Tuesday, February 23, 2010

Game On! Again

This week President Obama introduced (finally) the Obama health care plan.

The plan, close to the Senate version but with concessions to the House version, will be pushed hard by the administration and Democratic leaders in the Congress.

The plan is long, complicated, has many moving parts and is liekly to change significantly.

More details to follow as we parse the plan and Congress begins to move.

Tuesday, February 2, 2010

While Rome Burns Nero Fiddles - Health Care Edition

While the House and Senate were trying to overhaul the entire health care system, key Medicare regulations were left in limbo. Those provisions are still in limbo.

Medicare physician reimbursement based on Sustainable Group Resources (SGRs) have been controversial and generally considered unworkable since being passed. The solution has been an annual fix rather than a permanent fix. The House bill had a permanent fix, but went nowhere.

As a result of not being fixed, some physicians will see draconian cuts in Medicare reimbursements as of March

Primary care docs will see a small increase in rates. Or there may be a fix, or maybe not.

Physical therapists who provide Medicare services are now subject to a cap, amounting to rationing, for elderly patients. This capping system was instituted in 1997 but an annual fix has prevented implementation. Now that too is in limbo, and therapists may be “donating” services in 2010, while waiting on an answer. If the cap remains, services will have to be rationed..

Seniors are very dependent on various forms of therapy to regain mobility and self-sufficiency after fractures, surgeries and strokes. Would we prefer nursing home placement instead?

If health care reform enlarges the role of the federal government, and this is how the feds do business, this could prove interesting.