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Bush Says He Opposes Extending Deadline for Medicare Enrollment

Bloomberg is reporting, President George W. Bush said he opposes extending the deadline to sign up for a new Medicare prescription drug benefit even though some of the people who are eligible may be confused about the program.

U.S. healthcare spending rose 7.4% last year

U.S. healthcare spending grew 7.4% in 2005 to surpass $2 trillion and is expected to grow 7.3% in 2006, the CMS said in an annual report. Thats down from a recent peak of 9.1% growth in 2002. The increase in spending on hospital services, 7.9%, outpaced overall healthcare spending growth for the second year in a row. The CMS said Medicare spending will exceed $790 billion in 2015, up from $309 billion in 2004. Medicaid spending, meanwhile, will hit $670 billion in 2015, up from $293 billion in 2004.

MODERN HEALTHCARE

The President’s Modest Medicare Proposal

Dr. Moffit of the Heritage Foundation has done a great job outlining the changes proposed in President Bush’s 2007 budget. Here are some of the highlights

Proposed a modest $36 billion reduction in the growth of the Medicare budget over 5 years. Medicare spending is projected to be $395 billing in 2007 and grow to $504.4 billing in 2011.

Reduction in the increase is primarily achieved by:

• Administrative and regulatory changes in the way payments are made to medical providers, particularly hospitals, nursing homes, and home health agencies.
• “Quality initiatives” to ensure that patients receive medically appropriate and cost-effective care.
• “Competitive bidding” for clinical laboratory services and certain physician-administered drugs, medical supplies, and equipment. “
• Adjustments to Medicare’s complex pricing system for doctors, hospitals, and other medical providers.
• Stronger cost control provisions.

READ the Entire Article from Dr. Moffit HERE.

The WSJ Examines Increased Cost of Entitlement Programs

The Wall Street Journal on Friday examined how the “significance” the fiscal year 2007 budget proposal that Bush plans to announce on Monday is “dwarfed by one daunting fact”: 84% of the federal budget is “essentially committed” to interest on the federal deficit, defense and homeland security and entitlement programs such as Medicare, Medicaid and Social Security.

Spending on entitlement programs has increased by about 8% annually in recent years, “far faster than either inflation or the economy,” and spending on Medicare — about $391 billion in the current fiscal year — “is close to equaling the entire domestic discretionary slice of the budget,” the Journal reports.

Bush on Tuesday in his State of the Union address proposed to eliminate or reduce spending for 140 federal programs to save $14 billion in FY 2007, but those proposed spending reductions would account for only 0.005% of the federal budget, the Journal reports.

According to the Journal, “By all accounts, a solution to the entitlements spending problem must be bipartisan so that the parties jointly convey the need for sacrifice and share political fallout.” However, “the political calendar works against … Bush achieving” major reforms to entitlement programs, and, in his state of the Union address, he proposed only to establish a bipartisan commission to address the issue, the Journal reports.

Rep. Jim Kolbe (R-Ariz.) said, “This will not get done in this president’s term,” adding, “Congress is never going to be willing to deal with this, because the members are always up for re-election, every two years.”

Meanwhile, Bush has shifted his focus to health care for individuals younger than age 65. In addition, Bush has sought to encourage Medicare beneficiaries to select private health plans for physician, hospital and prescription drug coverage; establish pay-for-performance standards for health care providers who participate in Medicare; and allow states to have more flexibility to administer their Medicaid programs (Calmes, Wall Street Journal, 2/3).

Reprinted from California Healthline

Medicare Advantage Plans Earning Season – Humana

Humana (NYSE: HUM), the 6th largest U.S. insurer by market capitalization, announced today 4th quarter profits rose 34% on the strength of its Medicare Advantage plans, however shares fell after the company did not raise its 2006 outlook and missed revenue expectations.

In the 4th quarter enrollment in Humana’s Medicare Advantage plans rose 48% to 557,000 members. Membership growth and higher premiums drove the increase in revenue up 54% to $1.22 billion.

Cigna, Aetna and Coventry Health are scheduled to report quarterly results this week, rounding the earning season for plans.

Yahoo Finance Story here

WSJ article on Part D Enrollment

In this article The Wall Street Journal outlines the aggressive land grab going on right now in the Medicare marketplace as plans use Part D enrollment to capture new applicants and then attempt to migrate them to a full Medicare Advantage program.  Also, the article discusses AARP’s influence on the senior population and the success some plans are having with enrollment despite the challenges of implementation by CMS.

 WSJ Article 

Can 2007 Institutionalized SNPs Survive?

Can 2007 Institutionalized SNPs Survive? 2006 Is the Year of the Medi-Medi SNP in the hopes of plans capturing as mant auto-assigned Part D enrollees at a low acquisition cost and then sign them up in to their duel-eligiable SNP. 2007 is the year of the institutionalized and chronic condition SNP…however will changes in the Long-Term Acute Care Reimbursment formula make this SNP a non-starter? The current proposed changes would reduce payments to Long-Term Acute Care Hospitals by 11.1% read on…

Bush Administration: “Plans Must Provide A 30 Day Supply”

Over the weekend the Bush Administration directed all health plans contracted under Medicare to “provide a 30-day supply of any drug a beneficiary was previously taking after tens of thousands of people were unable to get medicines promised by Medicare, the New York Times reported on Monday.” The directive further stated all plans must take immediate steps to ensure that low-income beneficiaries were not charged more than $2 for a generic drug and $5 for a brand-name drug, according to the Times.

This directive comes after many states have declared public health emergencies, and many states announced that they would step in to pay for prescriptions that should have been covered by Medicare’s new prescription drug program, which started on Jan. 1, the Times said.

Despite all of the challenges with implementing the new drug program the program is covering over 1,000,000 prescriptions a day.

Source Story…

Medicare | MedPAC Votes To Adopt Final Medicare Payment Recommendations for 2007

The Medicare Payment Advisory Commission on Tuesday voted to adopt several final recommendations to Congress for fiscal year 2007, including a plan to increase Medicare hospital inpatient and outpatient payments by the market basket increase minus 0.45%, CQ HealthBeat reports. The recommendation would result in a payment increase of 3.55% for inpatient care, with an adjustment for productivity. The final payment recommendation for outpatient care reflects a decision to allow “relatively generous private insurance payments” offset hospitals’ losses on Medicare beneficiaries, according to MedPAC staff members, according to CQ HealthBeat. Other recommendations for FY 2007 made by MedPAC are summarized below.

Continue reading Medicare | MedPAC Votes To Adopt Final Medicare Payment Recommendations for 2007…

Part D In the News….

Medicare Rx benefit still leaves many in fog

Dianna Johnson hit the ultimate Catch-22 trying to get her medications amid the maze of questions surrounding the new federal Medicare Part D prescription drug …

Medicare Part D Preparedness Study Conducted by Delta Marketing …

Research concludes that there is a minimal level of preparedness for introduction of the Medicare Part D prescription drug program among patients and …
Medicare Part D Preparedness Study Conducted by Delta Marketing … PharmaLive.com (press release)
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