ObamaCare -- polarization in a name

I recently ran across Wendell Potter's piece for the Center for Public Integrity (read it here:  http://www.natlawreview.com/article/analysis-obamacare-label-sticking).  Even though he wrote the article in Sept. 2011, I believe the principles still apply:  Americans generally have no idea what the Affordable Care Act does, and they have been inundated with false claims and negative publicity about "ObamaCare" that they have become ignorantly polarized.  Now that the Supreme Court has issued its opinion on the constitutionality of the Affordable Care Act's Individual Mandate and Medicaid Expansion, and now that the Presidential election is getting closer, it seems that health care has come even more into focus while it still remains out-of-focus with regards to clarity.  To put it another way, with the political race going on, there is a lot of talk about health care, but it is mostly wrong and meant to scare people into voting a certain way.  Heck, I've been reading state governors' responses to whether they will expand Medicaid in their states, and over half of them seem not to have a clue about what the program does for their state.  The Obama Administration needs to get CMS and HHS to put together a massive education campaign about what the Affordable Care Act has done, is doing, and will do.  Fear is a strong motivator, and people are being fed fear right now.  Listening to an NPR broadcast, I heard an interview from an older man who said that he really like the Massachusetts health care plan (he had friends and family there), but he didn't like the Affordable Care Act plan because it was a tax.  It's essentially the same thing!  Moreover, the "tax" classification was merely a constitutionality hook, just as used to uphold Social Security. 

So, to avoid being someone who critiques without taking action to remedy the situation, I am pledging to write President Obama and Secretary Sebilius about the need for education about the Affordable Care Act.  What will you do?

HHS Cutting Red Tape for Physicians

HHS announced this week that it's going to implement new electronic fund transfer regulations to help physicians deal with the amount of red tape they have to go through in order to be paid.  First, it's good to see things made easier for physicians.  They often work long, hard hours taking care of patients, and any extra energy they have shouldn't be wasted on unnecessarily difficult billing procedures.  Second, it's very good to see an overal savings being projected for health care costs.  I know from my research in Tennessee about the TennCare program, the additional administrative costs would sometimes force physicians out of practice or cluster them in larger practices, with the result being fewer physicians in smaller, rural practices.  By making the billing easier, the federal government is promoting the expansion of practices into less-populated regions, which, in turn, promotes regular, preventive care and good health in those regions.  Of course, the more people with better health care and with regular preventive care, the less health care will cost all of us.  Lots of downstream effects!

Obama administration issues new rules to cut red tape for doctors and hospitals, saving up to $9 billion

Health and Human Services (HHS) Secretary Kathleen Sebelius announced today the release of a new rule that will cut red tape for doctors, hospitals, and health plans. In combination with a previously issued regulation, the rule will save up to $9 billion over the next ten years. The regulation adopts operating rules for making health care claim payments electronically and describing adjustments to claim payments.

“These new rules will cut red tape, save money and ensure doctors spend more time seeing patients and less time filling out forms,” said Secretary Sebelius.
Studies have found that the average physician spends three weeks a year on billing and insurance related tasks, and, in a physician’s office, two-thirds of a full-time employee per physician is necessary to conduct these tasks. Many physician practices and hospitals receive and deposit paper checks, and manually post and reconcile the health care claim payments in their accounting systems. By receiving payments electronically and automating the posting of the payments, a physician practice and hospital’s administrative time and costs can be decreased.

The operating rules build upon industry-wide health care electronic fund transfer (EFT) standards that HHS adopted in January of this year. Together, the previously issued EFT standards and the EFT and electronic remittance advice (ERA) operating rules announced today are projected to save between $2.7 billion and more than $9 billion in administrative costs over ten years by reducing inefficient manual administrative processes for physician practices, hospitals, and health plans.

Operating rules include best business practices on how electronic transactions are transmitted and often target obstacles that physician practices and health insurers have with using electronic transactions. For instance, the rule announced today requires insurers to offer a standardized, online enrollment for EFT and ERA so that physicians and hospitals can more easily enroll with multiple health plans to receive those transactions electronically. The rule also requires health plans to send the EFT within a certain amount of days of the ERA, which helps providers reconcile their accounts more quickly.
Today’s rule, Administrative Simplification: Adoption of Operating Rules for Health Care Electronic Funds Transfers (EFT) and Remittance Advice Transactions were developed through extensive discussions with industry stakeholders. The rule adopts the Council for Affordable Quality Healthcare's Committee on Operating Rules for Information Exchange (CAQH CORE) Phase III EFT & ERA Operating Rule Set, including the CORE v5010 Master Companion Guide Template, with the exception of Requirement 4.2 of the Phase III CORE 350 Health Care Claim Payment/Advice (835) Infrastructure Rule. Collectively, these rules are referred to as the EFT & ERA Operating Rule Set.

The regulation announced today may be viewed at www.ofr.gov/inspection.aspx and will be effective upon its publication in the Federal Register on Aug. 10, 2012. The comment period closes on Oct. 9, 2012.

The compliance date for operating rules for the health care electronic funds transfers and remittance advice transaction is Jan. 1, 2014.

A fact sheet with technical information on the rule is found at http://www.cms.gov/apps/media/fact_sheets.asp.

How the ACA is Helping People

Just got this press release from HHS about all the people that the ACA has been helping.  I'll try to publish some stats on how much annual wellness exams improve overall health and reduce health care costs for society, but for now,  you're just going to have to believe it.  In addition, while a copay of $5 sounds minimal to most of us (I'm thinking $5???  Mine's $25!), it is a significant amount of money to many Americans on Medicare and who need to go to the doctor often.  Remember that many people don't accrue savings for their retirement, or if they did, it's now gone, whether due to being too small or bad investing. 

Here's the announcement:

News Release

FOR IMMEDIATE RELEASE
July 10, 2012
Contact: HHS Press Office
(202) 690-6343

More than 16 million people with Medicare get free preventive services in 2012
Affordable Care Act made many preventive services no cost to beneficiaries

The Affordable Care Act – the new health care law – helped over 16 million people with original Medicare get at least one preventive service at no cost to them during the first six months of 2012, Health and Human Services (HHS) Secretary Kathleen Sebelius announced today. This includes 1.35 million who have taken advantage of the Annual Wellness Visit provided by the Affordable Care Act. In 2011, 32.5 million people in Medicare received one or more preventive benefits free of charge.

“Millions of Americans are getting cancer screenings, mammograms and other preventive services for free thanks to the health care law,” said Secretary Sebelius. “These new benefits, made possible through the health care law, are helping people stay healthy by giving them the tools they need to prevent health problems before they happen.”

Prior to 2011, people with Medicare faced cost-sharing for many preventive benefits such as cancer screenings. Through the Affordable Care Act, preventive benefits are offered free of charge to beneficiaries, with no deductible or co-pay, so that cost is no longer a barrier for seniors who want to stay healthy and treat problems early.

The law also added an important new service for people with Medicare — an Annual Wellness Visit with the doctor of their choice— at no cost to beneficiaries.

For more information on Medicare-covered preventive services, please visit: http://www.healthcare.gov/law/features/65-older/medicare-preventive-services/index.html

To learn what screenings, vaccinations and other preventive services doctors recommend for you and those you care about, please visit the myhealthfinder tool at www.healthfinder.gov.