public intellectuals both liberal and conservative" -- also have "tiptoed around the problem."
He proposed that "some public-spirited sugar daddy ... sponsor a short book" that would invite six think tanks, three liberal and three conservative, to discuss the issue. Such a book "would force think tanks to compete," he wrote, adding, "They'd have to make their vision of the future explicit within the untidy framework of government's past commitments. It would illuminate the connections between defense spending, retirement benefits, health care, economic growth and much more" (Kaiser Daily Health Policy Report, 8/1). Summaries of responses appear below.
Robert Bixby, Concord Coalition: "Think tanks are not political parties," Bixby, executive director of the Concord Coalition, writes, adding, "They are a collection of scholars who do not necessarily agree on specifics. Thus the absence of a competition among them on specific plans does not, as Samuelson implies, indicate venal motives." Bixby concludes, "The problem is not timid think tanks. It is timid politicians" (Bixby, Washington Post, 8/8).
Stuart Butler, Heritage Foundation: "Another book-length compendium of detailed plans, as Samuelson proposes, would do nothing to resolve" U.S residents' "emotional and contradictory feelings about entitlements and intergenerational obligation," Butler, vice president for domestic and economic policy studies at the Heritage Foundation, writes. He concludes, "That's why leading think tanks are focused on understanding and changing public perceptions about the values and risks involved in controlling entitlements, to improve the climate for political debate," adding, "That's why {The Brookings Institution] and Heritage have joined others in talking directly to real Americans and why we are working to structure public dialogues to explore ways to craft serious reform" (Butler, Washington Post, 8/8).
Maya MacGuineas, New America Foundation: "Samuelson suggests that think tanks aren't proposing specific solutions to the demographic and budgetary crises facing the country. As the recipient of more than my fair share of angry e-mails from people who haven't appreciated some of the specifics our think tank has recommended, I would respectfully disagree," MacGuineas, fiscal policy program director at the New America Foundation, writes. She continues, "Samuelson is right, of course, that one of the important roles of a think tank is to provide bold policy solutions to help move the political discussion forward. That is what the New America Foundation has been doing for years" (MacGuineas, Washington Post, 8/8).
Additional responses from think tank officials are available online as a part of the Post's regular Think Tank Town, which features such organizations debating public policy.
Reprinted with permission Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at The Kaiser Daily Health Policy Report, a free service of The Henry J. Kaiser Family Foundation. © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Showing posts with label Medicaid. Show all posts
Showing posts with label Medicaid. Show all posts
Friday, August 10, 2007
Texas Medicaid Beneficiaries Lack Access To Care, State Medical Association Says
Medical News Today - The Kaiser Daily Health Policy Report, Wed. Aug. 9, 2007
Only 18% of physicians in Austin, Texas, accept all new Medicaid beneficiaries, according to a survey of physicians by the Texas Medical Association, the Austin American-Statesman reports. According to the American-Statesman, "Austin has become ground zero in what some in the medical community are calling an unfolding Medicaid crisis in Texas."
The medical association's survey, which is conducted every two years, found that the number of physicians accepting all new Medicaid beneficiaries statewide declined from two-thirds in 2000 to 38% last year. The survey also found that 9% of orthopedic surgeons in the state accept all new Medicaid beneficiaries, and the percentages of some other specialists who accept all new beneficiaries also are in the single digits, the American-Statesman reports. Over the past year, the Texas Health and Human Services Commission said it has paid travel expenses for about 100 Medicaid beneficiaries in Austin to receive care in San Antonio, Texas.
William Hinchey, head of the state medical association, said, "Some of us believe [Medicaid] has collapsed because these patients do not have access to care like they should." Regina Rogoff, head of the People's Community Clinic in Austin, said Medicaid in the state has "effectively collapsed," adding, "If the state paid a fair rate for Medicaid, then those patients would be able to be seen in the private sector."
However, Stephanie Goodman, a spokesperson for the commission, said, "I could not disagree more strongly with that." Goodman said that the program has problems but is still functional, adding, "We pay for more than half of all births and two-thirds of all nursing home care. It is a huge program and takes up a quarter of the state's budget. Are there issues out there? Yes. But the good works shouldn't be lost."
Goodman said the situation should improve after Medicaid reimbursement rates to physicians are increased Sept 1. Some of the increases are required by a settlement in a 14-year-old class-action lawsuit filed by parents of children receiving Medicaid benefits who had difficulty finding physicians because of low reimbursements. Reimbursements for physicians who care for child beneficiaries will increase by an average of 25%, and reimbursements to dentists who treat children will increase by 50%. The state Legislature also increased physician reimbursements for adult care by 10% (Jaspin, Austin American-Statesman, 8/6).
Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Only 18% of physicians in Austin, Texas, accept all new Medicaid beneficiaries, according to a survey of physicians by the Texas Medical Association, the Austin American-Statesman reports. According to the American-Statesman, "Austin has become ground zero in what some in the medical community are calling an unfolding Medicaid crisis in Texas."
The medical association's survey, which is conducted every two years, found that the number of physicians accepting all new Medicaid beneficiaries statewide declined from two-thirds in 2000 to 38% last year. The survey also found that 9% of orthopedic surgeons in the state accept all new Medicaid beneficiaries, and the percentages of some other specialists who accept all new beneficiaries also are in the single digits, the American-Statesman reports. Over the past year, the Texas Health and Human Services Commission said it has paid travel expenses for about 100 Medicaid beneficiaries in Austin to receive care in San Antonio, Texas.
William Hinchey, head of the state medical association, said, "Some of us believe [Medicaid] has collapsed because these patients do not have access to care like they should." Regina Rogoff, head of the People's Community Clinic in Austin, said Medicaid in the state has "effectively collapsed," adding, "If the state paid a fair rate for Medicaid, then those patients would be able to be seen in the private sector."
However, Stephanie Goodman, a spokesperson for the commission, said, "I could not disagree more strongly with that." Goodman said that the program has problems but is still functional, adding, "We pay for more than half of all births and two-thirds of all nursing home care. It is a huge program and takes up a quarter of the state's budget. Are there issues out there? Yes. But the good works shouldn't be lost."
Goodman said the situation should improve after Medicaid reimbursement rates to physicians are increased Sept 1. Some of the increases are required by a settlement in a 14-year-old class-action lawsuit filed by parents of children receiving Medicaid benefits who had difficulty finding physicians because of low reimbursements. Reimbursements for physicians who care for child beneficiaries will increase by an average of 25%, and reimbursements to dentists who treat children will increase by 50%. The state Legislature also increased physician reimbursements for adult care by 10% (Jaspin, Austin American-Statesman, 8/6).
Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Saturday, June 23, 2007
Two FW hospitals among nation's deadliest for heart patients
Baylor All Saints, Huguley say they respect U.S. study, but numbers may mislead
By JASON ROBERSON - The Dallas Morning News -Friday, June 22, 2007
Fort Worth is home to two of the nation's deadliest hospitals for patients being treated for heart failure: Baylor's All Saints Medical Center and Huguley Health System, according to a report from the U.S. Department of Health and Human Services.
After reviewing data on 4,500 hospitals across the country the department's Centers for Medicare & Medicaid Services division released a list of hospitals it said are performing either better or worse than the nation's average mortality rate for patients treated for heart attacks or for heart failure. The report did not list the national averages, nor did it reveal how far off a hospital was from those averages.
All Texas hospitals performed at the national average for heart attacks while five Texas hospitals made the Health and Human Services list for heart failure.
Hendrick Medical Center in Abilene and Christus St. Michael Health System in Texarkana also performed worse than average.
Meanwhile, Houston's Memorial Hermann Healthcare System was the only Texas hospital to do better – with a lower mortality rate than the national average.
The mortality numbers were based on a year's worth of hospital admissions, from July 1, 2005, to June 30, 2006.
The Centers for Medicaid & Medicare Services says it will use the report to help motivate hospitals to improve their quality.
In fiscal year 2008, ending September 2008, poor performing hospitals must show improvement in order to receive full Medicare and Medicaid reimbursements. Health and Human Services will tighten the "pay for performance" incentive measures it has used since 2003.
Executives and spokespeople at Texas' losing hospitals spoke of their hopes to do better. No one disputed the findings.
"What's weird is that we just received an award from the Texas Medical Foundation two weeks ago for clinical excellence," Mr. Adamie said. He added that Huguley, by just two deaths, missed the bell curve separating average performing hospitals from those performing worse than the national average.
The largest Texas hospital with a higher mortality rate than average is Baylor All Saints.
"Patients should be reassured that there is oversight; people are concerned and we're working to make the necessary improvements," said Dr. Clyde Yancy, medical director of Baylor's Heart and Vascular Institute. "I respect the overall study. Obviously we have to take a look internally."
In a letter obtained by The Dallas Morning News, the Centers for Medicare & Medicaid Services gave hospitals the following disclaimer to its report:
In an interview, Dr. Yancy said that adjusting for patient risk factors (such as the number with complicated cases) might have altered the findings.
Still, the report helped identify which areas of heart care need improvement at All Saints, he said.
Since the Fort Worth hospital was on par with the nation for heart attack treatment, Dr. Yancy said he targeted heart failure care with comprehensive educational programs for nurses in February.
Heart failure is the result of any number of diseases that prevent the heart from pumping blood normally. A heart attack is a type of heart failure where too little blood reaches the heart, resulting in damage to the heart's muscle.
Baylor's All Saints Medical Center has scored high in some state quality rankings. According to recent data from the Texas Department of State Health Services, Baylor All Saints' overall in-hospital mortality rate is the fourth lowest among more than 60 Dallas and Fort Worth area hospitals.
At the Hendrick Medical Center in Abilene, which also performed below average, marketing director Karen Brittain said patients should look at a variety of quality indicators. She added that her hospital was recognized as a Blue Distinction Center of Cardiac Care by Blue Cross/Blue Shield of Texas.
"But we certainly welcome any data sources that help us get better," Ms. Brittain said.
Houston's Memorial Hermann Healthcare System, which the Department of Health and Human Services ranks as one of the nation's best, was the only Texas hospital to have a lower than average mortality rate for heart failure patients.
Dr. Shabot said officials at the hospital were not surprised by their high ranking, having come to expect accolades. "In some ways we're competing with ourselves," he said.
Dr. Shabot did not take issue with the report's assessments.
Read more
By JASON ROBERSON - The Dallas Morning News -Friday, June 22, 2007
Fort Worth is home to two of the nation's deadliest hospitals for patients being treated for heart failure: Baylor's All Saints Medical Center and Huguley Health System, according to a report from the U.S. Department of Health and Human Services.
After reviewing data on 4,500 hospitals across the country the department's Centers for Medicare & Medicaid Services division released a list of hospitals it said are performing either better or worse than the nation's average mortality rate for patients treated for heart attacks or for heart failure. The report did not list the national averages, nor did it reveal how far off a hospital was from those averages.
All Texas hospitals performed at the national average for heart attacks while five Texas hospitals made the Health and Human Services list for heart failure.
Hendrick Medical Center in Abilene and Christus St. Michael Health System in Texarkana also performed worse than average.
Meanwhile, Houston's Memorial Hermann Healthcare System was the only Texas hospital to do better – with a lower mortality rate than the national average.
The mortality numbers were based on a year's worth of hospital admissions, from July 1, 2005, to June 30, 2006.
The Centers for Medicaid & Medicare Services says it will use the report to help motivate hospitals to improve their quality.
In fiscal year 2008, ending September 2008, poor performing hospitals must show improvement in order to receive full Medicare and Medicaid reimbursements. Health and Human Services will tighten the "pay for performance" incentive measures it has used since 2003.
Executives and spokespeople at Texas' losing hospitals spoke of their hopes to do better. No one disputed the findings.
But a Huguley Health System spokesman said the numbers are somewhat misleading. After receiving news of their mortality ranking on June 11, Huguley hospital administrators pulled the files of deceased patients submitted for the study.
Of the 29 deaths occurring during the study, 10 people were already in hospice care before their heart failure, suggesting they were expected to die, while one was 100 years old and another 98 years old, said Huguley spokesman Kurt Adamie.
"What's weird is that we just received an award from the Texas Medical Foundation two weeks ago for clinical excellence," Mr. Adamie said. He added that Huguley, by just two deaths, missed the bell curve separating average performing hospitals from those performing worse than the national average.
The largest Texas hospital with a higher mortality rate than average is Baylor All Saints.
"Patients should be reassured that there is oversight; people are concerned and we're working to make the necessary improvements," said Dr. Clyde Yancy, medical director of Baylor's Heart and Vascular Institute. "I respect the overall study. Obviously we have to take a look internally."
In a letter obtained by The Dallas Morning News, the Centers for Medicare & Medicaid Services gave hospitals the following disclaimer to its report:
"It is important to note that while your hospital, your state and the national crude mortality rates are all reported here for your reference, they are not directly comparable as they have not been risk-adjusted to account for patient differences, nor have any hospital adjustments been made to account for differences in sample sizes."
In an interview, Dr. Yancy said that adjusting for patient risk factors (such as the number with complicated cases) might have altered the findings.
Still, the report helped identify which areas of heart care need improvement at All Saints, he said.
Since the Fort Worth hospital was on par with the nation for heart attack treatment, Dr. Yancy said he targeted heart failure care with comprehensive educational programs for nurses in February.
Heart failure is the result of any number of diseases that prevent the heart from pumping blood normally. A heart attack is a type of heart failure where too little blood reaches the heart, resulting in damage to the heart's muscle.
Baylor's All Saints Medical Center has scored high in some state quality rankings. According to recent data from the Texas Department of State Health Services, Baylor All Saints' overall in-hospital mortality rate is the fourth lowest among more than 60 Dallas and Fort Worth area hospitals.
At the Hendrick Medical Center in Abilene, which also performed below average, marketing director Karen Brittain said patients should look at a variety of quality indicators. She added that her hospital was recognized as a Blue Distinction Center of Cardiac Care by Blue Cross/Blue Shield of Texas.
"But we certainly welcome any data sources that help us get better," Ms. Brittain said.
Houston's Memorial Hermann Healthcare System, which the Department of Health and Human Services ranks as one of the nation's best, was the only Texas hospital to have a lower than average mortality rate for heart failure patients.
"We as a hospital system are so focused on clinical quality for our patients that we take every guideline endorsed by cardiology societies to heart and work on those every day, so that every patient with a heart attack, every patient with heart failure, gets every known beneficial therapy,"said Dr. Michael Shabot, chief quality officer.
Dr. Shabot said officials at the hospital were not surprised by their high ranking, having come to expect accolades. "In some ways we're competing with ourselves," he said.
Dr. Shabot did not take issue with the report's assessments.
Read more
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