Ryan now has the muscle to phase out Medicare — within months

http://www.sfgate.com/politics/article/Ryan-now-has-the-muscle-to-phase-out-Medicare-10613139.php?utm_campaign=KHN%3A+Daily+Health+Policy+Report&utm_source=hs_email&utm_medium=email&utm_content=37625118&_hsenc=p2ANqtz-8__03zRw-gu7XJrwOBmO6XYdGObArnMQTK9_dRrTgDh69s7q3OUq53AcYCfr9bwrtHj5mbLYOPIBBdQVoE_yCtdZWBTg&_hsmi=37625118

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House Speaker Paul Ryan’s plan to phase out Medicare is nothing new. But now, under a Trump presidency and with both houses of Congress in Republican hands, it looks like he could finally make it happen, possibly within months.

Back in 2011, as a U.S. representative for Wisconsin’s 1st Congressional District, Ryan floated a plan to turn Medicare into a “premium support” program. The “premium support” would be a payment that would let you buy insurance from private insurers. But you won’t get full coverage.

As Josh Marshall acidly noted Sunday in a blog for TPM, “In any case, rather than Medicare you’ll have insurance from an insurance company, which everybody should love because haven’t you heard from your parents and grandparents how bummed they were when they had to give up their private insurance for Medicare?

“You’ll hear lots of people calling this ‘reform’ and other catchwords. But Medicare is a single payer, universal health care system. Replacing it with private insurance means getting rid of it. Even calling it ‘privatization’ masks what is really afoot.”

On Fox News Special Report on Thursday, Ryan was asked about entitlement reform. His answer:

“You have to remember, when Obamacare became Obamacare, Obamacare rewrote Medicare, rewrote Medicaid. If you are going to repeal and replace Obamacare, you have to address those issues as well. What a lot of folks don’t realize is this 21-person board called the IPAP is about to kick in with price controls on Medicare. What people don’t realize is because of Obamacare, Medicare is going broke, Medicare is going to have price controls because of Obamacare, Medicaid is in fiscal straits. You have to deal with those issues if you are going to repeal and replace Obamacare. Medicare has serious problems [because of] Obamacare. Those are part of our plan.”

Marshall says that’s false, and Ryan knows it. Instead of putting Medicare under deeper financial stress, the Affordable Care Act has had the opposite effect and actually extended Medicare’s solvency by over 10 years, he says.

According to Medicare’s trustees, the “Part A” trust fund — the costliest component of Medicare, covering hospitalization — is set to become insolvent in 2028. In 2009, before the passage of the Affordable Care Act, it was projected that fund would go broke in 2017.

Paul Ryan is determined to gut Medicare. This time he might succeed

http://www.latimes.com/business/hiltzik/la-fi-hiltzik-medicare-ryan-20161114-story.html?utm_campaign=KHN%3A+Daily+Health+Policy+Report&utm_source=hs_email&utm_medium=email&utm_content=37625118&_hsenc=p2ANqtz-8op3UbE6wkf1QHSbmlOITUvS45OW4rFAoMDUSaFiNXpSZN2Afucl6wLeww-aou9CIZqsrb3AUTqQwZmAAU0vubnznweA&_hsmi=37625118

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Bursting with the policymaking power that control of both houses of Congress and the White House gives Republicans, House Speaker Paul D. Ryan (R-Wis.) has lost no time in teeing up a favorite goal: gutting Medicare.

In an interview with Fox News Channel last Thursday, Ryan said: “Obamacare rewrote Medicare … so if you’re going to repeal and replace Obamacare, you have to address those issues as well. … What people don’t realize is that Medicare is going broke, that Medicare is going to have price controls. … So you have to deal with those issues if you’re going to repeal and replace Obamacare. Medicare has got some serious problems because of Obamacare. Those things are part of our plan to replace Obamacare.”

There’s no secret about what specifically Ryan has in mind. He intends to replace traditional Medicare, an efficient program offering guaranteed treatment and featuring rock-bottom administrative costs, with a privatized program. Seniors would get a federal voucher to help them pay premiums charged by commercial insurance plans. Ryan calls this system “premium support.”

The 1 thing about healthcare that needs to change: 4 executives weigh in

http://www.beckershospitalreview.com/hospital-management-administration/the-1-thing-about-healthcare-that-needs-to-change-4-executives-weigh-in.html

Self-Discovery

From the shift to value-based care to increased price transparency, the healthcare industry is in the midst of significant changes that are aimed at efficiently improving care. However, for that goal to be achieved, problems in the industry such as disparity in access to care and confusing billing systems still need to be addressed, according to healthcare executives.

In a panel discussion on Nov. 9 at the Becker’s 5th Annual CEO + CFO Roundtable in Chicago moderated by Rhoda Weiss, PhD, nationally recognized consultant, speaker, and author, four great minds in healthcare discussed the changes they would like to see in the industry, what gives them pride in their organizations and the issues that keep them awake at night.

Hospital executives’ 12 most pressing post-election questions, answered

http://www.beckershospitalreview.com/hospital-management-administration/hospital-executives-12-most-pressing-post-election-questions-answered.html

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https://www.advisory.com/Research/Health-Care-Advisory-Board/Expert-Insights/2016/2016-Election-12-Questions-Every-Executive-Should-Be-Asking

In a stunning upset, Donald Trump took the stage early yesterday morning to claim victory as the next president of the United States while Republicans celebrated retaining control of both the House and the Senate.

While the outcome of the election has long been expected to have a far-reaching impact across a number of policy areas, the Republican sweep of Congress and White House could result in profound changes in health policy after a hard-fought election on both sides of the aisle.

Although the exact implications of the race will become more apparent in the coming days and weeks, we expect Republicans to emphasize the election results as a mandate for change and use the opportunity to pursue significant new initiatives.

So what can providers expect from a Trump administration and a GOP Congress? Let’s take a look at what’s potentially in store for Medicare, Medicaid, and the private insurance market—and what those changes mean for provider strategy—by looking at the most common questions I’ve already received following the election.

Drug prices tug on the economy of healthcare

http://www.fiercehealthcare.com/finance/drug-prices-tug-economy-healthcare?mkt_tok=eyJpIjoiTmpjd1pURm1NR0ZqTlRWbSIsInQiOiI5MkdaMWJlaGV4dlppeWNkY1NqNTNtTFJ1MFlrcWtQQWxcL2hvYWVUK3lmNEJRT1lCVTJLQTFwdGFcL0dLWWlGMnBzbGNQbXhDdnFDVUdsdkthR3Y4UzJIVm5sT25iNHJmYWd2aGlFXC9ycVNDST0ifQ%3D%3D&mrkid=959610&utm_medium=nl&utm_source=internal

Money Pills

Drug prices continue to bedevil the economics of the U.S. healthcare system in a variety of ways.

Prescription drug prices rose 7 percent between September 2015 and September of this year, according to a new report (.pdf) from the Altarum Institute’s Center for Sustainable Healthcare Spending. No other category rose more than 2.9 percent. Hospital prices rose just 1.2 percent, although that’s up significantly from the 0.7 percent annual increase between September 2014 and September of last year.

Meanwhile, Altarum’s healthcare spending report (PDF) tells a slightly different story. Prescription drug spending rose only at a 4.5 percent annual rate between September 2015 and August of this year. That’s down from the 7.2 percent growth rate from September 2014 to 2015, and the 12.4 percent rate between August 2013 and 2014.

However, hospital spending grew at a 6.6 percent annual rate in September, up from 3.4 percent between September 2014 and 2015. That’s higher than the overall 5.5 percent growth rate.

That dovetails with forecasts that U.S. healthcare spending will reach 20 percent of the gross domestic product (GDP) by the middle of next decade. According to Altarum, it currently amounts to 18.2 percent of GDP. But another report suggested that the Affordable Care Act will actually cut healthcare spending over the long term by $2.6 trillion.

The report, which is closely read by many healthcare policy experts but gains little attention in most media circles, raised some concerns from advocacy groups.

California Dreamin’ in a post-Trump healthcare world

http://www.fiercehealthcare.com/finance/suddenly-it-s-much-darker-california-dreaming-may-be-one-silver-lining?utm_medium=nl&utm_source=internal&mrkid=959610&mkt_tok=eyJpIjoiTmpjd1pURm1NR0ZqTlRWbSIsInQiOiI5MkdaMWJlaGV4dlppeWNkY1NqNTNtTFJ1MFlrcWtQQWxcL2hvYWVUK3lmNEJRT1lCVTJLQTFwdGFcL0dLWWlGMnBzbGNQbXhDdnFDVUdsdkthR3Y4UzJIVm5sT25iNHJmYWd2aGlFXC9ycVNDST0ifQ%3D%3D

California flag and American flag

The consensus among policymakers and observers: Not good.

“At risk is insurance coverage for literally millions of Americans,” said Anthony Wright, executive director of the advocacy group Health Access California.

Jim Lott, who teaches healthcare policy at USC and Cal State Long Beach and was the longtime executive vice president of the Hospital Association of Southern California, noted that even if parts of the law are preserved the way Trump suggests, it would still be imperiled.

“If you don’t have an employer mandate and an individual mandate, the market would self-destruct,” Lott said. “It will create havoc.”

Barcellona, an attorney by training, concurred with Lott. “The law matters and these federal programs are conditioned on the act being implemented in a certain way,” he said.

Barcellona also brought up a consequence that would be utterly disastrous for millions of middle-class Americans: If the ACA is eliminated in the middle of a calendar year, it could put them on the hook for repaying billions of dollars in premium tax credits.

3 ways hospitals must prepare for a likely recession

http://www.fiercehealthcare.com/healthcare/3-ways-hospitals-must-prepare-for-a-likely-recession?utm_medium=nl&utm_source=internal&mrkid=959610&mkt_tok=eyJpIjoiTmpjd1pURm1NR0ZqTlRWbSIsInQiOiI5MkdaMWJlaGV4dlppeWNkY1NqNTNtTFJ1MFlrcWtQQWxcL2hvYWVUK3lmNEJRT1lCVTJLQTFwdGFcL0dLWWlGMnBzbGNQbXhDdnFDVUdsdkthR3Y4UzJIVm5sT25iNHJmYWd2aGlFXC9ycVNDST0ifQ%3D%3D

money

Bad economic times are coming, says Jeff Goldsmith, Ph.D.

The U.S. is in the 89th month of an economic recovery–among the longest since World War II–which means a recession is overdue and healthcare organizations should prepare now, writes Goldsmith, a national adviser to Navigant Healthcare, in Hospitals & Health Networks.

Healthcare systems can get ready for that inevitable economic downturn by taking the following steps:

Look for ways to do more with less. Healthcare organizations can expect to live with slow or shrinking revenues. Scrutinize physician compensation and productivity. Reduce layers of management and examine contracts for supplies and services.

Tighten up revenue cycle functions.  Improve your patient collections process. Make payment obligations clear to patients and ensure that billing staff keep better track of denied claims from insurance companies.

Fight for health policies that work for healthcare organizations. Lobby members of Congress, state legislators and governors to protect Medicaid funding. “Hospitals must insist that policymakers keep their commitments when times are tough,” Goldsmith says.