We want to control healthcare spending and improve the quality of the care delivered at the same time – the challenge is how to do it. The Chief of Surgery at MGH recently sent out a departmental email describing what he called “always events” that pertain to inpatient care.
• Always record an accurate list of the patient’s prior medications within 24 hours of admission.
• Practice appropriate hand hygiene using Cal Stat, an alcohol based skin cleanser before entering a patient’s room and after leaving it – every time.
• Always use an electronic medical record and electronic prescriptions to document patient care.
• When discharging a patient from the hospital to a non-acute care facility, always give the next provider a full set of critical information about that patient (we have defined a minimum of seven agreed-upon elements that should be communicated).
We don’t do all of these things 100% of the time yet, but by setting the goal at always, Dr Warshaw has defined a clear target. Read more…
Governor Arnold Schwarzenegger recently proposed leasing the California state lottery to a private company as a way to generate revenue for his health reform proposal. Since Governor Schwarzenegger’s health reform plan draws so heavily from the Massachusetts reform law, I’ve been wondering whether our state should also consider linking health reform to gambling, particularly since gambling is such a hot topic in Massachusetts right now. I’ll leave it to the lawmakers to decide whether to allow casino gambling here, but if they do, there might be ways to use casinos to support health reform. In fact, this linkage would be fitting, since we’d be effectively replacing one form of gambling—going without health coverage—with another.
There are all kinds of ways we could use casinos to support health reform. For example, casinos might be a wonderful new location to provide education and outreach about the new state’s new coverage options and responsibilities. Imagine an entire social marketing campaign conducted through slogans on poker chips and cocktail napkins: Health Insurance: We Bet You’ll Love It! Health Coverage: The Wonder of It All! Health Insurance, Oh Yeah! Feel Like a Winner: Get Insured! Bronze with Drug Coverage: The Biggest Little Policy in the World! Read more…
Early this week, the state is expected to release the number of employers (with 11 or more workers) who have paid a fine, for the first time, for failure to provide health insurance. There have been many predictions about how much the state will raise through the fine, which was estimated at $295 for uninsured each worker.
At the time the bill passed lin April 2006, the fine was expected to raise 45 million dollars.
In October 2006, the Romney administration lowered that expectation to 26 million dollars. Some health care advocacy groups said the number dropped because the Romney administration’s definition of what it means to make a “fair and reasonable contribution” to employer coverage was too lenient. Here’s the regulation; the key section is at the top of page 3.
Earlier this year, the Patrick administration predicted the fine would bring in 24 million dollars.
Some business leaders say that less money from the fine means more employers are providing coverage than predicted…and that’s good news. More on that later this week.
In the meantime, what’s your guess, about either the number of employers who don’t offer coverage, or the amount of money the penalty will raise?
Entries in the Commonhealth blog in recent weeks referred to Senate President Murray’s encouraging words on getting at the escalating health insurance costs in order to make health care reform a long time success. On Tuesday at the Annual Meeting of the Retailers Association of Massachusetts, House Speaker DiMasi also focused on the issue of cost, much to the delight of the small business owners present at the meeting.
With major statements on health insurance cost from the leaders of both legislative chambers in recent weeks, we should all be encouraged that action will occur sooner rather than later to rein in the double digit premium increases small purchasers have seen over the last seven years.
As the employer and individual requirements under the law now begin to kick in, there is no question that increased access and universal coverage will only become long term realities if something is done to address the unrestrained increases by the big hospitals and big insurers. Read more…
The state’s largest insurer, Blue Cross and Blue Shield paid William van Faasen 19.4 million dollars last year. The payment includes just under 3 million in compensation and 16.4 million in a lump sum retirement package. Spokesman Christopher Murphy says the package was based on van Faasen’s 17 years with Blue Cross, 13 as CEO, and was reviewed by two outside consulting firms.
“It is imperative that as a large health insurer in the state MA, we attract and retain the best leadership available in the market.”
Senate President Therese Murray says it will be difficult to control rising health care costs when “non-profits” are compensating executives at this level.
Time is running out for uninsured residents who qualify for subsidized health plans and want to avoid a fine for failure to have coverage. Free and subsidized insurance is only available through the state’s Health Insurance Connector. Spokesman Dick Powers says residents who hope to have a plan by next month need to enroll and make an initial payment through the Connector by the end of the day.
Folks who sign up after that, it’s possible that we can get them enrolled, but there is no guarantee, which is why the 15th is so critical.
Residents who earn up to 300% of the federal poverty level, or almost $31,000 for an individual, qualify for insurance subsidies. Uninsured residents who don’t qualify for insurance assistance and expect to buy coverage from a private health plan have until the end of this month or the end of December to sign up, depending on which insurer you chose. The penalty for failure to have health insurance this year is $219. Next year, the penalty will be half the cost of the cheapest insurance plan. As Ann M. explains in an earlier comment, you will pay based on the number of months that you do not have coverage in 2008.
Here are a couple of resources that might be helpful:
1) The Connector’s website
2) The Health Care for All helpline is 1-800-272-4232
In health care this week, attention is on employers, and it begins with the release today of a new survey on employers and health care reform. The news is promising. Employers largely support health care reform and the fair share requirement, and we have observed little sign of “crowd-out,” or employers dropping coverage.
The Blue Cross Blue Shield of Massachusetts Foundation, joining with the Robert Wood Johnson Foundation, funded researchers at the National Opinion Research Center (NORC) to survey Massachusetts employers on coverage trends generally as well as their perceptions of health care reform and how it will affect them. There’s a lot of information in the survey – data which will be available for analysis through NORC as a public use file. Some of the findings are analyzed in a Health Affairs web-exclusive article published today authored by NORC Senior Researcher Jon Gabel. See the Foundation website for the report as well as the press release and chartpack.
So how does it look out there for employers in the early days of health care reform? Simply put: better than we thought.
Many assumed that small employers in particular would resist health care reform, resent the fair share requirement, and start to drop health insurance altogether, leaving the state to foot the bill. They did not. Read more…
The Massachusetts Health Care Quality and Cost Council is committed to changing the face of health care delivery in Massachusetts over the coming years and to improving our quality of care, contain costs, and reduce racial and ethnic disparities. One key objective is to provide Massachusetts residents with the information they need to obtain high quality health care at a reasonable cost. Yesterday, the Council released the findings of a statewide survey of consumer interest in health care quality and cost information. The survey found several indicators that consumers in Massachusetts are very interested in getting that information.
The Council is mandated to create a user-friendly website that will enable consumers to compare quality and cost data for all major health care providers in the area. The Council commissioned this survey to help it design a website that will be truly useful to residents across the state. The survey found several key points:
1. Patients trust doctors above all other sources of health care information. Read more…
Transcript of the Q&A Mandatory Health Insurance November 8, 2007
This is the log of the live chat today with questions and answers about mandatory health insurance in Massachusetts. You can add comments or questions at the end of the transcript.
12:55 Spine is my nickname I cannot listen to the program, but I have a problem and would like to know who to call. I haven’t had good luck so far with the government numbers I’ve called so far.
12:55 marthabebinger Hi Spine – two suggestions:
12:55 marthabebinger 1) connector@state.ma.us
or
2) the Health Care For All help line, 1-800-272-4232
12:57 marthabebinger If you don’t get what you need, post a response back on the blog with your e-mail and I’ll get in touch, Martha
12:59 Norma hello martha and all are we starting? thank you for this chat room to answer questions.