Roundup: Md. Blues chief pans hospital costs shift plan; Pharmacies struggle with new drug controls

Sep 28 2012

A selection of health policy news from Maryland, Florida, Massachusetts, California, Kansas and Oregon.

Kaiser Health News: Capsules: Md. Blues Chief Blasts Plan To Shift Hospital Costs To Insurers
Negotiations to avert a breakdown in Maryland's unique system of regulating hospital prices have deteriorated into a stalemate between the state's largest insurer and the Maryland Hospital Association. CareFirst BlueCross BlueShield CEO Chet Burrell, speaking out for the first time about the talks, blames hospitals for their proposal to shift hundreds of millions in costs to CareFirst and other private insurers in an attempt to control rising Medicare spending (Hancock, 9/27).

The Wall Street Journal: Making The 'Pharmacy Crawl'
The clampdown by Florida and at least seven other states has left some pain-sufferers struggling to get their medicine. That has put drug-enforcement and public-health officials at odds with some doctors and patients legitimately prescribed the pills. Several states now make doctors criminally liable and revoke their licenses for writing prescriptions for painkillers that lead to overdoses, prompting many to stop prescribing them at all. Other states have tightened regulation of pain clinics, forcing so-called pill mills to close but leaving people in need of pain medications with fewer doctors (Martin, 9/26).

The Boston Globe: Mass. Insurance Plans Again Earn Top Ranking On Member Satisfaction, Improvement Process
Health insurance plans in Massachusetts again earned top rankings in an analysis of member satisfaction, clinical quality, and improvement processes by the National Committee of Quality Assurance. The results, released last week, put Harvard Pilgrim Health Plan in the no. 1 slot among private plans for the ninth consecutive years. Tufts Health Plan's products were ranked at no. 2 and no. 4 on the list (Conaboy, 9/26).

The Associated Press/Washington Post: Md. Health Reform Panel To Vote On State's Benchmark Health Benefit Plan
A Maryland panel working on implementing federal health care reform is planning to take a vote on the state's benchmark health benefit plan. The Maryland Health Care Reform Coordinating Council is scheduled to meet Thursday in Annapolis (9/27).

Modern Healthcare: Calif. Looks To Speed Health Data Exchange
A new program in California will use health information exchange technology to facilitate the flow of data between health care providers. The California Health eQuality, or CHeQ, program, will be led by Dr. Kenneth Kizer, director of the UC Davis Health System's Institute for Population Health Improvement (Robeznieks, 9/26).

Kansas Health Institute News: Waiting-List Investigation 'Not Formal,' Says KDADS Official
Kansas Department for Aging and Disability Service Secretary Shawn Sullivan today said federal officials are not actively investigating complaints that years-long waiting lists for community-based services for the physically and mentally disabled constitute violations of the Americans with Disabilities Act. "There is no formal investigation into Olmstead," Sullivan said, adding that he was uncomfortable saying much more. Sullivan was testifying before a meeting of the Joint Committee on Home and Community Based Services Oversight (Ranney, 9/26).

The Lund Report: Coordinated Care Organizations Could Advance Public Health Priorities
The new coordinated care organizations provide enormous opportunities to further the state's public health agenda, but the new organizations are more likely to be successful in counties with strong existing public health departments, the state's top public health officer told The Lund Report. Oregon Public Health Director Dr. Mel Kohn said that it's too early to say if public health considerations are playing a key role in the new organizations, but he singled out Lane County as very forward thinking, in part due to the strong leadership shown by the county's public health officer, Pat Luedtke (Widman, 9/26).

The Miami Herald: Pediatricians: Florida State Officials Refuse To Meet To Talk About Implementing Obamacare
With the clock ticking on Florida's ability to control how it applies the federal Patient Protection and Affordable Care Act, pediatricians say they've been trying to meet with the agency that oversees the state's Medicaid program --- to no avail. The Agency for Health Care Administration last month declined a request from the Florida Pediatric Society to discuss how the state will implement those aspects of the federal health-care overhaul that relate to children. "Whatever program is ultimately designed, there are risks where children could fall through the cracks in a system that's really oriented to adults," said former state lawmaker Sam Bell, a lobbyist for the pediatricians' group (Menzel, 9/27).

California Healthline: Is Quality Key To Cutting Long-Term Cost?
National health care reform presents an opportunity to improve the way California delivers and measures the quality of long-term care and save money along the way, according to organizers of a long-term care conference last week in Sacramento. The long-term care population -- often elders with multiple chronic conditions, multiple providers and sometimes dozens of medications -- is an expensive one to treat. According to Lisa Shugarman, director of policy at the SCAN Foundation, which sponsored the conference, national reform gives California a chance to change the way it handles long-term issues (Gorn, 9/27).

California Healthline: FTC, Calif. AG Put Pressure on M&A – And Confuse Providers
The [FTC] has deepened its pressure on hospital deal-making -- scrutinizing dozens of mergers, filing motions to block several acquisitions and even examining whether hospitals' purchases of physician groups may be anti-competitive. And federal regulators' efforts are trickling down to the state level. As reported in California Healthline last week, Golden State's attorney general has launched her own study of whether hospital-physician consolidation is leading to higher health care costs. Industry leaders say that the regulators' timing couldn't be worse, or more confusing (Diamond, 9/26).