Currently there are no hearings scheduled to review Dr. Berwick’s nomination.

AP NEWS:
http://news.yahoo.com/s/ap/20100707/ap_on_bi_ge/us_obama_health_care_appointment

Dynamic Healthcare Systems, a provider of enterprise technology solutions for Medicare-focused health plans, today announced that VIVA Health, Inc., a managed care company with over 32,000 Medicare Advantage members, purchased the Voyager suite including the following modules: Sales/Marketing, Enrollment, Reconciliation, HCC Analytics, RAPS Management and Premium Billing.  Dynamic Healthcare Systems is designed to ensure health plans meet the complex compliance and data processing requirements to be properly compensated.

“After reviewing several technology options for managing enrollment and risk adjusted payment, we selected Dynamic’s suite of solutions because they offered the right combination – a comprehensive software solution and expertise in this field,” said Libba Yates, VIVA’s Vice President of Corporate Development.  “We value the ability to create an integrated view of our Medicare business and process transactions in a single system.”

The Voyager solutions enable a plan to eliminate compliance risks associated with sales/marketing, enrollment and member management, and risk adjustment requirements by controlling and monitoring operational processes.  In addition, plans are able to optimize their premium payments from CMS by correctly, accurately and timely creating, submitting and reconciling enrollment and risk adjustment transactions with CMS.

“To gain a competitive edge today, health plans have to manage and integrate their operations across departments,” said Ken Stockman, Founder and Chief Executive Officer of Dynamic Healthcare Systems.  “Voyager is designed to allow plans to eliminate operational barriers between departments and take advantage of the cost and risk reductions and payment optimization that integrated delivery organizations enjoy.”

Claims containing June 2010 dates of service which have been paid at the negative update rates will be reprocessed as soon as possible.  Under current law, Medicare payments to physicians and other providers paid under the MPFS are based upon the lesser of the submitted charge on the claim or the MPFS amount.  Claims containing June dates of service that were submitted with charges greater than or equal to the new 2.2 percent update rates will be automatically reprocessed.  Affected physicians/providers who submitted claims containing June dates of service with charges less than the 2.2 percent update amount will need to contact their local Medicare contractor to request an adjustment.  Submitted charges on claims cannot be altered without a request from the physician/provider.  Physicians/providers should not resubmit claims already submitted to their Medicare contractor.

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

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 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

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