State Roundup: N.Y. Small Businesses Protest Health Insurance Premium Hikes; Arizona Medicaid Crisis; A New Payment System For Massachusetts?

The Boston Globe: Massachusetts officials are "reviving the state's ambitious plan to change how doctors and hospitals are paid, aiming to hand the Legislature a specific proposal by Jan. 1" to end disagreement over controlling health spending. "Dr. JudyAnn Bigby, secretary of health and human services, convened a small group of state officials and health care executives earlier this month to draft a first-in-the-nation blueprint for scrapping the current payment system, in which doctors and hospitals are typically paid a negotiated fee for every procedure and visit. This system, called fee for service, is widely viewed as lacking coordination and encouraging unnecessary tests and procedures." A new system would "essentially" give providers a budget for each patient. "The system, called global payments, would require doctors, hospitals, and other providers to band together into groups called accountable care organizations that would split the payments and better coordinate patient care, thereby improving quality" (Kowalczyk. 9/27).

New York Post: "In letters to the [New York] state Insurance Department and the insurance carriers, seething business owners are calling on Albany to reduce [double digit] rate hikes … Under the new law, health insurers must obtain 'prior approval' from the department before rate hikes go into effect in 2011, and customers get to submit comments to regulators as part of the review" (Campanile, 9/27).

The Arizona Republic: Health benefits in Arizona's Medicaid program could be cut beginning this week. "The Arizona Health Care Cost Containment System will cut coverage for basic health services such as physicals, most dental care, podiatry, some organ transplants and other programs. … Administrators say the cuts, which take effect Friday, are necessary to deal with the state's budget crisis and an increase in the number of enrollees during the bad economy. ... More than 1.3 million Arizonans were enrolled in the state's Medicaid program as of Sept. 1" (Alltucker, 9/26).

Los Angeles Times: Women are experiencing delays in getting biopsies at some Los Angeles County-run hospitals. There are "increasingly long waits for biopsies at Harbor-UCLA, while those seeking biopsies at other hospitals are treated within weeks, if not sooner. The delays do no violate state or federal law, but patients and advocates say they cause excessive stress, and do not bode well for the county's ability to adapt to national healthcare reforms. … Hospital officials insist that claims of excessive delays for biopsies are exaggerated but acknowledge the number of patients seeking care at the county's Department of Health Services has surged, as fewer private providers, especially specialists, are willing to treat patients without private insurance" The newspaper cites an example of a 5-month wait for a biopsy of a breast lump (Hennessy-Fiske, 9/26).

Los Angeles Times, in a separate story: Gov. Arnold Schwarzenegger is calling for a change to the law there that allows felons to work in some health care fields with the elderly. Schwarzenegger called it a "public safety crisis" and "demanded that lawmakers take action to address the situation. The governor made his comments in a letter to legislative leaders after The Times reported that people convicted of such crimes as rape, murder and elder abuse are paid to provide services for some of the most vulnerable Californians in their residences" (Halper, 9/25).

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