Archive for January 2020

After a two-and-a-half-month delay, the long-awaited regulations for accountable care organizations (ACOs) were released on March 31. Policy wonks, health lawyers, and hospital consultants were so eager to read what the Centers for Medicare & Medicaid Services (CMS) had written that they almost crashed the website the afternoon it was released. Now that the dust…

The Social Security trustees released their annual report in May, and the news was not good for Medicare. The Medicare hospital insurance trust fund, which last year had been projected to remain solvent until 2029, is now expected to run out of money by 2024. The five-year reduction insolvency is primarily attributable to the slow…

The CMS actuaries published their annual estimates of health- care spending and projections of future spending at the end of July. Their report contains good news and bad news—depending on your predilections and your views of the coming decade. Healthcare spending in 2010 grew 3.9 percent, reaching $2.6 trillion. This growth rate is just below…

As states continue to struggle with their budgets, controlling spending on Medicaid looms as one of their most difficult challenges. The states are coming to realize that future efforts must focus not just on slowing Medicaid spending, but also on improving the value it delivers. This is not to suggest that getting the greatest possible…

Last year’s Affordable Care Act dealt primarily with the easy part of healthcare reform—reforming the health insurance market and expanding coverage. Both are important changes, but they are far from all that will be needed to address the problems facing the U.S. healthcare system. The legislation also directly included some limited delivery system reforms, such…

After three days of riveting hearings at the Supreme Court concerning various aspects of the Affordable Care Act, we are left waiting, probably until the last week in June, to see what, if any, portions of the act will be struck down by the There has been a lot of commentary on whether the Affordable…

Congress is again struggling with physician payment under Medicare. It has been slightly more than four years since I have written a column focused on physician payments and the challenge that the resource-based relative-value scale (RBRVS) and sustainable growth rate (SGR) present to the Congress. Once again, Congress has been holding hearings discussing the problems…

Now that the dust is settling on the recent Supreme Court decision regarding the constitutionality of the Affordable Care Act (ACA), it is important that hospitals and physicians recognize how much uncertainty still remains in their future and plan accordingly. The Supreme Court has resolved the constitutionality of the mandate (by declaring the penalty a…

In these most political of times, it should come as no surprise that the recent slowdown in healthcare spending has also become a political issue, with the Democrats linking it to the Affordable Care Act—most notably President Clinton at the Charlotte convention. To better understand the issue, we need to know how much healthcare spending…

India’s Supreme Court recently rejected a request from Novartis for a second patent for its cancer drug Gleevec. Forty other countries, including the United States, have provided protection for the patent. The patent is a secondary rather than a primary patent, and the court rejected it as not being a novel invention because Novartis had…