NN&I - May 2010
Health Care Beat 22 Nephrology News & Issues May 2010www.nephronline.com Presented by:Vascular Access Management in the U.S. Date: Wednesday, May 19 Time: 3 pm EDT Register today at www.nephronline.com/webinarSPONSORED BY:Join us from your of\037ce or home for a free webinar Optimal vascular access is an ongoing challenge for dialysis care professionals. In this one-hour presentation, we identify the problems created by inadequate access care, and ask experts in the \037eld to offer new strategies for improving access management. Current Challenges and the Potential for Improvement webinar ad.indd 1 4/13/10 10:35:58 AM [ HEALTH CARE BEAT , continued from page 16 ]no longer serve new Medicaid patients as of April 15. The other half of the 32 million plus an estimated 9 million people covered by existing private plans will wind up buying private insurance through new exchanges set up in every state, accord-ing to the Congressional Budget Office analysis. Besides serving as a clear -ing house where individuals and firms can purchase policies deemed to have adequate coverage under the new law, the exchanges will be required to police new regulations. But most people without coverage who use the exchanges will need sub-sidies, since the average family health insurance policy now exceeds $13,000 a year, while two-thirds of the unin-sured earn less than twice the nation's poverty rate, according to the Kaiser Family Foundation. Thus, by the time the bill is fully in effect in 2019, the government will be spending an addi -tional $212 billion a year for expand-ing Medicaid and subsidizing private insurance for families who work at jobs without coverage. About $400 billion of the $940 billion 10-year price tag on the bill will come from tax increases, primarily on upper income households. But the admin-istration's assumption, confirmed by CBO, is that efficiencies in Medicare will pay for the rest. The CBO analysis showed the federal deficit will actually decrease by more than $130 billion over the bill's first decade. Some savings like the gradual elimination of sweet -ener payments for Medicare Advantage programswill be easily achieved. But cuts to the Medicare program may be problematic. Physicians put up a bat -tle each year to protect their income (see National News, page 11). Congress has been delaying a permanent fix to the sustainable growth rate formula which regulates Medicare physician paymentsand each year, they make a last-minute rescue so physicians don't see a pay cut (this year it would have been 21.5%). Congress now has until May 31 to find a permanent fix or patch it once again. But with pressure from the new health care bill to shave Medicare costs, will they cover the cuts next time? For the renal community, the new health care reform bill came without a House proposal for lifetime immu-nosuppressive drug coverage, a dis-appointment for the transplant com -munity. Advocates are hopeful that it can still be funded later this year in a follow-up health care bill. Other provi-sions, carried over from the Senate ver -sion of the reform bill, include a study by the into the impact of adding Part D drugs to the forthcoming bundled pay-ment system for dialysis servicesa option now in the hands of CMS. Health care reform is not final. What happens next are the deals, the nego-tiations, the trade-offs. Let's hope renal care makes the grade. HCB_NNI0510_4.indd 22 4/19/10 4:19:45 PM
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