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Health On The Hill – November 22, 2010

The Department of Health and Human Services released regulations Monday dealing with the medical loss ratio, a provision in the health law that requires insurers spend at least 80 percent of premium dollars of health care. Meanwhile, before the Senate adjourned for Thanksgiving the chamber passed a one-month patch to prevent physicians who see Medicare patients from having their payments reduced. The House is expected to approve the measure on Nov. 29 when it returns from the Thanksgiving break.

By alley

Nov. 22, 2010

New Law’s Health Insurance Regulations Could Mean Rebates For Consumers

Millions of Americans might be eligible for rebates starting in 2012 under regulations released Monday detailing the health care law's requirement that insurers spend at least 80 percent of their revenue on direct medical care.

By Julie Appleby

Nov. 22, 2010

Big Hospitals Dictate Premiums Using Their Clout

Hospitals are using their size and pricing clout to define premiums for people around America, like in the Sutter Health system in California, where hospital prices are among the highest in the nation.

By Sarah Varney, KQED

Nov. 22, 2010

Opinion Column

The Roadmap Lives

Rep. Paul Ryan, R- Wis., took the courageous step of going first with a bold plan -- his Roadmap -- to fundamentally restructure the tax and entitlement policies that threaten to push the federal budget past the breaking point. Now others, even some from the other side of the aisle, are joining him in sponsoring similar plans.

By James C. Capretta

Nov. 22, 2010

‘Don’t Litigate, Innovate.’ How To Implement A Fully Funded Alternative To The New Health Care Overhaul — And It’s Already In The Law

What if a Republican governor and a Republican legislature had the ability to implement their version of health insurance reform and the federal government would have to pay for it? It's a great idea. And I'm thrilled to say that a bi-partisan bill has already been introduced in the Senate by Ron Wyden, D-Ore., and Scott Brown, R-Mass., that would help facilitate exactly this end.

By Robert Laszewski

Nov. 22, 2010

As Hospital System Expands, Patient Advocates Worry

Sutter Health, the most expensive health system in California, is expanding at a rapid pace and transforming itself into an "accountable care organization." Some worry about the nonprofit hospital's growing leverage.

By Jordan Rau

Nov. 21, 2010

Q&A With Sutter Health’s CEO, Patrick Fry

Patrick Fry is president and CEO of Sutter Health, one of Northern California's largest provider networks with 22 acute care hospitals and thousands of physicians in affiliated medical foundations.

By alley

Nov. 19, 2010

Health Industry Cool To Complete Repeal Of Reform Law

Republicans in Congress say their priority for next year is to build momentum for an eventual repeal of the new health law. But they could be in for a surprise: While repeal may be popular with Republican voters, the GOP could face pushback from some allies in the health care industry.

By Julie Rovner, NPR News

Nov. 19, 2010

A Hospital Chief’s Tough Task In Tough Times: Cut Costs, Improve Quality

CEO Judy Rich has kept the Tucson Medical Center running well through Arizona's tough economic recession. Now, she's staring at a slew of changes coming her way from the new federal health law. But she's optimistic.

By alley

Nov. 19, 2010

Insurers’ Payments To Hospitals Vary Significantly By Region

A study of four major insurers' payments to hospitals finds great differences among different parts of the country. San Francisco is the most expensive city among the eight areas in the study.

By Jordan Rau

Nov. 18, 2010

Opinion Column

The Texas Medicaid Scenario — Why It’s Never Going To Happen

Withdrawing from Medicaid would be political suicide. Despite post-election bluster, no governor or legislature will seriously attempt such a maneuver because of the related administrative, economic and organizational difficulties.

By Harold Pollack

Nov. 18, 2010

Opinion Column

The Medicare Doc Fix: Physicians Again Are Staring Into The Abyss

At the end of November, the most recent "doc fix" will expires. Without congressional action, physicians who see Medicare patients will face an across-the-board 23% reduction in their fees. If nothing happens by January, physicians would face an additional 7 percent reduction.

By Gail Wilensky

Nov. 18, 2010

Compared To Other Countries, U.S. Patients Have More Access To Specialists, Less To Primary Care

A new study finds that U.S. consumers report greater access to specialty health care but also have a tougher time seeing a doctor on the day they need help than consumers in many of other Western countries.

By Amita Parashar

Nov. 18, 2010

Can Florida Really Alter Medicaid?

Florida Republican leaders said Tuesday they want to overhaul the Medicaid program and don't want the federal government tying their hands. But their message may fall on deaf ears in Washington.

By Jim Saunders, Health News Florida

Nov. 18, 2010

Vulnerable Democrat Looks For Alternatives To Health Insurance Mandate

Facing what could be a tough reelection fight in 2012, Sen. Ben Nelson, D-Neb., is looking for politically safer alternatives to the individual insurance mandate that takes effect in 2014.

By Bara Vaida, KFF Health News

Nov. 17, 2010

Berwick Pushes Quality Of Health Care, Defends Reform Law

In his first appearance before a congressional committee since becoming administrator of the Centers for Medicare and Medicaid Services, Dr. Donald Berwick told the Senate Finance Committee that the health law would help make the delivery of medical care more efficient and reduce its cost. KHN's Mary Agnes Carey talks about the hearing.

By alley

Nov. 17, 2010

Opinion Column

Letter: Nursing Home Trade Association CEO Responds To Medicaid Opt Out Proposal

The 11/12 New York Times news article produced in partnership with Kaiser Health News, "Battle Lines Drawn Over Medicaid in Texas" reflects the post-election reality faced by vulnerable populations and the providers who care for them, on a variety of significant levels.

By alley

Nov. 17, 2010

New Deficit Report Recommends Seniors Pay More For Medicare

A blue-ribbon bipartisan panel of experts, chaired by former budget director Alice Rivlin and former Sen. Pete Domenici, recommends major changes to the way the government pays for health care.

By Jordan Rau and Phil Galewitz

Nov. 17, 2010

Administration Unexpectedly Expands Bonus Payments For Medicare Advantage Plans

The Obama administration will spend up to $1.3 billion to extend special payments -- meant to reward top-performing insurers -- to those that score only average ratings.

By Julie Appleby

Nov. 16, 2010

New Medicare/Medicaid Projects Aimed At Cheaper, Better Care

The new Center for Medicare and Medicaid Innovation launched Tuesday a series of initiatives aimed at improving care while reducing its cost.

By Mary Agnes Carey

Nov. 16, 2010

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