February 6, 2012

Unintended (or Intended?) Consequences

In case you missed it -- In a recent NY Times "Opinionator" column, Ezekiel Emanuel and Jeffrey Liebman (both former advisers to President Obama) predicted that health insurers will be "extinct" by 2020 because ACOs will make them "superfluous." To support that theory, the authors explained why they think ACOs will have more permanence and do a better job of controlling costs and improving care than the HMOs that came before them. Read the column here.

January 25, 2012

HANYS Study: Gloomy Forecast on Physician Shortage

Released January 24, 2012:

Hospitals across the state are facing a serious physician shortage that is expected to worsen as the pace of pysician departures and retirements accelerates, and hospitals are having problems recruiting new doctors, according to a new report by the Healthcare Association of New York States (HANYS).

Read the HANYS press release, then click through to the full report on the HANYS website.

January 24, 2012

Hospital "Amenities Units" in the Spotlight

The January 22 issue of the NY Times featured an article written by a journalist after her "unofficial visits" to hospital rooms specially designed to attract patients paying cash.

Read "Chefs, Butlers, Marble Baths: Hospitals Vie for the Affluent" here.

January 19, 2012

Private Health Insurers Are Being Driven Out Of The Markets, Affecting Millions - Forbes

Well. Who would've guessed?

In New York, Empire BlueCross BlueShield said it is no longer offering health insurance plans that cover about 20,000 businesses. Mark Wagar, president and CEO of Empire, said that the company will eliminate seven of the 13 group plans it currently offers to businesses which have two to 50 employees. The move is expected to have a great and potentially "catastrophic" impact on small businesses in New York, according to James L. Newhouse, president of Newhouse Financial and Insurance Brokers in Rye Brook, NY.

Read the full article at the Forbes website.

January 18, 2012

Cuomo Offers Budget With More Trims Than Deep Cuts - NYTimes.com

Today's NY Times highlights some pieces of Governor Cuomo's state of the State:

Mr. Cuomo also proposed saving more than $750 million by limiting planned increases on mental health programs and social services, including eliminating an automatic cost-of-living increase for nonprofit providers of services like foster care, adoption and family counseling.

Addressing a major concern of local governments, Mr. Cuomo proposed that the state gradually take over yearly increases in Medicaid expenses that are now shouldered by county governments and New York City.

Read the full article at the New York Times website, or visit the Governor's executive budget webpage directly.

January 12, 2012

2012-13 Budget Presenation Scheduled

Governor Cuomo will give his 2012-13 Executive Budget presentation next Tuesday, January 17.

WHEN: Tuesday, January 17, 2012

TIME: 2:00 PM

WHERE: Hart Theatre, Egg Center for Performing Arts

Albany, NY 12224

January 6, 2012

Study of Medicare Patients Finds Most Hospital Errors Unreported - NYTimes.com

Hospital adverse events are woefully underreported, if a new inspector general report covered in today's New York Times is to be believed:

Hospital employees recognize and report only one out of seven errors, accidents and other events that harm Medicare patients while they are hospitalized, federal investigators say in a new report.

Read the full article on the New York Times website.

State Health Department Awards $500,000 in Doctors Across New York Funds

From the DOH website December 29, 2011:

State Health Commissioner Nirav R. Shah, M.D., M.P.H., today announced that five health care providers have been awarded grants totaling up to $500,000 over two years to support physicians who practice medicine in underserved communities through the "Doctors Across New York" Program.

Read the rest of the press release on the DOH website.

December 29, 2011

St. John's Episcopal Hospital Laboratory Permit Suspended for 30 Days

From the Department of Health website December 16th:

The New York State Department of Health (DOH) has suspended the laboratory permit of St John's Episcopal Hospital in Far Rockaway, Queens, for blood transfusion and related testing.

Read the DOH press release online at the DOH website.

St. Luke's-Roosevelt and Mount Sinai Settle Respective Nursing Disputes

From the City Room at the New York Times online December 29th:

A nursing strike has been averted at two of Manhattan's busiest hospital centers, as union and hospital negotiators reached tentative deals over pay and benefits, officials involved in the talks said Tuesday. The 1,300 nurses at St. Luke's-Roosevelt Hospital Center had given notice they would strike on Jan. 3 but were able to resolve disagreements over health benefits. Officials at Mount Sinai Medical Center said Tuesday that they, too, had reached a tentative settlement with the nurses' union, though details of the deal were not available.

Read the full story here.

Montefiore Nurses Dispute Heats Up

From the City Room at the New York Times online December 29th:

In an unexpected move, nurses at Montefiore Medical Center in the Bronx said Wednesday that they would strike on Jan. 10 if they could not resolve issues involving staffing levels and salaries.

Read the full story here.

December 13, 2011

Mail Order Pharmacy Approval Message

APPROVAL MEMORANDUM - No. 14 Chapter 597

MEMORANDUM filed with Assembly Bill Number 5502-B, entitled:

"AN ACT to amend the insurance law, in relation to the purchase of
prescription drugs"; and

MEMORANDUM filed with Assembly Bill Number 7779, entitled:

"AN ACT to amend the insurance law, in relation to the purchase of
prescription drugs"


Both of these bills seek to improve consumer convenience by expanding
the options by which consumers can fill their drug prescriptions. The
first, Assembly Bill 5502-B, would require certain insurers that provide
coverage for prescription drugs when dispensed by a mail order pharmacy
to also permit an insured, at his or her option, to fill a prescription
at a network participating non-mail order retail pharmacy ("retail phar-
macy") without imposing additional co-payment, fees or other conditions
on the insured, provided that the retail pharmacy offers to accept a
price that is comparable to that of the mail order pharmacy. The second
bill, Assembly Bill 7779, would similarly allow an insured to purchase
fertility drugs at a local specialty pharmacy without incurring any
additional financial burdens by virtue of not using a mail order pharma-

While I support their objectives, I have concerns with these bills. To
address these concerns, both houses of the Legislature have agreed to
pass amending legislation making several changes, including providing
that the retail pharmacy must agree in advance to accept the same
reimbursement rate and applicable terms and conditions established for
mail order pharmacies. With the understanding that these amendments will
be passed, I approved these bills.

These bills are approved. (signed) ANDREW M. CUOMO

Cuomo approves mail order pharmacy bills

Governor Cuomo has approved two bills relating to health plans requiring the use of mail order pharmacy - one generally and the other in relation to fertility drugs.

These bills have attracted significant attention from both sides of the issue and there has been discussion of a chapter amendment to address some concerns. Both chapters are accompanied by approval messages which may be illuminating, however text is not yet available. I will be sure to pass along additional information of interest to the section as it becomes available.

November 11, 2011

Wal-Mart: "We are not building a national, integrated, low-cost primary care health care platform"

The New York Times health section covers a stir around a recent Wal-Mart RFI, which went to several dozen providers and suppliers.

Wal-Mart would not disclose which medical care providers or suppliers received the requests, but analysts said what the retailer is considering the kind of partnerships with hospitals and clinics that are being formed by chains like CVS and Walgreen Company.

Apparently the wording of the RFI raised some eyebrows, as Kaiser Health News published the document itself and also quoted it in an article as illustrating Wal-Mart's intent to "dramatically ... lower the cost of healthcare ... by becoming the largest provider of primary healthcare services in the nation."

Wal-Mart, through Dr. John Agwunobi, President of its health and wellness operations in the U.S., responded with denials both categorical and specific, including this one: "We are not building a national, integrated, low-cost primary care health care platform."

Which is too bad, because that's exactly what we need.

November 7, 2011

State Health Department Awards 4.5 Million to Combat Childhood Obesity

From the DOH website yesterday, November 7:

State Health Commissioner Nirav R. Shah, M.D., M.P.H., today announced that nine organizations have been awarded State grants totaling up to $4.5 million over five years to reduce child and adolescent obesity.

The grants are targeted to help children and adolescents in populations reflecting high incidence of obesity and excess weight, including low-income populations, certain racial and ethnic minorities, and persons with developmental disabilities. The grant funding will support training for health care providers and other initiatives.

Read the rest of the press release and see the list of recipients on the DOH website.

For additional posts, see the archive headings in the right hand column.