The Centers for Medicare and Medicaid Services issued bidding instructions urging private plans in Medicare to simplify their offerings for 2007. However, the CMS "call letters" instructing prescription drug and managed care plans on preparing their bids for next year do not formally standardize those offerings, a step urged by some congressional Democrats. CMS said it wants "clearly understandable" options and that plans should compete by making it easier for beneficiaries to make comparisons. Read more »
Health policy analysts praised the political accomplishment of Massachusetts lawmakers in enacting a plan that covers almost all of the state's half a million uninsured residents, but they said money is a big obstacle to replicating that model nationwide. The plan makes Massachusetts the first state in the nation to require residents without health insurance to obtain coverage, just as drivers are required to buy automobile insurance. Uninsured residents with low incomes will receive state subsidies to buy health coverage. Read more »
A day after party infighting forced House Republican leaders to send members home for recess without passing a budget, GOP leaders pledged they would resume negotiations when they return from the two-week Easter break. "I don't think we should be throwing in the towel," House Republican Conference Chairwoman Deborah Pryce, R-Ohio, said. House Majority Whip Roy Blunt, R-Mo., said he believes the GOP can eventually pass a budget resolution (H Con Res 376) despite the intense disagreement among appropriators, conservatives and moderates that sank the effort this week. Read more »
The Centers for Medicare and Medicaid Services said that payment rates for Medicare managed care plans will rise only modestly in 2007. While payment rates are set to rise an average of 4 percent next year, those rates will be subject to a technical adjustment for the way physicians code patients for billing purposes. That technical adjustment on average would leave plans with a payment rate increase of 1.1 percent assuming the overall health status of their Medicare enrollees stayed about the same between 2006 and 2007. Read more »
Despite the perception that the U.S. health care system is the best in the world, studies conclude that Americans are not getting their money's worth. The first of two reports from the Commonwealth Fund found that the U.S. health care system performed poorly compared with other countries in terms of providing care equitably, safely, efficiently or in a patient-centered manner. The second study concluded that U.S. adults with below-average incomes fare worse than their counterparts in four other countries. While the U.S. system scored well on effectiveness of care—in particular preventive care—there are wide disparities based on income, according to patient surveys. Read more »
The lack of consensus over how to make health coverage affordable for small businesses was as clear at a Senate hearing as the growing pressure members of Congress feel to deliver on the issue. Senators made passionate pitches for different solutions. Business officials testifying at the hearing by the Senate Finance Committee were similarly out of sync. Insurance market researchers voiced strong criticisms of the small business coverage bill (S 1955) that has progressed farthest in the Senate. Read more »