State roundup: Mass. cost control plan advances; Texas Senate's abortion bill vote; Miami's public hospital crisis

Feb 19 2011

Reuters: Massachusetts Plans To Take On Health Cost Spiral
The governor of Massachusetts proposed changes on Thursday to the state's comprehensive healthcare program, one often seen as a prototype for national reforms, to attempt to bring rising costs under control. The plan would give the U.S. state more authority to scrutinize fees paid to hospitals and doctors, reform the current standard by which healthcare providers are compensated and enact medical malpractice reform. "The existing fee for service payment system is outdated," Governor Deval Patrick, a Democrat, said at a Greater Boston Chamber of Commerce breakfast. "There is no financial incentive in the system for good care, only for more care" (Krasny, 2/17).

WBUR: Patrick's Health Care Plan Gets Mixed Reaction 
Patrick wants the authority to decide how much our insurance premiums can rise every year. That, says the governor, is the stick. ... The "carrot" is giving hospitals and doctors flexibility in deciding how they will lower costs and encouraging, but not forcing, everyone into larger, full-service health care organizations. ... Health providers are generally pleased that moving to a new payment system in this bill is voluntary, not mandatory, and it sets alternative payments, not global payments, as the goal. So there is more flexibility here than the Patrick administration may have originally imagined (Bebinger, 2/18).

Georgia Health News: Health Budget Under The Microscope
When the state's main health agency presented its fiscal 2012 budget numbers to a legislative panel Thursday, most of the proposed spending reductions went unchallenged by the lawmakers. Included in the financial blueprint is a 1 percent pay cut to doctors, dentists, and nursing homes serving Medicaid and PeachCare patients. ... Lawmakers focused on the proposed elimination of dental, podiatry and vision benefits for adults on Medicaid, the program covering the poor and disabled. The state will save about $7 million by eliminating the benefits (Miller, 2/17).

Connecticut Mirror: Despite Malloy's Support, Expansion Of Medical Homes Faces Obstacles
As part of an overhaul of state Medicaid programs, the administration plans to aggressively expand the use of patient-centered medical homes, an increasingly popular model for delivering care that is still relatively rare in practice. Some were heartened by (Gov.) Malloy's campaign pledge to expand a small Medicaid pilot program that pays providers for care coordination. Details have not been fleshed out, but the administration has indicated that it wants to go even further, encouraging providers in Medicaid to become fully recognized patient-centered medical homes. ... So far, only four medical practices in the state have achieved it (Becker, 2/17).

The Miami Herald: Jackson Execs Ask County For $32 Million Advance
In the grimmest projection yet, Jackson Health System executives told Miami-Dade County commissioners Thursday that cash for the public hospitals will run out by the end of July unless dramatic steps are taken. In the annual meeting between commissioners and Jackson's governing board, the Public Health Trust, executives said they need a $32 million cash advance in the next several months. For the first time, executives also outlined plans to deal with a projected shortfall of $77 million for the fiscal year ending Sept. 30. Though details were vague, they proposed cutting indigent care by $20 million — perhaps denying treatment for undocumented immigrants — and find $16.5 million in savings through operational and "labor efficiencies" (Dorschner, 2/17). 

Houston Chronicle: Senate Passes Sonogram Measure 21-10
Doctors would have to perform a sonogram at least 2 hours before an abortion and describe the embryo or fetus for the woman - including cardiac activity, internal organs, arms and legs -- under a bill approved 21-10 Thursday by the Texas Senate. Doctors also would have to give a woman the option of viewing the sonogram and hearing the heartbeat, but she could refuse those options. Women only could refuse the description if the pregnancy was a result of sexual assault or incest; if they were minors and obtaining the abortion under judicial bypass procedures allowing them to do without parental consent; or because their fetus had an irreversible medical condition or abnormality (Fikac, 2/17). 

The Texas Tribune has video of the sonogram debate (2/17).

California Healthline: Biomedical Jobs No. 1 in San Diego Health Care Work Force
In a region with a 10.1% unemployment rate, San Diego's health care sector is holding its own. Hospitals have seen a decline in revenue, but employment has mostly held steady, experts say. San Diego's biomedical industry stands out as a leader, continuing to thrive and gain jobs even as the rest of the state experiences losses. In 2009, California's biomedical industry lost 6,000 jobs, most heavily in Los Angeles and Orange Counties. San Diego, which is home to more than 400 biotechnology companies, gained 678 positions during the same period. That was the finding of a recent report by the California Healthcare Institute, a La Jolla-based not-for-profit public policy research organization for California's biomedical research and development industry (Zamosky, 2/17).