On Wednesday the Senate agreed to avoid planned steep cuts in Medicare pay for doctors by shifting money from the President's health care overhaul law to cover it. When passing the health care laws, Medicare cuts were used to pay for most of the cost and now lawmakers are reversing the money to delay the scheduled 25% cut to doctors, which would have begun January 1, 2011. This measure was important in stabilizing Medicare as an estimated two thirds of doctors were planning to stop taking new Medicare patients under this cut. This would also affect Tricare recipients, which covers military service members and their families as well as retirees. The $19 billion to pay doctors in 2011 will come from tightening the rules on tax credits in health care laws to prevent wasteful spending. Lawmakers will use the next year to come up with a way to pay doctors for quality care instead of quantity of tests and treatments. These doctor pay cuts are part of a 1990 budget-balancing law, which was an attempt to keep Medicare spending in line using automatic reductions. President Obama has said it is time for a permanent solution and not another temporary fix and he looks forward to working with Congress on this next year.
Fears of Possible Backlash to ACOs
Beginning in 2012 accountable care organizations (ACOs), which are groups of doctors and hospitals that coordinate efficient, quality care to Medicare patients, will be formed. This week the Medicare Payment Advisory Commission (MedPAC) warns that there might be a backlash in the ACO-assignment process, with beneficiaries feeling pushed into certain managed care without seeing any benefits in the change. In order to entice beneficiaries, they might need to offer incentives like reduced beneficiary cost sharing or sharing in the savings; as well as, offering the choice to switch from an assigned primary care provider to another not in the ACO program. Also, the American Medical Association said the government needs to make safe harbors from antitrust enforcement and anti-kickback laws as currently laws favor hospital-based systems with employed physicians as opposed to small physician practices.
Cold and Flu What Works and What Falls Short
As winter begins in the next few weeks, cold and flu season is out in full force, which puts a damper on our busy schedules. Emily Sohn and Rachel Johnson, Ph.D., M.P.H.'s research on what works and what falls short is good to keep in mind as your throat becomes itchy.
The first suggestion of what works is Vitamin D. Laboratory studies have indicated that Vitamin D may help your immune system to identify and destroy bacteria and viruses that can make us sick. However, the Institute of Medicine released a report on November 30th stating that Vitamin D is best for bone health and there is not yet enough evidence that improves immunity and reduces infection. Still, many experts recommend a vitamin D supplement or you can also get it from fatty fish, fortified milk, and from the sun. Another suggestion to try is green tea, which has potent plant antioxidants that gives it immune-boosting effects. Lab studies suggest that polyphenols called catechins may kill influenza viruses and to maximize the benefits you should use below-boiling water, steeping green tea no more than a couple of minutes, and adding only a little lemon or honey to help the bitterness (adding milk will bind the polphenols, making them no longer effective). Probiotics (or “good bacteria") have been shown to suppress the bad bacteria and activate the immune system when they reach the lower intestine. However, although the level probiotics boost the immune system is low, you can help by eating yogurts or kefir labeled with a "Live & Active Cultures" seal. The last suggestion is soluble fiber, which can help fight inflammation. Eating a lot of citrus fruits, apples, carrots, beans, and oats helped mice in a recent study from Brain, Behavior, and Immunity recover from a bacterial infection in half the time than the mice that ate a mixed fiber diet.
The two things that fall short are Airborn and Glaceau's Vitamine water "Defense." Airborn contains excess of 1667% of the daily recommended value of vitamin C. With the exception of smokers, pregnant women, breastfeeding women, and the elderly most people get enough of the nutrients (vitamins A, C, E, zinc, and selenium) in the supplement with the food we eat. Adding more to our diet is not always better; in fact, it can be ineffective. Additionally Glaceau's Vitamine water “Defense" claims to be formulated with the nutrients required for optimal functioning of the immune system; however, a 20-ounce bottle contains 150% of the daily recommended value of vitamin C. The bottle of water also has 125 calories.
Forethought Released in Texas
Effective December 10, 2010 Forethought is released in Texas - please see the Texas Rates and Application or call 1-800-998-7715 to get contracted.
Sources: KHN, The Associated Press, The Hill, EatingWell