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 & state government, large employers, and most importantly, consumers.

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Explore Our Library of Memos

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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