15 Responses

  1. Health reform could ‘rock the business landscape’

    As noted in our book, and this essay, while politicians and consumers debate the effect of healthcare reform on the patient population, industry leaders are turning their attention to how it will impact the business of healthcare; especially for doctors and hospitals.



    Ann Miller RN MHA


  2. Individual Insurance Under Healthcare Reform: A Boon For Policyholders

    A recent study of health insurance coverage under individual insurance plans indicates that more generous insurance coverage is associated with a lower risk of high out-of-pocket spending, and that the probability of very high out-of-pocket spending is expected to be reduced for everyone who purchases insurance through a health insurance exchange mandated under the ACA.

    Click to access ins.pdf

    Robert James Cimasi MHA AVA CMP™
    via Ann Miller RN MHA


  3. Obama vs. Romney
    [A Detailed Analysis of Mitt Romney’s Health Care Reform Plan]

    We encourage all ME-P readers to take a look at Mitt Romney’s Health Care plan using his own outline (“Mitt’s Plan”) on his website.


    Ann Miller RN MHA


  4. Through the Affordable Care Act, Americans with Medicare will save $5,000 through 2022

    [5.5 million seniors saved money on prescription drugs and 19 million got free preventive care in 2012]

    Because of the health care law – the Affordable Care Act – the average person with traditional Medicare will save $5,000 from 2010 to 2022, according to a report today from the U.S. Department of Health and Human Services. People with Medicare who have high prescription drug costs will save much more – more than $18,000 – over the same period.

    HHS Secretary Kathleen Sebelius also announced that, because of the health care law, more than 5.5 million seniors and people with disabilities saved nearly $4.5 billion on prescription drugs since the law was enacted. Seniors in the Medicare prescription drug coverage gap known as the donut hole have saved an average of $641 in the first eight months of 2012 alone. This includes $195 million in savings on prescriptions for diabetes, over $140 million on drugs to lower cholesterol and blood pressure, and $75 million on cancer drugs so far this year. Also in the first eight months of 2012, more than 19 million people with original Medicare received at least one preventive service at no cost to them.

    “I am pleased that the health care law is helping so many seniors save money on their prescription drug costs,” Secretary Sebelius said. “A $5,000 savings will go a long way for many beneficiaries on fixed incomes and tight budgets.”

    The health care law includes benefits to make Medicare prescription drug coverage more affordable. In 2010, anyone with Medicare who hit the prescription drug donut hole received a $250 rebate. In 2011, people with Medicare who hit the donut hole began receiving a 50 percent discount on covered brand-name drugs and a discount on generic drugs. These discounts and Medicare coverage gradually increase until 2020, when the donut hole will be closed.

    The health care law also makes it easier for people with Medicare to stay healthy. Prior to 2011, people with Medicare had to pay for many preventive health services. These costs made it difficult for people to get the health care they needed. For example, before the health care law passed, a person with Medicare could pay as much as $160 for a colorectal cancer screening. Because of the Affordable Care Act, many preventive services are now offered free to beneficiaries (with no deductible or co-pay) so the cost is no longer a barrier for seniors who want to stay healthy and treat problems early.

    In 2012 alone, 19 million people with traditional Medicare have received at least one preventive service at no cost to them. This includes 1.9 million who have taken advantage of the Annual Wellness Visit provided by the Affordable Care Act – almost 600,000 more than had used this service by this point in the year in 2011. In 2011, an estimated 32.5 million people with traditional Medicare or Medicare Advantage received one or more preventive benefits free of charge.

    For state-by-state information on savings in the donut hole, please visit: http://downloads.cms.gov/files/Summary-Chart-2010-2012.pdf

    For state-by-state information on utilization of free preventive services, please visit: http://downloads.cms.gov/files/preventive-services-data.pdf

    For more information on the estimate that the average Medicare beneficiary will save $5,000 from 2010 to 2022 as a result of the health care law, please visit: http://aspe.hhs.gov/health/reports/2012/beneficiarysavings/ib.shtml

    Hope Rachel Hetico RN MHA


  5. What’s on Deck for the ACA in 2013

    Although most of the coverage expansions and insurance reforms under the Affordable Care Act don’t kick in until 2014, several key ACA provisions are scheduled to take effect next year, including:

    •Medicaid payments to primary care physicians for primary care services will increase to 100% of Medicare rates for two years.

    •States that offer Medicaid coverage with no patient cost-sharing for recommended preventive services will receive a one percentage point increase in federal matching payments.

    •Medicare will test bundled payments for physician services, acute inpatient hospital services, outpatient hospital services, and post-acute care services for a patient’s episode of care.

    •The federal government will impose an excise tax of 2.3% on the sale of taxable medical devices.

    •Reductions will begin on disproportionate share hospital payments under Medicare and Medicaid.

    •Non-profit, member-run health insurance companies known as Consumer Operated and Oriented Plans (CO-OPs) will launch.

    Source: Kaiser Family Foundation Health Reform Implementation Timeline via aMednews [11/19/12]


  6. Health Insurance – Are you sure?


    Insurers warn of overhaul-induced sticker shock.



  7. CO-OP Health Insurance Program: October 2013 Implementation

    The Affordable Care Act of 2010 created funding for the creation of Consumer Operated and Oriented Plan (CO-OP) programs in every state in lieu of a public health insurance option. The intent of CO-OPs is to expand consumer options and enhance competition and accountability among insurance carriers.

    Click to access COOP.pdf

    However, recent legislation passed on January 1, 2013 rescinded all but 10 percent of unobligated CO-OP funds, presenting significant financial hurdles for CO-OPs scheduled to begin consumer enrollment on October 1, 2013

    Ann Miller RN MHA
    via http://www.HealthCapital.com


  8. ACA

    Recent polls by the Kaiser Family Foundation found that more than two-thirds (67 percent) of uninsured Americans age 65 and younger and 57 percent of the overall population say they do not understand how the Affordable Care Act will affect their lives.

    And, 42 percent of us are still unaware that health care reform has been the law of the land since 2010.

    Dr. Morgan


  9. Many thanks to our text book purchasers!

    This book has been rocketing up the rankings, of late, and sales are expanding.
    So, thanks to all ME-P readers and subscribers for getting the word out.
    We are working hard, for you.

    Hope Rachel Hetico RN MHA


  10. Moody’s


    Predicts more bad news for nonprofit hospitals.



  11. I just purchased it!

    Financial Management Strategies for Hospitals and Healthcare Organizations: Tools, Techniques, Checklists and Case Studies


    Will send in a review after received and read.



  12. The Median Fiscal and Operational Performance of US Hospitals

    2009 2010 2011 2012 Change 2011-2012 Change 2009-2012 Average Annual Change

    * Net Operating Revenue $7,656 $7,635 $7,870 $7,906 0.5% 3.3% 1.1%
    * Total Expense per Discharge $7,198 $7,243 $7,477 $7,547 0.9% 4.8% 1.6%
    * Total Margin 3.35% 5.67% 6.04% 5.53% -8.4% 65.2% 16.7%

    Publication Source: HealthLeaders Media, September 2013
    Data Source: Truven Health Analytics


  13. Moody’s upgrades hospital outlook

    Because health system operators reacted quickly to manage payment cuts and lower patient volumes, Moody’s Investors Service has upgraded its for-profit hospital outlook to positive from stable.




  14. Hospital business model threatened – But the retail medicine outlook looks bright

    The currents of health reform and consumerism are getting more treacherous for incumbent hospital businesses, according to a new report by Standard and Poor’s Rating Services.




  15. Just-in-time

    (JIT) is an inventory-light manufacturing practice of sourcing materials right when you need them. It has been the industry standard for five decades.

    OK, now terminate your emotional connection with JIT.

    Once upon a time—as in, last year—automakers (and many other makers like medical ventilators) were card-carrying just-in-timers. The term is now taboo, as companies struggle to procure inventory.

    The new term: Stock-pile it.



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