Medicare beneficiaries who have chosen to change their health and drug coverage for 2008 should experience very few difficulties when getting their covered prescription drugs through Medicare Part D, the Centers for Medicare and Medicaid Services (CMS) announced Dec. 28.CMS has improved procedures for getting accurate plan information into the E1 eligibility system--the computer system that pharmacists use to identify current plan enrollment--especially for beneficiaries who were reassigned to new plans, or who may not have received their new drug card. The agency also supports a point-of-sale facilitated enrollment process that provides immediate coverage for people with Medicare who have Medicaid or have qualified for extra help, but aren’t enrolled in a Medicare drug plan.Earlier this fall, CMS sent letters explaining steps beneficiaries could take to remain in their plan by paying a small premium and included a list of all the zero-premium plans available in their community. Read the press release.
The IRS has issued an updated version of Form 990, the return that charities and other tax-exempt organizations are required to file annually. The final form, released Dec. 20, retains the redesigned draft’s format of a core form and a series of schedules. In response to public comments, the new core form allows an organization to describe its exempt accomplishments and mission up front and provides more opportunities throughout the form for the organization to explain its activities. Other major changes were made to the form’s summary page, governance section, and various schedules, including those relating to executive compensation, related organizations, foreign activities, hospitals, noncash contributions, and tax-exempt bonds. A checklist of schedules was also added.
The new form, Return of Organization Exempt from Income Tax, will be used for the 2008 tax year (returns filed in 2009). The IRS plans to release the related instructions in early 2008.
HFMA worked with the IRS in redesigning the form to enhance transparency, promote tax compliance, and minimize the burden on the filing organization. In Schedule H of the new form, there is a reference to HFMA's Statement 15. Read the HFMA comment letter. Access more information on the new form.
Despite significant federal funding increases, community health centers (CHCs)--the backbone of the nation’s safety net--are struggling to meet rising demand for care, particularly for specialty medical, dental, and mental health services, according to a study released Dec. 19 by the Center for Studying Health System Change (HSC). The study’s findings are detailed in a new HSC issue brief, Community Health Centers Tackle Rising Demands and Expectations.
Since 2000, federal funding for federally qualified community health centers--key providers of preventive and primary care for underserved people--has doubled to nearly $2 billion annually in 2006, according to the Health Resources and Services Administration (HRSA). More than 16 million patients--primarily racial or ethnic minorities, low income, uninsured, or covered by Medicaid--received care at more than 1,100 federally qualified and look-alike health centers in 2006, up from just more than 10 million patients in 2001, according to HRSA.
Much of the recent federal investment has gone to build health centers in additional communities, while support for existing CHCs has not kept pace with operating expense increases and patient growth. At the same time, according to the HSC study, recruiting and retaining staff members in a competitive labor market has grown more difficult, and CHCs are facing other demands, including increased quality reporting expectations, addressing racial and ethnic disparities, and preparing for public health emergencies. Read the issue brief.
States have promised at least $2.73 trillion in pension, healthcare, and other retirement benefits for public employees over the next three decades, according to a report released Dec. 18 by The Pew Charitable Trusts’ Center on the States. Promises with a Price finds that states have saved enough to cover about 85 percent of their long-term pension costs, but only 3 percent of the funds needed for promised retiree health care and other nonpension benefits. All told, states already have set aside about $2 trillion to meet their long-term obligations. But they still need to come up with about $731 billion--a conservative figure that does not include all costs for teachers and local government employees.
However, a range of promising approaches are being used by an increasing number of states. For example, at least five states offer hybrid pension plans that combine elements of both defined benefit and defined contribution plans, and at least 13 states have set up irrevocable trusts to pay for retiree health care in years to come. Download the report.
Occasional bond payment defaults by not-for-profit hospitals are likely to continue in the coming decade, according to a special comment by Moody’s Investors Service. The agency reviewed sector performance of its rated institutions over the past 37 years and reports that, since 1970, the not-for-profit healthcare industry has had 17 Moody’s-rated defaults; 10 of those occurred between 1970 and 2000, while seven occurred in the past seven years, indicating modest acceleration in not-for-profit healthcare defaults.
According to Moody’s, defaults are largely due to structural weaknesses that correspond to six factors:* Excessive board/management emphasis on mission over margin, manifested typically in recurring operating losses and high reliance on investment income* Board failure to check management’s unfettered capital spending* Weak market share or failure to establish a clear niche in competitive markets* Inability to recruit physicians and attract volumes to replacement hospitals or new hospitals* Failure to plan for and react to weak local area economic conditions* Inflexible responses to cuts in Medicare, Medicaid, or disproportionate share funds
For more information, call (212) 553-1653.
Department of Health and Human Services (HHS) Secretary Mike Leavitt on Dec. 14 announced the approval of a Medicaid waiver that will allow the state of Indiana to implement an innovative healthcare proposal giving approximately 120,000 low-income, uninsured residents access to critical healthcare services. Through the waiver, the state will be able to begin accepting applications for the new healthcare coverage, called the Healthy Indiana Plan (HIP).
HIP was approved as a Medicaid Section 1115 demonstration project and will extend health insurance to low-income parents of children now covered by Medicaid and the State Children’s Health Insurance Program, as well as childless adults. Enrollment in the plan will give participants access to a high-deductible health plan that includes an account patterned on the model of a health savings account. Benefits will include physician services, prescription drugs, home health services, inpatient and outpatient hospital services, mental health and substance abuse treatment, and preventive services. Learn more about the plan.
If implemented along with universal health insurance, a combination of selected federal policy options could save $1.5 trillion in national health expenditures over 10 years, while also improving value in terms of access, quality, and healthcare outcomes, according to a report prepared for the Commonwealth Fund Commission on a High Performance Health System. In Bending the Curve: Options for Achieving Savings and Improving Value in U.S. Health Spending, the authors examine 15 federal policy options that have the potential to lower health spending relative to projected trends.
The report includes policies that would produce and use better information for healthcare decision making, promote health and enhance disease prevention, align financial incentives with quality and efficiency, and correct price signals in healthcare markets. Download the report.
Congress is on the verge of passing legislation mandating that health plans cover mental health and substance abuse treatment to the same extent that they cover other medical and surgical treatment. In a study published Dec. 18 on the Health Affairs web site, researchers say that passage of either the Senate or House version of this legislation would constitute a major improvement over the current 1996 Mental Health Parity Act, which guaranteed only equal annual and lifetime payment limits. However, the authors also warn that parity legislation could actually reduce access to mental health treatment for some patients if it does not facilitate treatment by providers outside insurers’ networks.
The version of parity legislation passed by the Senate would allow plans to vary the types of mental disorders covered under parity and to drop out-of-network mental health coverage altogether if they decide that offering such benefits is not in their best interest. In contrast, the parity bill moving through the House would require plans to cover all mental disorders and to cover out-of-network mental health treatment at the same levels as other out-of-network treatment. Read the abstract.
The Department of Health and Human Services (HHS) Office of Inspector General (OIG) semiannual report to Congress reported total FY07 savings and expected recoveries of $43 billion; $5 billion more than last year and more than double the savings and recoveries of just five years ago.
OIG’s FY07 $43.08 billion in savings encompasses $39 billion in implemented recommendations and other actions to put funds to better use; $1.9 billion in audit receivables, up from $789 million in FY06; and $2.18 billion in investigative receivables, an increase of $578 million from FY06.
Also for this reporting period, OIG reported exclusions of 3,308 individuals and entities for engaging in fraud or abuse with respect to federal healthcare programs and/or their beneficiaries; 447 criminal actions against individuals or entities that engaged in crimes against departmental programs; and 262 civil actions, which include False Claims Act and unjust enrichment suits filed in district court, Civil Monetary Penalties Law settlements, and administrative recoveries related to provider self-disclosure matters. Download the document.
The Center for Medicare and Medicaid Services (CMS) has announced updates to the Medicare deductible, coinsurance, and premium rates for 2008. The new rates are as follows:
2008 Part A (Hospital Insurance)• Deductible: $1,024• Coinsurance: $256/day for 61st-90th day• $512/day for 91st-150th day (lifetime reserve days)• $128/day for 21st-100th day (skilled nursing facility coinsurance)• Base premium (BP): $423/month• BP with 10 percent surcharge: $465.30/month• BP with 45 percent reduction: $233/month (for those who have 30-39 quarters of coverage)• BP with 45 percent reduction and 10 percent surcharge: $256.30/month
2008 Part B (Supplementary Medical Insurance)• Standard premium: $96.40/month• Deductible: $135/year• Coinsurance: 20 percent
The implementation date for these changes is Jan. 7, 2008.
At its meeting in Washington, D.C., in early December, the Medicare Payment Advisory Commission (MedPAC) focused in large part on its upcoming recommendations to Congress regarding provider payment updates. At its January 2008 meeting, MedPAC will finalize those recommendations for the different payment systems based on fiscal and calendar years 2009, which will be submitted to Congress in the commission’s March 2008 report.
The draft recommendations are the same as those formulated last year, including:
Download the December meeting transcript.
The Centers for Medicare and Medicaid Services (CMS), with the National Committee for Quality Assurance (NCQA), on Dec. 14 released for public comment a proposed set of structure and process measures for Medicare special needs plans (SNPs). The proposed measures will examine how SNPs set up case management programs for members with complex needs and how they act to improve clinical care and patient experience.
SNPs are one of the fastest growing health plan options available as part of Medicare Advantage. SNPs provide special clinical programs to help people with distinct healthcare needs, reducing the need for them to be hospitalized or placed in an institution. As of 2007, more than 470 SNPs are serving more than 1 million beneficiaries, and more than 760 SNPs will be available in 2008. Comments are due by Jan. 15, 2008. Access the CMS SNP web page.
In a Dec. 12 letter to the House, President Bush vetoed H.R. 3963, the Children’s Health Insurance Program Reauthorization Act of 2007. “Like its predecessor, H.R. 976,” said the letter, “this bill does not put poor children first and it moves our country’s healthcare system in the wrong direction. Ultimately, our nation’s goal should be to move children who have no health insurance to private coverage--not to move children who already have private health insurance to government coverage.”
The veto was not unexpected; Bush had vetoed similar legislation in October and had threatened to continue fighting the reauthorization bill because it “does not responsibly offset its new and unnecessary spending, and still raises taxes on working Americans.” Like its predecessor, the revised bill would have provided $35 billion in new funding over five years.
In related news, the House voted 385-27 yesterday to pass a continuing resolution funding SCHIP at FY07 levels through Dec. 21, because Congress has not yet passed most bills intended to fund federal programs for FY08, which began Oct. 1. Read the president’s letter.
In recent years, wealthy countries, multinational organizations, and philanthropies have increasingly mobilized to address global health issues such as the spread of HIV/AIDS and other diseases. To help inform these efforts, the Kaiser Family Foundation and the Pew Global Attitudes Project released findings Dec. 13 from their new report on a 47-country survey that provides information about how people around the world perceive and prioritize health in their countries and gauge the efforts of donor nations.
Preventing and treating HIV/AIDS is the top-rated health priority in the countries surveyed in sub-Saharan Africa and Asia. Fighting hunger and malnutrition is the top priority among countries surveyed in Latin America and the Middle East. And access to health care is seen as the top priority in Central/Eastern Europe.
Majorities in nearly every country surveyed say wealthier countries are not doing enough to help poorer nations with problems such as economic development, reducing poverty, and improving health. But among countries surveyed that were major recipients of development aid, people were more likely to say that wealthy nations are doing enough to help poorer nations. In addition, the survey shows substantial support among wealthier nations to do more to help poorer nations. Download the report.
The National Federation of Independent Business (NFIB), a national small-business association, on Dec. 12 laid out a plan to address the No. 1 issue plaguing small-business owners for more than two decades--access to high-quality, affordable health care. NFIB unveiled its “small business principles for healthcare reform” and revealed details about research projects that will undergird the development of healthcare reform policies for small businesses.
The group calls for health care to be universal, private, affordable, unbiased, competitive, portable, transparent, efficient, evidence-based, and realistic. Read the document.
U.S. hospitals charged $873 billion in 2005--a nearly 90 percent increase from the $462 billion charged in 1997--according to the most recent News and Numbers from the Agency for Healthcare Research and Quality (AHRQ). The average yearly rate of increase over the past several years in the national hospital bill was 4.5 percent. At this rate, researchers estimate that the annual national hospital bill may reach $1 trillion by 2008.
Among other facts, the AHRQ study also found that one fifth of the national hospital bill was for treatment of just five conditions--coronary artery disease ($46 billion), pregnancy and childbirth ($44 billion), newborn infant care ($35 billion), heart attack ($32 billion), and congestive heart failure ($30 billion).
This information is based on data included in the December 2007 AHRQ statistical brief The National Hospital Bill: Growth Trends and 2005 Update on the Most Expensive Conditions by Payer. The report uses statistics from the Nationwide Inpatient Sample, a database of hospital inpatient stays that is nationally representative of inpatient stays in all short-term, non-Federal hospitals. The data are drawn from hospitals that comprise 90 percent of all discharges in the United States and include all patients, regardless of insurance type, as well as the uninsured. Access the brief.
The North Carolina Healthcare Information and Communications Alliance, Inc., and the Workgroup for Electronic Data Interchange Timeline Initiative have announced the release of their first estimated timeline database addressing proposed healthcare standards, regulations, and other initiatives.
The timeline estimates that, based on current assumptions, implementation of the 5010 version of HIPAA transactions will be complete in 2014. The date is important because the ICD-10 clinical coding system cannot be used until 5010 transactions are implemented. Project management software is being used to identify the critical issues that affect the implementation of 5010 transactions and may provide opportunities to shorten the time frame for implementation. Access the Timeline Initiative.
In a memorandum issued Dec. 10, the Congressional Budget Office (CBO) estimates that the additional funding required to maintain the State Children’s Health Insurance Program at currently projected levels of enrollment for 2008 is an additional $1.4 billion; the net federal cost of providing that funding is estimated at $800 million in new money.
The estimate is based on the $5 billion in funding for 2008 that CBO assumes in its baseline projections, the amount of funding from previous years that remains available, and states’ projections of spending in 2008. (The memorandum explains that a continuing resolution provided funding at an annual level of $5 billion, but limited states’ use of the funds to the period ending Dec. 14, 2007.)
The CBO anticipates that, without additional funding, 21 states will exhaust their SCHIP funding in 2008, and that the first states to exhaust their funding will do so in March 2008. Read the memorandum.
The U.S. Department of Health and Human Services (HHS) and the State Food and Drug Administration (SFDA) of the People’s Republic of China yesterday signed a memorandum of agreement to enhance the safety of drugs, excipients, and medical devices exported to the United States from China. The agreement was signed in Beijing by HHS Secretary Mike Leavitt and SFDA Commissioner Shao Mingli.
Specifically, the two countries are establishing a bilateral mechanism to help ensure these imported products meet standards for safety and effectiveness by building quality into the process from the start. SFDA will require firms that manufacture certain products intended for export to the United States to register with SFDA. SFDA will also work toward a system that will enable it to certify that firms that manufacture products, and the products themselves, meet HHS/Food and Drug Administration requirements.
Among the drugs covered by the agreement are certain antibiotics, human growth hormone, glycerin, glucose test strips, and condoms. Read the press release.
The widely held vision of achieving electronic clinical data exchange across the United States is far from a reality with few organizations facilitating such exchange and many failing in the process, says a new web exclusive study by Harvard researchers published today by Health Affairs.
The study, based on a 2007 survey of 145 regional health information organizations (RHIOs), is a comprehensive assessment of the state of electronic health data exchange--hailed at one time as the key to improving the quality, efficiency, and coordination of care. However, at the time the survey was conducted, nearly one-quarter of the 145 RHIOs were defunct. Only 20 initiatives were deemed to be of at least modest size and exchanging some clinical data. Five of those RHIOs exchanged data for a specific population; only 15 RHIOs exchanged clinical data across a range of patient populations.
“If we want RHIOs to attain the vision of comprehensive health information exchange, we need to increase our investments in them,” said lead study author Julia Adler-Milstein, a doctoral candidate in health policy at Harvard University. “Otherwise, many of these RHIOs will be unable to sustain themselves under the current market-oriented approach.” Read the abstract.
Disease management programs that help guide the care of patients with chronic health problems appear to improve the quality of health care, but there is little evidence that such efforts actually save money, according to a study issued Dec. 10 by the RAND Corporation.
The RAND Health study reviewed all past research on disease management programs, which seek to help patients with conditions such as diabetes and congestive heart failure by offering a system of coordinated healthcare interventions. These interventions can range from prerecorded telephone reminders to home visits by medical professionals.
Researchers selected 29 evaluations, systemic reviews, and meta-analyses to focus on, covering 317 unique studies. That review found consistent evidence that these programs can improve healthcare quality, improve disease control, and, in the case of patients with congestive heart failure, reduce hospital admission rates. But patients with depression who were enrolled in disease management programs were more likely to use outpatient care and prescription drugs, increasing costs. There also is little evidence about whether these programs improve health outcomes over the long term.
The study report, “Evidence for the Effect of Disease Management: Is $1 Billion a Year a Good Investment?” will appear in the December issue of The American Journal of Managed Care. Read the abstract.
Among the resources are a new chartpack with findings from a public opinion poll, Views about the Quality of Long-Term Care Services in the United States, which finds that 68 percent of the public have an immediate family member or someone they know well receiving care as a nursing home resident, at home, or in another type of facility; 64 percent say there is not enough government regulation of nursing home quality. The nationally representative survey, with 1,032 adults including 326 adults ages 65 and older, was conducted via telephone interviews in October 2007.
The foundation also released a short film, “Nursing Home Reform: Then and Now,” that examines the history surrounding the landmark law, including the state of nursing home care before the law, an overview of the legislative process that brought about the law, and recent developments in nursing home quality.
Finally, a new report, Nursing Home Care Quality: Twenty Years After the Omnibus Budget Reconciliation Act of 1987, was also released. The brief explains the key provisions of OBRA ’87 related to nursing home care and examines the progress and problems in quality assurance in nursing homes over the past 20 years. Access the resources.
Although states experienced stable finances in 2007, overall revenue growth has slowed and tighter fiscal conditions are expected in 2008, according to the National Governors Association (NGA) and the National Association of State Budget Officers (NASBO).
In a report released Dec. 5, The Fiscal Survey of States, NGA and NASBO found that although most states experienced healthy revenue growth during FY07, some states already have seen significant deterioration of their fiscal conditions and expect revenue and expenditure growth to slow significantly in FY08. States expect continued expenditure pressures from a variety of sources, including increased funding demands related to health care and Medicaid and to long-term challenges such as demographic shifts, employee pensions, and infrastructure.
States’ single largest expenditure for FY07 was health care, which accounts for nearly one-third of total state spending. Medicaid alone makes up about 22 percent of total state spending, and with a projected spending growth rate of 8 percent annually for the next decade, the program will continue to strain state budgets. Meanwhile, states face significant challenges in funding and providing health care in FY08, including expanding the State Children’s Health Insurance Program to reduce the number of uninsured children in their states, reductions at the federal level for public and other health programs, and the impact of the aging population on long-term care financing. Download the report.
The AARP Foundation and the Robert Wood Johnson Foundation on Dec. 5 announced the launch of the Center to Champion Nursing in America--a joint initiative undertaken to address the growing nurse shortage.
The center is intended to serve as a focal point for advocacy and educational efforts working toward affordable, high-quality health care. The center will advocate at the state and national level for greater funding to support expanded nursing education programs and to prepare more nursing faculty, and for a more prominent role for nursing leaders. In particular, the Center will press for more nurse leaders on the governing boards of hospitals and other healthcare institutions to provide critically needed practical perspective on improving the safety and quality of care. Read the announcement.
Health Level Seven, Inc. (HL7), America’s Health Insurance Plans (AHIP), and the Blue Cross and Blue Shield Association (BCBSA) on Dec. 4 announced they have signed a memorandum of understanding to create a collaborative process for the maintenance of portability standards for personal health records (PHR).
The memorandum expands the number of stakeholders involved in the standards development process to help facilitate data portability between health insurance plans to give plan members the ability to move their personal health data when their health coverage changes.
HL7 formed a PHR working group in early 2005 to develop a set of functions present in a PHR system and guidelines that facilitate health information exchange among different PHR systems and between PHR and EHR systems. In early 2008, HL7 intends to publish a PHR-S functional model draft standard for trial use version to allow the industry to work with a stable standard for up to two years while it is being refined into an ANSI-accredited version. Read the press release.
The Financial Accounting Standards Board (FASB) on Dec. 5 issued FASB Statements No. 141 (revised 2007), Business Combinations, and No. 160, Noncontrolling Interests in Consolidated Financial Statements. Effective for fiscal years beginning after Dec. 15, 2008, the standards will improve, simplify, and converge internationally the accounting for business combinations and the reporting of noncontrolling interests in consolidated financial statements.
Statement 141(R) improves reporting by creating greater consistency in the accounting and financial reporting of business combinations, resulting in more complete, comparable, and relevant information for investors and other users of financial statements. Statement 160 improves the relevance, comparability, and transparency of financial information provided to investors by requiring all entities to report noncontrolling (minority) interests in subsidiaries in the same way--as equity in the consolidated financial statements. Moreover, Statement 160 eliminates the diversity that currently exists in accounting for transactions between an entity and noncontrolling interests by requiring they be treated as equity transactions. Read the press release.
A new study finds that U.S. physicians overwhelmingly believe that incompetence and mistakes among peers should be reported. However, when face to face with these problems, nearly one-half fail to do just that, which can have harmful and even fatal consequences.
A survey of more than 1,600 physicians by the Institute on Medicine as a Profession, published in the Dec. 4 issue of the Annals of Internal Medicine, shows that 45 percent of those surveyed with direct knowledge of impaired or incompetent colleagues in their practice did not always report them. Forty-six percent of physicians who knew of a serious medical error did not report it to authorities at least once, says the report, "Professionalism Among Physicians: Results of a National Survey."
"There is a measurable disconnect between what physicians say they think is the right thing to do and what they actually do," says lead author Eric Campbell, PhD, associate professor at Massachusetts General Hospital’s Institute for Health Policy and Harvard Medical School. "This raises serious questions about the ability of the medical profession to regulate itself."
The researchers surveyed 1,662 physicians from six specialties (cardiology, anesthesiology, family practice, surgery, internal medicine, and pediatrics) between November 2003 and June 2004. They reported other areas where individual physician behavior is at odds with what they believe is best for patients and the profession, including ordering unnecessary medical tests, managing conflicts of interest, and informing patients about conflicts of interest. Access the chartbook.
With key technical standards now in place, the time has arrived for the federal government to start using its buying power to promote the adoption of health IT, says Health and Human Services Secretary Michael O. Leavitt in a Health Affairs web exclusive interview published Dec. 4.
In a conversation with Leonard Schaeffer, founding chairman and CEO, WellPoint Inc., and former administrator of HCFA (now the Centers for Medicare and Medicaid Services), Leavitt says that the Bush administration opted for setting standards through "a hard, collaborative process" using the American Health Information Community, a federal advisory panel with both public and private representation.
But once interoperability standards are developed, "the second job is to get adoption," Leavitt says. "At some point in time, the federal government needs to say, ‘If you’re going to do business with us, you will adopt a system of your choice that will allow these standards to be met’." Leavitt cautions, however, "We can’t just go out and by fiat say, ‘By Jan. 1, 2010, everyone must have . . . ,’ because we’re talking about a huge sociological change. Not just in systems, but in the way clinicians practice and the way people are accustomed to dealing with each other--interfacing." Read the interview.
In today’s Federal Register, the Centers for Medicare and Medicaid Services (CMS) clarifies the Medicaid definition of “covered case management” and “targeted case management” (TCM) services with an interim final rule with comment period. According to the rule, case management consists of services which help beneficiaries gain access to needed medical, social, educational, and other services; “targeted” case management services are those aimed specifically at special groups of enrollees such as those with developmental disabilities or chronic mental illness.
Widespread improper billing by states of the Medicaid program for services mandated by other programs helped prompt Congress to address the problem in the Deficit Reduction Act, which redefined the scope of allowable case management services, strengthened state accountability, and required that CMS issue regulations. In one investigation of TCM claims, the Government Accountability Office (GAO) found that inappropriate billing to Medicaid generated an estimated $12 million in extra federal funds to Georgia and $68 million in extra federal funds to Massachusetts from 2000 to 2004.
The proposed clarifications are expected to save the program $1.2 billion over the next five years. Public comments will be accepted through the close of business on Feb. 4, 2008. The provisions of the interim final rule will become effective on March 3, 2008. Download the interim final rule.
The IRS on Nov. 30 released the fall 2007 issue of the Statistics of Income Bulletin, featuring data from 134.4 million individual income tax returns filed for tax year 2005. U.S. taxpayers reported $7.4 trillion of adjusted gross income less deficit in tax year 2005, up 9.3 percent from tax year 2004 when 132.2 million returns were filed.
In addition to the income statistics, which may be helpful in employee benefit program administration, provider organizations may also find the following information useful:* The number of private foundations that filed Form 990-PF remained nearly the same between tax years 2003 and 2004, while the number of nonexempt charitable trusts treated as private foundations that filed the return increased by 12 percent. In tax year 2004, private foundations distributed $27.6 billion in contributions, gifts, grants, and other outlays for charitable purposes, while nonexempt charitable trusts distributed $314 million.* For tax year 2004, nonprofit charitable organizations exempt from income tax under Internal Revenue Code Section 501(c)(3) filed more than 276,000 information returns, an increase of 5 percent from 2003. These organizations held more than $2.0 trillion in assets, a real increase of 5 percent from the previous year and 52 percent over the past decade. Read the press release.
The IRS on Nov. 27 issued the 2008 optional standard mileage rates used to calculate the deductible costs of operating an automobile for business, charitable, medical or moving purposes. Beginning Jan. 1, 2008, the standard mileage rates for the use of a car (including vans, pickups or panel trucks) will be:• Driven for business: 50.5 cents per mile• Driven for medical or moving purposes: 19 cents per mile• Driven in service of charitable organizations: 14 cents per mile
The new rate for business miles compares to a rate of 48.5 cents per mile for 2007. The new rate for medical and moving purposes compares to 20 cents in 2007. The rate for miles driven in service of charitable organizations has remained the same. Read the press release.
Because differences exist between individual tumors within each cancer type, it may be more important to design carefully tailored combinations of therapies for different patients than to determine pricing structures, say three oncologists in interviews published Nov. 27 on the Health Affairs web site.
Although promising new treatments targeted at molecules produced in particular tumors can extend lives while avoiding some of the debilitating side effects that have characterized traditional cancer drugs, they also carry a very high price tag. How can the drug and insurance industries work with the health policy community to establish ground rules for protecting innovation and advancing patient care, while also keeping the economics of health care firmly in mind?
These questions are among the issues raised by Health Affairs contributing editor Barbara Culliton, who spoke with Lee Newcomer, MD, an oncologist who is the business leader of oncology services at UnitedHealthcare in Minneapolis; Thomas Roberts, MD, a former Harvard oncologist who is currently a hedge fund manager for Noonday Global Management in Charlotte, N.C.; and Victor Velculescu, MD, an assistant professor of oncology and director of the Cancer Genetics Library at the Johns Hopkins School of Medicine in Baltimore.
The interviews suggest one possible approach toward reconciling innovation and affordability: Direct each new drug to only those patients whose tumors contain the specific molecules likely to make them amenable to the treatment. For some new treatments, such as the breast cancer drug Herceptin, diagnostic tests already exist that can steer the drug to the patients most likely to benefit; for other treatments, more research will be needed to develop such tests. Access the interviews.
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