[…] But although the spending caps will be beneficial to families that have large medical expenses, they do nothing to actually address the rising cost of health care, and the over-utilization that is also driving costs. This has been a recurring theme with a lot of the provisions created by health care reform: we’re finding ways to spread the costs in a more equitable fashion, but we’re not really addressing the fact that the total cost burden of health care in this country isn’t sustainable on its current trajectory, no matter how much we spread it out across the population.
Health Care Reform
[…] Most of us agree that we need to find a way to reduce overall healthcare spending, but we also need to make sure that we don’t compromise future healthcare outcomes in the process. While some of the issues mentioned in the study – such as the drop in routine blood tests for people with diabetes – are definitely concerning, we shouldn’t simply assume that a reduction in overall preventive care will automatically lead to poorer health in the future.
[…] Senate Bill 200 (the Colorado Health Benefit Exchange Act), co-sponsored by Senator Betty Boyd (D – Lakewood) gets the ball rolling on the health insurance exchange that the state will have to have in place by 2014. Specifically, the bill would create a “nonprofit unincorporated public entity known as the Health Benefit Exchange”. It includes guidelines for the appointment of a 12-member board of directors (9 of whom will be voting members) who will oversee the exchange, and lays out their responsibilities. […]
[…] I wrote last fall about the new high risk pool in Colorado – GettingUsCovered – and how it differs from our existing high risk pool, CoverColorado (which has been operating for two decades). In states like Colorado that have existing state pools in addition to the federally-backed pools, there may be adequate options for people with pre-existing conditions, assuming that funding for both programs holds out until 2014. But in states that only have a PPACA-created pool, there are definitely some cracks to fall through, including the requirement that applicants be uninsured for six months before they can join the pool.
As of April 1, 2011, CoverColorado will be switching to a new fee schedule for reimbursing providers. In the past, CoverColorado has used the Rocky Mountain Health Plans provider network, and doctors were paid according to the RMHP network-negotiated rates when they treated CoverColorado members. The new CoverColorado-specific fee schedule applies to any provider who treats a CoverColorado member, regardless of whether that provider is part of the RMHP network or not. […]
Since January 1, 2011, all new individual health insurance policies issued in Colorado have included maternity coverage as required by a new state law. The text of the bill was quite clear in stating that its provisions would apply to all “policies issued or renewed on or after the applicable effective date of this act.” (see the top of page 3 of the text). But until now, there was still some confusion around maternity coverage and policy renewals, and inconsistencies in how the law was being applied. […]
[…] The study’s authors note that implementing mandatory health insurance rules is not likely to result in a significant decline in the number of medical bankruptcies nationwide unless we also focus on improving the level of coverage that people have (to reduce out of pocket exposure), and on expanding access to disability insurance that can help provide income to people who are unable to work because of a major illness or injury. […]
[…] Colorado has been taking an active role in reforming healthcare for some time now. And our legislators are obviously still focusing on healthcare reform at a state level, from several different angles. Based on the initiative the state has shown over the last few years, I’m guessing that if the state waivers are available from HHS as of 2014, Colorado will likely take advantage of the opportunity to craft at least some aspects of our own healthcare regulation.
The Healthcare Opportunity and Patient Empowerment (HOPE) Act (HB 1273) was introduced in the Colorado House of Representatives this week, with primary House sponsorship from Reps Nikkel and Stephens (the House majority leader), and primary Senate sponsorship from Senator Kopp. The idea behind HB1273 is to allow Colorado to legally opt out of the PPACA – not just the individual mandate portion, but the entire law. […]
Tort reform has long been a contentious topic in the healthcare reform debate. Many Republican lawmakers – on both a state and federal level – have proposed tort reform as one of the major platforms of their alternative healthcare reform proposals. It’s the sort of issue that people tend to see as black and white, but is really many shades of grey. […]
The New America Foundation (NAF) and the University of Denver’s Center for Colorado’s Economic Future recently published a new study in conjunction with The Colorado Trust and The Colorado Health Foundation. The study was designed to look at the projected economic outcomes for the state of Colorado with and without health care reform. For the reform scenario, the researchers concentrated on the recommendations created by the Colorado Blue Ribbon Commission (208 Commission) a few years ago. They compared that data with the projected outcomes if we do nothing and simply maintain the current system with regards to health care. […]
[…] There has been much debate recently about what is the most efficient and cost-effective method of reimbursing doctors and hospitals. While most providers now are paid on a fee-for-service model, there’s concern that such a model tends to encourage over-utilization. ACOs might pose a possible solution, although their designers would be wise to ponder the data regarding pay-for-performance, since much of the success of ACOs could hinge on providers’ ability to “perform” in terms of keeping their patients healthy and avoiding costly hospitalizations.
In a continuation of the string of healthcare-related legislation we’ve seen recently, Colorado Senate Bill 168 was introduced earlier this week. SB 168 would create a nonprofit healthcare cooperative to act as the benefits administrator and payer for health care services in Colorado. Similar to several other healthcare bills we’ve seen over the years, this one would implement change in a multi-step process: first by creating a proposed Colorado Health Care Authority, which would design the cooperative and take it to the legislature and then voters for approval. […]
[…] Today, HHS has proposed additional regulations specifically aimed at student health insurance policies, in order to make sure that those plans meet the guidelines created in the PPACA. In essence, it would define student health plans as “individual health insurance coverage” and would eventually obligate student health plans to meet the same requirements as any other individual policy. […]
[…] As I’ve mentioned before, health care costs are what drive health insurance premiums. And until we figure out how to reduce the amount we spend on health care, health insurance premiums will continue to rise. But they will rise even faster if we require health insurance carriers to accept all applicants without imposing some sort of system that eliminates the possibility for people to wait until they are sick to purchase coverage.
[…] But like any big project, nobody said this will be an easy transition. The government has created an incentive program to help providers with the financial aspect of transitioning from paper records to EHR, but of course there are hoops to jump through. It’s not as simple as just setting up the first EHR system you come across and then getting money from the government to help pay for it. In order to qualify for the incentive program, EHR systems must meet meaningful use criteria as laid out by the Centers for Medicare and Medicaid Services last year. […]
[…] We cannot continue to tackle the health care mess by focusing on health insurance reform. That has been a large part of the focus of debate over the last couple years, mainly because health insurance is the point at which most people interact with the financial aspects of their health care. But health care costs are what drive health insurance premiums, and there’s no getting around that. It’s refreshing to hear the President of the Colorado Medical Society talking about the need for evidence-based medicine and a general scaling back of what we spend on health care. […]
I doubt that regulators will simply throw out the existing rules and allow ACOs to operate without consumer protections to place to guard against fraud and abuse. Instead, I see them coming up with new regulations that take into account the changing landscape of health care delivery, including ACOs. But either way, the creation of new consumer protections while suspending others does make for an interesting discussion. […]
Last week, the House of Representatives voted to repeal the PPACA. One of the Representatives voting for repeal was Scott Tipton, a Republican from Colorado’s 3rd congressional district. Obviously each Representative had to vote according to his or her own conscience and the general consensus from constituents, but one would also hope that prior to voting, each Representative would clearly understand the facts surrounding the various issues within the law. […]
Colorado Senator Irene Aguilar, a Democrat from Denver, will be introducing legislation next month to address the fact that there are still 700,000 people in Colorado without health insurance. Although Colorado has made strides recently in areas like the expansion of Medicaid, we didn’t even come close to fulfilling former Governor Bill Ritter’s hopes for health insurance for all Colorado citizens by the end of 2010. […]
[…] But is having to wait to see a specialist for a non-emergency situation really that much of a drawback, when we consider that this sort of “rationing” might be what we need to bring our healthcare costs down to a reasonable level (and thus make healthcare more available to more Americans)? Maybe we don’t need MRI machines to be as conveniently-located as ATMs… Our current costs (and the rate at which they are increasing) aren’t really sustainable long-term, and the Healthcare Technology News article is a good reminder of how we stack up against the rest of the world.
[…] People who already max out their HSA contributions and still have money left over to contribute more would likely appreciate the removal of the HSA contribution cap. But those are not the people who are struggling to afford health insurance or pay for medical care. They are not the people our elected representatives should be focusing on when coming up with solutions for health care reform. Although I like our HSA and the flexibility it gives us to save for future medical expenses, I acknowledge that HSAs are not a panacea for what ails our health care system. […]
[…] HB 1025, introduced by Colorado Springs Republican Rep Janak Joshi, would repeal the Health Care Affordability Act of 2009 (HB 1293). That Act introduced the Hospital Provider Fee system to generate about $600 million annually in funds for the expansion of Medicaid, the Colorado Indigent Care Program (CICP) and Child Health Plan Plus (CHP+). Those funds are supplemented with federal matching of an additional $600 million for the expansion of those programs in Colorado. The Health Care Affordability Act was widely supported by hospital and medical groups in the state. […]
Accountable Care Organizations (ACOs) have received a lot of buzz lately as the nation grapples with ways to reign in health care costs. But I think that there’s still a lot of confusion about how they would work. A couple of very informative posts on the topic were included in this week’s Grand Rounds, and I wanted to share them with our readers. […]
I’ve long supported the idea that our health care system was in need of reform that would make care more affordable and accessible to everyone, regardless of their health or financial situation. But I’m starting to feel a bit frustrated by what feels like an over-emphasis on regulation of health insurance carriers and not enough focus on ways to actually control the cost of health care (including over-utilization). If people are thinking of this process as health insurance reform rather than health care reform, it’s doomed to failure. […]