Blogs at the CUNY Graduate School of Journalism

Drani & Lia blog post 3.16.09

March 16th, 2009 by Lia Wallon

With the release of an easy-to-read outline for the Fiscal Year 2010 budget, President Obama’s new administration seems to be making good on campaign promises of transparency and accountability.

The Department of Health and Human Services tackles health insurance – the question that has been looming larger as the ranks of unemployed swell daily.

The $634 billion 10-year reserve fund apportioned by the FY2101 budget follows on the heels of the American Recovery and Reinvestment Act of 2009, where $20 billion was apportioned for a mandatory adoption of health  information technology, or Electronic Health Records. Health information technology is expected to make it more difficult for fraud to be perpetrated with unnecessary treatments. EHR also target medical errors – another source of wasteful spending.

Improving the efficiency of medical care is only one arm of the budget’s goals. One billion dollars from the American Recovery and Reinvestment Act of 2009 was slated for comparative effectiveness research. The money will help the Center for Medicare Services streamline payments and close loopholes.

The reserve fund grapples with several leaks in the system, mostly via Medicare managed-care insurers. Use of the National Correct Coding Initiative edits aim to align Medicaid payments. Physician-owned specialty hospitals, imaging services and Medicare home health payments will be monitored more carefully, saving about $40 billion.

Private health insurers will be subjected to a competitive system to determine Medicare Advantage plan payments, with a projected savings of nearly $180 billion.

Obama’s budget aims to focus on quality of care, by paying physicians for quality of care instead of quantity.  By switching the focus away from quantity hopefully there will be less incentive for doctors to submit multiple bills for services and products never delivered.However, the oversight for such quality improvements remains a mystery.

Will Medicare still be required to pay claims within 14 days?  If so, how will quality improve on the doctors’ side if it is not improved on the administration side?  Although the 14-day turnaround provides the funds necessary for hospitals and doctors to continue working, it doesn’t help program oversight.  It seems that a little more transparency is needed in just what the Obama administration plans to do.

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