Consumer: Making Money System

Today, the CMS Office of the Actuary released its report on how much the United States spends on health care now and in the future. The report shows a 3.9 percent growth in health spending in 2010 – an historic low. Overall Medicare cost growth dropped from 7.9 to 4.5 percent between 2009 and 2010. This slow-down occurred at the same time that many seniors with Medicare received cheaper prescription drugs. According to the report, private health spending has and will continue to be low in the next few years. And the report estimates that private benefit spending growth per enrollee will be 3 percent this year, rather than 4.7 percent thanks in part to the Affordable Care Act’s policy that allows young adults to stay on their parent’s plan.

The report concludes that:

Average annual growth in national health spending is expected to be 0.1 percentage point higher (5.8 percent) under current law compared to projected average growth prior to the passage of the Affordable Care Act (5.7 percent) for 2010 through 2020. Simultaneously, by 2020, thirty million Americans are expected to gain health insurance coverage as a result of the Affordable Care Act.

The bottom line from the report is clear: more Americans will get coverage and save money and health expenditure growth will remain virtually the same. But the report doesn’t tell the whole story.

The Affordable Care Act creates changes to the health care system that typically don’t show up on an accounting table. We know these new provisions will save money for the health care system, even if today’s report doesn’t credit these strategies with reducing costs. These provisions include:

The Administration’s Partnership for Patients: Better Care, Lower Costs, a new private-publicpartnership to achieve two goals: reduce preventable hospital-acquired conditions by 40 percent and reduce hospital readmissions by 20 percent between 2010 and 2013. Over 2,000 hospitals as well as employers, physicians, nurses, and patient advocates have committed to these goals which, over the next ten years, could reduce costs to Medicare by about $50 billion and help put our nation on the path toward a more sustainable health care system.

Support for voluntary Accountable Care Organizations that make it easier for health care providers to work together to coordinate care for an individual patient across care settings – including doctor’s offices, hospitals, and long-term care facilities. The Affordable Care Act rewards ACOs that lower health care costs while providing high quality care, and could generate as much as $960 million in Medicare savings over three years.

Bundled payment programs that will reward doctors and hospitals for working together to provide higher quality care to patients rather than bill for each individual procedure or test.

Demonstrations launched by the new Innovation Center that will build and test models that will save money for both Medicare and the private sector, and then expand the use of the models that work.

Important investments in programs that save money over the long-term like prevention and wellness programs.

Americans know that these common-sense strategies will reduce health care costs. Preventing disease and illness before it happens can keep people out of the hospital or the doctor’s office in the first place. Making health care more efficient improves the quality of care and saves money. And investing in new innovations can help generate new ideas and new delivery system reforms that reduce costs. Further, these provisions of the law represent ideas that hospitals, doctors, and employers all over America have been putting into practice for years, where they’ve been able to increase the quality of health care and reduce costs.

We are confident that these reforms – in addition to those in the law – will help make our health care system more efficient, provide better health care to millions of Americans, and bring down health care costs for all of us.

Nancy-Ann DeParle is White House Deputy Chief of Staff

Will and Kate's visit to Los Angeles will be a whirlwind of photo-ops: The Duke and Duchess of Cambridge chatting with J. Lo at BAFTA's "Brits to Watch" event; a polo match, for which a Beverly Hills plastic surgeon is not on standby; a possible bite at Pink's.

As the purpose of this trip is to focus on the couple's charities, they'll also visit skid row, the nation's homeless capital. "Are they going to spend the night there?" an editorial board member quipped. In fact, Will may have, as he has done in the past, but their plane home leaves that evening.

While there's not much the couple can do in one afternoon, we can use their visit as yet another opportunity to reignite the conversation over how best to solve L.A.'s homeless problem. There are several schools of thought on this. Some advocates say it would be best to decentralize homeless people so that they're scattered around the city, no longer enabling one another or falling prey to drug dealers who'll always know where to find them. Then there's the view that what homeless people need most is understanding and compassion.

It would be impossible to come up with a one-size-fits-all solution because there are a number of different reasons for why people end up homeless. But The Times' editorial board strongly believes that permanent supportive housing is the most productive solution. Beyond a place to sleep, it would give people a brick-and-mortar address so that they may receive Social Security checks. They'd also have resources, including an employment center and mental health counselors, so that they may have the best shot at rehabilitation.

So, on the occasion of Will and Kate's trip to skid row, I dug up a few editorials from over the years to explain the board's position. Here are excerpts:

Skid row's revolving door | Oct. 09, 2006

It has taken far longer than it should have, but the city and the police department are finally starting to wrest back control of skid row. Two weeks ago, officers began arresting transients for sleeping on sidewalks during daylight hours, removed scores of homeless encampments and have made more than 800 arrests.

The aim is not to harass the thousands of homeless people who call downtown home but to crack down on the criminals and drug dealers who prey on them -- and to begin to change the culture of lawlessness and despair. […]

Part of the problem is that the jail and prison systems are seriously overcrowded. That's why the district attorney and local judges say they have no choice but to let convicted criminals from all over the city back out on the streets. But turning around skid row doesn't require flooding the system with scores of new prisoners. We just need to get serious about the relatively small number of offenders who commit a disproportionate share of the crimes. Police say they know who they are because they see them every day.

Our shared affliction | Dec. 25, 2006

It's important to remember, though, that the denizens of skid row represent just a fraction of the county's homeless population. Recognizing this, county supervisors dedicated an unprecedented $100 million from the general fund to combat homelessness. The money will be used for such projects as a community court in Santa Monica to steer homeless people into treatment programs instead of jails. But to make a long-term dent in the problem, the region needs more affordable housing -- in particular, "supportive housing" that combines apartments with social services for the chronically homeless. About 40% of the county's homeless fall into that category.

Skid row sanity | Oct. 12, 2007

The U.S. 9th Circuit Court of Appeals struck down the city's policing of the homeless in the first place because it is both cruel and preposterous to arrest someone for sleeping outside when that person has nowhere else to sleep. The settlement provides no deadline for completing those 1,250 units, and city officials have the option of simply accepting the long-term non-enforcement of the sidewalk ban if supportive housing falls off the city's priority list.

It's not part of the agreement, but City Council President Eric Garcetti stuck his neck out and said those units will be completed within three years. That's an important commitment because it keeps the city on track toward housing its homeless as a long-term solution.

Los Angeles cannot tolerate hundreds and thousands of people living on its streets -- for the welfare of the homeless and that of the rest of the city.

A foundation, at least | Oct. 01, 2008

It is easy -- too easy -- to be underwhelmed by the housing plan released this week by Mayor Antonio Villaraigosa. Much of it we have seen before: streamline the development process, encourage denser housing near transit stops, build permanent supportive housing to get the chronically homeless off the streets. Great ideas, if only they would be fully implemented. Even controversial elements such as "mixed-income housing" -- a mandate that all new developments include "affordable" units -- come with few particulars and leave the nuts-and-bolts discussions for later.

But the mayor's "Housing That Works" is one of those few programs that are more revealing from a distance than in the details. It represents the first time that Los Angeles has pooled its many housing programs and funds, analyzed them and produced a comprehensive, if still sketchy, plan for making the most of its resources.

Solving homelessness will require cooperation | Nov. 09, 2010

The most obvious challenge will be freeing about $230 million annually to provide permanent supportive housing for all the chronically homeless over the next five years. Just as big a hurdle, though, could be the lack of coordination among the many layers of government and the private and nonprofit service providers that play a role in combating homelessness. Cooperation has been improving, yet the task force will still have to sell its plan to multiple factions that don't always see eye to eye on the nature of the problem, let alone the solution. Here's hoping that the clarity and ambition provided by the plan doesn't get lost in the struggle to implement it.

Homeless vets deserve more | June 09, 2011

Veterans are 50% more likely to become homeless than the average American, and homeless vets account for nearly 20% of the people living on the streets and in shelters in L.A. […]The VA and its allies say they're making slow but measurable progress toward eliminating homelessness among veterans by 2014. Some homeless advocates also say the department now recognizes the importance of providing housing and services in combination for the most severely disabled vets. Still, the Los Angeles VA's most touted supportive housing program is a collaborative effort aimed at the city's 60 most vulnerable homeless vets, a tiny fraction of the total.

RELATED:

Full coverage: Will and Kate's L.A. visit

Takin' a royal ride: William and Kate, floor it!

-- Alexandra Le Tellier

Photos: Prince William and Princess Kate, the Duke and Duchess of Cambridge, arrive at Los Angeles International Airport for a three day visit, Friday July 8, 2011. Credit: Brian van der Brug / Los Angeles Times. Bottom: Church volunteers from Riverside greet Pops, a blind homeless man who lives along Sixth Street in downtown Los Angeles. Credit: Luis Sinco / Los Angeles Times

surface encounters reviews url

Friday, July 29, 2011

Making Money System

No comments:

Post a Comment

Followers

Blog Archive

About Me