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GLG News by this Author

What are these “Further Adjustments?”

November 11, 2009

Analysis of:AHA applauds reform bill, urges further adjustments | www.modernhealthcare.com

Healthcare Reform has passed the House, with some changes from the two versions in the Senate. What are the items that will affect hospitals and what can hospitals expect for margins in the future.

Why is Healthcare Reform Losing Popularity

August 28, 2009

Analysis of:Deficit Plays into Health Reform | www.washingtonpost.com

The polls are showing healthcare reform is losing its support on main street. The country is realizing the cost of universal coverage is going to be high, and the national debt and annual budget deficits are at unbelievably high levels even without health care reform. The consequences of healthcare reform are either the deficit will grow more, or shortages will develop with the healthcare industry. What does the future for taxpayers, patients, and providers look like?

Healthcare Reform Train under full steam

July 15, 2009

Analysis of:Hospitals accept deal that would cut reimbursement | www.modernhealthcare.com

Healthcare Reform, Where are we, how will the Federal Government pay for it, what does it mean for hospitals, and what does it mean in the long run?  Congress is under pressure to develop a healthcare reform bill, which makes me nervous.  The issues of Tort Reform and sustainable payments to providers need to be addressed in order for the healthcare reform to be a long term success.

Achieving Health Care Reform

May 28, 2009

Analysis of:Achieving Health Care Reform--How Physicians Can Help | content.nejm.org

The authors of the article build their case for healthcare reform on assumptions that may not be correct, but nevertheless accept the assumptions as givens.  The authors outline a system of reform that relies heavily on government interventions and the supply side of the healthcare industry without adequately considering the demand side.  Finally, the authors would like to pay for expanded coverage by a formula driven reduction in the current health expenditure growth rate and efficiencies gained from integrated systems without quantifying the cost of expanding insurance coverage to the un-insured or the savings to be achieved.

634 Billion will not come close for Health Care Reform

March 6, 2009

Analysis of:Obama Puts Health Care Reform at Heart of Budget. | www.google.com

 The goal of Obama’s health care reform is to insure all Americans have access to affordable health care.  There is not enough money in the Federal treasury to reach such a goal.  President Obama will be frustrated in trying to extract the savings he desires by eliminating duplications and errors.  Computerized electronic records will not result in budget savings to the extent that the administration desires.  The laws of economics will rule the day and the President’s desire to solve both healthcare prices and access to care at the same time will fail

Elastic or Inelastic is not the only question

January 9, 2009

Analysis of:Medical devices not immune to recession worries | www.boston.com

Demand for healthcare is viewed as inelastic, meaning that price changes have a small effect on demand for services.  This aspect of the healthcare industry allows providers to cost-shift, increase prices more for one group of payors when another group does not increase their reimbursement commensurate with input price inflation.  However, there is a limit to cost-shifting that the market will bear.  Consumers are self denying care due to economic concerns.  With the rise in unemployment, providers are finding more patients are not able to pay for services.  While EMTALA laws dictate that patients will not be refused care, providers are looking to cut cost in order to manage the rising uncompensated care.

Can any group fix the healthcare system

December 5, 2008

Analysis of:Group Offers Fixes for Health Care System | www.startribune.com

The items listed in this article sound wonderful, but offer limited promise to affect the healthcare industry.  Puting rules in place to limit the amount of healthcare consumed without enacting malpractice reform and altering the demand of the public for healthcare will frustrate the goals of the National Priorities Partnership group.  The answer to the problem of medical errors is not reducing payments to hospitals, but to make money available to hospital to increase staffing.

The Dismal Science

October 28, 2008

Analysis of:Financial Meltdown Hits Home | modernhealthcare.com

Credit will likely get tighter before it eases.  1) Bank Letter of Credits will be called upon to provide liquidity, making less funds available to be lent out.  2)  Car manufactures and other industries dependent on consumers purchaing with the use of credit. 3)  Traditional sources of debt for hospitals will decline, making it tougher for hospitals to purchase equipment and expand.  4) All this leads to a contraction of the money supply and a recession.

Hospital Death Rates Unveiled for Second-time

September 2, 2008

Analysis of:Hospital Death Rates Unveiled for First-Time Comparison | www.usatoday.com

1) Health Care Financing Administration published hospital mortality rates in the 80's, only to later discontinue the practice.  2) Mortality rates are a poor proxy for quality.  3)  Other measures are better to assess quality of care.

When CMS put objectives in the blender, providers get the mash

June 4, 2008

Analysis of:CMS ANNOUNCES DEMONSTRATION TO ENCOURAGE GREATER COLLABORATION AND IMPROVE QUALITY USING BUNDLED HOSPITAL PAYMENTS | www.cms.hhs.gov

CMS has the objective of keeping their costs down, increasing quality, protecting the Stark laws against physician referrals, and guarding against beneficiaries being enticed to receive more services than necessary.  CMS threw all these objectives into the ACE demonstration project.  The problems with the ACE demonstration project are:    1)      Providers are already suffering with negative Medicare margins, 2)      Medicare initiatives do not drive quality as much as threats of malpractice do, 3)      CMS has moved the politics of physician reimbursement away from Washington D.C. and into the hospital CEO’s office, 4)      Providers do not have assurance that the “gain” will be there to be “shared” in the future given CMS’s past actions,It is unclear how the prohibitions against beneficiary enticement and paying for physician referrals will be enforced.

Post Election Trauma

January 28, 2008

Analysis of:Hospital industry may hit rough patch, Moody's warns | www.chicagotribune.com

The status quo will be maintained during the election year.  But, what will happen to the funding for physicians and hospitals after the election?   Healthcare and defense are the two largest components of the Federal budget.  Congress will likely act to gain budget reductions in both areas.  The hospital component is the largest of the federal healthcare budget and makes an easy target.  In addition to revenue pressures, hospitals are facing mounting input cost pressures.  Hospital margins are projected to decline in the near future.

Physician use of Computers

September 7, 2007

Analysis of:Columbia Docs Enter Computer Age | blogs.wsj.com

The implications from physicians using an electronic medical record are better care of the patient as the latest results can be reviewed and compared longitudinally, less tests being ordered, fewer medication errors, and greater access to the patient's health information by the physician.

Does Baltimore (CMS) understand reality?

August 22, 2007

Analysis of:By 2008, Medicare won't pay for hospital errors | www.fiercehealthcare.com

1)  Payment reductions for medical errors will not change provider behavior. 2)  Reduced payments to providers could accelerate medical errors.    

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