NJ hospital group asks for delay of new referral list
SEPTEMBER 30, 2015 LAST UPDATED: WEDNESDAY, SEPTEMBER 30, 2015, 1:21 AM
BY MARY JO LAYTON
STAFF WRITER |
THE RECORD
A group representing Catholic hospitals in New Jersey is asking the state to delay the rollout of a plan by New Jersey’s largest insurer, saying it excludes nearly 90 percent of Catholic hospitals.
The president of Catholic HealthCare Partnership of New Jersey said Catholic hospitals could be forced to close their doors – resulting in the loss of health care access for uninsured residents – if the proposal by Horizon Blue Cross and Blue Shield goes into effect.
The concerns raised Tuesday by the group and by Assemblywoman Valerie Vainieri Huttle, D-Englewood, add to the backlash over a plan to create a tier system that would funnel patients to select hospitals.
Patients could use other hospitals, but their out-of-pocket costs would be higher.
“Insurance companies should not be able to dictate which of our state’s hospitals succeed and which ones fail,” said Sister Patricia Codey, president of the Catholic HealthCare Partnership of New Jersey, whose members include nine acute health care systems, specialty hospitals and other facilities.
“Horizon’s decision will undoubtedly make it more difficult for Catholic hospitals to continue our mission of providing access to health care for New Jersey’s poor and underinsured citizens,” Codey said.
After the plan was made public this month, executives at hospitals left off the list of the select group known as “Tier One” questioned how the list was formed.
School board addresses comments by teachers union leader
SEPTEMBER 25, 2015 LAST UPDATED: FRIDAY, SEPTEMBER 25, 2015, 12:31 AM
THE RIDGEWOOD NEWS
BOE addresses union leader’s statements
To the Editor:
Mike Yannone, Ridgewood Education Association (REA) president, made several erroneous statements at the Sept. 21 Ridgewood Board of Education meeting that warrant response.
* A $2.5 million tax burden is being placed on teachers.
It is not a tax. State law known as “Chapter 78,” phased in over four years, requires that all public employees contribute towards their health benefits. The $2.5 million is the sum of this year’s contribution.
* The board passed a resolution to remove collective bargaining rights for teachers and did not provide it to the public.
Last March, the board approved a resolution asking that Chapter 78 be excluded from negotiations. This resolution was posted on the board and superintendent’s web pages at ridgewood.k12.nj.us within 24 hours of the board approving the meeting minutes.
* Contract negotiations are stalled due to a highly paid RBOE attorney spokesperson.
The RBOE has included an attorney on its negotiating team for over 15 years. He is an experienced, reasonably priced attorney. The REA’s negotiating team includes a NJEA representative. The REA collects over $650,000 annually from its members. Some of this money is used to pay NJEA for this service.
* The settlement of the contract is not the top board goal.
This is untrue. On Sept. 21, the RBOE approved a goal “to negotiate with the REA to settle a new contract.” It is a priority for this year.
* The district says its financial hands are tied, which is disrespectful to teachers.
The district’s annual budget is capped at 2 percent on the amount the tax levy can be increased. Law mandates this and it is the reality under which we operate. Disrespecting our staff is not part of the equation. We honor and appreciate the fine work of our staff.
* Each year the board hires new administrators who are doing less work.
In 2008, the board was forced to reduce administrative positions when all categorical state aid was cut. Over the last three years, we have rebuilt our administrative team. We have reinstated five administrators and added 33 teachers. Every staff member — administrators, teachers and support staff — are doing more work, not less.
Mr. Yannone asked if the RBOE was going to Atlantic City again at taxpayers’ expense. Yes, the Board of Education will attend the NJSBA workshop in October. Board members are the only New Jersey elected officials legally required to receive training. Workshop provides this training and opportunities to learn about best practices and hone leadership skills. The district pays for registration and accommodations.
The RBOE has high regard for our talented teaching staff and secretaries. The partnership with our teachers is a longstanding one that values their input in improving education for our students. In negotiating a contract, the board is mindful of the financial reality and tasked to balance this reality with the need to fairly compensate our teachers.
It may not seem like much — just an extra hundred dollars or so a year.
But the steady upward creep in health insurance deductibles has easily outpaced the average increase in a worker’s wages over the last five years, according to a new analysis released on Tuesday by the Kaiser Family Foundation.
Kaiser, a health policy research group that conducts a yearly survey of employer health benefits, calculates that deductibles have risen more than six times faster than workers’ earnings since 2010.
“It’s a very powerful trend,” said Drew Altman, Kaiser’s chief executive.
Four of five workers who receive their insurance through an employer now pay a deductible, in which they must pay some of their medical bills before their coverage starts, according to Kaiser.
Those workers’ deductibles have climbed from a yearly average of $900 in 2010 for an individual plan to above $1,300 this year, while employees working for small businesses have an even higher average of $1,800 a year. One in five workers has a deductible of $2,000 or more.
By Tom Howell Jr. – The Washington Times – Sunday, September 13, 2015
President Obama will need to more than double the number of Americans enrolled in Obamacare exchange plans to reach 21 million next year, the target set in budget projections, in what is shaping up as the next major test for the health care law.
As of June, the Department of Health and Human Services counted 9.9 million customers who have bought plans through the federal HealthCare.gov portal and a handful of state-run exchanges.
That puts the administration ahead of it’s own estimates for 2015, but is less than half what the Congressional Budget Office projected for 2016, showing just how much work officials have ahead of them as the next round of enrollment begins in less than two months.
AUGUST 4, 2015, 11:10 PM LAST UPDATED: WEDNESDAY, AUGUST 5, 2015, 12:09 PM
BY LINDY WASHBURN
STAFF WRITER |
THE RECORD
Nearly every hospital in New Jersey is being penalized by the federal government because too many Medicare patients had to be readmitted within a month of their discharge — the highest percentage of hospitals penalized in the 50 states.
The cuts — of up to 2.49 percent of a hospital’s Medicare payments — total $23 million for the state, the New Jersey Hospital Association estimated. It is the second year in a row that nearly every hospital was penalized, except for a handful that are exempted.
Only Bergen Regional Medical Center in Paramus received no penalty.
Medicare, the health care program for those over 65, provides more than $3 billion annually to New Jersey hospitals, making it the single largest source of their revenue and a huge influence on hospital policies. This is the fourth year that payments from the government program have been tied to readmissions, in an effort to reward the quality rather than the quantity of hospital care.
Fourteen New Jersey hospitals will see cuts of more than 1 percent to their Medicare reimbursements beginning in October, including three in North Jersey: Palisades Medical Center in North Bergen, St. Joseph’s Regional Medical Center in Paterson and The Valley Hospital in Ridgewood. Their patients returned at higher-than-expected rates after being treated for pneumonia, chronic obstructive pulmonary disease, heart attack, heart failure, and knee or hip replacements, the five conditions measured.
Nationwide, about one in five patients treated for those conditions returned to the hospital within a month.
ObamaCare enrollees are less satisfied with their plans than people with other types of health insurance, according to a new poll.
The poll from the Deloitte Center for Health Solutions, the research arm of the consulting firm, finds that 30 percent of people with insurance through ObamaCare’s marketplaces are satisfied with their plans.
That compares with 42 percent satisfaction from people with employer-sponsored plans, 48 percent with Medicaid and 58 percent with Medicare.
Cost is the most common reason cited for the dissatisfaction with ObamaCare. Republicans have attacked the high deductibles and other out-of-pocket expenses under the system.
An analysis from the consulting firm HealthPocket found that last year the average deductible for a silver-level ObamaCare plan was $2,907, more than twice as much as the average deductible in an employer-sponsored plan.
(Reuters Health) – Online symptom checkers often misdiagnose patients’ problems, often encouraging people to seek care for minor issues that don’t need immediate attention and other times incorrectly telling people with true emergencies that treatment can wait, a U.K. study suggests.
Researchers tested 23 online and mobile apps used by millions of people who are trying to find out if their symptoms are serious and what might make them feel better. The apps were imperfect at best, offering the correct diagnosis on the first try only about a third of the time.
For triage – assessing the urgency of the problem – the apps were too cautious in situations requiring only self-care: only 33 percent of the time, on average, were patients appropriately advised not to go to the doctor.
At the other extreme, symptom checkers typically missed the severity of the situation in one of every five cases requiring emergency treatment.
Overall, the computer programs offered accurate triage advice for 57 percent of the standardized scenarios that were used in the researchers’ tests.
“The risk is that people will be told to get care when they didn’t need it and bear the costs and inconvenience, or they will be told not to seek care when they have a life-threatening problem,” senior author Dr. Ateev Mehrotra, a health policy researcher at Harvard Medical School in Boston, said by email.
Because patients may not get much useful information from a long list of possible diagnoses, the researchers rated the symptom-checkers based on whether the programs spit out the right answer first, or somewhere lower down on a list of up to 20 possible alternative diagnoses.
What is organized crime? The dictionary defines it as a means of generating income through bribery and threats of grievous retribution, often buying political patronage for immunity from exposure and prosecution. Perpetrators of organized crime typically use credible front organizations, such as hospitals and charities. These establishments do not tolerate competition and constantly fight for monopolization, or “market share.” When organized crime is involved, goods and services cost more.
So how does this apply to our current medical care delivery “system?” Since the passage of the Affordable Care Act, there is a concerted effort to put everyone into a highly organized “insurance plan,” despite the fact that the plan costs far more than the free market would dictate. The overpricing ensures a steady flow of revenue to be siphoned off to the administrators and government officials. Campaign or “foundation” coffers are regularly subsidized to ensure favorable treatment by elected officials. And the people pay a huge price for poorer access and diminished quality.
Insurance companies claim to provide “protection” against financial ruin by selling a card that promises access to high quality care whenever it is needed. But the protection is illusion, as the purported savings are often fictitious.
Coffee purveyor increases average price by about 1% to cover rising wages, rent
By
JULIE JARGON
July 6, 2015 2:02 p.m. ET
Starbucks Corp. is raising prices slightly on some of its beverages to cover rising costs including wages and rent, even as prices for raw coffee have been falling.
The Seattle company, like other coffee purveyors, often raises prices for its products when coffee prices increase, but the latest move comes despite a decline of about 42% in Arabica futures prices from a peak late last year. The increase, which takes effect Tuesday, will increase the cost of the average customer order by about 1%, Starbucks said. Bagged coffee won’t be affected.
The increase comes from an overall need to manage business costs, including labor and rent expenses, a Starbucks spokeswoman said.
“Our pricing philosophy is to balance our need to run our business effectively while providing maximum value to our customers,” she said.
The Supreme Court on Thursday upheld the nationwide tax subsidies under President Barack Obama’s health care overhaul, in a ruling that preserves health insurance for millions of Americans.
The justices said in a 6-3 ruling that the subsidies that 8.7 million people currently receive to make insurance affordable do not depend on where they live, under the 2010 health care law.
The outcome is the second major victory for Obama in politically charged Supreme Court tests of his most significant domestic achievement.
Chief Justice John Roberts again voted with his liberal colleagues in support of the law. Roberts also was the key vote to uphold the law in 2012. Justice Anthony Kennedy, a dissenter in 2012, was part of the majority on Thursday.
“Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them,” Roberts wrote in the majority opinion.
Nationally, 10.2 million people have signed up for health insurance under the Obama health overhaul. That includes the 8.7 million people who are receiving an average subsidy of $272 a month to help pay their insurance premiums.
Adviser whose comments on Affordable Care Act touched off a furor worked more closely than previously known with White House
By
STEPHANIE ARMOUR
Updated June 21, 2015 5:56 p.m. ET
Jonathan Gruber, the Massachusetts Institute of Technology economist whose comments about the health-care law touched off a political furor, worked more closely than previously known with the White House and top federal officials to shape the law, previously unreleased emails show.
And so will “Republican strategists.”
by Michael Walsh
June 21, 2015 – 11:54 am
Of course they will. Even though not a single Republican voted for this monstrosity as it was shoved down the throats of the American people. Because, subsidies:
The pressing problem for the 2016 Republican field falls into the “dog catches car” category: It’s one thing to call for the Affordable Care Act to be repealed or to promise an Oval Office signing ceremony for its repeal. It’s another to endorse pulling insurance subsidies used by more than 6 million people in 34 states, including at least 1.3 million Florida residents.
A ruling that subsidies provided to consumers to help them purchase health insurance are not legal could spark chaos in the insurance marketplace and help shape the electoral landscape in several key swing states. Beyond those voters directly affected, many more could see their premiums increase if the law unravels, driving up the number of uninsured.
WASHINGTON (Reuters) – Tensions are building inside and outside the white marble facade of the U.S. Supreme Court building as the nine justices prepare to issue major rulings on gay marriage and President Barack Obama’s healthcare law by the end of the month.
Of the 11 cases left to decide, the biggest are a challenge by gay couples to state laws banning same-sex marriage and a conservative challenge to subsidies provided under the Obamacare law to help low- and middle-income people buy health insurance that could lead to millions of people losing medical coverage.
Many legal experts predict the court will legalize gay marriage nationwide by finding that the U.S. Constitution’s guarantees of equal treatment under the law and due process prohibit states from banning same-sex nuptials.
The four liberal justices are expected to support same-sex marriage, and conservative Justice Anthony Kennedy, the expected swing vote, has a history of backing gay rights.
In three key decisions since 1996, Kennedy has broadened the court’s view of equality for gays. The most recent was a 2013 case in which the court struck down a federal law denying benefits to married same-sex couples.
During oral arguments in the gay marriage case on April 28, Kennedy posed tough questions to lawyers from both sides but stressed the nobility and dignity of same-sex couples.
The healthcare decision is tougher to call. Chief Justice John Roberts, the swing vote when the court upheld Obamacare in 2012, said little during the March 4 oral argument to indicate how he will vote.
The court will issue some rulings on Monday, with more likely later in the week.
For the justices, the pressure is on to have the rulings ready. That can be difficult as the cases in which they are closely divided are generally the ones left until the end.
Outside the court, those with a stake in the outcome of the rulings are left anxiously waiting.
James Obergefell, one of the plaintiffs in the gay marriage case, said he will be at the court for all the remaining decision days.
President Obama admits HealthCare.gov was a “well-documented disaster,” but says it helped the federal government better understand how to handle technology.
“With all the crises we were dealing with — the economy collapsing, the auto industry on the verge of collapse, winding down wars — this did not get the kind of laser-focused attention until HealthCare.gov, which was a well-documented disaster, but ended up anyways being the catalyst for us saying, ‘Okay, we have to completely revamp how we do things,’ ” Obama said in aninterview with Fast Company published Monday.
Obama’s comments come as he’s trying to promote his administration’s efforts to overhaul the government’s ancient technology infrastructure.
The president said outdated procurement rules and a lack of technological expertise hampered large-scale government projects, such as HealthCare.gov. But he said his administration has adopted new rules and recruited staffers from Google, Facebook and Twitter to beef up its tech efforts.
“If we are able through the U.S. digital team to recruit a baseline of talent and create a — pipeline — on a regular basis … what I do believe will happen is the government as a whole will start thinking about its relationship to citizens differently,” Obama said.
Richard Wolf, USA TODAY4:44 p.m. EDT June 14, 2015
WASHINGTON — The future of same-sex marriage and President Obama’s health care law hang in the balance as the Supreme Court’s 2014 term draws rapidly to a close this month. But those aren’t the only big issues on the justices’ plate.
Free speech and fair elections. Religious liberty and racial discrimination. Clean air and capital punishment. All await rulings over the next three weeks as the court completes action on 20 cases remaining this term. The next decisions will come Monday morning.
Here’s a look at the Elite Eight:
• Same-sex marriage. In a decision likely to come on the term’s last day — possibly June 29 or 30 — the court will decide whether gays and lesbians have a constitutional right to marry or whether state bans against same-sex marriage can remain in place.
Six cases from Ohio, Michigan, Tennessee and Kentucky have been consolidated for the court’s consideration. In them, 32 total plaintiffs are asking for the right to marry or to have marriages licensed elsewhere recognized in their home states. Most legal experts predict the court, led by Justice Anthony Kennedy, will rule in favor of the gay and lesbian couples.
