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MedPAC disputes that half of new Medicare enrollees pick Advantage

Half of new Medicare beneficiaries are opting for private plans over the traditional fee-for-service program. That's a statistic that's been reported by Modern Healthcare and other publications in recent years. Healthcare consultant John Gorman, one of the foremost experts on Medicare Advantage, has frequently touted it.

It's a startling figure given that roughly 10,000 individuals are aging into Medicare every day and helps explain why health plans with significant Medicare business have fought so tenaciously (and often successfully) against proposed cuts to the program in recent years.
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Consumer access to online health data spotty, usage low

Only about 1 of every 4 consumers has online access to their medical records with less than half of that group using such access, according to a report released Monday by the Office of the National Coordinator for Health IT.

Among the 28% of patients who have been offered online access to their records, 54% did not access them, according to a 2013 survey conducted by NORC, a social research institute at the University of Chicago, according to the report. Among the major reasons cited for not using online access is a lack of interest (74%), concerns about privacy (28%) and lack of Internet access (23%).
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Sunshine Act's financial disclosure policy drawing more frowns

The chorus to delay or change the types of financial disclosures required by the Physician Payments Sunshine Act is getting louder.

Now, a group of 64 patient-advocacy groups led by the National Health Council is asking the CMS to exclude medical-device and drug companies from reporting indirect payments to these organizations.
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More hospitals shunning furniture with flame retardants

A few months ago, Kaiser Permanente said it would stop buying furniture with flame retardants because the chemicals are believed to be toxic. Now several other large hospital systems are following suit.

A group of hospital systems—Advocate Health Care, an 11-hospital based in Downers Grove, Ill.; Beaumont Health System, a three-hospital system based in Royal Oak, Mich; New Jersey's 685-bed Hackensack University Medical Center; and University Hospitals, a six-hospital system in Ohio—said this week they will buy upholstered furniture only if the pieces do not contain flame retardant chemicals.
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Some providers already taking Medicare's RAC appeal deal

It's been about two weeks since the CMS told hospitals and health systems it would pay a portion of appealed inpatient-status claims, and at least a few have taken Medicare up on its offer.

As of Sept. 9, four unnamed providers submitted paperwork that would result in the CMS paying 68% of inpatient-status claims that are sitting idly in the appeals process, according to a document posted on the CMS website.
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Uninsured rate for children holds steady after ACA

7:30 pm, Sep. 10 |

While millions of uninsured adults have received health insurance coverage since the implementation of the Patient Protection and Affordable Care Act, the uninsured rate among children has remained relatively unchanged, according to new research.

Because of previous efforts to cover children under Medicaid and the Children's Health Insurance Program, the uninsured rate among children was well below the rate for adults before the reform law was enacted.
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Blues plans dominated ACA exchanges in a dozen states

Pearson (AP Photo)
WellPoint and other Blue Cross and Blue Shield plans enrolled the largest number of consumers through the insurance exchanges during the initial open-enrollment period in 12 of 15 states and the District of Columbia, according to an analysis released Wednesday by Avalere Health.

The numbers add to increasing evidence that many new entrants to the individual market struggled to attract customers during the first year of the marketplaces. In some cases, those carriers are aggressively cutting prices to be more competitive in 2015.
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Berwick falls short in Mass. gubernatorial bid

Former CMS Administrator Dr. Donald Berwick, the noted healthcare quality guru and vocal advocate of a single-payer health insurance system, will not be the next governor of Massachusetts. Berwick finished third in Tuesday's Democratic primary, which was won by Massachusetts Attorney General Martha Coakley.

Berwick, 68, who founded the Institute for Healthcare Improvement, drew support from 21% of primary voters, compared to 42% for Coakley and 36% for state Treasurer Steve Grossman.
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New entrants to individual market struggled to capture customers

The establishment of state and federal exchanges spurred many new entrants into the individual insurance market in 2014. But many of those new entrants—including consumer-governed co-op plans, provider-sponsored plans and Medicaid managed-care insurers—struggled to attract a significant number of customers, according to a new analysis of the individual market in four states.

Healthcare finance analyst Allan Baumgarten analyzed the markets in Arizona, Michigan, Minnesota and Wisconsin by looking at quarterly filings from the National Association of Insurance Commissioners. Baumgarten compared enrollment data at the end of 2013 to the same data after the second quarter of 2014, when open enrollment under the Patient Protection and Affordable Care Act had concluded. Those figures include individuals who signed up through the exchanges, but also those who went through brokers or signed up directly with insurers.
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Brain chemistry may be linked to obesity

Differences in brain chemistry could explain why obese people may be more tempted to eat than people of normal weight. The finding could change the way healthcare providers help obese patients lose weight.

Environmental triggers to eat, such as food smells, were found to cause different reactions in the brain in obese people, compelling them to eat more often, according to a study published online Tuesday in the journal Molecular Psychology.
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