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Health Management Technology News
  April 11, 2014
In this issue:
 

 Sebelius resigns after troubles over health site

 Health Management Technology’s Resource Guide sign-up

 Not getting health care will cost you, but not a lot

 Slowing healthcare costs counteract Fed's inflationary medicine

 Bill against ‘Obamacare’ advances

 International professors discuss healthcare concerns

 Doctors' billing system stays stuck in the 1970s for now


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Sebelius resigns after troubles over health site

Kathleen Sebelius, the health and human services secretary, is resigning, ending a stormy five-year tenure marred by the disastrous rollout of President Obama’s signature legislative achievement, the Affordable Care Act.

Mr. Obama accepted Ms. Sebelius’s resignation this week, and on Friday morning, he will nominate Sylvia Mathews Burwell, the director of the Office of Management and Budget, to replace her, officials said.

The departure comes as the Obama administration tries to move beyond its early stumbles in carrying out the law, convince a still-skeptical public of its lasting benefits, and help Democratic incumbents, who face blistering attack ads after supporting the legislation, survive the midterm elections this fall.

Officials said Ms. Sebelius, 65, made the decision to resign and was not forced out. But the frustration at the White House over her performance had become increasingly clear, as administration aides worried that the crippling problems at HealthCare.gov, the website set up to enroll Americans in insurance exchanges, would result in lasting damage to the president’s legacy.

Even last week, as Mr. Obama triumphantly announced that enrollments in the exchanges had exceeded seven million, she did not appear next to him for the news conference in the Rose Garden.

The president is hoping that Ms. Burwell, 48, a Harvard- and Oxford-educated West Virginia native with a background in economic policy, will bring an intense focus and management acumen to the department. The budget office, which she has overseen since April of last year, is deeply involved in developing and carrying out health care policy.

“The president wants to make sure we have a proven manager and relentless implementer in the job over there, which is why he is going to nominate Sylvia,” said Denis R. McDonough, the White House chief of staff.

Read the full article from The New York Times here  

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Not getting health care will cost you, but not a lot

The deadline for getting health insurance has come and gone, and despite all the hoopla, you didn’t do anything about it.

What now?

You probably can’t buy a policy now, unless you can point to a big change in your employment or family size. Private health insurance is not generally available throughout the year, insurers say, with most carriers restricting their “open enrollment” period to a few months a year.

The Affordable Care Act includes a fine of $95 or 1 percent of income for anyone who was eligible for health insurance yet did not purchase a policy. In Washington-speak, it’s called a “fee,” or the “individual shared responsibility payment.”

As explained by U.S. Health and Human Services Secretary Kathleen Sebelius at a recent New Jersey appearance, the fee was imposed because people who decide to forgo health insurance can sometimes end up in a hospital emergency room. Once there, they will receive “charity” care, or care the hospital is able to provide by charging all of its patients a bit more.

It’s only right, then, that those people contribute a little something toward the cost of their free care, she said. The fine starts small but will grow in subsequent years.

“When someone without health coverage gets urgent — often expensive — medical care but doesn’t pay the bill, everyone else ends up paying the price,” states the federal website, healthcare.gov.

Read the full NJ.com article here  

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Slowing healthcare costs counteract Fed's inflationary medicine

A welcome relief from rising health-care costs for U.S. consumers is being less warmly received at the Federal Reserve.

The slowdown is frustrating the efforts of Chair Janet Yellen and her colleagues to lift inflation out of the doldrums, suggesting they will need to press on with record-low interest rates.

Price increases, not counting volatile food and energy costs, decelerated to a 1.1 percent year-over-year pace in February from 2 percent two years earlier, with medical goods and health-care services accounting for almost a third of the slowdown, according to data compiled by Bloomberg based on the government's personal consumption expenditures price index.

The cost of health care services rose just 0.8 percent in February from a year earlier, compared with an average 2.6 percent pace in the prior 10 years. Prices of medical goods such as prescription drugs rose 2.2 percent, down from the 10-year average of 2.7 percent.

Behind the slowdown in medical costs: cuts in Medicare reimbursements under last year's budget sequestration, and an influx of cheaper generic drugs as patents expired on brand-name prescription medications. Downward pressure on health costs will ease this year with fewer patent expirations and no repeat of sequestration. Still, that won't be enough to lift overall price increases to the Fed's 2 percent goal.

"It's going to be a slow grind for medical care this year overall," said Omair Sharif, an economist at RBS Securities in Stamford. Health care inflation levels are "not going back to the pre-recession days."

Read the full ctpost.com article here  

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Bill against ‘Obamacare’ advances

Louisiana would join an interstate compact aimed at giving states authority over health care policy under a bill that advanced out of a House committee Wednesday.

The national effort is being led by opponents of the federal Affordable Health Care Act, who are taking a different approach to escape its provisions.

Eleven states have either approved participation or passed legislation signaling support of the movement, including Texas and Alabama.

The movement is considered more of an expression of sentiment against the ACA, also known as Obamacare. Critics say the chances of the compact getting required congressional approval are unlikely.

Numerous efforts by Republican congressmen to repeal the ACA have failed. On top of that, Congress never granted permission for states to form one to shield them from federal law.

“Health care decisions should be made in states,” said state Rep. Paul Hollis, R-Covington, sponsor of House Bill 1090.

Read the full article from The Advocate here  

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International professors discuss healthcare concerns

Two speakers gave a joint lecture Wednesday on international health policies at the University’s School of Public Health, drawing around 40 graduate students and faculty.

Johan Mackenbach, professor of public health at Erasmus University Medical Center in Rotterdam, the Netherlands, spoke of the recent divergence of life expectancy in Europe and possible explanations for such a trend.

Mackenbach said the trends, which show health disparity based on national income gaps, are the result of a variety of cultural factors. Using charts, graphs and other data to help illustrate his point, Mackenbach showed that periods of democracy had historically higher life expectancies, while periods of more chaotic political climates showed dips in the life expectancies.

Mackenbach outlined 11 specific areas of focus for health policies, including tobacco control, alcohol control, child health and road traffic injury. He said countries that have more preventative health policies — contrary to most U.S. delivery models — showed fewer instances of health problems related to each area of concern.

For example, he said countries with stricter tobacco control regulations and preventative measures to discourage smoking had fewer smokers, lower cigarette sales and fewer smoking-related health issues in the population.

Read the full The Michigan Daily article here  

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Doctors' billing system stays stuck in the 1970s for now

For doctors, hospitals and insurance companies, all the complexities of medicine get boiled down into a system of codes.

These codes are used to track and pay for every procedure you can think of. There's 813.02 for mending a broken forearm, and 800.09 for treating a concussion. There's even 960.0 for being hurt in an "unarmed fight or brawl."

But this coding system is now four decades old. The codes were scheduled to be upgraded in October, but last week Congress delayed the switch.

JaeLynn Williams, for one, is seriously bummed out. "It's kind of like looking forward to Christmas, and it doesn't come," she says.

Williams and her company, 3M Health Information Systems, are helping about 5,000 hospitals upgrade from the old coding system, called ICD-9, to the new one, ICD-10.

It's a $100 million project for 3M Health. Williams is passionate about the upgrade since it will give doctors, hospitals, researchers and insurance companies better data — which will allow them to zero in on the best, most cost-effective treatments.

"With ICD-9 there's only so much information that's captured with each code," she says. ICD-9 offers about 4,000 codes for procedures. ICD-10 has about 72,000.

Read the entire article from NPR here  

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