Kings, dogs and Burwells: The latest policy posts from the Health Wonk Review #HWR

BHN is hosting this week’s round-up. In anticipation of the King v. Burwell decision, we offer kings and Burwells. The content of the images is not meant as a BHN endorsement for either position. Same goes for the opinions in these posts. Some say the ruling may come down today, others bet on 6/29. SCOTUS Blog is the site to watch. (For actual posts on the pending decision, see the 6/3 edition.)

Finally, our thoughts are with the members of Emanuel African Methodist Episcopal Church and the staff at one more hospital that had to brace for victims of a mass shooting.

The posts:

By Roland Godefroy

Joseph Paduda at Managed Care Matters writes: Health care cost drivers; or, here’s where you’re getting screwed. Two studies published in Health Affairs shed much light on hospital costs and the societal implications of physician practice consolidation. Both are a bit scary.
A post from Health Affairs analyzes the major elements of the final rule recent Medicare Shared Savings Program Final Rule.Lawrence Kocot, of Ross White,
HHS photo

and Mark McClellan at KPMG offer alternatives for CMS and the possible future of the program
From David Willams at the Health Business Blog notes: Long term care insurance -narrow framing is not the problem. Why don’t people buy long term care insurance? Because for many it’s not a good value
David Harlow at the HealthBlawg: Outsourced Chronic Care Management Service s Can Help Physicians and Patients. I wrote this post with a client about Chronic Care Management, a newly-reimbursable service under Medicare as of January 2015, and a service that is specifically non-face-to-face. The federales are dedicating significant funds to this service based on the belief that it will reduce expenditures on other services for multiply-chronically-ill elders.
From Boston Health News, links to stories on telemedicine and hospitals as step-down units.
From Roy Poses at Health Care Renewal: Health Care Professional Societies Whose Lead ership Betrays Their Own Members – the APA Alleged to Have Supported Torture, and Deceived its Members to Collect Money. Health care professionals need to be extremely skeptical of the leadership and governance of all health care organizations. True health care reform requires organizational leaders who understand the health care system, uphold its values, and are willing to be accountable.
Tom Lynch of Workers Comp Insider offers “the word of the week: horrendoma. That’s a description he applies to the healthcare system after looking at billed vs paid hospital data and the concept of charges as a “starting point.” See his post: Hospital Medicare Charges: You Don’t Always Get What You Want.
By Metro-Goldwyn-Mayer, Inc.
Henry Stern at InsureBlog asks “What carrier in its right mind would cover” sex change surgery? Transjenner Insurance: In case you were wondering: Yes, ObamaPlans *do* cover sex-changes. InsureBlog has the, er, straight scoop.
From Health System Ed: Decrying the End of Private Physician Practice? Not so fast! Experts have been saying that the private physician practice is no longer sustainable under managed care but then along comes ACOs and perhaps that tune is changing when the focus turns from volume to outcomes.
This Health Affairs post focuses specifically on the provisions of the rule dealing with benchmarking and distribution of shared savings and losses and suggests that CMS consider the possibility of graduated rates of sharing savings and loss distribution.y Carrie Colla, Scott Heiser, Emily Tierney, and Elliott Fisher at Dartmouth
Finally, Brad Wright asks : T his Father’s Day, Give 1 For Dad
In honor of his father, he’s donating to “Give 1 For Dad campaign to fund an important clinical trial for prostate cancer at the Duke Cancer Institute. At issue is that the treatment uses a safe generic drug, which is great because it isn’t toxic like other current treatments, but not so great because no major pharmaceutical companies are willing to fund a clinical trial of a generic drug.”