Daily Health Policy Report

Wednesday, January 9, 2013

Last updated: Wed, Jan 9

KHN Original Reporting & Guest Opinion

Health Reform

Capitol Hill Watch

Medicare

Medicaid

Quality

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Doctors And Dentists Lure Patients With Saving Deals Online

Kaiser Health News staff writer Ankita Rao reports: "While most health-related deals on sites like Groupon and Living Social are for cosmetic procedures like Botox, providers also offer everyday medical, vision and dental services. Health and medical deals make up about 5 to 10 percent of the online coupon industry, according to Unaiz Kabani, data product manager at Yipit, a service that aggregates companies' daily deals" (Rao, 1/8). Read the story.

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Capsules: A Regional Analysis Of Which Hospitals Got Rewards, Penalties Based On Quality

Now on Kaiser Health News' blog, Jordan Rau reports: "In Medicare's new program that ties about $1 billion in payments to quality of care, hospitals in Fort Wayne, Ind., are faring the best on average while hospitals in Washington, D.C., are doing the worst, according to a Kaiser Health News analysis of the country's 212 major health care markets" (Rau, 1/9). Check out what else is new on the blog.

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Twitter Topics: We're Talking Public Health Funding

What are our social media talking about? Recently, Kaiser Health News' Tweet sparked conversation about  how and why public health funding is falling in the face of the recession.

Do you think public health funding will return to pre-recession levels? Join the conversation on Twitter using the hashtag #PublicHealthFunding and follow @KHNews for the latest.

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Political Cartoon: 'Sign Of The Times?' by Clay Bennett

Kaiser Health News provides a fresh take on health policy developments with "Sign Of The Times?" by Clay Bennett.

Meanwhile, here is today's health policy haiku:

WHOM TO BELIEVE?

Florida's guv'ner
mulls Medicaid expansion
sans correct info?
-Anonymous

If you have a health policy haiku to share, please send it to us at http://www.kaiserhealthnews.org/ContactUs.aspx and let us know if you want to include your name. Keep in mind that we give extra points if you link back to a KHN original story.

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Health Reform

Federal Officials Scale Back Maine's Plan For Medicaid Cuts

The Obama administration has denied Republican Gov. Paul LePage's idea to cut health coverage for more than 20,000 low-income residents, but let stand provisions that would cut benefits for another nearly 13,000 residents.

The Associated Press: Federal Officials Scale Back Maine Medicaid Cuts
The Obama administration has rejected Republican Gov. Paul LePage's plan to cut health care coverage for more than 20,000 low-income Mainers but left intact provisions approved by the former GOP-controlled Legislature that'll eliminate benefits for another 12,600 residents. The administration denied Maine’s request to eliminate Medicaid coverage for Maine parents who make between 100 percent to 133 percent of the federal poverty level and to drop coverage for 19- and 20-year-olds, changes that combined would have eliminated coverage to more than 20,000 people (Sharp, 1/8).

The New York Times: Maine: Medicaid Purge Is Rejected
The Obama administration rejected Gov. Paul R. LePage's request to drop thousands of people from Medicaid rolls. Mr. LePage, a Republican, had sought to eliminate Medicaid coverage for nearly 15,000 parents with incomes between the federal poverty level ($23,050 for a family of four last year) and 133 percent of that level ($30,657 for a family of four). He also wanted to end coverage for more than 6,000 19- and 20-year-olds (Goodnough, 1/8).

The Wall Street Journal's Washington Wire: Federal Officials Deny Maine's Medicaid Cuts
Several states had suggested that the Supreme Court's opinion last summer to nix penalties in the health law for states that chose not to expand their Medicaid programs could have also lifted the law's ban on cuts to their existing programs. The Obama administration told Mr. LePage's health and human services commissioner, Mary Mayhew, that it doesn’t believe that’s the case (Radnofsky, 1/8).

Politico Pro: Administration Says Maine Can Make Some Medicaid Cuts
The Obama administration has told Maine that it could make some Medicaid cuts, but not as deeply as the state requested — and it's unclear whether Gov. Paul LePage will keep fighting the feds on his preferred cuts. … CMS allowed Maine to reduce income eligibility levels for certain groups, but the agency cited MOE in its rejection of proposed cuts to parents and 19- and 20-year-olds. Maine's next steps are uncertain, and a LePage spokeswoman didn't immediately respond to a request for comment (Millman, 1/8).

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Medicaid Cost Estimates Trigger Florida Flap

Florida Gov. Rick Scott's concerns about the health law's Medicaid expansion during a meeting Monday with HHS Secretary Kathleen Sebelius is continuing to draw criticism that he is exaggerating the potential cost.  

The Associated Press: Fla. Gov. Under Fire For Health Care Cost Estimate
Gov. Rick Scott is again facing criticism that he is overstating the potential cost to Florida taxpayers of the federal health care overhaul. ... The Republican governor told Sebelius that state taxpayers will have to pay near $26 billion over the next 10 years to implement the overhaul. That figure - drawn up last month by the state's main health care agency - is three times higher than one drawn up by state economists back in August (Fineout, 1/8).

Health News Florida: Scott To Look At Other Medicaid Cost Estimates
Gov. Rick Scott is willing to look at estimates on the cost of Medicaid expansion other than the ones he has been using, according to a release Tuesday evening. The statement from Scott's Communications Director Melissa Sellers came in apparent reaction to Health News Florida's report early Tuesday headlined "Legislative Analysts told Scott His Medicaid Estimates Are Wrong (But He's Using Them Anyway)" (Gentry, 1/9).

In other health law news --

Health Policy Solutions (a Colo. news service): Real Cost Of Medicaid Expansion Scrutinized
When Gov. John Hickenlooper announced his endorsement of a plan to expand Medicaid coverage under the Affordable Care Act last week, he outlined a proposal that would cost Colorado an estimated $128 million over the next decade. But cost containment strategies would save $280 million in state and federal funds, he said, making the expansion a bargain. On Monday, it fell to the staff of the state Department of Health Care Policy and Finance to persuade skeptical legislators on the Joint Budget Committee that the plan really will work (Carman, 1/8).

The Oregonian: Governor, Federal Officials To Speak At Oregon's Health Insurance Exchange
Federal officials and Gov. John Kitzhaber will speak Thursday at a meeting of Oregon's new health insurance exchange. The exchange, known as Cover Oregon, will operate an online website that serves as marketplace for individuals and small businesses. Starting in October, they'll be able to purchase health insurance, as well as obtain tax credits if they qualify (Budnick, 1/8).

Politico Pro: Many States Let HHS Pick Their EHB Plans
About half the states let HHS set their mandated health benefits after a late-December deadline for states to pick their own quietly passed. States faced a Dec. 26 deadline to set the benchmark for required benefits in their small-group and individual markets in 2014. If they didn't pick one, they automatically wound up with their largest small-group plan as the benchmark for essential health benefits required under the Affordable Care Act. It's not the first deadline states faced to choose a benefits benchmark — but this one passed with much less controversy than the first (Millman, 1/8).

CQ HealthBeat: Actuarial Industry Study Questions Health Law's Age Bands
Insurance industry officials are continuing to push back on the new age rating requirement under the health care law, this time with a new study from the American Academy of Actuaries that says the provision could cause premiums for young, healthy individuals to increase by more than 40 percent. The study focused on adults ages 21-29 because, the authors said, even accounting for the 2010 law's provision allowing people up to age 26 to remain on their parents' insurance, "this age group has an uninsured rate that is roughly twice the uninsured rate for the nonelderly population as a whole" (Bunis, 1/8).

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Capitol Hill Watch

Republicans Take Aim At Planned Parenthood's 'Record' Taxpayer Support

Also making headlines, a group of House Democrats are pressing the White House to retain funding for mental health, and some of New York's members of Congress are pushing to include cancer care in the 9/11 health program.

Fox News: Planned Parenthood Receives Record Amount Of Taxpayer Support
Planned Parenthood reported receiving a record $542 million in taxpayer support in fiscal 2012, marking a steady increase in government funding despite Republican-led efforts at the state and federal levels to cut off that stream. The funding figures were included in the abortion provider's annual report released Monday. The numbers showed roughly 45 percent of Planned Parenthood's budget now comes from taxpayer dollars. Pro-life groups quickly seized on the report to renew their calls for Congress to "defund" Planned Parenthood. "Americans are sick and tired of underwriting the nation's largest abortion business," said Marjorie Dannenfelser, president of the Susan B. Anthony List. Republican Tennessee Rep. Diane Black said the report "underscores the pressing need to cut off all federal funding for Planned Parenthood" (1/8).

The Associated Press: Vt. US Rep. Welch Seeks To Ease Health Care Costs
Vermont U.S. Rep. Peter Welch says he wants to use the federal health care reform law to help control health care costs. Welch, a Democrat, outlined his plans Tuesday during a visit to a Montpelier doctor's office. Welch is a member of the House’s Energy and Commerce Committee, which has jurisdiction over federal health care policy (1/8).

CQ HealthBeat: Retain Funds For Mental Health, Democrats Urge White House
Three House Democrats are gathering signatures on a letter that calls on the Obama administration to preserve mental health funding in its fiscal 2014 budget proposal. In the letter, Alcee L. Hastings of Florida, Grace F. Napolitano of California and Eddie Bernice Johnson of Texas describe the “five large scale shootings” that have occurred since 2007, including the deadly shooting at a Connecticut elementary school in December. They also note that, from their understanding, the individuals behind the killings all suffered from mental illness, substance abuse disorders or a combination of the two (Attias, 1/8).

CQ HealthBeat: New York Lawmakers Continue Push To Include Cancer In 9/11 Health Program
A study calling into question the link between cancer and exposure to debris at Ground Zero hasn’t changed the opinion of three House lawmakers from New York City that the connection exists. Democratic Reps. Carolyn B. Maloney and Jerrold Nadler, along with Republican Rep. Peter T. King, have fought for the last two years to have cancer treated under the health care program Congress created in 2010 for those sick or injured from working or living near the World Trade Center site after the Sept. 11 terrorist attacks (Scholtes, 1/8).

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Medicare

Medicare Spends About As Much Screening For Breast Cancer As Treating It

Medicare spends $1 billion annually on breast cancer screening, a new study has found. Another report, this one from UnitedHealth, says changes to how the government coordinates patient care could save half a trillion dollars over a decade.

Reuters: Medicare Spends $1 Billion On Mammograms: Study
"It's known that we're spending over $1 billion on treating cancer, but we were surprised to find that we're also spending over $1 billion for screening," said Dr. Cary Gross, the study's lead author from Yale University in New Haven, Connecticut. Using a database of Medicare claims between 2006 to 2007, Gross and colleagues tracked about 137,000 women, who did not have breast cancer and who were over 66 years old, to see how much they spent on screening and initial treatment for breast cancer (Seaman, 1/8).

MPR News: Changes To Govt. Health Care Could Save On Costs, UnitedHealth Group Reports
A report by UnitedHealth Group said the U.S. could reduce spending on Medicare and Medicaid by doing a better job of coordinating patient care, particularly for those with chronic illnesses such as diabetes. The report's author, Simon Stevens, said the U.S. could save more than half a trillion dollars over a decade by changing how it cares for patients on those government health plans, which provide coverage for the elderly, disabled, and low income. ... Stevens said while budget talks in Washington focused on cutting benefits or doctor's pay to rein in program costs, there is another way (Stawicki, 1/9).

And CMS released it's annual assessment of Medicare spending --

The Medicare NewsGroup: Medicare Sees 2011 Spending Spike While Overall Health Spending Hold Steady
Medicare spending rose an estimated 6.2 percent during 2011, driven by a big jump in payments to skilled nursing facilities, more spending at doctors’ offices and bigger outlays for Medicare Advantage plans, the Center for Medicare and Medicaid Services (CMS) reported Monday in its annual survey of projected health spending. The report has projected figures for 2012 forward, and estimated figures for 2011 spending. Medicare's total outlays reached $554 billion in 2011, an increase of $32 billion from the previous year. The 6.2 percent growth in spending accelerated from an expansion of 4.2 percent in 2010 (Rosenblatt, 1/8).

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Medicaid

Whistleblowers, Sheltered Assets Key In Medicaid Fraud And Abuse

Whistleblowers are an increasingly important part of detecting Medicaid fraud while GOP lawmakers look more closely at those who shelter their assets in order to qualify for the program's long-term care.

The Wall Street Journal: Whistleblowers At Center Of States' Medicaid Fraud Action
Whistleblowers are becoming an increasingly important source of settlements from Medicaid fraud prosecutions as states try to raise revenue and eliminate waste and abuse (DePietro, 1/7).

CQ HealthBeat: House GOP Members Probe Medicaid Eligibility Problems In The States
As Congress sharpens its focus on deficit reduction and health care spending, some GOP members of Congress are taking a fresh look at how people shelter their assets in order to qualify for Medicaid long-term care. The move revives a long-running debate over whether Medicaid should be regarded as a middle-class entitlement or an assistance program for the truly needy. It also raises the question of whether 2005 changes in the law were effective in ensuring that people with enough money to afford nursing home care couldn't game the system (Norman, 1/8).

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Quality

KHN Analyzes Regional Variations In Medicare Quality Payment Program

Fort Wayne, Ind., fared the best among the major health care markets, the analysis finds. Meanwhile, a new study of a plan to tie Medicare's payments to the quality of doctors' services suggests many physicians may face penalties.

Kaiser Health News: A Regional Analysis Of Which Hospital Got Rewards, Penalties Based On Quality
In Medicare's new program that ties about $1 billion in payments to quality of care, hospitals in Fort Wayne, Ind., are faring the best on average while hospitals in Washington, D.C., are doing the worst, according to a Kaiser Health News analysis of the country's 212 major health care markets (Rau, 1/9).

The Hill: Study: Most Medicare Docs Set To Face Performance Penalties
More than 80 percent of Medicare providers will face penalties for failing to meet quality thresholds if current performance trends continue, according to a new study. The Harvey L. Neiman Health Policy Institute found Tuesday that fewer than one in five Medicare providers meet the program's Physician Quality Report System (PQRS) standards and are eligible for related bonus payments. This point spells trouble for Medicare providers as the bonus program is converted to penalties for failing to meet PQRS requirements this year, researchers wrote (Viebeck, 1/8).

And in another study --

Modern Healthcare: EHR Tech Help, Quality Gains Linked: Study
High-intensity technical assistance might be key to realizing quality gains from the use of electronic health-record systems among small-practice doctors and those practicing in underserved areas, a new study suggests. The study, published in Health Affairs and undertaken by researchers from Weill Cornell Medical College and the Primary Care Information Project of the New York City Health Department, found that EHR implementation alone was not enough to improve the quality of care provided by the primary-care physicians studied, who worked in small practices in underserved neighborhoods in New York. Physicians receiving assistance from the Primary Care Information Project scored higher on selected quality measures than physicians not receiving the assistance. The Primary Care Information Project provided subsidized EHR software, clinical-decision support and onsite technical assistance to about 3,300 physicians at roughly 600 primary-care practices, according to a Weill Cornell news release (Barr, 1/8).

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State Watch

Former CMS Head Berwick Eyes Run For Mass. Governor

The former director of the Centers for Medicare & Medicaid Services was a lightning rod for debate in Congress after Republicans accused him of supporting health care rationing, but he remains a respected health care expert.

Boston Globe: Health Care Expert May Run For Mass. Governor
A former Obama administration official whose nomination to a powerful health care post was derailed by Senate Republicans said Tuesday that he is strongly considering a run for governor in 2014. If he decides to run, Dr. Donald M. Berwick would follow a path charted by Elizabeth Warren, who began her term as senator this week, two years after her nomination to lead a federal consumer protection agency was shelved amid Republican opposition. Berwick ran the Centers for Medicare & Medicaid Services and is one of the nation's leading ­experts on health cost and quality. Obama installed him using a ­recess appointment in 2010, but Berwick resigned in late 2011 when Republicans made clear they would strongly oppose his confirmation. At the time, the height of the national debate over Obama’s health care overhaul, Republicans accused ­Berwick of wanting to ration services, a charge he called a mischaracterization (Bierman and Levenson, 1/9).

The Hill: Report: Former Obama Health Official Might Run For Mass. Governor
Donald Berwick, formerly a top health care official in the Obama administration, is reportedly considering a run for Massachusetts governor in 2014. Berwick was controversial on Capitol Hill, but he remains a widely respected doctor and health care expert. He served as director of the Centers for Medicare and Medicaid Services, before stepping down when his interim appointment expired (Baker, 1/8).

Politico: Berwick Eyeing Run For Massachusetts Governor
Former Obama administration Medicare chief Don Berwick -- vilified by Senate Republicans who made his confirmation impossible -- is considering a run for Massachusetts governor in 2014, he told POLITICO late Tuesday (Kenen, 1/8).

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Insurers in California, Elsewhere, Propose Steep Rate Hikes

California's insurance commissioner criticized Anthem Blue Cross for raising rates for small businesses but acknowledged he has no authority to block it. Medpage Today looks at double-digit increases in the individual and small group markets nationwide.

Los Angeles Times: California Regulator Scolds Anthem, Praises UnitedHealth On Rates
California's insurance commissioner scolded Anthem Blue Cross for raising rates for small businesses while praising industry rival UnitedHealth Group Inc. for cutting worker premiums. ... But state regulators have no authority to block Anthem's rate increase from taking effect this month. "This is a huge loophole in California law and in the federal Affordable Care Act," [Insurance Commissioner Dave] Jones said (Terhune, 1/8).

San Francisco Chronicle: State Opposes Anthem Rate Increase
California's insurance commissioner on Tuesday called a proposed rate hike by Anthem Blue Cross for small businesses "unreasonable" and accused the health insurer of improperly imposing fees associated with the federal health law. Insurance Commissioner Dave Jones said his department's actuaries carefully reviewed the health insurer's plans, which he said would raise rates by nearly 11 percent. The company, he said, overestimated its projected medical costs and how much in services it expects its policyholders to use. Anthem officials disputed Jones' claims (Colliver, 1/8).

Politico Pro: Calif. Insurance Commissioner: Anthem Is Raising Rates Early
Anthem Blue Cross California is already including two 2014 fees for the health care reform law in its 2013 insurance prices, a move California Insurance Commissioner Dave Jones says is unlawful. On a conference call with reporters Tuesday, Jones said Anthem wants to raise rates by more than 10 percent for its small-group market and attributed the increase, in small part, to two fees that will hit insurers in 2014: a tax on health insurers and a fee to spread the risk among insurers who have to take on the sickest customers (Haberkorn, 1/8).

In another story about premium increases nationwide -

Medpage Today: Health Insurers Still Requesting Steep Rate Hikes
Although one goal of the Affordable Care Act (ACA) was to rein in the high cost of health insurance, dozens of health plans continued to implement double-digit rate hikes. For instance, in California, premiums on separate UnitedHealth plans rose 12.3 percent and 14.3 percent, according to the state's Department of Insurance. An Aetna plan covering more than 76,000 people jumped 20.4 percent and another covering 21,000 people shot up nearly 19 percent. Celtic Insurance Company in Ohio requested a 39 percent increase for some of its plans in the state, according to the Department of Health and Human Services (HHS). So far, 44 states have programs to review rate increases in their states. For states that don't have such programs, HHS reviews the proposals (Pittman, 1/8).

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Roundup: Kan., Ga., Mass., Neb. Face Decisions On Implementing Health Law

Health policy news from Kansas, Georgia, Massachusetts, New York and Nebraska.

Georgia Health News: Medicaid Provider Fee Gets Maximum Priority
At an Atlanta panel discussion Tuesday previewing children's health issues for the upcoming General Assembly session, one item stood out. State Sen. Fran Millar (R-Atlanta) was officially on the panel to highlight "School Flexibility," but he summed up what he sees as the urgency of passing a Medicaid hospital provider fee during the legislative session. Approving the hospital assessment is "perhaps the most critical thing we have to do," Millar said. The session begins next week (Miller, 1/8).

Kansas Health Institute: State Officials Propose Trimming Number Of KanCare Workgroups
State officials say they want to consolidate four KanCare workgroups into two and include more Medicaid enrollees or their family members on the remaining panels. "Now that we're implementing (KanCare), we need to look at things a little differently and have more consumer input," Becky Ross, Medicaid initiatives coordinator at the Kansas Department of Health and Environment, told members of the KanCare Advisory Council (Shields, 1/8).

Politico Pro: Mass. May Shift Health Coverage Penalties
In a step toward bringing Massachusetts in compliance with the federal health law, Massachusetts Gov. Deval Patrick Tuesday proposed legislation that would ease some of his own state's coverage requirements for small business. The landmark Massachusetts reform law, signed by Gov. Mitt Romney in 2006, requires all businesses with 11 or more workers to offer a certain portion of their workers coverage or else face a "Fair Share" penalty of $295 per worker. But the federal Affordable Care Act has coverage requirements for businesses with 50 or more employees(Cheney, 1/8).

Fox News: Nebraska Wendy's Franchisee Slashes Worker Hours To Sidestep ObamaCare
A Nebraska Wendy's franchise is slashing employee hours so the owners do not have to pay for health benefits for their workers under ObamaCare's requirements. WOWT reports about 100 workers in non-management positions at 11 Omaha-area Wendy's will have their hours cut to 28 a week (1/9).

Modern Healthcare: NYC System Pegs Sandy Costs At $810 Million
The New York City Health and Hospitals Corp. estimates that costs related to superstorm Sandy will hit $810 million. HHC said the cost to fully reopen hospitals closed by superstorm Sandy, repair other storm damage across the system and prepare for future storms will total $610 million. The figure includes $137.5 million for initial response to the storm. ... Bellevue Hospital remains closed to inpatients. Coney Island Hospital began to admit a limited number of psychiatric patients at the end of December (Evans, 1/8).

The Wall Street Journal: Cuomo Seeks An Overhaul In Gun Control
Mr. Cuomo is also seeking a new law to address the role mental health can play in gun crimes. The talks on these issues were still fluid Tuesday evening, but Mr. Cuomo had considered requiring mental-health screening and more rigorous background-check requirements for gun owners, people familiar with the matter said (Nahmias, 1/8).

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Editorials and Opinions

Viewpoints: 'Accepted Wisdom' About Cutting Entitlements Disputed; Profit Motive Doesn't Lead To Good Health Care

Baltimore Sun: The Hoax Of 'Entitlement Reform'
It has become accepted economic wisdom that the only way to get control over America's looming budget deficits is to "reform entitlements." The accepted wisdom is wrong. ... Medicare and Medicaid costs are projected to soar. But here again, look closely and you'll see neither is really the problem. The underlying problem is the soaring cost of health care overall, combined with the aging of the boomer generation. The solution isn't to reduce Medicare benefits. It's for the nation to contain overall health care costs and get more for its health care dollars (Robert B. Reich, 1/9).

The New York Times' Economic Scene: Health Care And Profits, A Poor Mix
These profit-maximizing tactics point to a troubling conflict of interest that goes beyond the private delivery of health care. ... In a way, private delivery of health care misleads Americans about the financial burdens they must bear to lead an adequate existence. If they were to consider the additional private spending on health care as a form of tax — an indispensable cost to live a healthy life — the nation’s tax bill would rise to about 31 percent from 25 percent of the nation’s G.D.P. (Eduardo Porter, 1/8). 

The Washington Post: Taming The Health-Care Monster 
For years, spiraling health costs — mainly for Medicare and Medicaid, which serve the elderly and the poor — have consumed a growing share of the federal budget. Meanwhile, rapid increases in premiums for employer-provided insurance have squeezed take-home pay. So it's good news that, for the third straight year, health spending rose modestly in 2011. To some analysts, this signals a new era of cost-containment. Well, maybe — and maybe not (Robert J. Samuelson, 1/8). 

Bloomberg: Smart Health-Care Strategies Hidden In 'Cliff' Deal
One little-noted provision I was encouraged to see tucked in last week’s fiscal-cliff legislation is Section 601(b): an incentive for doctors to expand their use of something called clinical data registries. These registries collect information on patient characteristics, patterns of care and outcomes that can be crucial to evaluating what medical techniques and strategies work and which ones don’t. Unfortunately, registries are not as widespread as they should be ... Medicare costs are driven disproportionately by a small number of very expensive patients, most of whom are heavy users of specialty treatment. So early promotion of registries in those areas could yield ideas for lowering the cost of some of the most expensive care (Peter Orszag, 1/8).

The Medicare NewsGroup: The Medicare Cost/Benefit Equation: Is The Program Worth What It Costs?
The "bundled payment" initiatives in the Affordable Care Act, including the patient-centered medical home and accountable care organizations, are designed to reward providers for high-value medical practice, not high volume. Examining the outcomes of care as closely as their cost is critical to making these new forms of medical practice pay off for those who excel at them (Michael Millenson, 1/8).

Los Angeles Times: New Study Helps Build The Case For Expanding Medi-Cal
After pushing to cut Medi-Cal spending in each of his first two years in office, Gov. Jerry Brown now has to decide whether to seek to expand it by billions of dollars -- largely, but not entirely, on Washington's dime. A new report from researchers at UCLA and UC Berkeley suggests that the expansion might actually pay for itself through higher tax revenue and lower spending in other state programs (Jon Healey, 1/8).

Sacramento Bee: Expanded Medi-Cal Will Bring Federal Money In Reform
Earlier this year, a San Bernardino doctor told a middle-aged patient named Lupe that she was facing a life-or-death situation. Her blood glucose level was alarmingly high, and she was diagnosed with diabetes. ... Today, Lupe has health care coverage through a county-based program that gives her access to a primary care physician who can manage her chronic disease. This coverage helps Lupe to continue working, avoid costly hospital stays and lead a healthier life. ... The health care coverage offered by Medi-Cal, California's Medicaid program, is much more than simply a budget obligation. The health programs offered by Medi-Cal are tailored to meet the unique needs of our diverse population (Peter Long and Dr. Robert Ross, 1/9).

Kansas City Star: Hiring More People With Disabilities Reduces Dependence
Can we afford the commitments we have made over the years to seniors, people with disabilities and government retirees? ... Last year, the Missouri legislature contemplated eliminating a health benefit for residents who are blind. Ignoring the long-held belief that taking away benefits for the disabled is a loser at the ballot box, the Missouri House budget opted to end the entitlement for 2,800 blind Missourians as a cost-saving measure. But this is the canary in a coal mine (Reinhard Mabry, 1/8).

Medpage Today: When To Use An IT Consultant, And When You May Not Need One
Should physicians use a consultant to help choose a practice management system or EHR for their practice? According to recent Medical Group Management Association surveys more than 50 percent of physicians used the services of a healthcare consultant or firm at least once in the previous 3 years. But did they have to? Was it a smart move? The Answer: It Depends. Not every practice needs a consultant's assistance when replacing and choosing a new system (Rosemarie Nelson, 1/8).

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EDITOR:
Stephanie Stapleton

ASSOCIATE EDITOR:
Andrew Villegas

WRITERS:
Ankita Rao
Marissa Evans

The Kaiser Daily Health Policy Report is published by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation. (c) 2012 Kaiser Health News. All rights reserved.