National Health Expenditures 2010 Highlights

U.S. health care spending grew 3.9 percent in 2010.  Coupled with record slow growth of 3.8 percent in 2009; the 2009-2010 represents the two slowest rates of growth in the fifty-one year history of the National Health Expenditure Accounts.  The Report reflects the following breakdown of these expenditures;

• Hospital Care: Hospital spending increased 4.9 percent to $814.0 billion in 2010 compared to 6.4-percent growth in 2009. Average annual growth in hospital spending between 2007 and 2010 was 5.5 percent. CMS reports this increase was slower than the trend between 2003 and 2006, when spending increased an average of 7.4 percent per year.  Growth in private health insurance spending for hospital services, which in 2010 accounted for 35 percent of all hospital care, slowed considerably in 2010.  The Report states that these trends occurred at the same time median inpatient hospital admissions declined and emergency department and outpatient hospital visits grew more slowly than in 2009.
• Physician and Clinical Services: Spending on physician and clinical services increased 2.5 percent in 2010 to $515.5 billion, a deceleration from 3.3-percent growth in 2009. The 2010 deceleration reflects a decline in utilization, driven by a drop in total physician visits between 2009 and 2010 and a less severe flu season than in 2009.
• Other Professional Services: Spending for other professional services, which includes providers of services such as physical therapy, chiropractic medicine, and mental health, decelerated slightly in 2010, increasing 3.6 percent to $68.4 billion after growth of 3.8 percent in 2009.
• Dental Services: Spending for dental services increased 2.3 percent in 2010 to $104.8 billion compared to growth of only 0.1 percent in 2009. Out-of-pocket spending for dental services (which accounts for over 40 percent of dental spending) increased 0.5 percent in 2010 following a decline of 5.2 percent in 2009.
• Other Health, Residential, and Personal Care Services: Spending for other health, residential, and personal care services grew 5.3 percent in 2010 to $128.5 billion, a deceleration from growth of 7.7 percent in 2009. This category includes expenditures for medical services delivered in non-traditional settings (such as schools or community centers), ambulance providers, and residential mental health and substance abuse facilities.
• Home Health Care: Spending growth for freestanding home health care services slowed in 2010, increasing 6.2 percent to $70.2 billion following growth of 7.5 percent in 2009, as Medicare and Medicaid spending growth slowed in 2010.
• Nursing Care Facilities and Continuing Care Retirement Communities: Spending for freestanding nursing care facilities and continuing care retirement communities increased 3.2 percent in 2010 to $143.1 billion, a deceleration from growth of 4.5 percent in 2009, driven by slower growth in Medicare and Medicaid spending.
• Prescription Drugs: Retail prescription drug spending grew only 1.2 percent to $259.1 billion in 2010, a substantial slowdown from 5.1-percent growth in 2009. The slowdown was driven by slower growth in the volume of drugs consumed, a continued increase in the use of generic medications, loss of patent protection for certain brand name drugs, fewer new drug introductions, and a substantial increase in Medicaid prescription drug rebates.
• Durable Medical Equipment: Spending for durable medical equipment, which includes items such as eyeglasses, contacts and hearing aids, increased 7.3 percent to $37.7 billion in 2010 after increasing 0.8 percent in 2009.
• Other Non-durable Medical Products: Spending for other non-durable medical products, such as over-the-counter medicines, reached $44.8 billion, an increase of 2.6 percent in 2010, the same rate of growth as in 2009.

 Health Spending by Major Sources of Funds:

The Report indicates that the portion of health care expenditures financed by private health insurance continued to decline as private health plan enrollment declined.  As a result, the proportion of health care expenditures paid by government programs continued to rise.  The federal government financed 29 percent of total health spending in 2010, a substantial increase from its share of 23 percent in 2007. Meanwhile, the shares of the total health care bill financed by state and local governments (16 percent), private businesses (21 percent), and households (28 percent) declined during the same time period.  Specifically, the Report indicates the following:

• Medicare: Medicare spending grew 5.0 percent in 2010 to $524.6 billion, a deceleration from growth of 7.0 percent in 2009. Spending for fee-for-service (FFS) Medicare grew 5.0 percent in 2010 following growth of 4.5 percent in 2009. Medicare Advantage (MA) spending increased 4.7 percent in 2010, a steep deceleration from 15.6-percent growth in 2009 that resulted from an adjustment to payment rates in 2010.
• Medicaid: Total Medicaid spending grew 7.2 percent in 2010 to $401.4 billion, a deceleration from 8.9-percent growth in 2009, driven primarily by slower growth in enrollment. Federal Medicaid expenditures increased 8.9 percent, while state Medicaid expenditures grew 3.9 percent. This difference in growth was due to approximately $41 billion in enhanced federal aid to states—a result of increased Federal Medical Assistance Percentages (FMAP) mandated by the American Recovery and Reinvestment Act of 2009 (ARRA).
• Private Health Insurance: Growth in total spending for private health insurance premiums slowed in 2010 to 2.4 percent from 2.6 percent in 2009, continuing a deceleration that began in 2003. Growth in aggregate benefit payments also slowed, from 3.7 percent in 2009 to 1.6 percent in 2010. The slowdown reflects a decline in private health insurance enrollment, increases in cost sharing, and a shift by some consumers to plans with lower premiums. However, for the first time in seven years, growth in total premiums exceeded growth in total benefits; as a result, the private health insurance net cost ratio increased from 11.4 percent in 2009 to 12.1 percent in 2010.
• Out-of-Pocket: Out-of-pocket spending grew 1.8 percent in 2010, an acceleration from growth of 0.2 percent in 2009. Faster growth in 2010 partially reflects higher cost-sharing requirements for some employers, consumers’ switching to plans with lower premiums and higher deductibles and/or copayments, and the continued loss of health insurance coverage.

The Report found household health care spending equaled $725.5 billion in 2010 and represented 28 percent of total health spending, slightly lower than its 29 percent share in 2007.  Growth in total private health insurance premiums slowed in 2010 to 2.4 percent from 2.6 percent in 2009, continuing a slowdown that began in 2003.  Despite this deceleration, for the first time in seven years, the growth in premiums exceeded the growth in insurer spending on health care benefits, with the net cost of insurance increasing by 8.4 percent or $11.3 billion in 2010. Out-of-pocket spending by consumers increased 1.8 percent in 2010, accelerating from 0.2-percent growth in 2009. 

The state and local government share of total health spending declined from 18 percent in 2007 to 16 percent in 2010 and totaled $421.1 billion, in part due to the temporary assistance in the Recovery Act.

 Project COPE: Coalition On Patient Empowerment & Coalition For Responsible Health Care Quality

Project COPE: Coalition on Patient Empowerment & the Coalition for Responsible Health Care Quality  are coalitions of individuals and organizations that share the belief that every American and American organization has a stake, and something to contribute to our ability to find and implement the best options for ensuring that the U.S. health care system provides quality, affordable health care.

Health care impacts every individual and every organization in America.  Consequently, every American citizen and organization including but not limited to health care providers, employers, insurer, and community organizations should take part.    The government, health care providers, insurers and community organizations can help by providing education and resources to make understanding and dealing with the realities of illness, disability or aging easier for a patient and their family, the affected employers and others. At the end of the day, however, caring for people requires the human touch.  Americans can best improve health care by not waiting for someone else to step up or speak up. 

Project COPE urges and invites each individual and organization speak up to help communicate and act to make health care work for themselves, their families and others when you can and share your input to help preserve and continue to develop real meaningful improvements to our health care system by joining Project COPE: Coalition for Patient Empowerment here by sharing ideas, tools and other solutions and other resources. 

Other Helpful Resources & Other Information

We hope that this information is useful to you.   If you found these updates of interest, you also be interested in one or more of the following other recent articles published on the Coalition for Responsible Health Care Reform electronic publication available here, our electronic Solutions Law Press Health Care Update publication available here, or our HR & Benefits Update electronic publication available here .  You also can access information about how you can arrange for training on “Building Your Family’s Health Care Toolkit,”  using the “PlayForLife” resources to organize low cost wellness programs in your workplace, school, church or other communities, and other process improvement, compliance and other training and other resources for health care providers, employers, health plans, community leaders and others here. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail by creating or updating your profile here. You can access other recent updates and other informative publications and resources. 

Examples of recent updates that may be of interest include:

• Transportation Barriers Challenge Health Care
• Maintaining Jobs Key To Keeping Americans Covered
• Senator Hatch Attacks Proposed ACA Premium Tax Credit Regulations
• CMS Celebrates 1st Anniversary of Strategic Framework on Multiple Chronic Conditions
• Texas Health Care Organizations Among 26 Organizations Receiving Awards To Promote Health Care Quality, Safety & Affordability
• Education Key To Helping Low-Income Families Make Better Health Choices
• Poor Planning & Execution Often Tank Wellness Programs
• Health Care Reform’s Pre-Existing Condition Insurance Plan Covers Fewer Than 50,000 of Millions With Pre-Existing Conditions
• Personal Responsibility: How Should It Play Into Who Gets Help Under Health Care Reform?
• ONC Awards Key Contract To Develop Patient Electronic Consent Trial Project
• Finding Ways To Pay For Mental Health: Kaiser Studies Examine Medicaid & Other Mental Health Financing Needs & Options
• Comment Deadline 1/31 On HHS Plan To Let States Define ACA “Essential Benefits” That Concerns Many
• 2/27 Deadline For Employers To Comment On DOL Proposed Rule Changes Extending Minimum Wage & Overtime Rules To More Home Caregiver Workers
• Senator Tells IRS To Fix Proposed Health Care Exchange Premium Tax Credit Regulations
• Labor Department Proposes Changing Minimum Wage& Overtime Rules For Home Caregivers, Keeps Heat On Health Care Employers
• CMS Adds “Physician Compare” Feature To Healthcare Provider Directory
• Join Project COPE: Help Develop Real Tools To Meaningfully Empower Patients & Improve Health Care Access, Affordability & Quality

For important information about this communication click here. 

©2011 Solutions Law Press.  All rights reserved.

Poor and other transportation impaired patients often can’t access or are delayed in accessing care because of diffculties in getting there.  Patients that can’t reliably get to sources of care experience greater complications and tend to be less compliant.  These and other transportation challenges have a real negative impact on the quality, effectiveness and cost of treating these patients.  However, finding solutions isn’t always easy.

The current system throws up many barriers to resolving transportation barriers to access of care. 

Patients and their families for reasons of finance or other practical reasons often cannot seslf-solve their own transportation challenges.  Sometimes it’s a question of money.  Sometimes it’s a question of the physical ability to transport themselves due to medical or other capacity limitations.

Systemic tools also often are not adequate. 

Medicare/ Medicaid rules often restrict providers from supplying free or discounted transportation. 

Goverment program funded care is narrowly restricted and highly regulated.  Until better solutioms can be developed, this is a great area of need for church and community groups and volunteers to provide solutions.  Overcoming transportation barrier issues is critical for the success of the medical home and other provider and plan strategies to promote quality, affordable care.  What kinds of solutions are happening in your community that could be used elsewhere?  Join the discussion about these and other health care challenges at http://www.linkedin.com/groups/Coalition-Responsible-Health-Care-Policy-2017652?trk=myg_ugrp_ovr.

Project COPE: Coalition On Patient Empowerment & Coalition For Responsible Health Care Quality

Project COPE: Coalition on Patient Empowerment & the Coalition for Responsible Health Care Quality  are coalitions of individuals and organizations that share the belief that every American and American organization has a stake, and something to contribute to our ability to find and implement the best options for ensuring that the U.S. health care system provides quality, affordable health care.

Health care impacts every individual and every organization in America.  Consequently, every American citizen and organization including but not limited to health care providers, employers, insurer, and community organizations should take part.    The government, health care providers, insurers and community organizations can help by providing education and resources to make understanding and dealing with the realities of illness, disability or aging easier for a patient and their family, the affected employers and others. At the end of the day, however, caring for people requires the human touch.  Americans can best improve health care by not waiting for someone else to step up or speak up. 

Project COPE urges and invites each individual and organization speak up to help communicate and act to make health care work for themselves, their families and others when you can and share your input to help preserve and continue to develop real meaningful improvements to our health care system by joining Project COPE: Coalition for Patient Empowerment here by sharing ideas, tools and other solutions and other resources. 

Other Helpful Resources & Other Information

We hope that this information is useful to you.   If you found these updates of interest, you also be interested in one or more of the following other recent articles published on the Coalition for Responsible Health Care Reform electronic publication available here, our electronic Solutions Law Press Health Care Update publication available here, or our HR & Benefits Update electronic publication available here .  You also can access information about how you can arrange for training on “Building Your Family’s Health Care Toolkit,”  using the “PlayForLife” resources to organize low cost wellness programs in your workplace, school, church or other communities, and other process improvement, compliance and other training and other resources for health care providers, employers, health plans, community leaders and others here. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail by creating or updating your profile here. You can access other recent updates and other informative publications and resources

For important information about this communication click here. 

©2011 Solutions Law Press.  All rights reserved.

Finding of a study published in  November, 2011 by the National Bureao of Economic Research shows that job losses during the economic recession are a key contributor to the growth in the number of uninsured in America. 

Authors of “the Impact of the Macoeconomy on Health Insurance Coverage:  Evidence From the Great Recession” report that:

• An estimated 9.3 million adult Americans, the vast majority of whom were men, lost health insurance due to a higher unemployment rate alone during the 2007-09 recession;
• A one percentage point increase in the state unemployment rate is associated with a 1.67 percentage point (2.12%) reduction in the probability that men have health insurance with job loss having the strongest effect on health coverage among college-educated, white, and older (50-64 year old) men.
• A one percentage point increase in the unemployment rate is associated with a 1.37 percentage point (4.69%) higher probability that a child is covered by public health insurance. We conclude with a discussion of how components of recent health care reform may influence these relationships in the future.

Learn more about the results of the study and the authors’ perspectives on the potential implications on certain aspects of health reform on this trend at http://www.nber.org/papers/w17600.

 Project COPE: Coalition On Patient Empowerment & Coalition For Responsible Health Care Quality

Project COPE: Coalition on Patient Empowerment & the Coalition for Responsible Health Care Quality  are coalitions of individuals and organizations that share the belief that every American and American organization has a stake, and something to contribute to our ability to find and implement the best options for ensuring that the U.S. health care system provides quality, affordable health care.

Health care impacts every individual and every organization in America.  Consequently, every American citizen and organization including but not limited to health care providers, employers, insurer, and community organizations should take part.    The government, health care providers, insurers and community organizations can help by providing education and resources to make understanding and dealing with the realities of illness, disability or aging easier for a patient and their family, the affected employers and others. At the end of the day, however, caring for people requires the human touch.  Americans can best improve health care by not waiting for someone else to step up or speak up. 

Project COPE urges and invites each individual and organization speak up to help communicate and act to make health care work for themselves, their families and others when you can and share your input to help preserve and continue to develop real meaningful improvements to our health care system by joining Project COPE: Coalition for Patient Empowerment here by sharing ideas, tools and other solutions and other resources. 

Other Helpful Resources & Other Information

We hope that this information is useful to you.   If you found these updates of interest, you also be interested in one or more of the following other recent articles published on the Coalition for Responsible Health Care Reform electronic publication available here, our electronic Solutions Law Press Health Care Update publication available here, or our HR & Benefits Update electronic publication available here .  You also can access information about how you can arrange for training on “Building Your Family’s Health Care Toolkit,”  using the “PlayForLife” resources to organize low cost wellness programs in your workplace, school, church or other communities, and other process improvement, compliance and other training and other resources for health care providers, employers, health plans, community leaders and others here. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail by creating or updating your profile here. You can access other recent updates and other informative publications and resources. 

Examples of recent updates that may be of interest include:

• New Guidance On Fiduciary Duties In Handling ACA Group Health Plan Premium Rebates Highlight Advisability Of Tightening Funding Terms & Fund Handling Practices To Manage Fiduciary Risks
• Mental Health Parity Guidance On Mental Health & Substance Abuse Copays, Utilization Management Limits Released
• Group Health Plans & Insurer To Get More Time To Meet Affordable Care Act Summary of Benefits and Coverage Requirements
• DFW Hospital Council Foundation Among 26 Organizations Selected To Lead Quality Effort
• CMS Final Medicare Rule Imposes Many Conditions On Access To Medicare Claims Data To Evaluate Providers & Suppliers
• EBSA Releases Collection of New M-1 and Other Guidance Impacting Multiple Employer Welfare Plans
• Incentives To Get Employee Into Wellness Education Requires Legal Risk Management
• HHS Chides Insurer For “Excessive” Premium Increases After Affordable Care Act Rate Audit
• Bill Extending Funding For Certain Veteran Medical and Other Projects Heads To President
• CMS Celebrates 1st Anniversary of Strategic Framework on Multiple Chronic Conditions
• Texas Health Care Organizations Among 26 Organizations Receiving Awards To Promote Health Care Quality, Safety & Affordability
• Education Key To Helping Low-Income Families Make Better Health Choices
• Poor Planning & Execution Often Tank Wellness Programs
• Health Care Reform’s Pre-Existing Condition Insurance Plan Covers Fewer Than 50,000 of Millions With Pre-Existing Conditions
• Personal Responsibility: How Should It Play Into Who Gets Help Under Health Care Reform?
• ONC Awards Key Contract To Develop Patient Electronic Consent Trial Project
• Finding Ways To Pay For Mental Health: Kaiser Studies Examine Medicaid & Other Mental Health Financing Needs & Options
• Recap of IRS Employee Plans 2011 1st Quarter Guidance
• Celebrate 1st Anniversary of Health Care Reform Passage By Discussing How It’s Working
• CMS Adds “Physician Compare” Feature To Healthcare Provider Directory
• Join Project COPE: Help Develop Real Tools To Meaningfully Empower Patients & Improve Health Care Access, Affordability & Quality

For important information about this communication click here. 

©2011 Solutions Law Press.  All rights reserved.

As created under the Affordable Care Act, Internal Revenue Code (Code) § 36B grates a refundable tax credit for certain individuals purchasing qualifying health insurance coverage from a qualified health plan.  According to Senator Hatch, IRS proposed regulations here to implement Code § 36B would violate its provisions by allowing individuals that buy coverage through federal exchanges to claim premium tax credits because the express language of the statute only calls for amounts paid for coverage from “State” exchanges to count when calculating the amount of the credit.

In a December 1, 2011 letter to Treasury Secretary Timothy Geithner and IRS Commissioner Douglas Shulman available for review here, Senator Hatch that Code § 36B only allows for its premium tax credit to be claimed when coverage is purchased from a State exchange.  According to Senator Hatch, the amount of the credit is determined based on the annual sum of the monthly “premium assistant amounts.”  Section 36B currently defines the Premium Assistance Amount as equaling the lesser of … (A) “the monthly premiums for such month for 1 or more qualified health plans offered in the individual market within a State which cover the taxpayer, the taxpayer’s spouse, or any dependent … and which were enrolled in through an Exchange established by the State under 1311 of the Patient Protection and Affordable Care Act” or (B) an amount calculated with reference to the “applicable second lowest cost silver plan.”   An applicable second lowest cost silver plan must be a plan offered “through the same Exchange through which the qualified health plans taken into account under” the immediately-aforementioned subparagraph (A)  – that is, through “an Exchange established by the State under [section] 1311” of PPACA.

In his December 1, 2011 letter, Senatory Hatch warned the Department of Treasury that the implementation of a regulation that would allow individuals to claim a premium tax credit under Code § 36B for coverage purchased through a federal exchange would be ‘legislative change to federal law without formal approval from Congress’ that would ‘exceed the constitutional authority of the Executive Branch.”  Given these concerns, Senator Hatch’s letter asks the Department of Treatsury to ensure that “any final regulations regarding Code section 36B clarify that the section 36B Health Insurance Premium Tax Credit will not be available based upon enrollment in a Federally-facilitated Exchange.

The Internal Revenue Service held hearings on its proposed regulations in November and has been accepting comments on their provisions.  Parties interested in reviewing or commenting on the proposed regulations should see here.

 Project COPE: Coalition On Patient Empowerment & Coalition For Responsible Health Care Quality

Project COPE: Coalition on Patient Empowerment & the Coalition for Responsible Health Care Quality  are coalitions of individuals and organizations that share the belief that every American and American organization has a stake, and something to contribute to our ability to find and implement the best options for ensuring that the U.S. health care system provides quality, affordable health care.

Health care impacts every individual and every organization in America.  Consequently, every American citizen and organization including but not limited to health care providers, employers, insurer, and community organizations should take part.    The government, health care providers, insurers and community organizations can help by providing education and resources to make understanding and dealing with the realities of illness, disability or aging easier for a patient and their family, the affected employers and others. At the end of the day, however, caring for people requires the human touch.  Americans can best improve health care by not waiting for someone else to step up or speak up. 

Project COPE urges and invites each individual and organization speak up to help communicate and act to make health care work for themselves, their families and others when you can and share your input to help preserve and continue to develop real meaningful improvements to our health care system by joining Project COPE: Coalition for Patient Empowerment here by sharing ideas, tools and other solutions and other resources. 

Other Helpful Resources & Other Information

We hope that this information is useful to you.   If you found these updates of interest, you also be interested in one or more of the following other recent articles published on the Coalition for Responsible Health Care Reform electronic publication available here, our electronic Solutions Law Press Health Care Update publication available here, or our HR & Benefits Update electronic publication available here .  You also can access information about how you can arrange for training on “Building Your Family’s Health Care Toolkit,”  using the “PlayForLife” resources to organize low cost wellness programs in your workplace, school, church or other communities, and other process improvement, compliance and other training and other resources for health care providers, employers, health plans, community leaders and others here. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail by creating or updating your profile here. You can access other recent updates and other informative publications and resources. 

Examples of recent updates that may be of interest include:

• New Guidance On Fiduciary Duties In Handling ACA Group Health Plan Premium Rebates Highlight Advisability Of Tightening Funding Terms & Fund Handling Practices To Manage Fiduciary Risks
• Mental Health Parity Guidance On Mental Health & Substance Abuse Copays, Utilization Management Limits Released
• Group Health Plans & Insurer To Get More Time To Meet Affordable Care Act Summary of Benefits and Coverage Requirements
• DFW Hospital Council Foundation Among 26 Organizations Selected To Lead Quality Effort
• CMS Final Medicare Rule Imposes Many Conditions On Access To Medicare Claims Data To Evaluate Providers & Suppliers
• EBSA Releases Collection of New M-1 and Other Guidance Impacting Multiple Employer Welfare Plans
• Incentives To Get Employee Into Wellness Education Requires Legal Risk Management
• HHS Chides Insurer For “Excessive” Premium Increases After Affordable Care Act Rate Audit
• Bill Extending Funding For Certain Veteran Medical and Other Projects Heads To President
• CMS Celebrates 1st Anniversary of Strategic Framework on Multiple Chronic Conditions
• Texas Health Care Organizations Among 26 Organizations Receiving Awards To Promote Health Care Quality, Safety & Affordability
• Education Key To Helping Low-Income Families Make Better Health Choices
• Poor Planning & Execution Often Tank Wellness Programs
• Health Care Reform’s Pre-Existing Condition Insurance Plan Covers Fewer Than 50,000 of Millions With Pre-Existing Conditions
• Personal Responsibility: How Should It Play Into Who Gets Help Under Health Care Reform?
• ONC Awards Key Contract To Develop Patient Electronic Consent Trial Project
• Finding Ways To Pay For Mental Health: Kaiser Studies Examine Medicaid & Other Mental Health Financing Needs & Options
• Recap of IRS Employee Plans 2011 1st Quarter Guidance
• Celebrate 1st Anniversary of Health Care Reform Passage By Discussing How It’s Working
• CMS Adds “Physician Compare” Feature To Healthcare Provider Directory
• Join Project COPE: Help Develop Real Tools To Meaningfully Empower Patients & Improve Health Care Access, Affordability & Quality

For important information about this communication click here. 

©2011 Solutions Law Press.  All rights reserved.

One in four Americans – and two out of three over 65 – have multiple chronic conditions. According to a new report issued by the Centers for Medicare & Medicaid Services (CMS), care for its beneficiaries with multiple chronic conditions accounts for 93 percent of Medicare expenditures.

In the Plan, HHS identified more than 100 programs, activities and initiatives that focus on improving the health of those with multiple chronic conditions by integrating strategies to care for some of our sickest patients in hopes of improving health outcomes, lowering costs and maximizing quality of life.

In addition to the new CMS data on numbers of Original Medicare beneficiaries with multiple chronic conditions, HHS also reported in its Chronic Conditions Among Medicare Beneficiaries report that Medicare beneficiaries with multiple chronic conditions are more likely to be hospitalized and are the biggest users of other high-cost health care services.

The information in the report is based on the roughly 65 percent of Medicare beneficiaries who were enrolled in the Original Medicare Fee-for-Service program for the entire year, and does not include beneficiaries who have a private Medicare plan. 

CMS is touting success from various programs including in the Plan at the close of its first year of operation.  CMS Acting Administrator Marilyn Tavenner says its Chronic Conditions Among Medicare Beneficiaries report will be an important resource for CMS, its partners, and providers, to help make more informed decisions about how to best treat patients with chronic conditions.”

 For more information about the HHS Strategy on Multiple Chronic Conditions and the Inventory of HHS Programs, Activities and Initiatives, go to: http://www.hhs.gov/ash/initiatives/mcc/

Project COPE: Coalition On Patient Empowerment & Coalition For Responsible Health Care Quality

Project COPE: Coalition on Patient Empowerment & the Coalition for Responsible Health Care Quality  are coalitions of individuals and organizations that share the belief that every American and American organization has a stake, and something to contribute to our ability to find and implement the best options for ensuring that the U.S. health care system provides quality, affordable health care.

Health care impacts every individual and every organization in America.  Consequently, every American citizen and organization including but not limited to health care providers, employers, insurer, and community organizations should take part.    The government, health care providers, insurers and community organizations can help by providing education and resources to make understanding and dealing with the realities of illness, disability or aging easier for a patient and their family, the affected employers and others. At the end of the day, however, caring for people requires the human touch.  Americans can best improve health care by not waiting for someone else to step up or speak up. 

Project COPE urges and invites each individual and organization speak up to help communicate and act to make health care work for themselves, their families and others when you can and share your input to help preserve and continue to develop real meaningful improvements to our health care system by joining Project COPE: Coalition for Patient Empowerment here by sharing ideas, tools and other solutions and other resources. 

Other Helpful Resources & Other Information

We hope that this information is useful to you.   If you found these updates of interest, you also be interested in one or more of the following other recent articles published on the Coalition for Responsible Health Care Reform electronic publication available here, our electronic Solutions Law Press Health Care Update publication available here, or our HR & Benefits Update electronic publication available here .  You also can access information about how you can arrange for training on “Building Your Family’s Health Care Toolkit,”  using the “PlayForLife” resources to organize low cost wellness programs in your workplace, school, church or other communities, and other process improvement, compliance and other training and other resources for health care providers, employers, health plans, community leaders and others here. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail by creating or updating your profile here. You can access other recent updates and other informative publications and resources

For important information about this communication click here. 

©2011 Solutions Law Press.  All rights reserved.

The Dallas-Fort Worth Hospital Council Foundation, the Texas Center for Quality & Patient Safety Hospitals and Lifepoint Hospitals, Inc. are three of the 26 state, regional, national, or hospital system organizations selected as Hospital Engagement Networks by the U.S. Department of Health and Human Services (HHS).  As part of the Partnership for Patients initiative, a nationwide public-private collaboration to improve the quality, safety, and affordability of health care for all Americans, the selected entities will share in $218 million in funding to help find solutions already working to reduce healthcare acquired conditions, and work to spread them to other hospitals and health care providers across the country.

The 26 selected recipients announced by HHS December 15, 2011  are:

• American Hospital Association;
• Ascension Health;
• Carolinas HealthCare System;
• Catholic Healthcare West;
• Dallas-Fort Worth Hospital Council Foundation;
• Georgia Hospital Association Research and Education Foundation;
• Healthcare Association of New York State;
• Hospital & Healthsystem Association of Pennsylvania;
• Intermountain Healthcare;
• Iowa Healthcare Collaborative;
• Joint Commission Resources, Inc.;
• Lifepoint Hospitals, Inc.;
• Michigan Health & Hospital Association;
• Minnesota Hospital Association;
• National Public Health and Hospital Institute;
• New Jersey Hospital Association;
• Nevada Hospital Association;
• North Carolina Hospital Association;
• Ohio Children’s Hospital Solutions for Patient Safety;
• Ohio Hospital Association;
• Premier;
• Tennessee Hospital Association;
• Texas Center for Quality & Patient Safety;
• UHC;
• VHA; and
• Washington State Hospital Association.

In announcing the awards today, HHS said the Hospital Engagement Networks’ will be funded with $500 million from the Centers for Medicare & Medicaid Services (CMS) Innovation Center established by the Affordable Care Act. Hospital Engagement Networks will work to develop learning collaboratives for hospitals and provide a wide array of initiatives and activities to improve patient safety.  They will be required to conduct intensive training programs to teach and support hospitals in making patient care safer, provide technical assistance to hospitals so that hospitals can meet quality measurement goals, and set up and implement a system to track and monitor hospital progress in meeting quality improvement goals.  The activities of the Hospital Engagement Networks will be closely monitored by CMS to make sure that they are improving patient safety.

Launched in April 2011, the Partnership for Patients now consists of more than 6,500 partners, including over 3,167 hospitals, along with 2345 physicians, nurses, patient advocates, 892 consumers and consumer groups, and 256 employers and unions. In addition, health plans, Area Agencies on Aging, and state and federal government officials who have pledged to work together to cut the number of hospital-acquired conditions by 40 percent and cut hospital readmissions by 20 percent by the end of 2013.

According to HHS, achievement of the Partnership for Patients’ objectives would mean approximately 1.8 million fewer injuries to patients in the hospital and save more than 60,000 lives over three years.

HHS has committed up to $1 billion in Affordable Care Act funding to help achieve the Partnership for Patients.  In addition to the funding to help reduce health care acquired conditions, $500 million has been made available through the Community-Based Care Transitions Program to ensure patients safely transition between settings of care to bring down readmissions.  Recently, seven organizations were selected as the first participants for the Community-Based Care Transitions Program. 

In addition to the Hospital Engagement Contract awards, HHS has awarded three other contracts to help in achieving the Partnership for Patients’ goals: the National Content Developer Contractor, the Beneficiary and Medical Professional Engagement Contractor, and the Evaluation Contractor.

For more information on the Partnership for Patients, see here.

Project COPE: Coalition On Patient Empowerment & Coalition For Responsible Health Care Quality

Project COPE: Coalition on Patient Empowerment & the Coalition for Responsible Health Care Quality  are coalitions of individuals and organizations that share the belief that every American and American organization has a stake, and something to contribute to our ability to find and implement the best options for ensuring that the U.S. health care system provides quality, affordable health care.

Health care impacts every individual and every organization in America.  Consequently, every American citizen and organization including but not limited to health care providers, employers, insurer, and community organizations should take part.    The government, health care providers, insurers and community organizations can help by providing education and resources to make understanding and dealing with the realities of illness, disability or aging easier for a patient and their family, the affected employers and others. At the end of the day, however, caring for people requires the human touch.  Americans can best improve health care by not waiting for someone else to step up or speak up. 

Project COPE urges and invites each individual and organization speak up to help communicate and act to make health care work for themselves, their families and others when you can and share your input to help preserve and continue to develop real meaningful improvements to our health care system by joining Project COPE: Coalition for Patient Empowerment here by sharing ideas, tools and other solutions and other resources. 

Other Helpful Resources & Other Information

We hope that this information is useful to you.   If you found these updates of interest, you also be interested in one or more of the following other recent articles published on the Coalition for Responsible Health Care Reform electronic publication available here, our electronic Solutions Law Press Health Care Update publication available here, or our HR & Benefits Update electronic publication available here .  You also can access information about how you can arrange for training on “Building Your Family’s Health Care Toolkit,”  using the “PlayForLife” resources to organize low cost wellness programs in your workplace, school, church or other communities, and other process improvement, compliance and other training and other resources for health care providers, employers, health plans, community leaders and others here. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail by creating or updating your profile here. You can access other recent updates and other informative publications and resources

For important information about this communication click here. 

©2011 Solutions Law Press.  All rights reserved.

According to the Healthy Cal report, the 2009 Pediatric Nutrition Surveillance data from the California Department of Public Health found that roughly 21 percent of the population in Orange County’s between the ages of 5 and 20 years, and 17 percent of children between the ages of 2 and 5 years were obese. 

Healthy Cal says the Network created a number of initiatives that have helped many of Santa Ana’s low-income population access healthy foods and conducted a broad range of other educational programs for the population.  Noting that the outreach sought improve food choices, cultural and awareness barriers and other understandings and patient and family behaviors and circumstances.  Healthy Cal reports that these efforts are paying off.  Learn more at Healthy Cal.

About Project COPE: The Coalition On Patient Empowerment & Its  Coalition on Responsible Health Policy

Sharing and promoting the use of practical practices, tools, information and ideas that patients and their families, health care providers, employers, health plans, communities and policymakers can share and offer to help patients, their families and others in their care communities to understand and work together to better help the patients, their family and their professional and private care community plan for and manage these  needs is the purpose of Project COPE. 

The Coalition for Responsible Health Policy

The best opportunity to improve access to quality, affordable health care for all Americans is for every American, and every employer, insurer, and community organization to seize the opportunity to be good Samaritans.  The government, health care providers, insurers and community organizations can help by providing education and resources to make understanding and dealing with the realities of illness, disability or aging easier for a patient and their family, the affected employers and others. At the end of the day, however, caring for people requires the human touch.  Americans can best improve health care by not waiting for someone else to step up:  Speak up, step up and help bridge the gap when you or your organization can do so by extending yourself a little bit.  Speak up to help communicate and facilitate when you can.  Building health care neighborhoods filled with good neighbors throughout the community is the key.

The outcome of this latest health care reform push is only a small part of a continuing process.  Whether or not the Affordable Care Act makes financing care better or worse, the same challenges exist.  The real meaning of the enacted reforms will be determined largely by the shaping and implementation of regulations and enforcement actions which generally are conducted outside the public eye.  Americans individually and collectively clearly should monitor and continue to provide input through this critical time to help shape constructive rather than obstructive policy. Regardless of how the policy ultimately evolves, however, Americans, American businesses, and American communities still will need to roll up their sleeves and work to deal with the realities of dealing with ill, aging and disabled people and their families.  While the reimbursement and coverage map will change and new government mandates will confine providers, payers and patients, the practical needs and challenges of patients and families will be the same and confusion about the new configuration will create new challenges as patients, providers and payers work through the changes.

We also encourage you and others to help develop real meaningful improvements by joining Project COPE: Coalition for Patient Empowerment here by sharing ideas, tools and other solutions and other resources. TheCoalition For Responsible Health Care Policy provides a resource that concerned Americans can use to share, monitor and discuss the Health Care Reform law and other health care, insurance and related laws, regulations, policies and practices and options for promoting access to quality, affordable healthcare through the design, administration and enforcement of these regulations.

Other Helpful Resources & Other Information

We hope that this information is useful to you.   If you found these updates of interest, you also be interested in one or more of the following other recent articles published on the Coalition for Responsible Health Care Reform electronic publication available here, our electronic Solutions Law Press Health Care Update publication available here, or our HR & Benefits Update electronic publication available here .  You also can access information about how you can arrange for training on “Building Your Family’s Health Care Toolkit,”  using the “PlayForLife” resources to organize low cost wellness programs in your workplace, school, church or other communities, and other process improvement, compliance and other training and other resources for health care providers, employers, health plans, community leaders and others here. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail by creating or updating your profile here. You can access other recent updates and other informative publications and resources.

For important information concerning this communication click here. 

©2011 Solutions Law Press, Inc.  All rights reserved.

The study highlights a common failure of many wellness efforts -  good intention with poor execution.  The reported findings of the study affirm what many others already show:  Even American’s trying to eat healthy don’t know how to make good choices. 

The study findings are illustrated by the wellness misstep shared with me by a friend.  Several years ago, the friend substituted juice drinks for soda, believing that juice drinks were “healthy.”  Instead of his customary eight cans of diet coke, he drank a glass of apple or orange juice.  Two weeks later, he was transported to the hospital after going into diabetic insulin shock.  Lesson learned, he reported: sugar is still sugar even when consumed in juice. 

Like my friend’s misplaced wellness effort, too many school, workforce, government, parent, community and individual wellness efforts fail from poor execution.  

Of course, let’s get on the wellness bandwagon and help others around you do the same.  To ensure that the effort is not wasted, however, let’s plan and act to promote the success of the effort by understanding clearly and specifically what needs to be done and putting in place all of the elements to support the success of the efforts.

We invite you to continue the discussion and help develop real meaningful health and health care system improvements by:

• Joining Project COPE: Coalition for Patient Empowerment here to exchange ideas, tools and other solutions and other resources for helping patients, employees and their families live healthier and deal with their health and the health care treatment; and 
• Join the Coalition for Responsible Health Policy here to participate in the discussion and collaborate about policy and other reforms that can help promote the mission of improving health care and our health care systems in the U.S. 

Other Helpful Resources & Other Information

We hope that this information is useful to you.   If you found these updates of interest, you also be interested in one or more of the following other recent articles published on the Coalition for Responsible Health Care Reform electronic publication available here, our electronic Solutions Law Press Health Care Update publication available here, or our HR & Benefits Update electronic publication available here .  You also can access information about how you can arrange for training on “Building Your Family’s Health Care Toolkit,”  using the “PlayForLife” resources to organize low cost wellness programs in your workplace, school, church or other communities, and other process improvement, compliance and other training and other resources for health care providers, employers, health plans, community leaders and others here. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail by creating or updating your profile here. You can access other recent updates and other informative publications and resources

For important information concerning this communication click here. 

©2010 Solutions Law Press.  All rights reserved.

Although the temporary the PCIP program began accepting applications for enrollment July, 2010 (July 1, 2010 for the federal program, dates for state programs varied), a recent report shows that very few Americans to date are receiving coverage from this program.

As of August 31, 2011, a recent report shows the PCIP Program only covered 33,958 people.  The following chart released October 14, 2011 by the Department of Health & Human Services shows the persons covered by the PCIP Program as of August 31, 2011 broken down by state

*MassachusettsandVermontare guarantee issue states that have already implemented many of the broader market reforms included in the Affordable Care Act that take effect in 2014.  Existing commercial plans offering guaranteed coverage at premiums comparable to PCIP are already available in both states.

** Enrollment appears to have decreased in the New Jersey PCIP. However, this is attributable to a reporting error that affected prior months’ enrollment reports.

• July 31, 2011 enrollment data available here
• June 30, 2011 enrollment data available here
• May 31, 2011 enrollment data available here
• April 30, 2011 enrollment data available here
• March 31, 2011 enrollment data available here  
• February 1, 2011 enrollment data available here

 Join Project COPE To Continue Discussion & Help Promote Meaningful Health Care Reforms To Improve U.S. Healthcare

The outcome of this latest health care reform push is only a small part of a continuing process.  Whether or not the Affordable Care Act makes financing care better or worse, the same challenges exist.  The real meaning of the enacted reforms will be determined largely by the shaping and implementation of regulations and enforcement actions which generally are conducted outside the public eye.  Americans individually and collectively clearly should monitor and continue to provide input through this critical time to help shape constructive rather than obstructive policy. Regardless of how the policy ultimately evolves, however, Americans, American businesses, and American communities still will need to roll up their sleeves and work to deal with the realities of dealing with ill, aging and disabled people and their families.  While the reimbursement and coverage map will change and new government mandates will confine providers, payers and patients, the practical needs and challenges of patients and families will be the same and confusion about the new configuration will create new challenges as patients, providers and payers work through the changes.

We also encourage you and others to help develop real meaningful improvements by joining Project COPE: Coalition for Patient Empowerment here by sharing ideas, tools and other solutions and other resources. 

Other Helpful Resources & Other Information

We hope that this information is useful to you.   If you found these updates of interest, you also be interested in one or more of the following other recent articles published on the Coalition for Responsible Health Care Reform electronic publication available here, our electronic Solutions Law Press Health Care Update publication available here, or our HR & Benefits Update electronic publication available here .  You also can access information about how you can arrange for training on “Building Your Family’s Health Care Toolkit,”  using the “PlayForLife” resources to organize low cost wellness programs in your workplace, school, church or other communities, and other process improvement, compliance and other training and other resources for health care providers, employers, health plans, community leaders and others here. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail by creating or updating your profile here. You can access other recent updates and other informative publications and resources

For important information concerning this communication click here. 

©2010 Solutions Law Press.  All rights reserved.

The letter as shared reads as follows:

“Dear Mr. President:

During my shift in the Emergency Room last night, I had the pleasure of evaluating a patient whose smile revealed an expensive shiny gold tooth, whose body was adorned with a wide assortment of elaborate and costly tattoos, who wore a very expensive brand of tennis shoes and who chatted on a new cellular telephone equipped with a popular R&B ring tone. While glancing over her patient chart, I happened to notice that her payer status was listed as “Medicaid”! During my examination of her, the patient informed me that she smokes more than one costly pack of cigarettes every day and somehow still has money to buy pretzels and beer. And, you and our Congress expect me to pay for this woman’s health care? I contend that our nation’s “health care crisis” is not the result of a shortage of quality hospitals, doctors or nurses. Rather, it is the result of a “crisis of culture”, a culture in which it is perfectly acceptable to spend money on luxuries and vices while refusing to take care of one’s self or, heaven forbid, purchase health insurance. It is a culture based in the irresponsible credo that “I can do whatever I want to because someone else will always take care of me”. Once you fix this “culture crisis” that rewards irresponsibility and dependency, you’ll be amazed at how quickly our nation’s health care difficulties will disappear.

Respectfully,

STARNER JONES, MD”

When deciding to tax or otherwise collect money from some Americans to pay for health care for other “needy” Americans, should some consideration be given to why the person asking for or being given the help “needs’ the help and why the person being asked or forced to help is able and expected to help.  

Some Americans who need more health care than they can afford to pay for are in a tough position despite their honest hardworking efforts.  Many of these individuals have worked hard, scrimped and saved, purchased health insurance, and done their part only to loose their job or be hit with an illness or injury requiring more care than their budget can handle. 

On the other hand, many people holding out their hand for health care assistance could have purchased health care coverage or better health care coverage but chose not to guard against a rainy day or don’t pay their health care coverage or medical expenses because they choose to buy other things that are more satisfying.  Many of these people making these choices also may make other unhealthy choices.

Should the help given depend on these choices?  How does personal responsibility weigh into the health care reform debate?  Share your point of view by joining the discussion at http://www.linkedin.com/groups?gid=3049544&trk=hb_side_g.

For More Information

We hope that this information is useful to you.  If you need assistance with these or other health care public policy, regulatory, compliance, risk management, workforce and other staffing, transactional or operational concerns, please contact the author of this update, Curran Tomko Tarski LLP Health Practice Group Chair, Cynthia Marcotte Stamer, at (214) 270‑2402, cstamer@cttlegal.com, Ms. Stamer has extensive experience advising clients and writes and speaks extensively on these and other health industry and other reimbursement, operations, internal controls and risk management matters. 

Ms. Stamer has extensive experience in these health care reform, public policy and other health industry related representation.  You can review other recent health care and related resources and additional information about the health industry and other experience of Ms. Stamer here. 

If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile at here, or e-mailing this information to cstamer@cttlegal.com, and/or by participating in the SLP Health Care Risk Management & Operations Group

If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile at here or e-mailing this information here.  To unsubscribe, e-mail here.

©2011 Cynthia Marcotte Stamer.  All rights reserved.