Few New Doctors Choose Primary Care


Topics: Marketplace, Delivery of Care

Dec 05, 2012

Less than a quarter of new doctors are choosing primary care as their specialty, even after finishing residency programs focused on internal medicine, a new study reports.

Reuters: Most Internists Don’t Plan To Stay In Primary Care
Less than a quarter of new doctors finishing an internal medicine training program planned to become a primary care physician instead of a specialist, in a new study. That suggests fewer generalists will be entering the workforce, researchers said – possibly exacerbating the primary care doctor shortage in parts of the United States (Pittman, 12/4).

Medpage Today: Few IM Residents Headed For Primary Care
Even in residency programs focused on primary care training, most residents do not plan on pursuing a career in general internal medicine, opting instead to practice subspecialty medicine, a survey showed. Only 21.5 percent of third-year residents in categorical and primary care programs said they were going to go into general internal medicine, whereas 64.2 percent said they planned a subspecialty career, according to Colin West, MD, PhD, and Denise Dupras, MD, PhD, of the Mayo Clinic in Rochester, Minn. Although those in a primary care program were more likely than those in a categorical program to plan a career in general internal medicine (39.6 percent versus 19.9 percent; OR 2.76, 99 percent CI 2.35 to 3.23), the majority still opted for other career paths, the researchers reported in the Dec. 5 issue of the Journal of the American Medical Association (Neale, 12/4).

In the meantime, women and nurse practitioners are both becoming a larger part of the medical workforce —

The Wall Street Journal: Women Notch Progress
Women account for a third of the nation’s lawyers and doctors, a major shift from a generation ago when those professions were occupied almost exclusively by men, new Census figures show. Women’s share of jobs in the legal and medical fields climbed during the past decade even as their share of the overall workforce stalled at slightly less than half (Mitchell, 12/4).

Stateline: Nurse Practitioners Step In Where Doctors Are Scarce
Most people in this rural logging area have only one choice when they need medical care: the Central Virginia Community Health Center. On most days, at least 200 people show up at the center seeking treatment for maladies ranging from sore throats to depression to cavities. The health center typically has four doctors on duty, but the clinical director, Dr. Randall Bayshore, says his staff would never meet local demand if it weren’t for the two nurse practitioners who provide the same care, to the same number of patients, as the doctors. Buckingham County is one of roughly 5,800 U.S. communities, with about 55 million residents, that have a shortage of primary care physicians. In these places, many residents are forced to forgo regular checkups and treatment for chronic diseases such as hypertension and diabetes — harming their overall health (Vestal, 12/5).

This is part of Kaiser Health News‘ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

Cover of the first issue of Journal of the Ame...

Cover of the first issue of Journal of the American Medical Association. (Photo credit: Wikipedia)

Advertisements

Olive Garden’s Parent Company Lowers Earnings Estimate After Health Law Comments


Topics: Health Costs, Marketplace, Health Reform

Dec 05, 2012

Restaurant officials say that earlier statements about the costly effects of the health overhaul have contributed to a reduction in revenues.

Politico: Obamacare Press Hits Olive Garden
Harsh press coverage of how the Olive Garden and Red Lobster are implementing Obamacare depressed earnings, the restaurants’ owner says. The company offered a lower earnings estimate for fiscal year 2013 on Tuesday, citing in part the media’s reporting on the company’s handling of the new health care law. The chains’ owner, Darden, has in the past been outspoken about what it viewed as adverse effects of the new health care law, taking steps like moving some employees to part-time status to reduce costs (Glueck, 12/5).

Los Angeles Times: Olive Garden Parent Darden Suffers From Bad Specials, ‘Obamacare’
The Olive Garden, Red Lobster and LongHorn Steakhouse parent lowered its profit and revenue projections for the quarter ended Nov. 25, blaming sour promotions in its eateries, Superstorm Sandy, its purchase of the Yard House USA chain and even its efforts to mitigate the coming costs of health care reform, also known as “Obamacare” (Hsu, 12/4).

The Hill: Restaurant Chain Says Criticizing ‘ObamaCare‘ May Hurt Its Earnings
Darden is one of several large employers to consider rolling back workers’ hours in response to the Affordable Care Act. But the company said Tuesday that negative publicity surrounding that position might be bad for business. … The company said it would figure out how to make the new health care requirements work. After saying Darden’s brands are working to improve their products and marketing, (Darden CEO Clarence) Otis added that “we are also committed to accommodating health care reform in ways that work for our employees and guests” (Baker, 12/4).

This is part of Kaiser Health News‘ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

English: President Barack Obama, Vice Presiden...

English: President Barack Obama, Vice President Joe Biden, and senior staff, react in the Roosevelt Room of the White House, as the House passes the health care reform bill. (Photo credit: Wikipedia)

Government Announces Fraud Collections Hit Record $5 Billion


Seal of the United States Office of National D...

Seal of the United States Office of National Drug Control Policy, a part of the Executive Office of the President. (Photo credit: Wikipedia)

Topics: Health Costs, Marketplace, Medicare

Dec 05, 2012

A large portion of the money came from health care probes.

The Washington Post: Justice Dept. Recovers Record $5 Billion Under False Claims Act
The Justice Department’s civil division recovered a record $5 billion in the past fiscal year from companies that defrauded taxpayers, with much of the abuse occurring in the health care and mortgage industries (Finn, 12/4).

Modern Healthcare: Feds Collect Record $4.9 Billion Under False Claims Act
Led by the record-breaking legal settlement with drugmaker GlaxoSmithKline, federal collections through the civil False Claims Act exceeded all previous years, topping $4.9 billion in the fiscal year ended Sept. 30. The one-year tally by the Justice Department included settlements with mortgage lenders and military contractors, but the biggest single chunk — more than $3 billion — came from health care companies accused of defrauding Medicare and other government health care programs. Fiscal 2012 marked the first time that health care tallies topped $3 billion (Carlson, 12/4).

Meanwhile, federal authorities are watching for a surge in pain drugs from Canada —

The Wall Street Journal: U.S. On Alert For Canadian Drugs
The White House has alerted police and border agents to prepare for a possible influx of addictive pain drugs from Canada, where cheaper, generic versions of OxyContin will soon become available. U.S. drug czar Gil Kerlikowske also called Canada’s health minister last week to discuss the issue and offer assistance to address the wave of prescription-drug abuse sweeping both countries, Mr. Kerlikowske’s office said (Barrett, Catan and Vieira, 12/4).

This is part of Kaiser Health News‘ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

Official portrait of United States Director of...

Official portrait of United States Director of National Drug Policy Gil Kerlikowske. (Photo credit: Wikipedia)

States Continue Sorting Out Choices About Health Exchanges, Medicaid Expansion


Topics: States, Health Reform, Politics, Medicaid, Marketplace, Insurance

Dec 05, 2012

Kansas, South Dakota and Texas are among the states still making decisions — or reconsidering old ones — about the health law’s insurance exchanges and the Medicaid expansion.

Kansas Health Institute News: ACA Opponent Says Brownback Should Reconsider Stand On Insurance Exchange
Like Kansas Gov. Sam Brownback, Bob Laszewski is a staunch opponent of the Affordable Care Act. Despite that, the Washington, D.C. consultant said at a meeting here today that Brownback is making a mistake by refusing to partner with the federal government to run the Kansas health insurance purchasing exchange that the law requires to be operational by 2014. … Brownback last year blocked Kansas Insurance Commissioner Sandy Praeger‘s attempts to establish a state-operated exchange, returning a $31.5 million federal grant in the process. Last month, the governor told Praeger, who also is a Republican, that he would not support her efforts to partner with the federal government to operate and fund the Kansas exchange (McLean, 12/4).

Politico Pro: South Dakota Governor: ‘No’ On Expansion For Now
South Dakota Gov. Dennis Daugaard says the state won’t expand Medicaid for now — but he’s not ruling it out for the long term. Daugaard, a Republican, included no funding for the optional expansion in his proposed budget for fiscal year 2014, which he released Tuesday. But he said in an address to the state Legislature that expansion is not “a now-or-never decision” — and left the door open for an expansion or partial expansion in the future (Smith, 12/4).

The Texas Tribune: Interactive: Comparing State Medicaid Expansions
If Texas lawmakers decide to expand Medicaid, as called for in the federal Affordable Care Act, the spending, savings, enrollment growth and reduction in the number of uninsured residents are poised to be greater in Texas than in most other states. This interactive compares the expansion of Medicaid in each state using data from a report by the Kaiser Family Foundation, a nonpartisan health care think tank (Aaronson, 12/5).

In the meantime, Health and Human Services Secretary Kathleen Sebelius will meet with state lawmakers on health law implementation Wednesday —

Politico Pro: Sebelius To Meet With State Lawmakers On ACA
State legislators are scheduled to meet with HHS Secretary Kathleen Sebelius at the department headquarters Wednesday to discuss implementation of the health care law. Sebelius asked for the meeting with the members of the National Conference of State Legislatures‘ Federal Health Reform Implementation Task Force, who are in town for the group’s fall forum. She is scheduled to meet with the legislators for 30 minutes Wednesday afternoon. Joy Johnson Wilson, who directs health policy for NCSL, said she wants to hear Sebelius talk about state flexibility. That’s a message that governors stressed during a White House meeting with President Barack Obama on Tuesday (Millman, 12/4).

This is part of Kaiser Health News‘ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

Portrait of United States Health and Human Ser...

Portrait of United States Health and Human Services Secretary . (Photo credit: Wikipedia)

Studies Gauge Health Law’s Impact On Consumer Savings, Rx Drug Coverage


Topics: Supreme Court, Insurance, Marketplace, Health Reform, States

Dec 05, 2012

The Commonwealth Fund concluded that consumers saved $1.5 billion in 2011 as a result of a provision that limits how much insurers can spend on expenses not related to medical care. Meanwhile, Avalere Health found that drug coverage plans offered on health exchanges will vary by state.

Los Angeles Times: ‘Obamacare’ Saves Consumers Nearly $1.5 Billion
Consumers saved nearly $1.5 billion in 2011 as a result of rules in President Obama’s healthcare law that limit what insurance companies can spend on expenses unrelated to medical care, including profit, a new analysis shows. Much of those savings — an estimated $1.1 billion — came in rebates to consumers required because insurers had exceeded the required limits. The study by the New York-based Commonwealth Fund also suggests that the Affordable Care Act forced insurers to become more efficient by limiting their administrative expenses, a key goal of the 2010 law (Levey, 12/5).

Modern Healthcare: Reform Law Aiding Insurance Consumers: Report
A new report estimated insurance consumers benefited from $1.5 billion in either rebates or reduced costs last year, due to requirements of the healthcare overhaul. But insurers warned that money could have funded anti-fraud and quality-improvement programs. Research supported by the Commonwealth Fund, which backed the Patient Protection and Affordable Care Act, concluded that the law’s medical loss-ratio requirements implemented in 2011 provided big savings—mainly in the individual insurance market. Individual market policyholders had “substantially reduced premiums” due to the law’s requirement that insurers spend at least 80% of premium dollars on direct healthcare or quality-improvement activities, or else pay a rebate to their customers, according to the report (Daly, 12/5).

The Associated Press/Washington Post: Study: Prescription Drug Coverage Under Obama Health Care Law Could Vary Markedly By State
A new study says basic prescription drug coverage could vary dramatically from state to state under President Barack Obama’s health care overhaul. That’s because states get to set benefits for private health plans that will be offered starting in 2014 through new insurance exchanges (12/4).

The Hill: Analysis Finds Big State-By-State Swings In Prescription Coverage
President Obama’s signature healthcare law requires insurance plans to cover a range of prescription drugs, but the number of drugs covered will vary widely from state to state, according to a new analysis from Avalere Health. The Affordable Care Act requires plans to cover a set of “essential health benefits,” including prescription drugs. To prevent benefit mandates from driving up premiums, the Health and Human Services Department has said it will let states fill in most of the details about their essential-benefits packages (Baker, 12/4).

In other coverage related to the health overhaul –

MPR: Federal Health Care Law
The federal health care overhaul is here to stay after surviving an epic legal battle at the United States Supreme Court and the contentious 2012 elections. But that does not mean the massive law will remain intact, as enacted. Congress may be tempted to raid some of the Affordable Care Act’s funding as part of a deal to avert the collection of automatic tax hikes and spending cuts known as the “fiscal cliff.” The court battles are hardly over; legal challenges involving issues the Supreme Court did not address when it upheld the law in June, 2012, are already underway. But for the most part, key provisions, such as the individual mandate requiring most Americans to obtain health insurance, will take effect January 1, 2014 (Stawicki, 12/4).

This is part of Kaiser Health News‘ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

English: President Barack Obama's signature on...

English: President Barack Obama’s signature on the health insurance reform bill at the White House, March 23, 2010. The President signed the bill with 22 different pens. (Photo credit: Wikipedia)

Health Stocks Embraced Amid Market Uncertainty


English: A screengrab from President Barack Ob...

English: A screengrab from President Barack Obama’s first White House news conference. (Photo credit: Wikipedia)

Topics: Health Costs, Marketplace, Medicare, Medicaid

Dec 05, 2012

The Wall Street Journal reports that following President Barack Obama’s re-election, health stocks are viewed as a port in the storm. Other news outlets explore how the markets have remained stable during the ‘fiscal cliff’ negotiations as investors count on an eleventh-hour deal.

The Wall Street Journal: Health Stocks A Port In Market Storm
Some investors believe they have found a remedy for the volatile market: health-care stocks. Money managers are embracing the group following the Nov. 6 U.S. presidential election, which ensured that the health-care overhaul championed by President Barack Obama will survive. While the overhaul of the U.S. health-care system creates winners and losers within the industry, investors say the newfound certainty heightens health care’s overall allure (Jarzemsky and Kiernan, 12/4).

The Associated Press/New York Times: As Budget Talks Continue, Markets Change Little
Stocks closed little changed Tuesday on Wall Street as budget talks continued in Washington. … Investors are waiting for developments on the budget talks, which are aimed at avoiding the government spending cuts and tax increases that would begin to arrive Jan. 1 and could eventually cause a recession. … Republicans, led by Mr. Boehner, have balked at Mr. Obama’s proposal of $1.6 trillion in additional taxes over a decade, and called on Monday for increasing the Medicare eligibility age and lowering cost-of-living increases for Social Security benefits (12/4).

The Washington Post: ‘Fiscal Cliff’ Warnings Yet To Faze Wall Street
The markets’ sense of confidence — or, arguably, complacency — is rooted in two strains of thought. One is that all the tough talk from the negotiators is mere posturing, nothing more than a signal to their allies that they are taking a stand in advance of real dealmaking closer to the deadline. Investors and executives have repeatedly seen brinkmanship out of Washington — including over raising the cap on government borrowing in the summer of 2011 — conclude with an agreement at the last possible moment (Irwin, 12/4).

This is part of Kaiser Health News‘ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

Overlap In Competing Budget Proposals Points Way To Deal


English: President George W. Bush and Presiden...

English: President George W. Bush and President-elect Barack Obama meet in the Oval Office of the White House Monday, November 10, 2008. (Photo credit: Wikipedia)

Topics: Health Costs, Medicare, Medicaid, Politics, States

Dec 05, 2012

The Associated Press reports the White House and House Republicans have identified areas of significant overlap that could form the basis for an agreement after posturing gives way to actual bargaining.

The Wall Street Journal: GOP Deficit Plan Irks Conservatives
The conservatives’ attitude could nonetheless complicate Mr. Boehner’s mission as he strives to negotiate with a re-elected Democratic president without losing so many Republican votes that his leadership would be in peril. GOP leaders said the criticism underscores how much Mr. Boehner’s proposal was an attempt at compromise, while Mr. Obama’s proposal, which would raise $1.6 trillion in new taxes, was not (Bendavid and Lee, 12/4).

The Associated Press/Washington Post: Hot Rhetoric Aside, There’s Overlap In Competing Fiscal Offers That Could Form Basis Of A Deal
Both sides now concede that tax revenue and reductions in entitlement spending are essential elements of any deal. If the talks succeed, it probably will be because House Speaker John Boehner yields on raising tax rates for top earners and the White House bends on how to reduce spending on Medicare and accepts some changes in Social Security (12/4).

Los Angeles Times: Republicans Drop Ryan Budget Plan In ‘Fiscal Cliff’ Negotiations
The austere federal budget plan drafted by Rep. Paul D. Ryan and embraced by Republicans as a sweeping reimagining of government has hit a roadblock on the way to the so-called fiscal cliff. Top Republicans, including Ryan, insisted this was not the end of the plan and pledged to “support and advance” its principles. But by sidestepping the plan, the House leadership sidelined the push for a transformative overhaul of federal entitlements — a move that quickly sparked dissent from the party’s conservative wing (Mason and Mascaro, 12/5).

The Washington Post: Governors Urge Obama, Lawmakers To Avoid ‘Fiscal Cliff’
Although some federal programs especially key for states — notably Medicaid — are exempt, many other federal grants to states would be cut. The Pew report said 18 percent of federal grant money would be subjected to the automatic hit. That includes Title I funding, which covers education programs for the poor and the disabled, medical research money, and health and human resource programs (Fletcher and Helderman, 12/4).

Stateline: In Fiscal Cliff Talks, Governors Get White House Seat
A bipartisan group of governors has called on Washington to find a solution — any solution — to the nation’s budget woes as the federal government nears its so-called ‘fiscal cliff.’ “It’s not acceptable to have failure when it comes to the fiscal cliff,” said Utah Republican Governor Gary Herbert, following a meeting Tuesday (December 4) with President Obama and five other governors. “We need the good people on both sides of the aisle to come together.” The governors — three Republicans and three Democrats — said they left the White House meeting feeling “encouraged” that Obama would strike a deal with Congressional Republicans before December 31, the date that would trigger a series of spending cuts and tax hikes to deal with the federal deficit but that economists say would plunge the nation back into recession (Clark and Malewitz, 12/5).

CQ HealthBeat: Governors Want To Be Heard In Fiscal Cliff Fight
Democratic and Republican governors who met Tuesday with the president and congressional leaders said they want a seat at the table when negotiations occur on spending cuts and major changes in health programs that could upend their state budgets. The bipartisan National Governors Association gave few specifics in a conference call with reporters after their meeting with President Barack Obama. The governors were equally vague when they spoke to reporters at the White House after their meeting with the president. But the state leaders said they want to be sure they’re not shut out from the deal-making among the White House and congressional Republicans and Democrats (Norman, 12/4).

This is part of Kaiser Health News‘ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.