Monday, November 21, 2011

A Dozen Health Care Uncertainties for 2012

Health care roses may not be cheaper by the dozen in 2012.

Health Care Florist

November 21, 2011- Cheryl Clark, senior editor for HealthLeaders Media,today delivered a bouquet of 12 reasons for health care uncertainty in 2012 in “Twelve Uncertainties Hovering Over Healthcare.”

Clark is the California correspondent for HealthMedia Leaders. California the site of the Tournament of Roses and the home of Gertrude Stein, who wrote that memorable line, “ A rose is a rose is a rose.” Health care roses next year by any other name might not be as sweet.

Enough word play.

Here are Clark’s dozen roses.

1. Super Committee on Deficit Reduction – A no-go. 2% automatic cuts across- the-board start in 2013.

2. Sustainable Growth Rate Repeal – Another no-go. 27.4% cuts for physicians scheduled for January 1, 2012.

3. Supreme Court on Accountable Care Act Constitutionality – Could be yet another no-go,this time for Obamacare. Decision scheduled for June.

4. Hospital readmissions - A thorn in Medicare’s side. Hospitals await CMS decisions on how to interpret and penalize excessive readmissions in 30 days after discharge.

5. More civil and criminal penalties on physicians – Fighting fraud and abuse is a good thing, but not if it makes most doctors feel like criminals awaiting public hangings.

6. More aggressive health plan premium reviews – The Obama administration has met the enemy, and it is those evil health plans who want to stay in business and satisfy stock holders.

7. Who will lead CMS? By end of year, it won’t be Donald Berwick, who is persona non grata among conservatives who see him as leader of the socialized medicine band.

8. Patient-Centered Outcomes Research Institute – This 21 member panel created by ACA will recommend what doctors can do and be paid for based on“ evidence.”

9. Meaningful use - In second quarter of 2012, CMS will announce details of how doctors will be rewarded or punished for installing and using EHRs, come October 1, 2012.

10. Accountable Care Organizations – Sometime this year CMS, FTC, and anti-trust division of Department of Justice will try to assure ACOs don’t dominate markets, skimp on services, and pressure enrollees to influence choice of providers. May not be important since few hospitals and doctors will elect to become ACOs.

11. Physician Payment Sunshine Act – Designed to limit influence of drugs, devices, and supply manufacturers on physicians and hospitals. Advocates claim little sun must shine on undue influences ; critics say it’s just another bureaucratic cloud.

12. Value-based Purchasing Payments Incentive – This is about CMS offering 1% hospital incentives for dropping mortality rates for heart attacks, health failure, pneumonia, and infections and hospital acquired conditions – falls, pressure sores, and infections.

Comparing health reform uncertainties to roses,
May not be best to show what goes on under our noses.
Butthe Affordable Care Act has its thorns,
And it doesn’t hurt to seize roses by their horns,
To show what challenges the future poses.

Tweet: The health care law has created profound uncertainties affecting all providers of health care, most increasing bureaucratic rules, penalties, and incentives.

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