Health Care Report

Posted on February 16, 2012 by ashot

Here is the first of what I hope to be a weekly post on Health Care.  This will be largely oriented towards the legal side of the health care world because that is the information I get on a daily basis.  But if anyone, especially, NoVa, wants to add links, please do so.

This is sort of not news because everyone knew it was going to to happen, but the scheduled 27% cut in Medicare fees for doctors is not going to happen. The “Doc Fix”, as it’s commonly known, is going to be part of the payroll tax deal. Maybe NoVa has heard differently, but I think hosptials and physicians know this dance can’t go on forever and that eventually reimbursement rates will be cut.

The administration was bragging about its success in fighting fraud. The DOJ attributes the success to city specific anti-fraud teams. As I’ve said before, a lot of the success is due to the spread of electronic health records.

This is a bit “inside baseball”, but CMS just issued a proposed rule regarding a provision in the ACA that requires providers to report overpayments within 60 days of “identifying” those overpayments. I don’t recommend reading the actual propose rule (unless you have trouble sleeping), but I mention this for several reason. First, it is a big deal for providers. Second, it’s an example of the (slow) legislative process. The ACA was passed 2 years ago and we are just now getting regulations on this aspect of the law. This is just the proposed rule after which people submit comments. After reviewing the comments, a final rule will be published. Lastly, it is an example of something posters have talked about here, where an unelected body (CMS) is, to a large extent, legislating. I don’t necessarily agree with some of the viewpoints expressed on that topic, but I think it can lead to an interesting discussion.  [Also of note is the look-back period.  CMS wants it to be 10 years, which is unheard of.  Currently, CMS can reopen a claim within 1 year of payment for for any reason and within 4 years is “good cause” is shown – NoVA]

According to CMS and HHS 86 million Americans took advantage of the “free” preventative services required by the ACA. The quotes around free are mine since I’m pretty sure we’re paying for these one way or another. As NoVa has pointed out several times, there is also a question as to the efficacy of these preventative treatments.

Speaking of preventative care, at least one insurer is increasing reimbursement for primary care doctors. According to the article, the plan is supposed to pay for itself through decreased ER visits and hospital admissions.

This focus on preventative care is part of a broader trend towards ephasizing wellness. In addition to cheaper and more efficient treatment of chronic and acute conditions, hospitals and doctors are going to try and keep people healthy. Why? Because under payment models like Accountable Care Organizations, hospitals well earn money if they get you out of the hospital faster or prevent complications from arising once you are in the hospital. But they will earn even more money if you never come to the hospital or doctor. While it’s nice to see the current incentives (more care = more money) turned on their head, there still seems to be incentives (other than good health) for health care consumers to buy into this. As things stand, providers will laregely be held responsible for patient non-compliance. Needless to say, that is a concern for hospitals and doctors.

A couple more random links: The Washington Times demagogues the daylights out of ACOs. I could spend a long time pointing out the errors in that article. Meanwhile, Forbes talks about how private insurers are adopting some of the payment models in the ACA.
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An article from the New England Journal of Medicine about the new American College of Physicians ethics manual guidelines of “parsimonious care” and how that relates to health care costs.
— Mike
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Here’s a link to the WSJ editorial QB referenced in his comment. I am familiar with the Center for Medicare and Medicaid Innovation, but not at all familiar with this task force. While I’m unlikely to see it as the menace QB does, I do appreciate being made aware of it.

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Fox News Questions Media Matters Tax-Exempt Status

Posted on February 16, 2012 by Kevin S. Willis

Like the poor, put-upon Pastor Manning (follow link at your own risk, dude is one Obama-hating trip; he’s like the Rev. Wright’s Evil Twin), Fox News thinks Media Matters should be investigated regarding their tax-exempt status.

[redaction–couldn’t embed Mediaite player, go watch it over there, I guess]

And . . . Media Matters tax-exempt status may face new scrutiny from Congress.

According to Rush Limbaugh, Tucker Carlson is actually Chatsworth T.Osborne, Jr.

And is Fox News working with Tucker Carlson on this vicious smear campaign?

If Tucker Carlson is pulling this all out of his ass and their t’ain’t nuthin’ to it, why hasn’t Media Matters corrected the story?

In the meantime, The Daily Caller has launched an all out assault on MM, with such pieces as these Interesting Nuggets from Media Matters 2010 Tax Records and this bit about Media Matters taking a donation to expand monitoring and fact checking (shouldn’t that be faith checking?) of religious broadcasts.

Happy Thursday, all!

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Medic 206 is Out of Service

Posted on February 16, 2012 by novahockey

 

 

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Morning Report

Posted on February 16, 2012 by Brent Nyitray

Vital Statistics:

Last Change Percent
S&P Futures 1341.4 -0.8 -0.06%
Eurostoxx Index 2471.7 -22.2 -0.89%
Oil (WTI) 101.61 -0.2 -0.19%
LIBOR 0.4931 -0.002 -0.40%
US Dollar Index (DXY) 79.952 0.225 0.28%
10 Year Govt Bond Yield 1.96% 0.03%

Global equity markets are weaker this morning as European leaders delay a vote on the Greek bailout until 2/20.  The finance leaders were able to squeeze some more concessions from political leaders, but there are still differences over surveillance and control. Separately, Moody’s threatened a downgrade of the global banking sector. Bonds and mortgage backed securities are slightly lower as well.

GM posted a record profit! I am sure tomorrow’s editorial pages will be filled with columns praising the auto bailout and using this earnings announcement as justification. Well, if you repudiate your debt and get rid of all that pesky interest, you had better post record earnings.  GM’s numbers were still below estimates and the stock is down a couple of percent pre-open. As an aside, Chrysler has to issue senior secured debt at 8%.  That is a usurious rate for senior secured debt. See, that is what happens when you re-order the priority of creditors. Investors remember.

Economic data this morning:  Producer Price Index more or less in line with expectations, running at 4.1% annually.  Initial Jobless Claims continue to fall, coming in at 348k vs 365k expected. We are more or less back in the historical “normal” range. Housing starts came in at 699k, above expectations, but still very low. In prior recessions, housing starts bottomed at 750k – 850k.  The last time we were above 1 million units was June of 2008.  1.5 million is normal. The lack of residential construction has been the achilles heel of the recovery so far.

Chart:  Housing Starts:

The minutes of the FOMC meeting were released yesterday. They really don’t add anything to what was said in the press conference after the rate decision.  The minutes don’t really address the question most had regarding the recent good economic data. “Many participants noted some indicators bearing on the economy’s recent performance had shown greater-than-expected improvement, but a number noted less favorable data…” The tone of the minutes was that the economy was improving, albeit slowly, and there is no reason to take our foot off the gas for the moment.  Maybe the Fed believes the Greek negotiations are simply a big kabuki dance and that a default is unavoidable.

RealtyTrac has released its U.S. Foreclosure Market Report for January 2012. Key Quote: “Although overall foreclosure activity was down from a year ago for the 16th straight month in January, we continue to see signs on a local and regional level that the frozen-up foreclosure process is beginning to thaw.” They predict increasing foreclosures in the coming months especially given the settlements in early Feb between the nation’s largest lenders and 49 state attorney generals. Clearing out the shadow inventory of foreclosed homes is a necessary but not sufficient condition for a recovery in house prices.

Filed under: Economic data, Federal Reserve, Foreclosure, Greece | 24 Comments »