Healthcare groups seeking IPAB repeal

Originally designed as a board of impartial experts to oversee the health care system and develop recommendations regarding the procedures, medications and spending priorities for Medicare and Medicaid, criticism against the Independent Payment Advisory Board (IPAB) reached a new level last week, when  a robust cross-section of health care stakeholders signed a letter to members of Congress urging them to repeal the controversial cost-cutting IPAB panel established under health care reform

The IPAB, which will not make it's first recommendation until 2014, is under intense scrutiny by stakeholders  concerned with it's ability to make rational recommendations to payment methods and the belief that the IPAB might lead the way to rate setting for all payers.    As currently defined, any IPAB recommendations would take effect without Congressional approval,  and as such, removes elected officials from the decision making process when changes occur in the Medicare and Medicaid programs.

Proponents point out that Market forces alone cannot control health care costs and by implementing best practices and devising methods by which Medicare and Medicaid may provide better services at lower costs, the IPAB is an impartial process that will control skyrocketing costs and allow the Medicare and Medicaid programs to continue.  A three-fifths Senate vote could override any recommended payment cuts, and Congress could always increase Medicare funding through independent legislation.



The House Energy and Commerce Committee is planning a hearing on the panel in July. 

Medicare Data Will Become Publicly Available

On June 3rd, the Centers for Medicare and Medicaid Services (CMS) announced proposed rules that will give certain organizations access to Medicare data.  The proposed rule supports efforts of the health reform law to improve health care quality and lower costs. 

Currently, private insurance companies sometimes make quality assessments on physicians based on their own claims data.  While the goal of the reports was and is to identify hospitals and physicians with the highest quality and cost-effective care, providers can receive multiple and sometimes contradictory reports from a variety of insurers and are often unable to appeal or correct inaccuracies in those reports.

Because Medicare is the largest payer in the US health care system, it's claims data can make quality measures more accurate.  The proposed rule will allow certain organizations access to Medicare claims data and would offer a more accurate snapshot of the performance of physicians and hospitals by ensuring the organizations that crunch the data combine both private sector claims data with Medicare data.  These organization would be required to share the reports confidentially with the providers prior to their public release.  In this way, physicians will have an opportunity to review and work with the company to prevent mistakes in the reports.    Public reports will contain aggregated information only, and no individual patient data will be shared.

CMS will formally publish the rule in the June 8th Federal Register and accept public comment for 60 days.

AMA names James L. Madara MD, as top executive

The American Medical Association has announced it's new executive vice president and CEO.  Effective July 1, 2011, James L. Madara, MD will become the top executive of the AMA. He will replace Michael Maves, who announced last November that he would be stepping down.

Madara, a pathologist and gastroenterologist, has most recently served as senior adviser at Leavitt Partners, a health care consulting firm founded and chaired by former Health and Human Services Secretary Michael O. Leavitt.  He has also served as the CEO of the University of Chicago Medical Center and Chair of the Department of Pathology and Laboratory Medicine at Emory University School of Medicine in Atlanta.  Dr Madara has published more than 200 research papers. 

In a Thursday conference call with reporters, Madara, an 11-year AMA member, said he was "enthusiastic" about his new job and vowed to "refocus" the nation's largest, oldest physicians' organization on its "core mission" of promoting medicine and the public health.