ACA/Obamacare Repeal/Replace Drama

[Belsnickel]

I feel like there is going to be a lot of discussion about this to come, but who knows. So, much like the Trump thread, bring on the ACA news.

Has anyone else found the whole secrecy behind the GOP replacement plan a bit interesting? Rand Paul is currently blasting them about it: http://thehill.com/policy/healthcare/321990-paul-blasts-house-gop-for-keeping-obamacare-bill-in-secure-location

Turn the dial back 7-8 years and we have the familiar sounds of "we have to pass it to see what's in it" filling our ears.

[Rotobeast]

He even brought his own copier....lol

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[BmorePat87]

dude tried to Ocean's 11 that bill.

[Vas Deferens]

Halliburton hasn't finished their last few chapters yet.

[Belsnickel]

Not a direct ACA thing, but related to it all and the health care debacle in this country: http://www.governing.com/topics/health-human-services/gov-hospital-federal-patient-safety-readmissions.html?utm_term=Why%20Feds%20Withhold%20Money%20From%20the%20Most%20Vulnerable%20Hospitals&utm_campaign=Why%20Feds%20Withhold%20Money%20From%20the%20Most%20Vulnerable%20Hospitals&utm_content=email&utm_source=Act-On+Software&utm_medium=email

Quote:No one who works in health care would dispute the need to keep hospital patients safe. But there’s plenty of debate over how best to achieve that and over whether the federal approach is the right one, particularly for hospitals that treat the most vulnerable Americans.

In December, the Centers for Medicare and Medicaid Services (CMS) handed down its list of hospitals that would be penalized in the current fiscal year for patient safety violations. In all, 769 hospitals were dinged for preventable conditions such as blood clots, falls and the presence of antibiotic-resistant germs. The hospitals will have 1 percent of their payments from CMS cut, which for a large hospital can exceed a million dollars.

CMS has another program with even stiffer punishments, penalizing hospitals that have what’s considered an excessive number of readmissions within 30 days of hospitalization. In August, CMS announced that nearly 2,600 hospitals would have up to 3 percent of their reimbursements withheld this fiscal year.

The penalities handed down by CMS are part of the Affordable Care Act. They’re meant to motivate hospitals to correct procedures so as to avoid patient safety violations. But the problem with these penalities, some health policy experts say, is that they don’t take into account the particular challenges that individual hospitals face. “Most of the penalized hospitals take care of the poorest and sickest,” says Ashish Jha, a professor at Harvard University who focuses on patient safety. Jha and others argue that CMS should add a risk adjustment factor. Until then, safety-net and academic-centered hospitals will continue to get slapped with the most penalties.

“We all want patients to be healthy once they leave, but we need to understand that patients in certain areas have a harder time achieving proper health,” adds Michael Consuelos, vice president for clinical integration at the Hospital and Healthsystem Association of Pennsylvania. For a struggling rural hospital, reduced payments from CMS “can equal a death spiral,” he says.

Providers say that the more thorough reporting required under the CMS patient safety programs also has been a major administrative burden. “We’ve spent hundreds of thousands of dollars and an enormous amount of time managing the process,” says Saul Weingart, chief medical officer at Tufts Medical Center and a National Patient Safety Foundation board member. “It’s a lot of combing over doctors’ notes, clarifying things written down, trying to determine if it’s clinically significant.”

Adding to the hospitals’ exasperation is the fact that there is little information about whether the penalties have actually improved health outcomes. “We have no real idea if patient safety has gotten better because none of that data has been subject to peer review,” says Jha. “We do know that readmissions have fallen, but the problem with that metric is a good chunk of readmissions are often necessary.”

Still, hospitals say they do put a lot of effort into addressing issues they’re penalized for. The Pennsylvania association, like many state hospital groups, works to facilitate data sharing among hospitals, Consuelos says. “Organizations know what they scored low on, and they do try to really focus in on those areas.” And, Tufts’ Weingart notes, because the hospital star ratings that CMS releases every year are partially tied to the penalty programs, hospital executives “feel it can be a reputational issue.”

All of this is playing out, of course, at a time when the future of the Affordable Care Act and the mandates it imposes are very much up in the air in Washington. These patient safety programs, says Jha, “require a lot of subtlety.” That’s a quality that few would associate with the debate over the federal health law.

[mallorian69]

(03-03-2017, 10:54 AM)Belsnickel Wrote: Not a direct ACA thing, but related to it all and the health care debacle in this country: http://www.governing.com/topics/health-human-services/gov-hospital-federal-patient-safety-readmissions.html?utm_term=Why%20Feds%20Withhold%20Money%20From%20the%20Most%20Vulnerable%20Hospitals&utm_campaign=Why%20Feds%20Withhold%20Money%20From%20the%20Most%20Vulnerable%20Hospitals&utm_content=email&utm_source=Act-On+Software&utm_medium=email

The readmission rates rarely have anything to do with the hospitals. Most insurance providers, including medicare and medicaid, often will only pay x number of days based on the admission diagnosis. This forces hospitals to either eat the cost of extra days, pass the cost on to patients that cant afford it, or send them home. Then many of those patients get sent to extended care facilities that were the reason they had to be hospitalized in the first place.

As for fall rates the government has tied the hands of hospitals by making it near impossible for them to sedate or restrain patients with Alzheimer's or other forms of dementia who are often the ones involved in falls. 

The government needs to let the patient's Dr decide what's best for their patient.

[BengalHawk62]

I don't think these people learn from history. Dems got in trouble for forcing Obamacare down everyones throat. It's a flawed law, but at least it was a step in the right direction and they had some courage to take these steps. Repeal and replace seems wasteful and risky. Why not amend and integrate? One big thing I've not seen from anyone (including Rand) is price transparency. Here's a clue to Washington, without price transparency mandates, nothing will slow the rising cost of healthcare.

[Rotobeast]

(03-04-2017, 11:35 AM)BengalHawk62 Wrote: Repeal and replace seems wasteful and risky. Why not amend and integrate? One big thing I've not seen from anyone (including Rand) is price transparency. Here's a clue to Washington, without price transparency mandates, nothing will slow the rising cost of healthcare.

Totally agree with this.

They want to repeal and replace, so they can keep adding to that near $10 Trillion open checkbook budget.



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[oncemoreuntothejimbreech]

They act like it is complicated or something.

[hollodero]

(03-04-2017, 02:19 PM)oncemoreuntothejimbreech Wrote: They act like it is complicated or something.

Who could have possibly known?
I just wonder why Republicans have to bother:

Donald Trump Wrote:When I say I would end Obamacare, I would also come up with a plan that would be far better, much easier to understand, and cost less!

Time to come up with that plan! Your minions struggle.

[BoomerFan]

They tried to repeal it 52 times when Obama was in office. Now they what, have nothing? Insurance costs are still high and the GOP holds all the cards. Where is this magic fix they've been promising?

[GMDino]

(03-04-2017, 02:28 PM)hollodero Wrote: Who could have possibly known?
I just wonder why Republicans have to bother:


Time to come up with that plan! Your minions struggle.

(03-04-2017, 03:04 PM)BoomerFan Wrote: They tried to repeal it 52 times when Obama was in office. Now they what, have nothing? Insurance costs are still high and the GOP holds all the cards. Where is this magic fix they've been promising?

[Belsnickel]

Well, the draft bill is out: https://waysandmeans.house.gov/wp-content/uploads/2017/03/AmericanHealthCareAct_WM.pdf

I won't link to all of the punditry about it, you can find that on your own to suit your own ideological bent. What's the good, bad, and ugly to you?

[*bfine32*]

(03-07-2017, 01:37 PM)Belsnickel Wrote: Well, the draft bill is out: https://waysandmeans.house.gov/wp-content/uploads/2017/03/AmericanHealthCareAct_WM.pdf

I won't link to all of the punditry about it, you can find that on your own to suit your own ideological bent. What's the good, bad, and ugly to you?

I'll read it after it's approved.

Ok, I doubt I'll study as that is not my area of concentration in HR; hell. I didn't even know there was a tanning bed tax. I will get feedback from those that do.

[Benton]

(03-07-2017, 01:37 PM)Belsnickel Wrote: Well, the draft bill is out: https://waysandmeans.house.gov/wp-content/uploads/2017/03/AmericanHealthCareAct_WM.pdf

I won't link to all of the punditry about it, you can find that on your own to suit your own ideological bent. What's the good, bad, and ugly to you?

Cursory thought after talking to a lawmaker about it last night (which I haven't read the whole thing), my first thought it: political pageantry continues as the uncomfortable parts get put off until the end of 2020... which is likely to be their last cycle with a majority.

[BmorePat87]

freedom caucus ain't happy.

[BmorePat87]

according to the White House, the new bill is better because it's smaller.

[jmccracky]

(03-07-2017, 07:40 PM)BmorePat87 Wrote: according to the White House, the new bill is better because it's smaller.

Ahhhhh! Now it can fit in Trumps hands!

[Aquapod770]

(03-07-2017, 07:40 PM)BmorePat87 Wrote: according to the White House, the new bill is better because it's smaller.

Maybe people will actually read it this time...

Preferably Senators and Representatives, you know the people who were supposed to read the ACA

[Rotobeast]

(03-07-2017, 07:40 PM)BmorePat87 Wrote: according to the White House, the new bill is better because it's smaller.

Well..... Obama being African-American, of course his is bigger than Trump's.