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Medicare, Medicaid, Health Reform

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Monthly Archives: September 2004

Prescription Drug Benefits for Retirees: Understanding Medicare’s New Retiree Subsidy

Under the Medicare Modernization Act (MMA), the new Medicare prescription drug benefit (aka, Medicare Part D) includes a retiree subsidy to encourage the continuation of employer-sponsored drug plans for retired Americans. Here are some excellent resources to help employers understand the Medicare retiree subsidy: - White Paper on Retiree Drug Coverage Under Medicare. From Centers for Medicare and Medicaid Services (CMS)....

Will Wal-Mart Compete with Clinics or Hospitals?

In an excellent new piece for HealthLeaders, E. Preston Gee asks an fascinating question with wide ranging implications for health care: "What if the mass merchandising giants like Wal-Mart or Target got into the healthcare delivery business in a big way?" Highly efficient, consumer friendly, and tech-savvy companies like Wal-Mart and Target stand in sharp contrast to health care delivery....

Medicare Prescription Drug Benefit: The States and Dual Eligibles

States will play a key role in the new Medicare prescription drug benefit. This includes financing much of the drug costs for low-income seniors and persons with disabilities. Here is some useful information for state leaders: - Implications of the New Medicare Prescription Drug Benefit for State Medicaid Budgets. From Kaiser Family Foundation (KFF). - Implementing the New Medicare Drug Benefit:...

Quality Health Care: A Guide to Developing and Using Indicators

There is ample evidence America has a serious problem with poor quality health care and high rates of preventable medical mistakes. Thankfully, there is no shortage of caring professionals motivated to improve care and the problems are solvable. As with any effort to improve performance, measurement is the first step to improving care and reducing medical mistakes. As I often...

Escape Fire: Designs for the Future of Health Care

Escape Fire is collection of compelling speeches by one of America's leading crusaders for health care quality and patient safety - Don Berwick, MD, founder and president of the Boston-based Institute for Healthcare Improvement. Each year, IHI hosts the National Forum on Quality Improvement in Health Care. The influential annual event draws 4,000 health care leaders from around the world...

Hospitals: Less Paperwork, More Time with Patients, Fewer Errors, and Happier Nurses

In the typical hospital, nurses spend only about 30 percent of their time on patient care. The remaining 70 percent of their long days are spent largely on paperwork. This lopsided situation is seen as a major cause of poor quality, patient dissatisfaction, nurse turnover, and operating inefficiency. Thanks to the ideas of the Institute for Healthcare Improvement and funding...

President Clinton’s Health Care

If President Clinton had to wait weeks or months for urgent bypass surgery like patients in Canada or the UK, he would be dead. Mr. Clinton's physicians said he was at serious risk of a major, life-threatening heart attack. He needed the bypass quickly and got it. In Canada, patients needing urgent attention wait over three weeks to see a...

Battle Over Definition of Medical Necessity in TennCare

Health insurers, whether commercial health plans or public programs like Medicaid and Medicare, only wish to pay for care that is necessary. Every day they make decisions on what is and is not "medically necessary." Gov. Phil Bredesen has proposed a new definition of medical necessity for TennCare, Tennessee's long-troubled Medicaid program. To be covered by TennCare, a health care...

Health Care Costs and Big Auto

Rick Wagoner, chairman and CEO of General Motors, is calling on both political parties to work together to solve the nation

Beyond Bankable Dollars: Establishing a Business Case for Improving Health Care

To address the enormous deficiencies in quality of health care, health care organizations need to make a business care for improvement. That is, they need to demonstrate a compelling rationale for the significant financial investments necessary to improve quality and reduce medical errors. To make decisions, businesses traditionally look at the potential return on investment (ROI). However, ROI projections are...

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