Medicare Part B premiums for 2012 lower than projected

The U.S. Department of Health and Human Services (HHS) announced that Medicare Part B premiums in 2012 will be lower than previously projected and the Part B deductible will decrease by $22. While the Medicare Trustees predicted monthly premiums would be $106.60, premiums will instead be $99.90. Earlier this year, HHS announced that average Medicare Advantage premiums would decrease by four percent and premiums paid for Medicare’s prescription drug plans would remain virtually unchanged.

Thanks to the Affordable Care Act, people with Medicare also receive free preventive services and a 50 percent discount on covered prescription drugs when they enter the prescription drug “donut hole.”  This year, 1.8 million people with Medicare have received cheaper prescription drugs, while nearly 20.5 million Medicare beneficiaries have received a free Annual Wellness Visit or other free preventive services like cancer screenings.

“The Affordable Care Act is helping to keep Medicare strong and affordable,” said HHS Secretary Kathleen Sebelius. “People with Medicare are seeing higher quality benefits, better health care choices, and lower costs. Health reform is also strengthening the Medicare Hospital Insurance Trust Fund and cracking down on Medicare fraud.”

Medicare Part B covers physicians’ services, outpatient hospital services, certain home health services, durable medical equipment, and other items. In 2012, the “standard” Medicare Part B premium will be $99.90. This is a $15.50 decrease over the standard 2011 premium of $115.40 paid by new enrollees and higher income Medicare beneficiaries and by Medicaid on behalf of low-income enrollees.

The majority of people with Medicare have paid $96.40 per month for Part B since 2008, due to a law that freezes Part B premiums in years where beneficiaries do not receive cost-of-living (COLA) increases in their Social Security checks. In 2012, these people with Medicare will pay the standard Part B premium of $99.90, amounting to a monthly change of $3.50 for most people with Medicare. This increase will be offset for almost all seniors and people with disabilities by the additional income they will receive thanks to the Social Security cost-of-living adjustment (COLA). For example, the average COLA for retired workers will be about $43 a month, which is substantially greater than the $3.50 premium increase for affected beneficiaries. Additionally, the Medicare Part B deductible will be $140, a decrease of $22 from 2011.

“Thanks in part to the Affordable Care Act, people with Medicare are going to have more money in their pockets next year,” said Centers for Medicare & Medicaid Services (CMS) Administrator Donald Berwick, M.D. “With new tools provided by the Affordable Care Act, we are improving how we pay providers, helping patients get the care they need, and spending our health care dollars more wisely.”

Today, CMS also announced modest increases in Medicare Part A monthly premiums as well as the deductible under Part A. Monthly premiums for Medicare Part A, which pays for inpatient hospitals, skilled nursing facilities, and some home health care, are paid by just the 1 percent of beneficiaries who do not otherwise qualify for Medicare. Medicare Part A monthly premiums will be $451 for 2012, an increase of $1 from 2011. The Part A deductible paid by beneficiaries when admitted as a hospital inpatient will be $1,156 in 2012, an increase of $24 from this year’s $1,132 deductible. These changes are well below increases in previous years and general inflation. 

For more information on how seniors are getting more value out of Medicare, please visit: http://www.healthcare.gov/news/factsheets/2011/10/medicare10272011a.html

For more information about the Medicare premiums and deductibles for 2012, please visit: https://www.cms.gov/apps/media/fact_sheets.asp

The Latest Health Care Reform Update, April 15, 2011

Obama Signs Repeal of Health Reform 1099 Reporting Rule 

On April 14, President Barack Obama signed legislation that repeals a much-criticized health care reform law provision requiring employers doing more than $600 in business with a corporate vendor to furnish Form 1099 statements. Small employers, in particular, complained that the burden imposed by the reporting provision, which had been scheduled to go into effect in 2012, was too great.

Obama’s Medicare Proposal: How Would It Work?

President Obama’s debt-relief plan differs profoundly with Republicans’ on the fate of Medicare.  As outlined on Wednesday, a central aspect of the president’s plan would be to double down on one of the most controversial aspects of his health care reform law: an independent board with the power to slow costs in the Medicare system if the program’s spending rises faster than set limits.

Under the health care law, this Independent Payment Advisory Board (IPAB) would start to work if Medicare spending rises faster than the annual growth of the U.S. gross domestic product, plus 1 percent.  Under the plan outlined by President Obama on Wednesday, the board would act if Medicare spending rises faster than GDP plus 0.5 percent.

As it is now structured, the IPAB is supposed to be an organization of 15 members appointed by the president and confirmed by the Senate.  The health care reform law calls for the board to have varied geographic and professional representation, with experts in health care finance, hospital management and health insurance, as well as physicians.

If Medicare spending surpasses its targets, these people are supposed to put their heads together and come up with ways to cut the program so the costs remain under the set threshold.  Their recommendations are then submitted to Congress.

  • If lawmakers vote to approve them, and they are signed by the president, they become law. 
  • If Congress does not vote on the recommendations, they become law.
  • If Congress votes the recommendations down, but the president vetoes what Congress did, and Congress cannot override the veto, they become law.

One thing that makes it controversial is that it takes away some of Congress’s power to deal with Medicare issues.  Former Obama budget director Peter Orszag has said the board might be “the largest yielding of sovereignty from the Congress since the creation of the Federal Reserve.”

According to an analysis of the current law by the Kaiser Family Foundation, the board is prohibited from making recommendations that would:

  • Ration health care procedures,
  • Increase taxes,
  • Change Medicare benefits, or
  • Make the program more expensive for beneficiaries.

What would the board be able to change?  

  • Things Medicare pays for,
  • What it pays to providers, and
  • The program’s structure, among other things.

Since a big target of spending reductions probably would be things that supply income to doctors, hospitals, and other providers, the IPAB is intensely unpopular in the medical establishment.  Changing or repealing it is one of the American Medical Association and the American Hospital Association’s highest priorities.

US News & World Report Ranks the Top Hospitals and Nursing Homes in 2011

Hospitals

U.S. News evaluated almost 5,000 hospitals to rank the best in 16 adult specialties from cancer to urology. Death rates, patient safety, and reputation with more than 9,000 specialists went into the 2010-11 rankings. Of 152 hospitals ranked in at least one specialty, 14 are featured in an Honor Roll for landing near the top in at least six specialties.

Childrens Hospitals

For the 2010-11 rankings, U.S. News requested data from 170 pediatric centers and used survey results from thousands of physicians in 10 pediatric specialties who were asked where they would send the sickest children. In all, 62 hospitals ranked in at least one specialty. The Honor Roll features eight hospitals that ranked in all 10.

Nursing Homes

The 12 nursing homes listed alphabetically below, culled from more than 15,500 homes in the latest U.S. News America’s Best Nursing Homes rankings, make up the Honor Roll. They had to get four straight quarters of perfect five-star ratings from the federal Centers for Medicare and Medicaid Services in each of the three categories in which the agency evaluates nursing homes: health inspections, nurse staffing, and quality of care. Several are pediatric facilities, defined as nursing homes because they provide Medicaid-funded long-term care or skilled rehabilitation services.

New Yorks Best Nursing Homes

New Jerseys Best Nursing Homes

Connecticuts Best Nursing Homes

HHS Launches New Consumer Focused Health Care Website

The U.S. Department of Health and Human Services today unveiled an innovative new on-line tool that will help consumers take control of their health care by connecting them to new information and resources that will help them access quality, affordable health care coverage.  Called for by the Affordable Care Act, HealthCare.gov is the first website to provide consumers with both public and private health coverage options tailored specifically for their needs in a single, easy-to-use tool. 

HealthCare.gov  is the first central database of health coverage options, combining information about public programs, from Medicare to the new Pre-Existing Conditions Insurance Plan, with information from more than 1,000 private insurance plans.  Consumers can receive information about options specific to their life situation and local community.

In addition, the website will be a one-stop-shop for information about the implementation of the Affordable Care Act as well as other health care resources.  The website will connect consumers to quality rankings for local health care providers as well as preventive services.

Health Care Reform Discussion

I will be commenting on specific aspects of the new Health Care Bill over the next several months.  Please see below my thoughts on the proposed reduction in Medicare Reimbursements.

I see a host of issues that must be addressed as a result of the new health care law from a pure delivery perspective.  I will only address one of these issues today and it’s the proposed 21% reduction in Medicare reimbursements to providers. 

Having convenient access to primary care is a fundamental component to managing ones healthcare, managing the costs of health care and having a patient centric delivery system.  By cutting reimbursements to Medicare providers we will reduce  the number of doctors participating in Medicare and drive seniors to seek fragmented care yielding greater financial stress to seniors and increasing costs within the current  delivery system.  Not to mention the impact to what primary care providers are currently being paid since insurance carriers provider reimbursements contracts  are tied to what Medicare pays its providers.  

Imagine the burden to the delivery system when the 20+ million uninsured are now receiving subsidized coverage and are seeking primary care within this stressed environment.  Will having coverage change how these 20 million receive care? Will they still treat the ER as the primary care setting?  This health care environment we’re creating is has no future and will only lead to a continuation of fragmented care, decrease in access to primary care doctors and hospitals, increased chronic disease, increased delivery costs and at the end of the day an increase in all of our individual and corporate tax rates. 

We need a healthcare delivery model that is built on a solid foundation of primary care delivered more effective, efficient, and equitable care than systems that fail to invest in primary care. Current patient centric delivery models are being studied and piloted around the country within diverse settings and patient populations, findings consistently indicate that investments to redesigning the delivery of care around primary care have yielded excellent results.  These are the initiatives we need to rally in order to access quality care and impact long term health care costs.

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