The Affordable Care Act Supreme Court Petitions: Issues and Implications

Timothy Yost

First posted 9/29/11 on The Health Affairs Blog

Copyright ©2011 Health Affairs by Project HOPE – The People-to-People Health Foundation, Inc. 

Wednesday, September 28 was a busy day at the Supreme Court clerk’s office.

It had been widely expected that there would be a major pleading filed with the clerk in an Affordable Care Act challenge, as the response of the United States to a certiorari petition in the Sixth Circuit’s Thomas More case, which had upheld the ACA as constitutional, was due.  A cert. petition asks the Supreme Court to exercise its discretion to review the decision of a lower court, and the losing plaintiffs in Thomas More had requested the Supreme Court to reverse that decision and find that Congress had no authority under the Commerce Clause of the Constitution to adopt the ACA’s minimum coverage requirement.

Continue reading “The Affordable Care Act Supreme Court Petitions: Issues and Implications”

Employers Perceive that Health Plans Add Value to ACOs

Vince Kuraitis

First posted 9/29/11 on e-CareManagement Blog

A just released study from Aon Hewitt and Polakoff Boland — 2011 Employer Driven Accountable Care Organizations Survey Report— examines employer attitudes toward ACOs.  The report provides useful insights into an area that hasn’t yet received much attention.

A couple tables in particular caught my attention.

(click on the graphic to view a larger version)

Key findings in this table include:

  • Hospitals come out lowest (employers are only 30% very/somewhat confident in hospital driven ACOs)
  • Large medical groups come out slightly higher (31% very/somewhat confident)
  • Involving a health plan significantly increases employer confidence for both hospitals and large physician group ACOs:
    • Confidence in a hospital/health plan ACO increases to 48% very/somewhat confident (up from 30% with hospital alone)
    • Confidence in a medical group/health plan ACO increases to 53% very/somewhat confident (up from 31% with medical group alone)
  • A large percentage (25–26% answered Do Not Know) to all options

Continue reading “Employers Perceive that Health Plans Add Value to ACOs”

Putting the Mouth Back Into the Body

Patricia Salber

First posted 9/29/11 on The Doctor Weighs In

Medicine has been great at creating body silos over the years.  The most obvious example is the disconnect between physical health and mental health.  Physical health providers often find it very difficult to get information about their patients’ mental condition from their patients’ mental health providers and mental health providers rarely connect with physical health providers to really understand the total health picture of the person they are treating.  Vision – mostly treated by optometrists is rarely integrated into general medical care and increasingly our feet are carved out to podiatrists practicing in a one-off fashion.

I could go on and on about body carve-outs, but won’t, as what I want to talk about today is oral health.  Unless you get a mouth cancer of some sort, oral health pretty much belongs to the dentists and the dentists are not really connected (or considered by most doctors to be a part of)  your medical care.

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Rising Premiums Do Not Square With Costs

Merrill Goozner

First posted 9/28/11 on Gooz News

The press releases flew from various House committees yesterday afternoon (which double as Republican Party campaign offices). The charge: rising health care premiums are due to “Obamacare.” The latest Kaiser Family Foundation employer survey of health care insurance costs, which was reported on the front page of all this morning’s newspapers, showed premiums rose 9 percent this year, substantially more than the 3 percent they went up last year.

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The Administration Decides That Sooner Is Better

Roger Collier

First posted 9/28/11 on Health Care Reform Update

Hot on the heels of Monday’s news that the Obama administration had decided not to ask for a re-hearing of the Eleventh Circuit Court’s ruling that the individual mandate is unconstitutional, came today’s announcement that the Justice Department had asked the Supreme Court to hear the case.

Given that other Appeals Court decisions may also be forwarded to the Supreme Court, it is not certain which case or cases the Court will decide to hear. However, a request by the administration is almost sure to be granted.

While the rationale for the Justice Department decision cannot be known, it seems that the administration believes that it has a better than evens chance of prevailing.

The critical issue now is timing, with a hearing most likely in the spring, and a decision—in the middle of the presidential election campaign—in June 2012.

The Health Leadership Council Medicare Proposal: Too Much Responsibility on Beneficiaries and Not Enough on Providers

Robert Laszewski

First posted 9/27/11 on Health Policy and Marketplace Review

The Health Leadership Council (HLC), a coalition of CEOs from many of the leading health care companies, has created a list of Medicare reform recommendations for the Super Committee tasked with finding at least $1.2 trillion in budget savings.

As we begin the national debate over what to do about Medicare’s unsustainable costs, I will suggest that the HLC proposal gives us one, of what will have to be many, outlines for discussion.
Continue reading “The Health Leadership Council Medicare Proposal: Too Much Responsibility on Beneficiaries and Not Enough on Providers”

Practical Approaches to Obesity Care and Chronic Illness In Busy Clinical Settings: Three Key Ingredients

Jaan Sidorov

First posted 9/27/11 on the Disease Management Care Blog

If anything is true about the population health management service providers, they are constantly looking for better ways to fit their programs into busy clinical settings.

That’s why this article on New and Emerging Weight Management Strategies for Busy Ambulatory Settings, courtesy of the American Heart Association, should be “must” reading for the vendor industry.  It’s chock full of practical advice on how to “engineer” the PHM-physician partnership. While the focus of the article is on a practical approach to obesity, its approach can be applied to other conditions, such as diabetes or tobacco abuse.

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