Obama Administration Mulls Rule To Give Home Health Aides Better Wages - Kaiser Health News

 

The average yearly salary for home health aides in 2012 was $21,830, according to the Labor Department.

Only 21 states and the District of Columbia extend minimum wage guarantees to at least some in-home care workers. Among them, 12 states have a minimum wage that is higher than the federal standard – $7.25 an hour.

The administration wants to change that, however. In December, 2011, President Barack Obama proposed a revision to the Fair Labor Standards Act that would extend both overtime and minimum wage protections to home-care workers employed by third parties, such as home care agencies. "They work hard and play by the rules and they should see that work and responsibility rewarded," Obama said.

The proposal has been under protracted review by regulators and is now being analyzed by officials at the Office of Management and Budget. Thousands of comments have been filed with the government on the plan.

When a 90-day review window came and went on April 15, key supporters of the proposal organized a conference call urging the Obama administration to expedite the change.

Bruce Vladeck, who ran Medicare and Medicaid under President Bill Clinton and is now a senior adviser at the consulting firm Nexera, pointed in that call with reporters to the political power of the home care industry, which is opposing the proposal. In a subsequent interview, he said, "Based on my understanding, the OMB folks have met with industry representatives who have raised concerns publicly about the impact on them with the proposal." He added, "It will take until somebody at the political level decides to either issue a regular order or bury it. There’s absolutely no telling."

The plan has been criticized by some Republican lawmakers and Medicaid directors. In addition, some disability advocacy groups have complained that it will increase the health care costs for people who want to remain in their homes and avoid moving to institutional care.

Obama Administration Mulls Rule To Give Home Health Aides Better Wages - Kaiser Health News

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Want to know the future of Obamacare? Take a look at Fort Dodge, Iowa.

 

In Fort Dodge, this is changing. UnityPoint Health (which was, until this week, named Iowa Health System) is one of the 32 Pioneer Accountable Care Organizations that volunteered to have part of their Medicare payments tethered to a set of quality metrics.

While UnityPoint has hospitals across the state, it decided to focus its ACO effort on a relatively small segment of its population to limit the health system’s exposure to the possibility of losing money on the endeavor.

“If we completely missed the mark, we knew it wouldn’t be disastrous from a financial standpoint,” UnityPoint President Bill Leaver said. “We knew it wouldn’t be overwhelming, but a good size to start with.”

The Pioneer ACOs launched Jan. 1, 2012, and for the first year, the program only required them to report quality metrics. Their payments would not yet depend on how well they met 33 measures.

The most difficult part of preparing to move to a system that pays for value rather than volume in Fort Dodge was asking doctors to rethink how they do their jobs. They would be encouraged to delegate relatively routine care, for example, to other advanced practitioners, while focusing their own work on care management.

“That is harder work than we thought,” Leaver said. “For physicians, they run the office and they’re the captain of the ship. Instead of seeing a strep patient now, you might have other people working for you that you’re going to deploy.”

Overall, Leaver describes his experience with the ACO Pioneer program as “generally positive.” What he likes most about the program is that, when the hospital gets a lump sum for each patient, it has more control over treatment. The health system can prescribe treatments that Medicare would not traditionally reimburse.

Want to know the future of Obamacare? Take a look at Fort Dodge, Iowa.

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PAFP/F: Access to Primary Care in Pennsylvania

Survey findings from the Pennsylvania Academy of Family Physicians, January 2013

PAFP/F: Access to Primary Care in Pennsylvania

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Report says Pennsylvania lags in public health spending - mcall.com

 

Pennsylvania's public health spending ranks in the lowest tier of states, according to a new survey released Thursday.

Public health officials said the study released by Trust for America's Health and the Robert Wood Johnson Foundation may not present a full apples-to-apples comparison with other states, but that shouldn't detract from the main finding that the federal and state governments are failing to keep up with public health needs.

The findings in the report, "Investing in America's Health: A State-by-State Look at Public Health Funding and Key Health Facts," showed that Pennsylvania ranks 43rd for per-capita state public health spending.

The state also gets a relatively small piece of federal public health spending, ranking 47th for state spending by the U.S. Centers for Disease Control and Prevention and 32nd for per-capita spending by the U.S. Health Resources and Services Administration.

Report says Pennsylvania lags in public health spending - mcall.com

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Health Reform Hits Main Street - Kaiser Health Reform

Follow the link at the bottom for the video…

Health Reform Hits Main Street

Confused about how the new health reform law really works? This short, animated movie -- featuring the "YouToons" -- explains the problems with the current health care system, the changes that are happening now, and the big changes coming in 2014. Learn more about how the health reform law will affect the health insurance coverage options for individuals, families and businesses with the interactive feature "Illustrating Health Reform: How Health Insurance Coverage Will Work."

Health Reform Hits Main Street - Kaiser Health Reform

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PolitiFact Virginia | Pete Snyder says Medicaid causes higher risk of surgery death

PolitiFact Virginia | Pete Snyder says Medicaid causes higher risk of surgery death

This is the fact check on that VA Medicaid outcomes study that conservatives love to willfully misinterpret:

But researchers place little of the blame on Medicaid.

They noted that Medicaid recipients are the poorest, sickest and least educated group of patients. They are the least likely group to seek preventive health care. As a result, they are more likely to enter hospitals in dire conditions that require emergency surgery.

"Medicaid patients had the highest incidence of acquired immunodeficiency syndrome, depression, liver disease, neurologic disorders and psychoses," the study said. "Furthermore, Medicaid patients had the highest incidence of metastatic cancer."

The researchers said that uninsured patients have similar characteristics to Medicaid recipients and that it is "plausible" that both groups may suffer from a "system bias" that limits their access to private hospitals and top physicians.

"For many surgical patients, private insurance status often allows for referral to expert surgeons for their disease," the study said. "Alternatively, Medicaid and uninsured patients may have been referred to less skilled and less specialized surgeons."

Does the research prove, as Snyder and other conservatives suggest, that it’s safer to be uninsured than on Medicaid? Ailawadi, co-author of the study, said it does not.

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Lessons from Vermont's Health Care Reform — NEJM

 

Policymakers and stakeholders in other states can learn some lessons from Vermont regarding ACA reform. First, engaging stakeholders while providing transparency at each stage of reform builds support for transition efforts. Second, the adage “work smarter, not harder” applies to the enormous task of implementing health care reforms: a central board can coordinate all implementation efforts, reduce redundancy and bureaucracy, and improve transparency. Third, the development of a health insurance exchange presents opportunities for state-specific health care innovation. And finally, instead of resisting the inevitable federal reforms in the name of federalism, states may capitalize on federal financing opportunities to build new state health programs and realize cost savings.

Lessons from Vermont's Health Care Reform — NEJM

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