FEATURED RESEARCH, TESTIMONY AND ANALYSIS:
Healthcare Reform and Medicaid: Patient Access, Emergency Department Use, and Financial Implications for States and Hospitals
The Patient Protection and Affordable Care Act expands insurance coverage in the United States. Importantly, the Obama reform coverage expansions are built around a strategy of expanding Medicaid. These expansions are problematic in a variety of ways. They are likely to dramatically expand the use of emergency room care, as Medicaid’s low reimbursement rates limit beneficiaries’ access to primary care physicians. In doing so, they will expand – not reduce – the overall economic cost of the U.S. health care system. We estimate that the emergency department impact alone will generate 68 million visits and add $36 billion to the nation’s healthcare bill. These additional costs will pose a financial threat to state budgets and hospital finances, especially as the reform law reduces funding dedicated to reimbursing hospitals for uncompensated care.
Medicare Part B Drug Reimbursement: Why Change A Market-Driven System That Works Well at Controlling Costs?
The Joint Select Committee on Deficit Reduction must focus on mandatory spending programs to be successful. Unfortunately, proposals to alter Medicare Part B drug reimbursement place a successful program and the patients it supports at risk and thus are not sound and sustainable reform policies that support overall debt reduction.
Moving Beyond Fee-For-Service: The Case for Managed Care in Medicaid
Fee-for-service (FFS) reimbursement is at the heart of what is wrong with the Medicaid program. By underpaying providers for uncoordinated care, FFS has impaired patient access, led to lower quality outcomes, and hampered efforts to instill greater program accountability. This paper makes the case for moving to managed care in Medicaid to deliver more consistent and higher quality care.
ADDITIONAL RESEARCH, TESTIMONY AND ANALYSIS
Weekly Checkup No. 031: E-Prescribing Helps Providers Eliminate Errors
The New York Times drew attention this week to the importance of e-prescribing technology and the impact it has on Adverse Drug Events (ADE’s) that result from prescription errors. The article cited a 2010 study published in the Journal of General Internal Medicine that examined prescription error rates between providers using e-prescribing (including physicians, nurse practitioners and physician assistants), in which clinicians choose from a list of prescriptions and dosage instructions on a computer and send the information electronically to the pharmacy, and those still handwriting their orders.
Weekly Checkup No. 029: Roadblock in the War on Cancer
The shortages of chemotherapy drugs have caused cancer care to resurface in the news. According to a recent study, patients may also soon face a shortage of cancer providers. Following an article about physicians having financial troubles that singled out oncologists as particularly struggling, is a study that many oncology practices are closing or being sold. The results, released by the Community Oncology Alliance, found that within the last five years, 241 cancer clinics have closed, 392 have been purchased or financially aligned with a hospital, 132 have merged or been acquired by a corporation, and 442 of the remaining clinics are struggling financially.
Weekly Checkup No. 023: Can EHRs by Meaningful but not Interoperable?
Drowning. That’s how providers must be feeling when the Centers for Medicare and Medicaid Services (CMS) released the long awaited standards for the Stage 2 of the meaningful use of electronic health records (EHRs) last Thursday. Although the 455 pages of proposed guidelines seem like a step in the right direction, the massive document outlining requirements does little more than place burdens on health professionals in their transition to a working EHR system
A hospital is a medical center that provides patients with diagnostic services, medical treatment, and inpatient beds for patients staying overnight. Hospitals exist to provide diagnostic and therapeutic patient services, including clinical laboratory and operating room services. Typical offerings include acute care services, surgical operations, radiology, respiratory therapy, clinical laboratories, and pharmacies. Most hospitals also have intensive care, critical care or coronary care units, as well as provide physical therapy, orthopedics, oncology services, and outpatient services.
For many of Americans, their physician represents the face of the nation’s healthcare system. Yet, few of us have a clear understanding of the policy environment in which physicians practice. A physician is a person qualified to practice medicine (diagnose and treat disease or injury) on the basis of a doctor’s degree which may be either allopathic (M.D.) or osteopathic (D.O.). In the United States, physicians must be licensed in the states or territories in which they practice. In some states, a single board licenses both allopathic and osteopathic providers, while in other states licensing is managed by separate boards depending upon the medical degree. Licensing standards vary by states, but always include successful completion of either the United States Medical Licensing Examination (USMLE) or the Comprehensive Osteopathic Medical Licensing Exam (COMLEX).
Allied Health Professions Primer
America has a growing need for allied health providers (non-physicians) due to the aging population of baby boomers, growth in the insured population as a result of the new health care reform law, an aging health care work force and the soaring cost of health care. The need for allied health providers is especially apparent in the field of primary care, which can be administered in hospitals, family practices and minute clinics. Americans receive most of their health care from primary care providers.