Ruling Expected on Health Care Reform

There's much anticipation as the nation's highest court makes a decision on health care reform.

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Modest Health Care Spending Rise Expected for 2013: Report

TUESDAY, June 12 (HealthDay News) -- Health care spending in the United States from 2011 to 2013 is expected to grow 4 percent, which is slightly more than the historic low of 3.8 percent in 2009, government officials said Tuesday.

According to the experts at the U.S. Centers for Medicare and Medicaid Services (CMS), growth in health care spending by consumers remained sluggish in 2011 and that trend is expected to continue this year and next.

"We are expecting near-historic low growth in health spending for the first three years of our projection period," Sean Keehan, a senior economist in the CMS Office of the Actuary and lead author of the report, said during an early-afternoon press conference.

But in 2014, when all the facets of the Affordable Care Act go into effect, health care spending is expected to increase significantly, he added. "This is especially the case for prescription drugs and clinician clinical services," Keehan said.

"In addition, by 2021, the number of uninsured people is expected to be reduced by nearly 30 million," Keehan noted.

By 2021, health care spending is expected to be 19.6 percent of the gross domestic product (GDP), up from 17.9 percent in 2010, according to the report published online June 12 and in the July print edition of Health Affairs.

Despite the slow rate in health spending growth seen during the recession and beyond, in 2014 health spending growth is expected to pick up and accelerate to 7.4 percent. This increase is largely due to the expansion of the Affordable Care Act, which will make medical care accessible for many more people, according to the report.

In addition, from 2011 through 2021, health care spending is expected to grow an average of 5.7 percent a year, which is 0.9 percent faster than the expected yearly increase in gross domestic product over that time.

And by 2021, federal, state and local government health care spending is expected to account for almost 50 percent of national health expenditures. That's up from 46 percent in 2011, with federal spending accounting for some two-thirds of the total government share, the researchers reported.

These rising costs are being driven by more baby boomers enrolling in Medicare and more people taking advantage of Medicaid as its coverage is expanded under the Affordable Care Act. In addition, subsidizing people who buy their health care insurance through health insurance exchange plans will increase government's bottom line, the report authors noted.

"By the end of the projection period, higher income growth and the continuing shift of baby boomers into Medicare are expected to cause health spending to grow roughly 2 percentage points faster than overall economic growth, which is about the same differential experienced over the past 30 years," the study authors concluded.

Some factors that may make it necessary to update these projections include the slow growth of the economy and the upcoming U.S. Supreme Court ruling on the Affordable Care Act, which is expected this month.

"Like everyone else, we are waiting to see what the Supreme Court finds," Keehan said. "We don't have any plans to redo the projections immediately following the decision, but those plans could change depending on what the decision is."

More information

For more about health care spending, visit the Kaiser Family Foundation.

View the original article here

Modest Health Care Spending Rise Expected for 2013: Report

TUESDAY, June 12 (HealthDay News) -- Health care spending in the United States from 2011 to 2013 is expected to grow 4 percent, which is slightly more than the historic low of 3.8 percent in 2009, government officials said Tuesday.

According to the experts at the U.S. Centers for Medicare and Medicaid Services (CMS), growth in health care spending by consumers remained sluggish in 2011 and that trend is expected to continue this year and next.

"We are expecting near-historic low growth in health spending for the first three years of our projection period," Sean Keehan, a senior economist in the CMS Office of the Actuary and lead author of the report, said during an early-afternoon press conference.

But in 2014, when all the facets of the Affordable Care Act go into effect, health care spending is expected to increase significantly, he added. "This is especially the case for prescription drugs and clinician clinical services," Keehan said.

"In addition, by 2021, the number of uninsured people is expected to be reduced by nearly 30 million," Keehan noted.

By 2021, health care spending is expected to be 19.6 percent of the gross domestic product (GDP), up from 17.9 percent in 2010, according to the report published online June 12 and in the July print edition of Health Affairs.

Despite the slow rate in health spending growth seen during the recession and beyond, in 2014 health spending growth is expected to pick up and accelerate to 7.4 percent. This increase is largely due to the expansion of the Affordable Care Act, which will make medical care accessible for many more people, according to the report.

In addition, from 2011 through 2021, health care spending is expected to grow an average of 5.7 percent a year, which is 0.9 percent faster than the expected yearly increase in gross domestic product over that time.

And by 2021, federal, state and local government health care spending is expected to account for almost 50 percent of national health expenditures. That's up from 46 percent in 2011, with federal spending accounting for some two-thirds of the total government share, the researchers reported.

These rising costs are being driven by more baby boomers enrolling in Medicare and more people taking advantage of Medicaid as its coverage is expanded under the Affordable Care Act. In addition, subsidizing people who buy their health care insurance through health insurance exchange plans will increase government's bottom line, the report authors noted.

"By the end of the projection period, higher income growth and the continuing shift of baby boomers into Medicare are expected to cause health spending to grow roughly 2 percentage points faster than overall economic growth, which is about the same differential experienced over the past 30 years," the study authors concluded.

Some factors that may make it necessary to update these projections include the slow growth of the economy and the upcoming U.S. Supreme Court ruling on the Affordable Care Act, which is expected this month.

"Like everyone else, we are waiting to see what the Supreme Court finds," Keehan said. "We don't have any plans to redo the projections immediately following the decision, but those plans could change depending on what the decision is."

More information

For more about health care spending, visit the Kaiser Family Foundation.

View the original article here

Nurse practitioners look to fill gap with expected spike in demand for health services

“We know that the Affordable Care Act will extend health coverage to millions of Americans,” said Penny Kaye Jensen, president of the American Academy of Nurse Practitioners. “It’s important for consumers to understand what we do and that we’re fully prepared to care for them.”

Through advertisements, public service announcements and events, the organization will try to raise the profile of the country’s 155,000 nurse practitioners.

The campaign looks to exploit what many say is a looming doctor shortage. The Association of American Medical College predicts that the country will have 63,000 too few doctors as soon as 2015.

“With the serious shortage of family doctors in many parts of the country, nurse practitioners — or NPs as they are known — can provide expert, compassionate and affordable care,” the group will contend in a radio public service announcement.

The AANP will follow up on the public relations blitz with state-level lobbying efforts, looking to pass bills that will expand the range of medical procedures that their membership can perform.

“A fully enabled nurse practitioner workforce will increase access to quality health care, improve outcomes and make the health-care system more affordable for patients all across America,” ­Jensen said.

All states have “scope of practice” laws, which regulate what medical procedures each profession can, and cannot, perform, given their level of education. These laws regulate everyone from dental hygienists to physician assistants up to nurse practitioners, who all hold graduate degrees in medical education.

In 16 states, nurse practitioners can practice without the supervision of another professional such as a doctor. Other states, however, require a physician to sign off on a nurse practitioner’s prescriptions, for example, or diagnostic tests.

As the health insurance expansion looms, expanding those rules to other states has become a crucial priority for nurse practitioners. “We’re all educated and prepared to provide a full range of services,” said Taynin Kopanos, AANP’s director of state government affairs.

The nurse practitioners’ campaign, however, is unlikely to move forward without a fight: doctors’ groups have often opposed such efforts of other professional societies to expand their medical authorities. The American Medical Association, which lobbies for doctors, often contends that such laws could put patients at risk.

“Non-physician professionals play vital roles in providing high-quality patient care, but no other health-care professionals’ education and training comes close to physicians’ more than 10 years of medical education and 16,000 hours of clinical experience,” AMA President Peter Carmel said.

Legislative analysts at the AMA say they’ve seen an uptick in state legislation meant to increase the powers of other professionals since the Affordable Care Act passed. Legislators have introduced about 400 such bills this year.

Nurse practitioners say they do have the skills necessary to treat patients with more autonomy. Unlike other nurses, all nurse practitioners hold either a master’s or doctorate degree in medical education.

Alongside the legislative push, the group also will focus on public education. Data suggest that they have their work cut out for them: A 2010 AANP poll found that while most Americans report having been seen by a nurse practitioner, few knew that their medical expertise goes beyond that of traditional, registered nurses, who go through less medical training.

Fourteen percent of the adults surveyed thought that nurse practitioners could prescribe medication, although sometimes with a physician’s supervision, an authority they have in all states. They can also order diagnostic tests and scans, such as X-rays and MRIs, but only 18 percent thought such powers were within their scope of practice.

“People stop at the word nurse and don’t understand the word practitioner,” Jensen said. “Obviously we are nurses, but we also have advanced education. We think there’s a misunderstanding on the patients’ behalf.”

Jensen hopes to see her members out at health fairs, church groups, rotary clubs and other community events to get the word out about the work they do, and the role they hope to fill as health insurance coverage expands.

“I think I was surprised about patients knowing so little, even if they’ve seen us,” she said. “That really was the springboard for this campaign, that we need to be expanding our visibility.”

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