Health Care Reform News Around the Nation for the Week of Feb. 19
Gov. Sonny Perdue's (R) proposed fiscal year 2009 state budget would increase physician payments for Medicaid and PeachCare, the state's version of the State Children's Health Insurance Program, by $154.8 million, the Atlanta Journal-Constitution reports.
The reimbursement rate increase, which has the support of businesses and county government groups, is the first since 2003, according to budget documents. Under the proposed budget, the physician payment rate would increase by 2.5%. Hospitals, home health agencies and nursing homes also would receive increases.
However, physicians and hospitals say the proposed increase would not be enough to address their losses. The Georgia Hospital Association said its goal is to bring Medicaid payments in line with the cost of providing care by 2011 (Miller, Atlanta Journal-Constitution, 2/12).
Illinois Comptroller Dan Hynes released a "special report" on state finances that indicates Medicaid payments to doctors could be further delayed if sales- and corporate-income-tax collections continue to decrease as expected, the Chicago Sun-Times reports.
According to the report, further delay in payments could lead providers to stop treating Medicaid beneficiaries (Fusco, Chicago Sun-Times, 2/12).
Premiums for Massachusetts' nonsubsidized Commonwealth Choice health plans are expected to increase by an average of 5% over last year's premiums -- about half as much as plans for people with employer-sponsored coverage, according to a state memo released on Wednesday, the Boston Globe reports.
Premiums for some individuals would increase by as little as 2%, depending on their coverage, but others could face "substantially larger increases," according to the Globe. In some cases, the modest premium increases could be paired with higher copayments for physician office visits and prescription drugs.
About 16,000 people are insured through Commonwealth Choice, and the state expects an additional 7,000 people to purchase coverage by the end of June. The increase would not affect the 170,000 low-income Massachusetts residents enrolled in state-subsidized plans, although they could face separate increases in premiums and copays that have not yet been determined, according to the Globe (Dembner, Boston Globe, 2/14).
In related news, Massachusetts residents made 12% fewer visits to hospitals seeking no-cost care in FY 2007 than in 2006, according to a report released on Wednesday by the Massachusetts Hospital Association. State officials said the reduction in no-cost-care visits indicates that Massachusetts' health care reform law is succeeding (Boston Globe, 2/14).
New York Gov. Eliot Spitzer (D) reduced revenue projections for FY 2009 by $384 million and will look to make up state budget shortfalls with additional cuts to health programs, the New York Post reports (Lovett, New York Post, 2/11).
Last month, Spitzer released a budget proposal with $980 million in cuts to Medicaid and other health programs (California Healthline, 1/24). However, the impact of subprime mortgage problems and lower-than-expected revenue from capital gains on real estate transactions led Spitzer to revise the revenue forecast, according to the New York Times.
Spitzer has proposed:
- Reducing the increase in Medicaid reimbursement rates for hospitals, nursing homes and home care organizations by 35% -- 10% more than previously proposed (New York Post, 2/11);
- Requiring health insurers to pay for some programs that the state had planned to fund, including vaccinations against cervical cancer and anti-obesity efforts (New York Times, 2/11);
- Encouraging beneficiaries in the Elderly Pharmaceutical Insurance Coverage program to use generic drugs to save an estimated $19 million (Madore, Long Island Newsday, 2/11); and
- Adding $50 million to the $140 million increase in the "covered lives assessment" on health insurance companies that was previously proposed (Odato, Albany Times Union, 2/11).
The Pennsylvania Chronic Care Management, Reimbursement and Cost Reduction Commission on Wednesday announced a program that aims to train family physicians and health clinics to help people manage their chronic conditions, the Philadelphia Inquirer reports.
Under the plan, family physicians and other clinicians will be encouraged to create a team-oriented system that would help change patient behaviors, for example, through providing basic education and calling patients who miss appointments or tests.
In addition, an electronic patient registry system will be developed to track the delivery of care and alert physicians to patient treatment needs. The system will be provided at no cost to primary care physicians.
The program is expected to be launched in May, beginning with an intensive "learning collaborative" among 50 to 100 caregivers in the Philadelphia area (Goldstein, Philadelphia Inquirer, 2/13).
Rhode Island Lt. Gov. Elizabeth Roberts (D) on Tuesday unveiled a health care reform plan that would require most residents to purchase health coverage and would implement cost-cutting strategies, the Globe reports.
Roberts' plan would require all state residents with annual incomes above 400% of the federal poverty level to purchase insurance by July 2009. Businesses that do not provide insurance would be required to pay $1,000 for each uninsured employee, which the state would use to fund insurance products beginning in 2012 if enough funds are collected.
The state also would expand Medicaid and SCHIP (Dembner, Boston Globe, 2/13). In addition, the state would establish an agency, HealthHub, to coordinate the purchasing and regulation of health plans (Needham, Providence Journal, 2/13).
The South Carolina Board of Economic Advisors estimated that state revenues will increase by 3.2% next year, but the funds likely will not be enough to cover the rising cost of health care for low-income residents and other programs, the Columbia State reports (O'Connor, Columbia State, 2/12).
Gov. Mark Sanford (R) has proposed cutting $326 million, or 4.6%, from the current $7 billion budget, including $22 million from Partners for Healthy Children, the state's version of SCHIP. He also has proposed requiring all Medicaid beneficiaries to switch to generic drugs to save $16 million (AP/Augusta Chronicle, 2/11).
In an interview last week, Utah Gov. John Huntsman (R) said that if health insurers do not offer plans that more state residents can afford by the end of the year, he will consider implementing an individual coverage mandate, the Salt Lake Tribune reports.
His statement comes after the state House earlier this month unanimously approved legislation (HB133) that would establish a legislative task force to develop a plan to overhaul the state's health system by November (May/Rosetta, Salt Lake Tribune, 2/13).
In developing the proposal, state lawmakers would consider allowing insurers to offer portable health coverage that workers would carry with them to different employers, exempting some plans from certain state regulations and providing a minimum level of coverage at a less-costly price than current plans (May, Salt Lake Tribune, 2/9).
The task force bill is "virtually certain to pass the Senate," according to the Tribune (Salt Lake Tribune, 2/13).