Health Care Reform Memo Library

The health care reform memos are issued on a weekly basis, highlighting news from the previous week’s activities in the new administration, and implications for the C-suite and various stakeholder groups. The purpose of these memos is to:

1. Provide current news on various health care reform efforts
2. Tease out how changes affect various stakeholder groups, including health plans, providers, life sciences companies, federal and state government, large employers, and most importantly, consumers.

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Explore Our Library of Memos

Memo: February 8, 2010

• Health reform spotlight shift to states: Medicaid the flashpoint
• FY11 budget: News is mixed for key health care sectors
• House Democrats plan bill to take away anti-trust exemption from health insurance companies; beginning of a la carte health reforms
• Health care lobbying: 2009
• End of life care: Second look
• House, Senate approve temporary provisions for physician fix
• Congressman Ryan proposal: raise eligibility age for Medicare enrollees
• Cloud computing access provides opportunity to accelerate clinical research and personalized medicine
• HITECH update
• Controversial autism study officially withdrawn from medical research
• FDA oversight of drug promotion increases

Memo: February 1, 2010

• CBO report, State of the Union highlight link between economic recovery and health care
• Update: health reform legislation in 2010
• What does it mean for key industry groups and observers? My take…
• HHS likely to expand transparency, performance-based payments with/without reform bill
• House Republican retreat features feisty exchange about health reform; GOP proposals presented
• House Energy and Commerce Committee to push for transparency in deals with industry groups
• HITECH update: CCHIT to begin EHR certification starting February 12; Beacon community applications due

Memo: January 25, 2010

• Massachusetts elects Brown to Kennedy Senate seat
• What’s next?
• What does it mean for now? Our take...
• Consumerism in California takes center stage: New rules for HMOs, universal coverage legislation introduced
• Hospital’s incentive for physicians EHR adoption gets attention
• Quotable
• Fact file

Memo: January 20, 2010

• Massachusetts Senate race: Implications for health reform legislation
• Quotable

Memo: January 18, 2010

• Massachusetts Senate race considered referendum on health reform
• Update: Reform bill negotiations among House, Senate Democratic leaders
• New coalitions emerge to advocate for single issues
• Employers’ considerations: Update
• Busy first year
• EHR requirements for vendors; Meaningful use criteria for hospitals and doctors published in Federal Register Wednesday
• Drug costs get attention of Congress

Memo: January 11, 2009

• Update: House-Senate bill reconciliation process
• CMS report Tuesday: 2008 health costs up to $7,681 per person
• Health reform: AMA lays out strategy for 2010
• Cardiologist file suit to challenge payment rates
• High value hospitals focus of reform, but methodology in question
• Reactions to “meaningful use” rules vary in initial comment period
• Action item: Health information exchange opportunity announced by Office of the National Coordinator
• Illinois legislation landmark: denied claims reviewed by independent physician
• Medicare Modernization Act — Case study in how markets work
• Sebelius announces health security strategy
• My take: delivery system reforms equal to insurance industry reforms in impact

Memo: January 4, 2010

• Reconciling differences in the House-Senate bills: Update
• Meaningful use regulations announced
• Special Report: New Taxes in the Senate Bill

Memo: Special Edition - December 24, 2009

• Senate passes bill; reconciliation with House bill next step
• Funding the Senate bill: four major sources
• What’s ahead?
• AMA endorsement
• GDP below forecasts
• CCHIT certifies 14 EHR vendors

Memo: December 22, 2009

• Senate bill update
• Significant discussion items
• Consumers believe health care reform leads to increased federal budget deficit and taxes: Deloitte Center for Health Solutions pulse survey
• Who are the uninsured today?
• COBRA subsidy eligibility to be extended through February 28, 2010
• HHS announces new $60M program to address IT adoption challenges
• Part D update: Kaiser analysis

Memo: December 14, 2009

• Senate debate enters third week
• Medicaid expansion problematic to states, some more than others
• CMS actuary study: Senate bill will increase the deficit and hurt hospitals
• Hospital performance-based payments update: CMS Hospital Compare, avoidable readmissions
• Issue brief: Administrative costs in health plans

Memo: December 7, 2009

• Senate debate takes spotlight; President focused on passage
• New studies got attention: focus on HR 3590 impact, variation, transparency
• Advocacy efforts increasingly visible
• Benjamin makes first major speech; calls for increased diversity in health care workforce
• Update: Office of the National Coordinator for Health Information Technology (ONC)
• HHS offer is $235 million to model health IT communities

Memo: November 23, 2009

• Senate votes 60-39 to proceed to floor debate on reform bill
• Quotable…from the Senate debate to block a filibuster and proceed to a debate on the floor…
• The “Baucus” bill versus the “Reid” bill
• The Senate debate ahead: watch for four major themes
• SGR fix update: House passes temporary fix
• Mammography study sparks reaction; linked to “government run health care” by conservatives
• German health system reforms: case study

Memo: November 16, 2009

• Spotlight next on Senate
• Medicare cuts, funding focus of Senate debate
• Medicare enrollee support for health reforms problematic
• Physician pay for performance results
• BusinessWeek 11/23 Cover Story: “Why Wait for Health Reform: 10 Ways to Cut Costs Right Now"
• Readmission rates: heart failure
• Primary care access uneven
• H1N1 prevalence (CDC), new vaccine for seasonal flu uses faster manufacturing process
• Data file: admin costs

Memo: November 9, 2009

• HR 3962 passes 220-215; Democrat Blue Dogs vote “no” due to cost
• Physician payment faces hurdle in House and Senate
• Deloitte Tax analysis of IRS data: 0.33 percent of tax payers will be subject to 5.4 percent tax
• Biofuel subsidy to paper companies becomes funding opportunity for health reform
• Senate bill to require spiritual healing coverage by plans
• Regional variation analysis in HR 3962; $1.42 trillion savings potential
• Some big questions from HR 3962 as the health reform process unfolds
• Snapshot: Costs of reform over ten years

Memo: November 2, 2009

• House bill presented Thursday—public option not tied to Medicare +5 percent a notable change
• Monday: Grassley requests information from HIT industry about business practices
• Blumenthal: $564M for states to form health information exchanges
• U.S. Department of Commerce economic outlook update: Slow recovery, health costs, interest on debt driving federal spending up faster than overall economy
• Small business focus of White House reform push
• Benjamin confirmed
• Hopkins study: 17,000 children died as result of lack of insurance
• CDC swine flu update
• Snapshot: 2009 Deloitte Survey of Global Health Consumers – report coming soon

Memo: October 26, 2009

• Anti-trust exemption on the table
• Public option gains momentum
• SGR fix stalls in Senate; $247 billion price tag an issue
• Small businesses face higher premiums
• Medicare premiums to increase 15 percent in 2010 for one in four enrollees
• Medicare Advantage cuts in Senate Finance bill might not impact 30 percent of enrollees benefit
• Update: employer pay or play mandates
• Health Reform Snapshot: Individual Mandate

Memo: October 19, 2009

• Senate Finance bill passes committee 14-9 with Senator Snowe’s support
• $1.4 trillion deficit for FY09
• Studies analyze financial impact of Senate Finance bill
• SGR fix proposal: S.1776 to be voted separately next week
• State tax collections in Q2 09 drop 16.6 percent from year earlier
• AAFP predicts 40,000 shortage of PCPs; reform bills include ten percent bonuses
• Senate Finance bill expands health information technology provisions to assist consumers, business, providers
• Paying for reform likely focus of next round of debate
• Carper alternative proposal gets attention; gives states greater role
• NEW! Snapshot: Rate banding proposals under health reform

Memo: October 12, 2009

• Senate Finance vote Tuesday; CBO scores it “deficit neutral”
• Seniors the most satisfied and secure in their insurance coverage
  

Memo: October 5, 2009

• President links health reform to economic recovery in weekly address
• Finance committee marathon hearings end: what’s next? First-hand observations
• White House considers extension of stimulus safety net provision to sustain economic recovery
• FDA to review Menaflex decision: spotlight on device review process and increased oversight
• Special report: Swine flu pandemic preparedness

Memo: September 28, 2009

• Senate Finance Committee deliberation likely to stretch into October
• Deloitte Center for Health Solutions Pulse Survey: Half are familiar with the public option
• CBO analysis: Public option tied to Medicare rates will reduce Medicare costs $85 billion over ten years
• Agency for Healthcare Research and Quality (AHRQ) study: Hospital admissions
• Outcomes-based payment for physicians proposed
• Humana Medicare Advantage communication to its enrollees prompts investigation, draws criticism of Senator Baucus
• Biden stumps for health insurance reform as President participates in G20 and UN Security Council
• Comparing the bills and subsidies (Kaiser Family Foundation)

Memo: September 21, 2009

• Presidential Sunday morning TV blitz
• Baucus bill introduced; reaction mixed
• Three major bills: Major differences and similarities
• Deloitte poll: Consumers suspect health care reform bill might not happen in 2009
• Individual mandate in all reform proposals thus far, but constitutional challenge might be on horizon
• Medical home pilots in states expanded: Health and Human Services (HHS)
• Experts suggest sugar-sweetened beverages tax
•  HITECH update: Meaningful use criteria to be basic in 2011

Memo: September 14, 2009

• President Obama makes primetime appeal for health reform bill September 9: Provides framework for approach
• Tort reform on the table; state-led pilots likely focus
• President’s willingness to consider alternatives to public option seems to drive health plan stock spurt
• Senate Finance Committee bill expected this week
• Blues begin national ad campaign
• Harkin to Chair Senate HELP
• Medical home pilots
• FDA launches electronic food registry
• U.S. adults grade U.S. system below ratings by citizens in France, UK, Switzerland, Canada; understanding of “systems” of care low everywhere

Memo: Special Edition - September 10, 2009
Read a re-cap of President Obama’s address on Wednesday, September 9 to a joint session of Congress on health care reform and some observations from the speech.

Memo: August 31, 2009
Note: There will not be a Health Reform Memo on September 7 in recognition of Labor Day; distribution will resume on September 14.

• Interim replacement for Kennedy likely; "the cause of his life" prominent in coverage
• Prospects for health reform: momentum lost?
• 2009 Deloitte Global Survey of Health Care Consumerism: Understanding of health systems low
• H1N1 could infect half of U.S. population; pandemic probable
• Privacy and security guidance provided; tougher reporting of breaches required
• Indicators suggest economic recovery underway but signals mixed and recovery likely slow

Memo: August 24, 2009 

• CBO to release update Tuesday showing deficit higher than earlier forecast; key factor in health reform
• President Obama promotes health reform; White House seeks to diffuse emotion and sharpen messaging
• Flex account limits might impact dental, over-the-counter purchases
• Grassley-Baucus relationship: not an odd couple after all
• Reconciliation route likely: Democratic Senate moderates key
• Individual mandate might face constitutional challenge
• CMS 2010 pay proposal: primary care increases, specialists cuts
• Health information technology grants announced; Blumenthal role expanded
• States hit hard even after stimulus funding for Medicaid
• Business Week: “Why Insurers are Winning” in Health Reform
• Appointment: Tobacco czar named
• Senate Finance Special Committee on Aging requests information from GPOs

Memo: August 17, 2009

• Town hall meetings get TV attention; White House willing to compromise on public option
• President stumping for health reform
• CCHIT to certify “meaningful use” starting in October 2009

Memo: August 10, 2009

• Town hall disruptions: orchestrated or real?
• Public option in non-competitive markets: AMA analysis
• HR 3200 public option: CBO assessment
• Co-op model is focus of Senate Finance alternative to public plan option; adjourns for recess without offering bill
• IT Update: 45-65 grants available to accelerate workforce HIT career pathways
• CMS announces 2.1 percent increase for hospitals
• Fact file: Canadians more satisfied than U.S. with their system

Memo: August 3, 2009

• Editorial by Paul Keckley on a significant change in strategy in the health reform debate
• HR 3200: House Energy and Commerce approves modified bill; public option included, sweeping insurance industry reforms a major focus
• House adjourns for recess; Democratic leaders focus on insurance industry reform in messaging at home
• Senate Finance postpones bill; considers taxes on “gold plated insurance plans” and co-ops
• Comparative effectiveness priorities include cost consideration; awards start in August
• Update: stimulus funding for hospital, physician EHRs
• FDA intensifies focus on food safety

Memo: July 27, 2009

• Health reform center stage last week; White House pressing hard for bill but concedes on timetable
• Update: HR 3200 – Blue Dogs key to House Energy and Commerce passage; leadership may take bill directly to floor without committee approval
• Public plan option “trigger” in Part D might be model for health reform
• Independent Council gaining momentum; CBO says it might not contain costs long-term if composed of physicians
• Republican leader offers GOP alternative

Memo - Special Edition: July 23, 2009

• Key themes from President Obama’s News Conference

Memo: July 20, 2009

• House bill announced, then summarily challenged by disappointing Congressional Budget Office (CBO) report
• Creation of independent authority to set Medicare rates gaining support
• Senate HELP supports biologics patent protection for 13½ years, contrary to White House view
• RHIO initiatives likely to revive with stimulus money
• Subsidies for health insurance: how many might be eligible?
• Delayed care due to economic downturn
• Employer, individual mandates get mixed reactions from consumers

Memo: July 6, 2009

• Quiet week as reform proposals await markups; Baucus bill anticipated week of July 6
• Unemployment higher than expected; economic recovery linked to health care cost containment a White House theme
• 6,300 new H1N1 cases in U.S. last week, pandemic anticipated
• Wal-Mart announces support for employer mandate
• Council, IOM reports provide priorities for comparative effectiveness effort

Memo: June 29, 2009 

• Costs of reform, public plan option focus of attention
• Pharmaceutical industry pledges $80 billion to reduce drug costs
• Baucus bill most watched
• Biotech industry proposal: Seven year patent protection from bio-generics
• Meaningful use guidance from ONC task force
• Anti-smoking bill, climate change legislation indicate increased attention to public health

Memo: June 22, 2009:

• Cost of reform draws attention; price tag could exceed $1.6 trillion
• AARP endorses PhRMA drug discounts for 3.5 million seniors
• Senate Democrats’ proposal includes individual mandate, no public plan – but higher employer taxes
• CBO estimate: insurance exchange will enroll 39 million and reduce employer sponsored coverage by 15 million
• MedPAC advises changes to provider payments; incentives to reduce costs a key feature
• Daschle, Dole, Baker weigh in on health reform; issue recommended plan

Memo: June 15, 2009

• President stumps for health reform in Green Bay; calls for Medicare and Medicaid cuts to fund reform
• Baucus, Conrad introduce comparative effectiveness bill
• Kennedy’s American Health Choices Act provides baseline for subsequent bills
• House Democrats’ reform outline released
• “Meaningful use" expected to be clarified this week
• Medicare prescription drug program popular with seniors, enrollment growing
• House, Senate approve tobacco industry regulation by FDA

Memo: June 8, 2009

• Health reform top issue on White House agenda: Support for individual mandate, public plan, elimination of employer tax exclusion apparent
• Kennedy releases American Health Choices Act; Features insurance reform, public plan, individual mandate
• Public plan emerging as focal point of reform debate
• Grassley, McConnell lead Republicans opposition to “Big” public plan
• Major trade groups propose savings up to $1.7 trillion; respond to White House challenge to reduce health costs
• Here and there on the health reform front
• Unemployment reaches 9.4 percent – highest in 26 years

Memo: June 1, 2009

• Kennedy announces his plan; public plan a central feature
• Moderate House Democrats propose independent comparative effectiveness research oversight
• Congressional Budget Office (CBO) mulls budget treatment of reform options
• Health care reform advocacy group quantifies hidden tax to pay for uninsured

Memo: May 26, 2009

• Health reform debate intensifies: the size and scope of a public plan a key focus
• Funding for reform gets attention
• Democrats appear aligned on major reform strategies
• Two alternative Republican proposals emerging; conservative, moderate views differ

Memo: May 18, 2009 

• Major trade associations announce support for cost containment; pledge to reduce by $2 trillion over next 10 years
• Wellness programs get attention
• $634 billion health care reserve fund revisited; funding short of goals
• Senate Finance Committee policy paper offers three public plan options
• Employer tax exclusion gets attention as alternative funding mechanism for health reform
• Medicare trust fund insolvent in 2017: Treasury department
• Medical home pilot results mixed
• Frieden new CDC Director Thursday

Memo: May 11, 2009

• $3.6 trillion FY10 budget released: 8 percent increase in Medicare-Medicaid planned
• Baucus Committee hosts second reform roundtable; the public plan a major focus
• America’s Health Insurance Plans (AHIP) responds to public plan proposals
• Jobless rate for April less than anticipated; unemployment at 8.9 percent
• May 7 New England Journal of Medicine (NEJM) features comparative effectiveness
• Primary care residency expansion sought in new bill
• Massachusetts health plans recommend payment reform

Memo: May 4, 2009

• Health reform: the first 100 days
• Sebelius confirmed; Childress named special advisor
• 4-5 percent cut in Medicare Advantage Plans premiums likely for 2010; plans have until June 1 to assess participation
• Senate Finance leaders Baucus and Grassley release comprehensive reform proposal Tuesday
• EHR watch: adoption getting attention from major trade organizations and legislators; open-source platform encouraged by National Center on Vital and Health Statistics
• “Meaningful use” gets attention
• Primary care gets attention; community health centers a key focus
• Chrysler bankruptcy filing gives Voluntary Employee Beneficiary Association (VEBA) 55 percent share of new company

Memo: April 27, 2009

• United Auto Workers – Chrysler – U.S. Treasury Department come to terms on retiree health coverage
• Five committees in spotlight as health reform gains momentum in both houses; reconciliation vote increases odds of reform in 2009
• PhRMA offers its solution to access; trade groups and special interests promoting their recommendations
• People and appointments: Chopra named first U.S. Chief Technology Officer with health care a key focus; Sebelius confirmation stalled

Memo: April 20, 2009

• Administration focused on Medicare Advantage plans; Private Fee-For-Service plans (PFFS) targeted for improved performance
• Council on Comparative Effectiveness Research begins work; report to HHS due June 30
• Koh named Assistant Secretary of Health
• HIMSS revisited: Leavitt calms debate about open-source platform for IT overhaul
• Obama issues guidelines permitting access to embryonic stem cell lines that would be disposed of by fertility clinics
• FTC weighs in on health IT related privacy issues; issues guidelines about breach
• AMA promotes individual mandates, universal coverage as keys to access
• Stimulus funds for EHR adoption significant for providers but significantly less if implementation delayed

 Memo: April 13, 2009 

• Battle lines forming around administration plans to create new public insurance plan for pre-Medicare enrollees
• Funding authorized for two health reform offices –the White House Office of Health Reform and  the Office of Health Reform in the Department of Health and Human Services
• FDA revisits safety oversight for older devices
• GOP physicians launch “The Republican Second Opinion”
• New IT systems for Veterans Affairs promised; features portable personal health records for vets
• HIMSS annual meeting draws 27,500; EHR stimulus funding hot topic

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