HealthLeaders Media Corner Office - June 12, 2009 | If Congress Can't Stand the Heat, Could MedPAC? View as a Webpage | Subscribe for Free
If Congress Can't Stand the Heat, Could MedPAC?
Philip Betbeze, Senior Editor-Leadership

Call it an admission that Congress simply can't perform one of its most important duties—controlling the purse strings. That's the undertone of President Obama's letter to Sens. Max Baucus and Ted Kennedy proposing that MedPAC be empowered to determine Medicare reimbursement to providers.
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  June 12, 2009

Editor's Picks
AMA opposes public healthcare plan
Of course they do. Physicians have apparently decided it's better to stick with the devil you know than try their luck with a public healthcare plan that would compete with private insurers. As much as physicians hate insurance companies, they would really hate a public plan that could essentially dictate reimbursement. My question is why did they wait so long before coming out against it? Though the vast majority of physicians still accept Medicare, they clearly aren't reimbursed as well through that plan as with private insurers and Medicaid is even worse. So why would they support a change that would make all their reimbursement subject to government decision-making? I don't have a position one way or another in the debate, but in this New York Times story, the lobby characterizes itself as looking out for the general public in opposing a public healthcare plan. Let's be real though. The AMA opposes it for the same reason any special interest opposes legislation—it would likely take money out of members' pockets. [Read More]
Assistants and Nurses Improve Specialists' Bottom Lines and Reduce Patient Wait Time
Physician assistants are valuable at helping physicians spend more time with complex patients and resolve bottlenecks in patient care, according to a California Healthcare Foundation study and a story by my colleague Cheryl Clark. Though many states have laws that are not compatible with allowing physician assistants to take part in certain aspects of patient care, "these models generally improved access, reduced wait times and proved financially sustainable." In fact, practices that participated in the study largely attributed their financial success to their ability to successfully integrate nurse practitioners and physician assistants into the patient care continuum. [Read More]
Infection Prevention Cuts May Be Costing Hospitals in Long Run
Economist John Maynard Keynes once said, "in the long run, we're all dead," but even so, this story might give you second thoughts about cutting back on infection prevention amid the economic downturn. My colleague Janice Simmons reports that based on a survey conducted by the Association for Professionals in Infection Control and Epidemiology, nearly 2,000 members, or 41%, reported that their budgets have been cut in the past 18 months. But as a leader, are you really thinking through the true costs of these cuts? Eliminating extra days in hospitals by preventing infections can save those hospitals money—especially when Medicare is declining now to pay for those hospital-acquired infection cases requiring longer hospitalizations. [Read More]

This Week's Headlines
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With an 11-figure incentive to invest in information technology and electronic medical records, healthcare executives need to determine if this offer from Uncle Sam is the kind of help that they are prepared to accept. [Read More]
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RAC Demonstration Project Offers Valuable Lessons: CMS created the Recovery Audit Contractors program as part of an effort to reduce improper Medicare payments by contracting independent auditors to detect and collect overpayments. The demonstration project, which ended its three-year process in March 2008, is the best body of evidence we have to project what the permanent program will be like as it continues to roll out across the country by 2010. Hospitals and other healthcare organizations interested in preserving their Medicare revenue would do well to study the demonstration and learn as much as they can to prepare for a future where RAC audits will soon become an unavoidable reality. [Read More]
Audio Feature

Dollars for Wellness: Wellness gets a lot of positive press, but there's often little in terms of carrots or sticks in many employer-sponsored programs to get measurable results. It's different at Carolinas Health System, says Donna Lockhart, a vice president with the system. Lockhart, whom I recently spoke with, says CHS' program is working by paying employees to comply. She says the benefits far outweigh the program's cost. [Listen Now]
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