Sunday, June 5, 2011

MASS HEATH CARE INSURANCE

The poll results show that residents with incomes below $30,000 — the bracket that would probably make them eligible for state-subsidized care — were the most likely to say the law is helping to control the cost of their care.


The law expanded eligibility for subsidized coverage to thousands more residents, and state figures a year after the law went into effect showed that more than 200,000 residents were added to state-run coverage.


The poll results also showed that the highest income group, those whose income exceeds $75,000, were more likely than the lowest income group to say the law is hurting their health costs.


Kay Lazar can be reached at klazar@globe.com.

Friday, April 1, 2011

uninsured coverage Mass Free Medical Care

Gov. Deval Patrick yesterday shrugged off a scathing inspector general’s report that found costly loopholes in the state’s $414 million free health-care pool — as Republicans pushed to put the brakes on the program.

“The depth of the issues is not as great as first read,” Patrick said of the report during the “Ask the Governor” segment on “Jim and Margery” on WTKK-FM (96.9).

The Herald this week reported that according to the IG probe, the state’s free medical care program — designed to help low-income uninsured Massachusetts residents — spent $7 million on hospital and doctors’ bills for out-of-staters and foreigners, and $6 million on duplicate claims.



“I venture to say that some of these issues might be a little exaggerated. That doesn’t mean to say an isolated incident isn’t significant,” Patrick said.

The IG’s office responded in a statement saying that because the administration had “failed to implement a claims adjudication system for outpatient claims . . . the Office commissioned its own claims editing adjudication.”

The office hired “an experienced health-care provider claims adjudication company,” Senior Assistant Inspector General Jack McCarthy said. “This vendor followed all Massachusetts laws and regulations.”

The report was hand-delivered to Health and Human Services Secretary JudyAnn Bigby on March 3, McCarthy said.

Meanwhile, Senate Minority Leader Bruce Tarr (R-Gloucester) and state Sens. Robert Hedlund (R-Weymouth), Michael Knapik (R-Westfield) and Richard Ross (R-Wrentham) called for better verification of applicants’ Medicaid eligibility, improved safeguards to prevent duplicate payments or payments for medically unnecessary procedures, and an audit of the state’s Medicaid program by the inspector general.

“We find it extremely troubling to learn there are such lax procedures in place that have allowed so many people to take advantage of the system,” Tarr said. “When health-care costs continue to grow at an unsustainable rate, we simply cannot allow such waste and abuse to continue.”

Tarr yesterday filed three amendments to the state’s 2011 supplemental budget to crack down on flaws in the system. The amendments failed last night.

“It’s deeply troubling that, in face of overwhelming evidence that health-care dollars are being spent appropriately, we failed to take action,” said Tarr, who scoffed at the majority party’s suggestion that safeguards are already in place. “If that’s the case, why was this report released?”

Hillary Chabot and Laura Crimaldi contributed to this report.

Tuesday, March 29, 2011

free care under healh care reform

We share the inspector general’s commitment to finding ways to enhance and improve the integrity of the claims adjudication systems at the Health Safety Net,” said Paulette Song, a spokeswoman for JudyAnn Bigby, secretary of the state’s Executive Office and Health and Human Services, “and are reviewing the 2011 report thoroughly to find opportunities to help increase efficiencies.”

Perhaps the report’s most troubling finding is that the state relies on the honor system when determining who is eligible for free care — and does not review an applicant’s assets, or even require a Social Security number to verify income, citizenship or address, Sullivan said.

Tuesday, March 22, 2011

This week marks the one-year anniversary of the Affordable Care Act.

Millions of Americans are already benefitting from our new health reform law. In the months ahead, even more of us will benefit if it improves care coordination, provides more preventive services, and makes coverage more affordable and secure. It only gets better from here.

That is, if we give reform time to work — and work together to make sure it gets implemented effectively.

Together, we’re working to build better care — care that is better coordinated, more centered on meeting the needs of patients, and more affordable. That's why I'm asking you to encourage the Senate to stand strong against efforts to repeal or defund health reform.

It’s time to move forward and fix our health care system.

We simply can’t afford to let anyone undermine our efforts to make America’s health care system work better for all of us — and especially for older adults, patients with multiple chronic conditions and their family caregivers.

Just ask Leslie Schlienger, a nurse from south Florida, who is working on the front lines.


Since graduating from nursing school in 1980, Leslie has been a head nurse in Veterans Administration and community hospitals, earned her certification in rehabilitation nursing and her master’s degree in nursing administration. For the last dozen years she’s been a home health nurse, and a critical part of her work is coordinating clients’ care with family, friends and medical professionals.

"The fragmentation of how care is delivered is a big issue," Leslie says. "Because of all the specialties, a single patient often has two or three physicians, and I’ve seen some with as many as seven or eight. Patients are overwhelmed by that. They’re lost in that system." (Read the rest of Leslie's story here.)


Now more than ever, we need better care coordination, improved communication among providers, medical records at our fingertips, and a system that doesn’t leave vulnerable patients and their family caregivers to fend for themselves.

To mark the one-year anniversary of the Affordable Care Act and honor the millions of Americans working every day for better care, urge your Senators to focus on fixing our health care system and reject any attempts to repeal or defund health reform.

I’ve already sent my message to Congress. Please send yours now!

Sincerely,

Thursday, March 3, 2011

Medicare Advantage

Improvements to Medicare Advantage • Today, Medicare pays Medicare Advantage insurance companies over $1,000 more per person on average than Original Medicare. These additional payments are paid for in part by increased premiums by all Medicare beneficiaries—including the 77% of seniors not enrolled in a Medicare Advantage plan. • The new law levels the playing field by gradually eliminating Medicare Advantage overpayments to insurance companies. • If you are in a Medicare Advantage plan, you will still receive guaranteed Medicare benefits. • Beginning in 2014, the new law protects Medicare Advantage members by taking strong steps to ensure that at least 85% of every dollar these plans receive is spent on health care, rather than administrative costs and insurance company profits.

Monday, February 28, 2011

Ventas buying Nationwide Health for $5.8 billion

2 hours, 27 minutes ago

(AP:NEW YORK) Ventas Inc. said Monday that it will buy Nationwide Health Properties Inc. in a $5.8 billion stock deal, creating the nation's largest health care real-estate investment trust.

The Nationwide purchase solidifies Ventas' position as a leading owner of senior housing communities, along with real estate properties including skilled nursing facilities, hospitals, and office buildings. The move also will make the company more diverse, combining Ventas' health care facilities with Nationwide's focus on senior housing and long-term care facilities.

The company will have more than 1,300 assets in 47 states, the District of Columbia, and two Canadian provinces. That includes operating 643 senior housing facilities and 379 skilled nursing facilities.

Ventas said private pay sources will account for 70 percent of the company's net operating income. Meanwhile, senior housing will account for about 55 percent of the combined company's net operating income, with skilled nursing facilities and medical office buildings accounting for about 22 percent and 11 percent, respectively.

Health care is one of the fastest growing segments of the economy, and both companies foresee growth as the population ages with the first wave of 79 million baby boomers turning 65 in 2011. Health care spending is projected to grow to 20 percent U.S. gross domestic product by 2019, from about 18 percent today.

Sunday, February 27, 2011

Health Costs Municipal Employees

jayboat How about having Municipal employees pay more than five dollars as their co-pay? Who else get health insurance with no deductibles? Make municipal employees join the GIC and pay the same co-pays and deductible as state employees. That will save the taxpayer millions of dollars.

Monday, February 14, 2011

MUNICIPAL HEALTH COSTS

A group of Massachusetts mayors, fed up with what they say is legislative inaction on skyrocketing municipal health care costs, has launched a ballot initiative for 2012 aimed at giving cities and towns more flexibility in reducing expensive benefits for employees, retirees and elected officials. Health costs in Massachusetts have added more than $1 billion to municipal budgets from 2001 to 2008, and some cities now devote close to 20 percent of their budgets to health care.

Saturday, February 12, 2011

The Effect of Repealing Health Reform on the State of Massachusetts:

CMMENTS FROM SEN. KERRY

•Repeal would take away $2 billion in additional federal assistance for MassHealth, which provides health coverage to more than one million Massachusetts children, families, seniors, and people with disabilities.


•Repeal would eradicate $860 million in federal funding of the Children’s Health Insurance Program (CHIP), which helps to ensure that virtually every child in Massachusetts has health care coverage.


•Repeal would make health coverage more expensive by taking away $4 billion in federal subsidies to purchase health insurance to over 254,000 Massachusetts residents.


•Repeal would prevent 75,000 people in Massachusetts with incomes between 300% of poverty to 400% of poverty—most of whom are older Americans under the age of 65—from receiving subsidies to purchase health coverage.


•Repeal would increase Medicare prescription drug costs for nearly 51,837 seniors in Massachusetts.


•Repeal would cut Medicare’s annual wellness visit and free preventive services for 1 million seniors in Massachusetts.


•Repeal would eliminate financial relief to 162 employers in Massachusetts who offer retiree health benefits.


•Repeal would make it more expensive for over 102,000 small businesses in Massachusetts to offer health coverage to their employees.


•Repeal would eliminate tens of millions of dollars in funding for community health centers in Massachusetts that provide high quality health care to about 800,000 state residents.


•Repeal would abolish $128 million in grants and tax credits to 312 small biotech companies in Massachusetts who are working to develop new therapies that prevent, diagnose and treat acute and chronic diseases.


•· Repeal would increase health insurance premiums in the nongroup market by 14 to 20%, costing Massachusetts families $1,950 to $2,790 more in premiums each year.


•Repeal would eliminate payment bonuses to about 11,500 physicians in Massachusetts who practice primary care.


•Repeal would reinstate a discriminatory Medicare reimbursement provision that penalizes Massachusetts hospitals by hundreds of millions of dollars each year.


•Repeal would expose nearly 4.5 million Massachusetts residents with private insurance coverage to having lifetime limits placed on how much insurance companies will spend on their health care.
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