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Costlier Care is Often Worse Care

For a provacative read, check out the article entitled "The Cost Conundrum" from the New Yorker Magazine. Gawande, the author, illustrates the cost conundrum in McAllen, TX, noted for being "the most expensive town in the most expensive country for health care in the world." Does this Texas town have something to teach us about health care?

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CMS Definition of a CAH

CMS has released a fact sheet that describes a Critical Access Hospital (CAH) and the additional payment programs available to them.

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Meeting with the Blue Dog Coalition

I had the opportunity to meet this morning for breakfast with the Blue Dog Democratic Coalition on Capitol Hill to discuss health care quality and health reform. The Blue Dog Coalition is a group of 52 moderate and conservative Democratic Party members of the United States House of Representatives. The Blue Dogs promote, among other things, fiscal conservatism and accountability. My message was simple and straightforward when it comes to rural providers: Rural should not be left behind in the...

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CMS postpones RAC complex reviews of medical necessity until 2010

CMS anticipates Recovery Audit Contractor (RAC) automated reviews will begin in late June and July, according to Marie Casey, deputy director of the Division of Recovery Audit Operations at CMS. However, this is not set in stone, she says, noting, "there is some leeway." But complex reviews won't begin until later, says Casey. CMS is aiming to begin certain types of complex reviews (e.g., coding and DRG validation) this fall. However medical necessity complex reviews won't begin until...

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An Economic Case for Reform

The White House Council of Economic Advisers has released a compelling report on June 2 which attempts to make the economic case for healthcare reform. It's a comprehensive overview of the issues surrounding the current state of healthcare in the USA. The most important fact, in my opinion, that could generate more momentum for change is the drag that healthcare costs makes on employee salary and wages. This graph from the report makes the case: [caption id="attachment_40" align...

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Kennedy Plan: Insurance Mandate and Public Option

[caption id="attachment_29" align="alignright" width="136" caption="Sen. Edward M. Kennedy"][/caption] Sen. Ted Kennedy, Chair of the Senate HELP Committee, is stepping up his efforts to reform the U.S. healthcare system. Sen. Kennedy wrote an OpEd piece in the Boston Globe, giving an overview of his plan. The Washington Post has printed an article which outlines some of Sen. Kennedy's plan that are as of yet, publicly undisclosed and more controversial. What will be the impact of these...

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