October 2011 Archives

Last week the federal government did its best to reignite enthusiasm around the so-called accountable care organizations, making significant changes that are meant to coax doctors and hospitals to come on board.

Accountable care organizations, or ACOs, are a centerpiece of the 2010 health reform law that aim to get doctors and hospitals to work together to keep patients healthier. The interim rule released in March was panned by doctors and hospitals expected to volunteer for the program.

The revisions include allowing ACOs to operate without financial risk and will let ACOs collect a full bonus once they hit a savings target; the interim rule would have kept the first 2 percent of savings for the federal government.

They also eliminate a confusing and unpopular provision that would have kept patients and doctors in the dark about who was actually included in an ACO, and they slash the number of quality measures doctors and hospitals will have to report from 65 to 33.

Are these changes enough to attract wary doctors and hospitals back to the ACO drawing board? Will ACOs help change how America pays for its health care?

2 responses: Mark Lutes, Jack Lewin

The Food and Drug Administration has been the target of criticism from Republicans and the medical device industry alike, arguing that increased medical device approval times are pushing innovation abroad.

After holding several hearings examining the FDA's approval process, House Energy and Commerce Chairman Fred Upton, R-Mich., last Friday unveiled a package of legislation that Republicans say will "improve the predictability, consistency, and transparency of FDA's medical device review and approval process."

The legislation would require FDA reviewers to provide "scientific or regulatory rationale for major decisions," and reaffirms that FDA should follow "least burdensome" practices to approve devices. You can read more about the bills here.

Do you think these proposals will be useful to getting new treatments to market? Or will these changes put patients in danger with unchecked devices?

3 responses: Meghan McCarthy, Meghan McCarthy, Jack Lewin

The controversial long-term disability insurance program, known as the Community Living Assistance Services and Supports program or CLASS, had a rough month in September. But the Obama administration hopes a report, expected out this week, might clear some of the bad air.

The insurance program, established under the 2010 health reform law, is on an indefinite hiatus. Staff at the CLASS office within HHS were reassigned last month. Senate Democrats removed all funding for CLASS in the Labor-Health and Human Services 2012 spending bill because program "implementation has been delayed." The program was originally intended to start collecting premiums in October 2012.

Assistant Secretary on Aging Kathy Greenlee said the report would include "recommendations about how to proceed."

Do you think the CLASS program can be saved? Is it possible to tweak the voluntary program so the premiums collected can cover the cost of benefits?

If not, what is needed for the estimated 10 million Americans that need long-term support services not covered in traditional health insurance plans?

1 response: Meghan McCarthy

The Institute of Medicine is expected to release a report Friday detailing exactly how the federal government should go about selecting what health benefits need to be covered by insurance plans in order to get on state exchanges.

The highly anticipated report has insurance companies concerned that HHS will add too many benefits, while consumer groups want as many covered benefits as possible.

Between both of those positions is the difficult balance of giving consumers affordable care that has enough benefits to help keep people healthy. Is it possible to give consumers affordable coverage with generous benefits? If you were at HHS, how would you balance affordable insurance coverage with adequate benefits?

4 responses: Jack Lewin, Tom Miller, Karen Ignagni, Arthur Kellermann