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ACA/Health thread part IV

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Old
06-06-2014, 01:51 AM
  #401
PredsV82
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Originally Posted by Sevanston View Post
Added costs to providers, sure, but not more costs to the Medicare program.

But that's the fine line that all government programs have to walk. When are you providing a cost-efficient service and when are you just placing more undue burdens on people?
of course it adds costs to the Medicare program… those additional regulations and programs to target fraud all have costs, both in people being hired and resources being utilized.

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06-06-2014, 09:16 AM
  #402
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Surely you realized I was talking about net costs.

If your fraud prevention schemes save you 8 times more than it costs to make them work, then they don't really cost you anything.

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06-07-2014, 08:19 AM
  #403
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Originally Posted by Sevanston View Post
Surely you realized I was talking about net costs.

If your fraud prevention schemes save you 8 times more than it costs to make them work, then they don't really cost you anything.
yes, but I highly doubt that is the ratio, and i wouldn't be surprised if the ratio is less than 1...

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06-14-2014, 07:23 AM
  #404
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can't remember if I have mentioned this or not, but CMS is going to start using patient satisfaction surveys as part of their reimbursement model…

so now when a physician doesn't give a patient the pain pills they want, or do an unnecessary procedure that the patient thinks they should have because their friends aunts neighbor had the same thing, and the patient leaves the office mad, then their reimbursement is going down.

of all the dumb, counterproductive, unintended consequences things the the medical bean counters have come up with, this one takes the cake..

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06-16-2014, 11:24 AM
  #405
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Hundereds of Thousands to be contacted to verify subsidy eligibility


In a development that should surprise no one, up to two million of the 8 million enrollees have financial or other information needed to verify eligibility for subsidies that doesnt match the records the government has. If the people cant provide appropriate documentation, their subsidies may have to be repaid next April with their tax return.

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06-16-2014, 12:04 PM
  #406
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Originally Posted by PredsV82 View Post
Hundereds of Thousands to be contacted to verify subsidy eligibility


In a development that should surprise no one, up to two million of the 8 million enrollees have financial or other information needed to verify eligibility for subsidies that doesnt match the records the government has. If the people cant provide appropriate documentation, their subsidies may have to be repaid next April with their tax return.
This is old news BTW.

How many will need to repay subsidies? Pretty sure the piece I read said actually very few have discrepancies that would actually nullify policy or subsidy even if nothing was done, which of course is not happening as these people are being contacted.

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06-16-2014, 03:08 PM
  #407
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U.S. Sen. David Vitter (R-LA), who is running to replace Bobby Jindal as Louisiana's governor in 2015, said Monday he would consider adopting Obamacare's Medicaid expansion if elected.

http://talkingpointsmemo.com/livewir...ampaign=buffer

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06-16-2014, 03:24 PM
  #408
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Quote:
Originally Posted by PredsV82 View Post
can't remember if I have mentioned this or not, but CMS is going to start using patient satisfaction surveys as part of their reimbursement model…

so now when a physician doesn't give a patient the pain pills they want, or do an unnecessary procedure that the patient thinks they should have because their friends aunts neighbor had the same thing, and the patient leaves the office mad, then their reimbursement is going down.

of all the dumb, counterproductive, unintended consequences things the the medical bean counters have come up with, this one takes the cake..
Yeah, patient satisfaction surveys don't really correlate with quality of care. Or at least the correlation certainly isn't strong enough to relate it to payment.

From my understanding, they mostly just show how good doctors are at communicating with their patients. A good thing, of course, but it shouldn't be given so much weight that it significantly lowers doctors' paychecks.

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Originally Posted by PredsV82 View Post
Hundereds of Thousands to be contacted to verify subsidy eligibility


In a development that should surprise no one, up to two million of the 8 million enrollees have financial or other information needed to verify eligibility for subsidies that doesnt match the records the government has. If the people cant provide appropriate documentation, their subsidies may have to be repaid next April with their tax return.
No surprises here. But also fortunately more of a hiccup compared with the catastrophe of the initial roll out.

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Originally Posted by Led Zappa View Post
U.S. Sen. David Vitter (R-LA), who is running to replace Bobby Jindal as Louisiana's governor in 2015, said Monday he would consider adopting Obamacare's Medicaid expansion if elected.

http://talkingpointsmemo.com/livewir...ampaign=buffer
It's a good issue to divide votes on. Vitter is smart to pursue it as an election issue.

But also, I'll believe it when I see it.

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06-16-2014, 03:25 PM
  #409
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The Commonwealth Fund released their new study comparing countries' healthcare systems again.

It's beating a dead horse at this point, but naturally, the US came in last overall.

http://www.commonwealthfund.org/publ.../mirror-mirror


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06-16-2014, 09:57 PM
  #410
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Originally Posted by Led Zappa View Post
This is old news BTW.

How many will need to repay subsidies? Pretty sure the piece I read said actually very few have discrepancies that would actually nullify policy or subsidy even if nothing was done, which of course is not happening as these people are being contacted.
I can imagine just the fact of having to produce the documents and getting them uploaded/mailed even if they are eventually approved will add a layer of frustration to the process that will be a net negative even if it doest cost them any money

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06-16-2014, 10:00 PM
  #411
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Originally Posted by Sevanston View Post
The Commonwealth Fund released their new study comparing countries' healthcare systems again.

It's beating a dead horse at this point, but naturally, the US came in last overall.

http://www.commonwealthfund.org/publ.../mirror-mirror

those data don't add up.

if the UK is number one in all those categories how the hell do they end up 10th in "healthy lives"??

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06-17-2014, 02:44 AM
  #412
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Dan Diamond at the research firm Advisory Board noted one of the most important trends as insurers prepare for enrollment in 2015: "In every state so far, more insurers are asking to participate in Obamacare."


http://talkingpointsmemo.com/dc/obam...odnewseveryone

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06-17-2014, 06:35 AM
  #413
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I guess they have figured out that the "loss corridors" basically mean government guaranteed profit for them. I have no idea why they all didn't want in right away.

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06-17-2014, 08:05 AM
  #414
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Originally Posted by PredsV82 View Post
those data don't add up.

if the UK is number one in all those categories how the hell do they end up 10th in "healthy lives"??
This is how it describes that:

Quote:
Healthy lives: The U.S. ranks last overall with poor scores on all three indicators of healthy lives—mortality amenable to medical care, infant mortality, and healthy life expectancy at age 60. The U.S. and U.K. had much higher death rates in 2007 from conditions amenable to medical care than some of the other countries, e.g., rates 25 percent to 50 percent higher than Australia and Sweden. Overall, France, Sweden, and Switzerland rank highest on healthy lives.

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06-17-2014, 09:32 AM
  #415
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I'm not sure why the UK's mortality amenable to healthcare is so high, but I found a study of that metric comparing 31 OECD countries and the UK still ends up better than average.



Here's the PDF I pulled that from

EDIT: This definitely isn't the same data the Commonwealth Fund used though. Canada's ranking is different.


Last edited by Sevanston: 06-17-2014 at 09:38 AM.
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06-17-2014, 08:00 PM
  #416
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Fox News just interviewed Hillary Clinton for a full half hour. Not one question about Obamacare. The worst piece of legislation ever and one that is going to destroy America and not one question about it.

The first 8 questions were about Benghazi

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06-18-2014, 07:51 AM
  #417
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Originally Posted by Led Zappa View Post
Fox News just interviewed Hillary Clinton for a full half hour. Not one question about Obamacare. The worst piece of legislation ever and one that is going to destroy America and not one question about it.

The first 8 questions were about Benghazi
Hillary isnt a declared candidate for president, and wasnt in the senate when it passed, so there really isnt much basis to ask her about the ACA. She didnt have anything do do with its passage and until she announces for president she cant be expected to say how she would do anything about changing it, so what is there is ask?

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06-18-2014, 11:08 AM
  #418
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Originally Posted by PredsV82 View Post
Hillary isnt a declared candidate for president, and wasnt in the senate when it passed, so there really isnt much basis to ask her about the ACA. She didnt have anything do do with its passage and until she announces for president she cant be expected to say how she would do anything about changing it, so what is there is ask?
Pahleeze

Could you be anymore obtuse?

Fox News isn't talking about Obamacare 24-7 because it's working. Before it's relative successes every person on the planet over there was either asking or being asked how long they thought it would take for Obamacare to kill them

And every reporter is treating Hillary as though she is running. It would be stupid to assume otherwise.

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06-18-2014, 05:47 PM
  #419
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Pahleeze

Could you be anymore obtuse?

Fox News isn't talking about Obamacare 24-7 because it's working. Before it's relative successes every person on the planet over there was either asking or being asked how long they thought it would take for Obamacare to kill them

And every reporter is treating Hillary as though she is running. It would be stupid to assume otherwise.
there is nothing obtuse about it. Hillary had zero to do with passing the ACA and so asking her about it would be no different than asking anyone on the street about it at this point... you arent going to get an undeclared candidate to start acting like a candidate... its part of the game they all play...

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06-19-2014, 10:19 PM
  #420
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oldie but a goodie.

http://voices.washingtonpost.com/ezr..._health-c.html



Quote:

In 1977, Maryland decided that, rather than leaving prices to the vagaries of a marketplace where insurers and hospitals negotiate behind closed doors, it would delegate the task of setting reimbursement rates for acute-care hospitals to an independent agency, the Maryland Health Services Cost Review Commission.

When setting rates, the Commission takes into account differences in labor markets and how much a hospital pays in wages; the amount of charity care the hospital does; and whether it treats a large number of severely ill patients. For example, the Commission sets the price of an overnight stay at St. Joseph Medical Center in suburban Towson at $984, while letting Johns Hopkins, in Baltimore Maryland, charge $1,555. For a basic chest X-ray, St. Joseph's asks $81 and Hopkins' is allowed to charge $155. The differences reflect Hopkins's higher costs as a teaching hospital and the fact that it cares for generally sicker patients.

Such adjustments are never perfect, but in this case, it appears that the Commission is treating hospitals equitably. Since the program started, the Wall Street Journal reports that Maryland hospitals have enjoyed a steady profit margin, unlike hospitals in other states that often make more money during boom years and less during a recession. Statewide hospital profit margins average 2.5% to 3% — just enough of a surplus to give hospitals maneuvering room when setting budgets. Before the commission was established, Maryland hospitals were losing money covering the uninsured.

What is most remarkable is how state regulation of prices has contained costs. When the program began in 1977, the state’s hospital costs were 25% higher than the national average. Today, Maryland’s hospital costs are 2% lower than the national average. Meanwhile, over the same span, Maryland boasts the nation's second-slowest increase in hospital costs.

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06-19-2014, 10:22 PM
  #421
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Quote:
Originally Posted by PredsV82 View Post
those data don't add up.

if the UK is number one in all those categories how the hell do they end up 10th in "healthy lives"??
It probably has something to do with their teeth.

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06-20-2014, 09:57 AM
  #422
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The headline is sort of overselling what this bill is, but...

http://www.vox.com/2014/6/20/5825230...amacare-really

Quote:
There's a bipartisan plan to fix part of Obamacare. Really.

On Thursday, four Senators — two Republicans and two Democrats — introduced legislation that would tweak an Obamacare program that is meant to improve patients' medical care, but, according to recent research, might actually be making things worse for low-income patients.

...

In theory, reducing readmissions is a great thing — avoidable hospitalizations are bad for patients and bad for health spending. But the story is a little different for safety-net hospitals, which are often located in urban centers and serve poor and vulnerable populations.

...

On Thursday, Senators Joe Manchin (D-W.Va.), Roger Wicker (R-MS), Mark Kirk (R-IL) and Bill Nelson (D-FL) introduced the Hospital Readmission Accuracy and Accountability Act, which would require Medicare to account for socioeconomic status of patients when calculating penalties.

Perhaps the most surprising thing here is the fact that a bipartisan crew of politicians came together to act: on Obamacare. "The readmissions policy has been flawed from the beginning," said Senator Kirk in a press release.
This is definitely a step in the right direction. Time to break out the winter jackets in hell.

More likely it will just get squashed though.

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06-20-2014, 10:09 AM
  #423
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Originally Posted by Sevanston View Post
The headline is sort of overselling what this bill is, but...

http://www.vox.com/2014/6/20/5825230...amacare-really



This is definitely a step in the right direction. Time to break out the winter jackets in hell.

More likely it will just get squashed though.
Two Dems (DINO's) that will get eviscerated on MSNBC and two GOPers (RINO's) who will meet their maker on Faux Gnus.

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06-20-2014, 10:14 AM
  #424
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Originally Posted by PredsV82 View Post
those data don't add up.

if the UK is number one in all those categories how the hell do they end up 10th in "healthy lives"??
Even the best care in the world can't overcome a sedentary population of pale people with poor dental care and a diet consisting of mostly fried or boiled meat.

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06-20-2014, 10:18 AM
  #425
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Even the best care in the world can't overcome a sedentary population of pale people with poor dental care and a diet consisting of mostly fried or boiled meat.
Don't knock deep fried snickers bars until you've tried one.

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