Frances Correa

Obesity makes it even less likely that a patient with arthritis is going to exercise, according to findings from two surveys conducted by the Centers for Disease Control and Prevention.

Arthritis is a common comorbidity of obesity. Approximately one-third (35.6%) of adults with self-reported obesity were also affected by physician-diagnosed arthritis, judging from the combined results of the surveys, which were performed in 2007 and 2009.

The combination of arthritis and obesity resulted in a more sedentary lifestyle: 22.7% of obese adults with arthritis were physically inactive, compared with 16.1% with arthritis alone, 13.5% with obesity alone, and 9.4% with neither condition (MMWR 2011;60:614–8).

The state-based, random-digit–dialed telephone survey included a total of 789,460 adults from 50 states, the District of Columbia, Puerto Rico, Guam, and the Virgin Islands. These surveys are part of a series conducted by the CDC to examine the affects of arthritis and comorbid conditions. Previous studies looked at arthritis comorbidity with diabetes and heart disease. CDC researcher Kamil Barbour, Ph.D., said in an interview that results show that patients with chronic conditions are less likely to be physically active if they also have arthritis.

In an editor's note, the CDC report observed: “Arthritis and obesity are common chronic conditions affecting an estimated 50 million and 72 million U.S. adults, respectively. The findings in this report indicate that these conditions co-occur commonly (one in three adults with obesity also has arthritis) and might hinder the management of both conditions by limiting physical activity. Among adults with both obesity and arthritis, the adjusted likelihood of physical inactivity was 44% higher compared with that of adults with obesity but without arthritis; all state-specific estimates were consistent with these results. These findings suggest that among many persons with obesity, arthritis might be an additional barrier to physical activity.”

Dr. Barbour said that numerous barriers involved in arthritis can hinder people's ability to be active, beyond just being obese. The findings of these surveys should encourage doctors to consider the patient's full range of difficulties when making recommendations to engage in exercise, he added.

“We want to make [physicians] aware that they should look beyond obesity and any of the current conditions that [patients] may have, and look at the arthritis-specific barriers and kind of tailor their interventions toward addressing these [barriers].”

Dr. Barbour said the CDC will be using this information to augment community physical activity programs through the CDC Arthritis Program. The programs include EnhanceFitness, the Arthritis Foundation Exercise Program, and the Arthritis Foundation Walk With Ease programs, as well as self-management education programs.

Dr. Barbour and the other researchers who conducted and reported the study all work for the CDC.

Obesity makes it even less likely that a patient with arthritis is going to exercise, according to findings from two surveys conducted by the Centers for Disease Control and Prevention.

Arthritis is a common comorbidity of obesity. Approximately one-third (35.6%) of adults with self-reported obesity were also affected by physician-diagnosed arthritis, judging from the combined results of the surveys, which were performed in 2007 and 2009.

The combination of arthritis and obesity resulted in a more sedentary lifestyle: 22.7% of obese adults with arthritis were physically inactive, compared with 16.1% with arthritis alone, 13.5% with obesity alone, and 9.4% with neither condition (MMWR 2011;60:614–8).

The state-based, random-digit–dialed telephone survey included a total of 789,460 adults from 50 states, the District of Columbia, Puerto Rico, Guam, and the Virgin Islands. These surveys are part of a series conducted by the CDC to examine the affects of arthritis and comorbid conditions. Previous studies looked at arthritis comorbidity with diabetes and heart disease. CDC researcher Kamil Barbour, Ph.D., said in an interview that results show that patients with chronic conditions are less likely to be physically active if they also have arthritis.

In an editor's note, the CDC report observed: “Arthritis and obesity are common chronic conditions affecting an estimated 50 million and 72 million U.S. adults, respectively. The findings in this report indicate that these conditions co-occur commonly (one in three adults with obesity also has arthritis) and might hinder the management of both conditions by limiting physical activity. Among adults with both obesity and arthritis, the adjusted likelihood of physical inactivity was 44% higher compared with that of adults with obesity but without arthritis; all state-specific estimates were consistent with these results. These findings suggest that among many persons with obesity, arthritis might be an additional barrier to physical activity.”

Dr. Barbour said that numerous barriers involved in arthritis can hinder people's ability to be active, beyond just being obese. The findings of these surveys should encourage doctors to consider the patient's full range of difficulties when making recommendations to engage in exercise, he added.

“We want to make [physicians] aware that they should look beyond obesity and any of the current conditions that [patients] may have, and look at the arthritis-specific barriers and kind of tailor their interventions toward addressing these [barriers].”

Dr. Barbour said the CDC will be using this information to augment community physical activity programs through the CDC Arthritis Program. The programs include EnhanceFitness, the Arthritis Foundation Exercise Program, and the Arthritis Foundation Walk With Ease programs, as well as self-management education programs.

Dr. Barbour and the other researchers who conducted and reported the study all work for the CDC.

Obesity makes it even less likely that a patient with arthritis is going to exercise, according to findings from two surveys conducted by the Centers for Disease Control and Prevention.

Arthritis is a common comorbidity of obesity. Approximately one-third (35.6%) of adults with self-reported obesity were also affected by physician-diagnosed arthritis, judging from the combined results of the surveys, which were performed in 2007 and 2009.

The combination of arthritis and obesity resulted in a more sedentary lifestyle: 22.7% of obese adults with arthritis were physically inactive, compared with 16.1% with arthritis alone, 13.5% with obesity alone, and 9.4% with neither condition (MMWR 2011;60:614–8).

The state-based, random-digit–dialed telephone survey included a total of 789,460 adults from 50 states, the District of Columbia, Puerto Rico, Guam, and the Virgin Islands. These surveys are part of a series conducted by the CDC to examine the affects of arthritis and comorbid conditions. Previous studies looked at arthritis comorbidity with diabetes and heart disease. CDC researcher Kamil Barbour, Ph.D., said in an interview that results show that patients with chronic conditions are less likely to be physically active if they also have arthritis.

In an editor's note, the CDC report observed: “Arthritis and obesity are common chronic conditions affecting an estimated 50 million and 72 million U.S. adults, respectively. The findings in this report indicate that these conditions co-occur commonly (one in three adults with obesity also has arthritis) and might hinder the management of both conditions by limiting physical activity. Among adults with both obesity and arthritis, the adjusted likelihood of physical inactivity was 44% higher compared with that of adults with obesity but without arthritis; all state-specific estimates were consistent with these results. These findings suggest that among many persons with obesity, arthritis might be an additional barrier to physical activity.”

Dr. Barbour said that numerous barriers involved in arthritis can hinder people's ability to be active, beyond just being obese. The findings of these surveys should encourage doctors to consider the patient's full range of difficulties when making recommendations to engage in exercise, he added.

“We want to make [physicians] aware that they should look beyond obesity and any of the current conditions that [patients] may have, and look at the arthritis-specific barriers and kind of tailor their interventions toward addressing these [barriers].”

Dr. Barbour said the CDC will be using this information to augment community physical activity programs through the CDC Arthritis Program. The programs include EnhanceFitness, the Arthritis Foundation Exercise Program, and the Arthritis Foundation Walk With Ease programs, as well as self-management education programs.

Dr. Barbour and the other researchers who conducted and reported the study all work for the CDC.

The federal government has launched a new website that provides evidence-based information on complementary and alternative medicine treatments, according to the National Center for Complementary and Alternative Medicine, one of the National Institutes of Health.

The site (http://nccam.nih.gov/

The site was developed based on a series of focus groups and in-person surveys that the NCCAM conducted with physicians, nurses, and physician assistants. Respondents noted that they were interested in online access to evidence-based information about CAM. According to the 2007 National Health Interview Survey, 40% of adults and 12% of children use some form of CAM. The most common uses are for musculoskeletal problems such as back, neck, or joint pain.

It's essential that physicians talk to patients about CAM use, NCCAM spokesperson Katy Danielson said in an interview: “Talking not only allows fully integrated care, but it also minimizes risks of interactions among a patient's treatments. … When providers ask their patients about CAM use, they can ensure that they are fully informed and can help patients make informed … decisions.”

The site offers patient resources including fact sheets, links to reviews and clinical practice guidelines, a summary of research studies, and a program for continuing educational credit.

The federal government has launched a new website that provides evidence-based information on complementary and alternative medicine treatments, according to the National Center for Complementary and Alternative Medicine, one of the National Institutes of Health.

The site (http://nccam.nih.gov/

The site was developed based on a series of focus groups and in-person surveys that the NCCAM conducted with physicians, nurses, and physician assistants. Respondents noted that they were interested in online access to evidence-based information about CAM. According to the 2007 National Health Interview Survey, 40% of adults and 12% of children use some form of CAM. The most common uses are for musculoskeletal problems such as back, neck, or joint pain.

It's essential that physicians talk to patients about CAM use, NCCAM spokesperson Katy Danielson said in an interview: “Talking not only allows fully integrated care, but it also minimizes risks of interactions among a patient's treatments. … When providers ask their patients about CAM use, they can ensure that they are fully informed and can help patients make informed … decisions.”

The site offers patient resources including fact sheets, links to reviews and clinical practice guidelines, a summary of research studies, and a program for continuing educational credit.

The federal government has launched a new website that provides evidence-based information on complementary and alternative medicine treatments, according to the National Center for Complementary and Alternative Medicine, one of the National Institutes of Health.

The site (http://nccam.nih.gov/

The site was developed based on a series of focus groups and in-person surveys that the NCCAM conducted with physicians, nurses, and physician assistants. Respondents noted that they were interested in online access to evidence-based information about CAM. According to the 2007 National Health Interview Survey, 40% of adults and 12% of children use some form of CAM. The most common uses are for musculoskeletal problems such as back, neck, or joint pain.

It's essential that physicians talk to patients about CAM use, NCCAM spokesperson Katy Danielson said in an interview: “Talking not only allows fully integrated care, but it also minimizes risks of interactions among a patient's treatments. … When providers ask their patients about CAM use, they can ensure that they are fully informed and can help patients make informed … decisions.”

The site offers patient resources including fact sheets, links to reviews and clinical practice guidelines, a summary of research studies, and a program for continuing educational credit.

Three new initiatives aim to help physicians make the jump to becoming part of an Accountable Care Organization, officials from the Centers for Medicare and Medicaid services announced May 17.

The Pioneer ACO Model would accelerate the process for ACOs that already have the infrastructure in place to coordinate care for patients. Under this model, private payers would offer provider incentives and would function on a separate contract from the Medicare Shared Savings Program.

About 30 integrated health systems are expected to participate in the Pioneer ACO Model project this summer, making a full transition to ACO by September or October, according to Jonathan Blum, director of the Center for Medicare Management, a part of the CMS.

Use of the pioneer model could result in $430 million in Medicare savings over 3 years, according to the CMS Office of the Actuary. The pioneer model will follow the same 65 quality measurements and regulations already assigned to ACOs.

The second initiative is a series of free accelerated development learning sessions to educate providers on becoming an ACO and implementing a coordinated care model. The first of the four learning sessions offered in 2011 will be available June 20-22 in Minneapolis. All materials from the sessions, including webcast sessions, will be publicly available.

Finally, the CMS is requesting public comment on the proposal for providing upfront payments to providers who are interested in becoming ACOs but lack the resources. The accelerated payment program would allow providers who lack the capital to invest in the necessary infrastructure and staffing, Mr. Blum said, adding that the CMS plans to determine how much funding might be provided after evaluating public comments.

These initiatives came as a result of feedback from medical associations during the comment period of the ACO regulations, according to Dr. Donald Berwick, CMS administrator, who added that the challenge to implementing the best model is striking a balance between patient and provider needs. This includes balancing an ACO's need for data with patient privacy, the need for better coordinated care without overburdening providers with regulations, and the need for creating provider incentives without allowing them to avoid methods of care that might threaten those incentives.

Regardless, Mr. Blum said the CMS is devising a model that will greatly improve care. “We think that the ACO model, both the base model but also the Pioneer [model], is one of the best ways for us to improve care and so we're very conscious of the fact that we have to create payment policies and other requirements that provide an attractive model.”

The comment period on accountable care organization regulation was scheduled to close on June 6.

Three new initiatives aim to help physicians make the jump to becoming part of an Accountable Care Organization, officials from the Centers for Medicare and Medicaid services announced May 17.

The Pioneer ACO Model would accelerate the process for ACOs that already have the infrastructure in place to coordinate care for patients. Under this model, private payers would offer provider incentives and would function on a separate contract from the Medicare Shared Savings Program.

About 30 integrated health systems are expected to participate in the Pioneer ACO Model project this summer, making a full transition to ACO by September or October, according to Jonathan Blum, director of the Center for Medicare Management, a part of the CMS.

Use of the pioneer model could result in $430 million in Medicare savings over 3 years, according to the CMS Office of the Actuary. The pioneer model will follow the same 65 quality measurements and regulations already assigned to ACOs.

The second initiative is a series of free accelerated development learning sessions to educate providers on becoming an ACO and implementing a coordinated care model. The first of the four learning sessions offered in 2011 will be available June 20-22 in Minneapolis. All materials from the sessions, including webcast sessions, will be publicly available.

Finally, the CMS is requesting public comment on the proposal for providing upfront payments to providers who are interested in becoming ACOs but lack the resources. The accelerated payment program would allow providers who lack the capital to invest in the necessary infrastructure and staffing, Mr. Blum said, adding that the CMS plans to determine how much funding might be provided after evaluating public comments.

These initiatives came as a result of feedback from medical associations during the comment period of the ACO regulations, according to Dr. Donald Berwick, CMS administrator, who added that the challenge to implementing the best model is striking a balance between patient and provider needs. This includes balancing an ACO's need for data with patient privacy, the need for better coordinated care without overburdening providers with regulations, and the need for creating provider incentives without allowing them to avoid methods of care that might threaten those incentives.

Regardless, Mr. Blum said the CMS is devising a model that will greatly improve care. “We think that the ACO model, both the base model but also the Pioneer [model], is one of the best ways for us to improve care and so we're very conscious of the fact that we have to create payment policies and other requirements that provide an attractive model.”

The comment period on accountable care organization regulation was scheduled to close on June 6.

Three new initiatives aim to help physicians make the jump to becoming part of an Accountable Care Organization, officials from the Centers for Medicare and Medicaid services announced May 17.

The Pioneer ACO Model would accelerate the process for ACOs that already have the infrastructure in place to coordinate care for patients. Under this model, private payers would offer provider incentives and would function on a separate contract from the Medicare Shared Savings Program.

About 30 integrated health systems are expected to participate in the Pioneer ACO Model project this summer, making a full transition to ACO by September or October, according to Jonathan Blum, director of the Center for Medicare Management, a part of the CMS.

Use of the pioneer model could result in $430 million in Medicare savings over 3 years, according to the CMS Office of the Actuary. The pioneer model will follow the same 65 quality measurements and regulations already assigned to ACOs.

The second initiative is a series of free accelerated development learning sessions to educate providers on becoming an ACO and implementing a coordinated care model. The first of the four learning sessions offered in 2011 will be available June 20-22 in Minneapolis. All materials from the sessions, including webcast sessions, will be publicly available.

Finally, the CMS is requesting public comment on the proposal for providing upfront payments to providers who are interested in becoming ACOs but lack the resources. The accelerated payment program would allow providers who lack the capital to invest in the necessary infrastructure and staffing, Mr. Blum said, adding that the CMS plans to determine how much funding might be provided after evaluating public comments.

These initiatives came as a result of feedback from medical associations during the comment period of the ACO regulations, according to Dr. Donald Berwick, CMS administrator, who added that the challenge to implementing the best model is striking a balance between patient and provider needs. This includes balancing an ACO's need for data with patient privacy, the need for better coordinated care without overburdening providers with regulations, and the need for creating provider incentives without allowing them to avoid methods of care that might threaten those incentives.

Regardless, Mr. Blum said the CMS is devising a model that will greatly improve care. “We think that the ACO model, both the base model but also the Pioneer [model], is one of the best ways for us to improve care and so we're very conscious of the fact that we have to create payment policies and other requirements that provide an attractive model.”

The comment period on accountable care organization regulation was scheduled to close on June 6.

Major Finding: The use of electronic health records cut Kaiser Permanente's use of paper by 1,373 tons annually. The system also decreased energy use by 3.3-10 million gallons of gasoline by reducing medical visits.

Data Source: Based on a 2011 internal analysis.

Disclosures: All seven researchers are employees of Kaiser Permanente.

Greater use of electronic health records would cut greenhouse gas emissions, energy use, waste and toxic chemical production, and water consumption, according to a study by Marianne C. Turley, Ph.D., and her associates at Kaiser Permanente.

Even after factoring in the additional energy consumption from the increased use of personal computers, the overall net effect on the environment would be favorable, the researchers concluded based on an analysis of the impact of the Kaiser Permanente EHR system, which covers 8.7 million beneficiaries.

Annually, the use of the Kaiser EHR system eliminated the use of 1,373 tons of paper by discontinuing the use of paper medical charts, x-ray jackets, and administrative forms. The system also decreased annual gas consumption by an estimated 3.3-10 million gallons by cutting the number of visits by 4-13 million.

Patients who were registered online could correspond with their providers about nonemergency concerns through secure e-mail messages, the investigators reported (Health Aff. 2011;30:938-46).

Switching from desktop to laptop computers saved 89,300 megawatt hours and digitizing x-rays eliminated the waste of 203 tons of plastic and 79 tons of toxic chemicals.

Using the Environmental Protection Agency's greenhouse gas equivalencies calculator, Dr. Turley and her associates estimated that Kaiser's efforts reduced greenhouse gas emissions by 9,200 tons.

Results were based on data from regional operational reports, paper-purchasing records, and internal pharmaceutical reports. Travel distance was estimated by calculating the distance from patient addresses to Kaiser-participating primary care buildings and aggregating them by region.

With a growing emphasis on health technology, the Kaiser study showed that “the use of electronic health records can both change the face of health care and help reduce its environmental footprint,” the researchers wrote.

Despite these findings, Dr. Turley and her associates said that the environmental impact of switching to electronic health records will vary from system to system. As the Affordable Care Act calls for implementation of electronic systems, they said further analysis is necessary to determine the impacts of widespread implementation.

Although 51% of office-based physicians are currently using an electronic system, only 10% of practices reported their systems as being fully functioning, according to the most recent evaluation from the Centers for Disease Control and Prevention. Regardless, implementation of electronic systems will probably increase as provisions in the American Recovery and Reinvestment Act of 2009 create incentives for providers who invest in electronic systems. Public and private investment in these systems is expected to reach $40 billion in the next several years, according to the investigators.

Major Finding: The use of electronic health records cut Kaiser Permanente's use of paper by 1,373 tons annually. The system also decreased energy use by 3.3-10 million gallons of gasoline by reducing medical visits.

Data Source: Based on a 2011 internal analysis.

Disclosures: All seven researchers are employees of Kaiser Permanente.

Greater use of electronic health records would cut greenhouse gas emissions, energy use, waste and toxic chemical production, and water consumption, according to a study by Marianne C. Turley, Ph.D., and her associates at Kaiser Permanente.

Even after factoring in the additional energy consumption from the increased use of personal computers, the overall net effect on the environment would be favorable, the researchers concluded based on an analysis of the impact of the Kaiser Permanente EHR system, which covers 8.7 million beneficiaries.

Annually, the use of the Kaiser EHR system eliminated the use of 1,373 tons of paper by discontinuing the use of paper medical charts, x-ray jackets, and administrative forms. The system also decreased annual gas consumption by an estimated 3.3-10 million gallons by cutting the number of visits by 4-13 million.

Patients who were registered online could correspond with their providers about nonemergency concerns through secure e-mail messages, the investigators reported (Health Aff. 2011;30:938-46).

Switching from desktop to laptop computers saved 89,300 megawatt hours and digitizing x-rays eliminated the waste of 203 tons of plastic and 79 tons of toxic chemicals.

Using the Environmental Protection Agency's greenhouse gas equivalencies calculator, Dr. Turley and her associates estimated that Kaiser's efforts reduced greenhouse gas emissions by 9,200 tons.

Results were based on data from regional operational reports, paper-purchasing records, and internal pharmaceutical reports. Travel distance was estimated by calculating the distance from patient addresses to Kaiser-participating primary care buildings and aggregating them by region.

With a growing emphasis on health technology, the Kaiser study showed that “the use of electronic health records can both change the face of health care and help reduce its environmental footprint,” the researchers wrote.

Despite these findings, Dr. Turley and her associates said that the environmental impact of switching to electronic health records will vary from system to system. As the Affordable Care Act calls for implementation of electronic systems, they said further analysis is necessary to determine the impacts of widespread implementation.

Although 51% of office-based physicians are currently using an electronic system, only 10% of practices reported their systems as being fully functioning, according to the most recent evaluation from the Centers for Disease Control and Prevention. Regardless, implementation of electronic systems will probably increase as provisions in the American Recovery and Reinvestment Act of 2009 create incentives for providers who invest in electronic systems. Public and private investment in these systems is expected to reach $40 billion in the next several years, according to the investigators.

Major Finding: The use of electronic health records cut Kaiser Permanente's use of paper by 1,373 tons annually. The system also decreased energy use by 3.3-10 million gallons of gasoline by reducing medical visits.

Data Source: Based on a 2011 internal analysis.

Disclosures: All seven researchers are employees of Kaiser Permanente.

Greater use of electronic health records would cut greenhouse gas emissions, energy use, waste and toxic chemical production, and water consumption, according to a study by Marianne C. Turley, Ph.D., and her associates at Kaiser Permanente.

Even after factoring in the additional energy consumption from the increased use of personal computers, the overall net effect on the environment would be favorable, the researchers concluded based on an analysis of the impact of the Kaiser Permanente EHR system, which covers 8.7 million beneficiaries.

Annually, the use of the Kaiser EHR system eliminated the use of 1,373 tons of paper by discontinuing the use of paper medical charts, x-ray jackets, and administrative forms. The system also decreased annual gas consumption by an estimated 3.3-10 million gallons by cutting the number of visits by 4-13 million.

Patients who were registered online could correspond with their providers about nonemergency concerns through secure e-mail messages, the investigators reported (Health Aff. 2011;30:938-46).

Switching from desktop to laptop computers saved 89,300 megawatt hours and digitizing x-rays eliminated the waste of 203 tons of plastic and 79 tons of toxic chemicals.

Using the Environmental Protection Agency's greenhouse gas equivalencies calculator, Dr. Turley and her associates estimated that Kaiser's efforts reduced greenhouse gas emissions by 9,200 tons.

Results were based on data from regional operational reports, paper-purchasing records, and internal pharmaceutical reports. Travel distance was estimated by calculating the distance from patient addresses to Kaiser-participating primary care buildings and aggregating them by region.

With a growing emphasis on health technology, the Kaiser study showed that “the use of electronic health records can both change the face of health care and help reduce its environmental footprint,” the researchers wrote.

Despite these findings, Dr. Turley and her associates said that the environmental impact of switching to electronic health records will vary from system to system. As the Affordable Care Act calls for implementation of electronic systems, they said further analysis is necessary to determine the impacts of widespread implementation.

Although 51% of office-based physicians are currently using an electronic system, only 10% of practices reported their systems as being fully functioning, according to the most recent evaluation from the Centers for Disease Control and Prevention. Regardless, implementation of electronic systems will probably increase as provisions in the American Recovery and Reinvestment Act of 2009 create incentives for providers who invest in electronic systems. Public and private investment in these systems is expected to reach $40 billion in the next several years, according to the investigators.

WASHINGTON – A plan to finally replace Medicare's much maligned Sustainable Growth Rate payment formula could be unveiled by this summer, federal lawmakers predicted at a committee hearing.

“Here's the bottom line: If we get to December and we're doing an extension, that's a failure on our part,” Rep. Michael Burgess (R-Tex.) said at the hearing. “We need a permanent solution that's predictable, updatable, and reasonable for this year – and nothing else will do.”

“Whatever virtues the SGR had when it was created 14 years ago, … it's clear that they have vanished,” noted Rep. Henry A. Waxman (D-Calif.). He added that in the past 2 years, Congress has had to pass legislation six times, blocking fee cuts of up to 21% or more.

About 30 medical associations responded to the House subcommittee's request for suggestions and proposals in developing a new system. Speaking with a five-person panel of experts from medical associations and health policy organizations, House subcommittee members considered alternatives to the current SGR formula.

One Size Won't Fit All

While the details of the plans vary, they do show a consensus on several fronts: repealing the SGR, moving away from the traditional fee-for-services payment model, and providing a 4- to 5-year transition period in which providers can experiment with a variety of payment systems.

The expert panel also stressed the importance of avoiding a “one size fits all” solution.

“I think we should also have a realization that what will work in one part of the country will not work in another part of the country, and that's why we have continued to talk about a variety of options,” said Dr. Cecil Wilson, president of the American Medical Association.

Dr. Wilson pointed to the provisions in the Affordable Care Act that allow for a variety of models of accountable care organizations, embodying the concept of options in the medical system. In that spirit, he said that the AMA has formed a physician leadership group to evaluate the effectiveness of alternative payment methods.

To strengthen primary care's role in Medicare, the American Academy of Family Physicians backs payment reforms that would boost primary care reimbursement and support the concept of the patient-centered medical home (PCMH). AAFP President Roland A. Goertz noted in written testimony to the committee that the proposal would create a blended reimbursement system for primary care delivered within a PCMH: fee-for-service payments and pay for performance, plus care management fees for PCMH-related activities that don't involve direct patient care.

Dr. David Hoyt, executive director of the American College of Surgeons, said the college is analyzing the use of bundled payments for surgery. Dr. M. Todd Williamson, of the Coalition of State Medical and National Specialty Societies, introduced the option of private contracting, in which patients would be free to apply their benefits to a doctor of their choice, who would be free to opt out on a per-patient basis.

Harold Miller, executive director of the Center for Healthcare Quality and Payment Reform, suggested an episode-of-care payment plan through which hospitals and physicians jointly charge one price for all services included in a hospitalization. The model would also include a warranty stating that any infections or complications would be treated at no additional cost. Also, a physician practice would receive one payment for all patient needs associated with chronic diseases or other conditions.

Rep. Burgess, who is also a doctor, said organizations should focus on ways to address patients with chronic conditions, adding that 80% of Medicare funding is spent by 20% of beneficiaries with chronic illnesses.

Is IPAB the New SGR?

Rep. Fred Upton (R-Mich.) raised concerns about the Independent Payment Advisory Board (IPAB), created by the Affordable Care Act. The board sets expenditure targets, on which it bases spending cuts. In 2018, targets will be based on the gross domestic product. “Sounds a lot like SGR, which we're trying to get rid of,” Mr. Upton said. “Since hospitals are exempt from IPAB cuts through the rest of the decade, it seems that the IPAB has the potential to undermine any serious efforts at physician payment reform.” Some panelists agreed.

“It's not impossible that [the IPAB] could serve a function,” Dr. Wilson said, “but as presently constituted, we see it [as] basically another target for physicians to meet – potential double jeopardy, with an SGR as well as the pronouncements from this body.”

The panelists also asserted their belief that whatever plan chosen should be physician led, with financial support of the government. “It would be helpful if physicians could get better financial support in their own payment system to enable them to lead all of those efforts,” said Dr. Mark B. McClellan, director of the Engelberg Center for Health care Reform and former administrator of the Centers for Medicare and Medicaid Services.

'What will work in one part of the country will not work in another,' said Dr. Cecil Wilson (center).

Source Courtesy American Medical Association

WASHINGTON – A plan to finally replace Medicare's much maligned Sustainable Growth Rate payment formula could be unveiled by this summer, federal lawmakers predicted at a committee hearing.

“Here's the bottom line: If we get to December and we're doing an extension, that's a failure on our part,” Rep. Michael Burgess (R-Tex.) said at the hearing. “We need a permanent solution that's predictable, updatable, and reasonable for this year – and nothing else will do.”

“Whatever virtues the SGR had when it was created 14 years ago, … it's clear that they have vanished,” noted Rep. Henry A. Waxman (D-Calif.). He added that in the past 2 years, Congress has had to pass legislation six times, blocking fee cuts of up to 21% or more.

About 30 medical associations responded to the House subcommittee's request for suggestions and proposals in developing a new system. Speaking with a five-person panel of experts from medical associations and health policy organizations, House subcommittee members considered alternatives to the current SGR formula.

One Size Won't Fit All

While the details of the plans vary, they do show a consensus on several fronts: repealing the SGR, moving away from the traditional fee-for-services payment model, and providing a 4- to 5-year transition period in which providers can experiment with a variety of payment systems.

The expert panel also stressed the importance of avoiding a “one size fits all” solution.

“I think we should also have a realization that what will work in one part of the country will not work in another part of the country, and that's why we have continued to talk about a variety of options,” said Dr. Cecil Wilson, president of the American Medical Association.

Dr. Wilson pointed to the provisions in the Affordable Care Act that allow for a variety of models of accountable care organizations, embodying the concept of options in the medical system. In that spirit, he said that the AMA has formed a physician leadership group to evaluate the effectiveness of alternative payment methods.

To strengthen primary care's role in Medicare, the American Academy of Family Physicians backs payment reforms that would boost primary care reimbursement and support the concept of the patient-centered medical home (PCMH). AAFP President Roland A. Goertz noted in written testimony to the committee that the proposal would create a blended reimbursement system for primary care delivered within a PCMH: fee-for-service payments and pay for performance, plus care management fees for PCMH-related activities that don't involve direct patient care.

Dr. David Hoyt, executive director of the American College of Surgeons, said the college is analyzing the use of bundled payments for surgery. Dr. M. Todd Williamson, of the Coalition of State Medical and National Specialty Societies, introduced the option of private contracting, in which patients would be free to apply their benefits to a doctor of their choice, who would be free to opt out on a per-patient basis.

Harold Miller, executive director of the Center for Healthcare Quality and Payment Reform, suggested an episode-of-care payment plan through which hospitals and physicians jointly charge one price for all services included in a hospitalization. The model would also include a warranty stating that any infections or complications would be treated at no additional cost. Also, a physician practice would receive one payment for all patient needs associated with chronic diseases or other conditions.

Rep. Burgess, who is also a doctor, said organizations should focus on ways to address patients with chronic conditions, adding that 80% of Medicare funding is spent by 20% of beneficiaries with chronic illnesses.

Is IPAB the New SGR?

Rep. Fred Upton (R-Mich.) raised concerns about the Independent Payment Advisory Board (IPAB), created by the Affordable Care Act. The board sets expenditure targets, on which it bases spending cuts. In 2018, targets will be based on the gross domestic product. “Sounds a lot like SGR, which we're trying to get rid of,” Mr. Upton said. “Since hospitals are exempt from IPAB cuts through the rest of the decade, it seems that the IPAB has the potential to undermine any serious efforts at physician payment reform.” Some panelists agreed.

“It's not impossible that [the IPAB] could serve a function,” Dr. Wilson said, “but as presently constituted, we see it [as] basically another target for physicians to meet – potential double jeopardy, with an SGR as well as the pronouncements from this body.”

The panelists also asserted their belief that whatever plan chosen should be physician led, with financial support of the government. “It would be helpful if physicians could get better financial support in their own payment system to enable them to lead all of those efforts,” said Dr. Mark B. McClellan, director of the Engelberg Center for Health care Reform and former administrator of the Centers for Medicare and Medicaid Services.

'What will work in one part of the country will not work in another,' said Dr. Cecil Wilson (center).

Source Courtesy American Medical Association

WASHINGTON – A plan to finally replace Medicare's much maligned Sustainable Growth Rate payment formula could be unveiled by this summer, federal lawmakers predicted at a committee hearing.

“Here's the bottom line: If we get to December and we're doing an extension, that's a failure on our part,” Rep. Michael Burgess (R-Tex.) said at the hearing. “We need a permanent solution that's predictable, updatable, and reasonable for this year – and nothing else will do.”

“Whatever virtues the SGR had when it was created 14 years ago, … it's clear that they have vanished,” noted Rep. Henry A. Waxman (D-Calif.). He added that in the past 2 years, Congress has had to pass legislation six times, blocking fee cuts of up to 21% or more.

About 30 medical associations responded to the House subcommittee's request for suggestions and proposals in developing a new system. Speaking with a five-person panel of experts from medical associations and health policy organizations, House subcommittee members considered alternatives to the current SGR formula.

One Size Won't Fit All

While the details of the plans vary, they do show a consensus on several fronts: repealing the SGR, moving away from the traditional fee-for-services payment model, and providing a 4- to 5-year transition period in which providers can experiment with a variety of payment systems.

The expert panel also stressed the importance of avoiding a “one size fits all” solution.

“I think we should also have a realization that what will work in one part of the country will not work in another part of the country, and that's why we have continued to talk about a variety of options,” said Dr. Cecil Wilson, president of the American Medical Association.

Dr. Wilson pointed to the provisions in the Affordable Care Act that allow for a variety of models of accountable care organizations, embodying the concept of options in the medical system. In that spirit, he said that the AMA has formed a physician leadership group to evaluate the effectiveness of alternative payment methods.

To strengthen primary care's role in Medicare, the American Academy of Family Physicians backs payment reforms that would boost primary care reimbursement and support the concept of the patient-centered medical home (PCMH). AAFP President Roland A. Goertz noted in written testimony to the committee that the proposal would create a blended reimbursement system for primary care delivered within a PCMH: fee-for-service payments and pay for performance, plus care management fees for PCMH-related activities that don't involve direct patient care.

Dr. David Hoyt, executive director of the American College of Surgeons, said the college is analyzing the use of bundled payments for surgery. Dr. M. Todd Williamson, of the Coalition of State Medical and National Specialty Societies, introduced the option of private contracting, in which patients would be free to apply their benefits to a doctor of their choice, who would be free to opt out on a per-patient basis.

Harold Miller, executive director of the Center for Healthcare Quality and Payment Reform, suggested an episode-of-care payment plan through which hospitals and physicians jointly charge one price for all services included in a hospitalization. The model would also include a warranty stating that any infections or complications would be treated at no additional cost. Also, a physician practice would receive one payment for all patient needs associated with chronic diseases or other conditions.

Rep. Burgess, who is also a doctor, said organizations should focus on ways to address patients with chronic conditions, adding that 80% of Medicare funding is spent by 20% of beneficiaries with chronic illnesses.

Is IPAB the New SGR?

Rep. Fred Upton (R-Mich.) raised concerns about the Independent Payment Advisory Board (IPAB), created by the Affordable Care Act. The board sets expenditure targets, on which it bases spending cuts. In 2018, targets will be based on the gross domestic product. “Sounds a lot like SGR, which we're trying to get rid of,” Mr. Upton said. “Since hospitals are exempt from IPAB cuts through the rest of the decade, it seems that the IPAB has the potential to undermine any serious efforts at physician payment reform.” Some panelists agreed.

“It's not impossible that [the IPAB] could serve a function,” Dr. Wilson said, “but as presently constituted, we see it [as] basically another target for physicians to meet – potential double jeopardy, with an SGR as well as the pronouncements from this body.”

The panelists also asserted their belief that whatever plan chosen should be physician led, with financial support of the government. “It would be helpful if physicians could get better financial support in their own payment system to enable them to lead all of those efforts,” said Dr. Mark B. McClellan, director of the Engelberg Center for Health care Reform and former administrator of the Centers for Medicare and Medicaid Services.

'What will work in one part of the country will not work in another,' said Dr. Cecil Wilson (center).

Source Courtesy American Medical Association

A 40% premium cut and simpler enrollment procedures are two changes the federal government is employing to increase enrollment in the Pre-Existing Condition Insurance Plan, Health and Human Services Secretary Kathleen Sebelius announced during a press briefing May 31.

Launched in July 2010 under the Affordable Care Act (ACA), the Pre-Existing Condition Insurance Plan (PCIP) provides an insurance option for people with pre-existing conditions who have been denied coverage and have been without insurance for 6 months or more.

To increase awareness for the program, HHS will offer payment for insurance brokers and agents for successfully connecting eligible enrollees with the PCIP program, said Richard Popper, deputy director of insurance programs in the Office of Consumer Information and Insurance Oversight.

Those seeking coverage under the PCIP will no longer have to wait to receive a denial letter from their insurance company in order to enroll. Instead, they can provide attestation of their condition from their physician, nurse practitioner, or physician assistant. Patients with pre-existing conditions still will be required to be without insurance for 6 months before they are eligible for coverage under the plan, said Mr. Popper. He added that HHS does not have the authority to waive the 6-month waiting period under the current health law.

Ms. Sebelius emphasized HHS’s priority to increase enrollment in the program.

"It’s encouraging to see more people who need health insurance the most getting it, but we know that’s not enough," Ms. Sebelius said.

The measures comply with the ACA provision requiring the PCIP to align premiums and benefits with the private insurance market, Mr. Popper said. However, he said there’s still plenty of room for new enrollees.

"We’ve been enrolling people at an increasing rate, but we know we have the capacity to cover even more people," Mr. Popper said.

He added that funding for the measures will fall under the original $5 billion set aside for the program through the health reform law, as well as existing member premiums.

Despite original HHS estimates that several hundred thousand people would benefit from the PCIP, 18,313 people were enrolled as of early May.

PCIP is run by the federal government in 23 states and the District of Columbia; remaining states operate their own programs using funding from the ACA. HHS sent letters to those 27 state programs, encouraging them to consider similar reforms to their programs.

A 40% premium cut and simpler enrollment procedures are two changes the federal government is employing to increase enrollment in the Pre-Existing Condition Insurance Plan, Health and Human Services Secretary Kathleen Sebelius announced during a press briefing May 31.

Launched in July 2010 under the Affordable Care Act (ACA), the Pre-Existing Condition Insurance Plan (PCIP) provides an insurance option for people with pre-existing conditions who have been denied coverage and have been without insurance for 6 months or more.

To increase awareness for the program, HHS will offer payment for insurance brokers and agents for successfully connecting eligible enrollees with the PCIP program, said Richard Popper, deputy director of insurance programs in the Office of Consumer Information and Insurance Oversight.

Those seeking coverage under the PCIP will no longer have to wait to receive a denial letter from their insurance company in order to enroll. Instead, they can provide attestation of their condition from their physician, nurse practitioner, or physician assistant. Patients with pre-existing conditions still will be required to be without insurance for 6 months before they are eligible for coverage under the plan, said Mr. Popper. He added that HHS does not have the authority to waive the 6-month waiting period under the current health law.

Ms. Sebelius emphasized HHS’s priority to increase enrollment in the program.

"It’s encouraging to see more people who need health insurance the most getting it, but we know that’s not enough," Ms. Sebelius said.

The measures comply with the ACA provision requiring the PCIP to align premiums and benefits with the private insurance market, Mr. Popper said. However, he said there’s still plenty of room for new enrollees.

"We’ve been enrolling people at an increasing rate, but we know we have the capacity to cover even more people," Mr. Popper said.

He added that funding for the measures will fall under the original $5 billion set aside for the program through the health reform law, as well as existing member premiums.

Despite original HHS estimates that several hundred thousand people would benefit from the PCIP, 18,313 people were enrolled as of early May.

PCIP is run by the federal government in 23 states and the District of Columbia; remaining states operate their own programs using funding from the ACA. HHS sent letters to those 27 state programs, encouraging them to consider similar reforms to their programs.

A 40% premium cut and simpler enrollment procedures are two changes the federal government is employing to increase enrollment in the Pre-Existing Condition Insurance Plan, Health and Human Services Secretary Kathleen Sebelius announced during a press briefing May 31.

Launched in July 2010 under the Affordable Care Act (ACA), the Pre-Existing Condition Insurance Plan (PCIP) provides an insurance option for people with pre-existing conditions who have been denied coverage and have been without insurance for 6 months or more.

To increase awareness for the program, HHS will offer payment for insurance brokers and agents for successfully connecting eligible enrollees with the PCIP program, said Richard Popper, deputy director of insurance programs in the Office of Consumer Information and Insurance Oversight.

Those seeking coverage under the PCIP will no longer have to wait to receive a denial letter from their insurance company in order to enroll. Instead, they can provide attestation of their condition from their physician, nurse practitioner, or physician assistant. Patients with pre-existing conditions still will be required to be without insurance for 6 months before they are eligible for coverage under the plan, said Mr. Popper. He added that HHS does not have the authority to waive the 6-month waiting period under the current health law.

Ms. Sebelius emphasized HHS’s priority to increase enrollment in the program.

"It’s encouraging to see more people who need health insurance the most getting it, but we know that’s not enough," Ms. Sebelius said.

The measures comply with the ACA provision requiring the PCIP to align premiums and benefits with the private insurance market, Mr. Popper said. However, he said there’s still plenty of room for new enrollees.

"We’ve been enrolling people at an increasing rate, but we know we have the capacity to cover even more people," Mr. Popper said.

He added that funding for the measures will fall under the original $5 billion set aside for the program through the health reform law, as well as existing member premiums.

Despite original HHS estimates that several hundred thousand people would benefit from the PCIP, 18,313 people were enrolled as of early May.

PCIP is run by the federal government in 23 states and the District of Columbia; remaining states operate their own programs using funding from the ACA. HHS sent letters to those 27 state programs, encouraging them to consider similar reforms to their programs.

A 40% premium cut and simpler enrollment procedures are two changes the federal government is employing to increase enrollment in the Pre-Existing Condition Insurance Plan, Health and Human Services Secretary Kathleen Sebelius announced during a press briefing May 31.

Launched in July 2010 under the Affordable Care Act (ACA), the Pre-Existing Condition Insurance Plan (PCIP) provides an insurance option for people with pre-existing conditions who have been denied coverage and have been without insurance for 6 months or more.

To increase awareness for the program, HHS will offer payment for insurance brokers and agents for successfully connecting eligible enrollees with the PCIP program, said Richard Popper, deputy director of insurance programs in the Office of Consumer Information and Insurance Oversight.

Those seeking coverage under the PCIP will no longer have to wait to receive a denial letter from their insurance company in order to enroll. Instead, they can provide attestation of their condition from their physician, nurse practitioner, or physician assistant. Patients with pre-existing conditions still will be required to be without insurance for 6 months before they are eligible for coverage under the plan, said Mr. Popper. He added that HHS does not have the authority to waive the 6-month waiting period under the current health law.

Ms. Sebelius emphasized HHS’s priority to increase enrollment in the program.

"It’s encouraging to see more people who need health insurance the most getting it, but we know that’s not enough," Ms. Sebelius said.

The measures comply with the ACA provision requiring the PCIP to align premiums and benefits with the private insurance market, Mr. Popper said. However, he said there’s still plenty of room for new enrollees.

"We’ve been enrolling people at an increasing rate, but we know we have the capacity to cover even more people," Mr. Popper said.

He added that funding for the measures will fall under the original $5 billion set aside for the program through the health reform law, as well as existing member premiums.

Despite original HHS estimates that several hundred thousand people would benefit from the PCIP, 18,313 people were enrolled as of early May.

PCIP is run by the federal government in 23 states and the District of Columbia; remaining states operate their own programs using funding from the ACA. HHS sent letters to those 27 state programs, encouraging them to consider similar reforms to their programs.

A 40% premium cut and simpler enrollment procedures are two changes the federal government is employing to increase enrollment in the Pre-Existing Condition Insurance Plan, Health and Human Services Secretary Kathleen Sebelius announced during a press briefing May 31.

Launched in July 2010 under the Affordable Care Act (ACA), the Pre-Existing Condition Insurance Plan (PCIP) provides an insurance option for people with pre-existing conditions who have been denied coverage and have been without insurance for 6 months or more.

To increase awareness for the program, HHS will offer payment for insurance brokers and agents for successfully connecting eligible enrollees with the PCIP program, said Richard Popper, deputy director of insurance programs in the Office of Consumer Information and Insurance Oversight.

Those seeking coverage under the PCIP will no longer have to wait to receive a denial letter from their insurance company in order to enroll. Instead, they can provide attestation of their condition from their physician, nurse practitioner, or physician assistant. Patients with pre-existing conditions still will be required to be without insurance for 6 months before they are eligible for coverage under the plan, said Mr. Popper. He added that HHS does not have the authority to waive the 6-month waiting period under the current health law.

Ms. Sebelius emphasized HHS’s priority to increase enrollment in the program.

"It’s encouraging to see more people who need health insurance the most getting it, but we know that’s not enough," Ms. Sebelius said.

The measures comply with the ACA provision requiring the PCIP to align premiums and benefits with the private insurance market, Mr. Popper said. However, he said there’s still plenty of room for new enrollees.

"We’ve been enrolling people at an increasing rate, but we know we have the capacity to cover even more people," Mr. Popper said.

He added that funding for the measures will fall under the original $5 billion set aside for the program through the health reform law, as well as existing member premiums.

Despite original HHS estimates that several hundred thousand people would benefit from the PCIP, 18,313 people were enrolled as of early May.

PCIP is run by the federal government in 23 states and the District of Columbia; remaining states operate their own programs using funding from the ACA. HHS sent letters to those 27 state programs, encouraging them to consider similar reforms to their programs.

A 40% premium cut and simpler enrollment procedures are two changes the federal government is employing to increase enrollment in the Pre-Existing Condition Insurance Plan, Health and Human Services Secretary Kathleen Sebelius announced during a press briefing May 31.

Launched in July 2010 under the Affordable Care Act (ACA), the Pre-Existing Condition Insurance Plan (PCIP) provides an insurance option for people with pre-existing conditions who have been denied coverage and have been without insurance for 6 months or more.

To increase awareness for the program, HHS will offer payment for insurance brokers and agents for successfully connecting eligible enrollees with the PCIP program, said Richard Popper, deputy director of insurance programs in the Office of Consumer Information and Insurance Oversight.

Those seeking coverage under the PCIP will no longer have to wait to receive a denial letter from their insurance company in order to enroll. Instead, they can provide attestation of their condition from their physician, nurse practitioner, or physician assistant. Patients with pre-existing conditions still will be required to be without insurance for 6 months before they are eligible for coverage under the plan, said Mr. Popper. He added that HHS does not have the authority to waive the 6-month waiting period under the current health law.

Ms. Sebelius emphasized HHS’s priority to increase enrollment in the program.

"It’s encouraging to see more people who need health insurance the most getting it, but we know that’s not enough," Ms. Sebelius said.

The measures comply with the ACA provision requiring the PCIP to align premiums and benefits with the private insurance market, Mr. Popper said. However, he said there’s still plenty of room for new enrollees.

"We’ve been enrolling people at an increasing rate, but we know we have the capacity to cover even more people," Mr. Popper said.

He added that funding for the measures will fall under the original $5 billion set aside for the program through the health reform law, as well as existing member premiums.

Despite original HHS estimates that several hundred thousand people would benefit from the PCIP, 18,313 people were enrolled as of early May.

PCIP is run by the federal government in 23 states and the District of Columbia; remaining states operate their own programs using funding from the ACA. HHS sent letters to those 27 state programs, encouraging them to consider similar reforms to their programs.

A 40% premium cut and simpler enrollment procedures are two changes the federal government is employing to increase enrollment in the Pre-Existing Condition Insurance Plan, Health and Human Services Secretary Kathleen Sebelius announced during a press briefing May 31.

Launched in July 2010 under the Affordable Care Act (ACA), the Pre-Existing Condition Insurance Plan (PCIP) provides an insurance option for people with pre-existing conditions who have been denied coverage and have been without insurance for 6 months or more.

To increase awareness for the program, HHS will offer payment for insurance brokers and agents for successfully connecting eligible enrollees with the PCIP program, said Richard Popper, deputy director of insurance programs in the Office of Consumer Information and Insurance Oversight.

Those seeking coverage under the PCIP will no longer have to wait to receive a denial letter from their insurance company in order to enroll. Instead, they can provide attestation of their condition from their physician, nurse practitioner, or physician assistant. Patients with pre-existing conditions still will be required to be without insurance for 6 months before they are eligible for coverage under the plan, said Mr. Popper. He added that HHS does not have the authority to waive the 6-month waiting period under the current health law.

Ms. Sebelius emphasized HHS’s priority to increase enrollment in the program.

"It’s encouraging to see more people who need health insurance the most getting it, but we know that’s not enough," Ms. Sebelius said.

The measures comply with the ACA provision requiring the PCIP to align premiums and benefits with the private insurance market, Mr. Popper said. However, he said there’s still plenty of room for new enrollees.

"We’ve been enrolling people at an increasing rate, but we know we have the capacity to cover even more people," Mr. Popper said.

He added that funding for the measures will fall under the original $5 billion set aside for the program through the health reform law, as well as existing member premiums.

Despite original HHS estimates that several hundred thousand people would benefit from the PCIP, 18,313 people were enrolled as of early May.

PCIP is run by the federal government in 23 states and the District of Columbia; remaining states operate their own programs using funding from the ACA. HHS sent letters to those 27 state programs, encouraging them to consider similar reforms to their programs.

A 40% premium cut and simpler enrollment procedures are two changes the federal government is employing to increase enrollment in the Pre-Existing Condition Insurance Plan, Health and Human Services Secretary Kathleen Sebelius announced during a press briefing May 31.

Launched in July 2010 under the Affordable Care Act (ACA), the Pre-Existing Condition Insurance Plan (PCIP) provides an insurance option for people with pre-existing conditions who have been denied coverage and have been without insurance for 6 months or more.

To increase awareness for the program, HHS will offer payment for insurance brokers and agents for successfully connecting eligible enrollees with the PCIP program, said Richard Popper, deputy director of insurance programs in the Office of Consumer Information and Insurance Oversight.

Those seeking coverage under the PCIP will no longer have to wait to receive a denial letter from their insurance company in order to enroll. Instead, they can provide attestation of their condition from their physician, nurse practitioner, or physician assistant. Patients with pre-existing conditions still will be required to be without insurance for 6 months before they are eligible for coverage under the plan, said Mr. Popper. He added that HHS does not have the authority to waive the 6-month waiting period under the current health law.

Ms. Sebelius emphasized HHS’s priority to increase enrollment in the program.

"It’s encouraging to see more people who need health insurance the most getting it, but we know that’s not enough," Ms. Sebelius said.

The measures comply with the ACA provision requiring the PCIP to align premiums and benefits with the private insurance market, Mr. Popper said. However, he said there’s still plenty of room for new enrollees.

"We’ve been enrolling people at an increasing rate, but we know we have the capacity to cover even more people," Mr. Popper said.

He added that funding for the measures will fall under the original $5 billion set aside for the program through the health reform law, as well as existing member premiums.

Despite original HHS estimates that several hundred thousand people would benefit from the PCIP, 18,313 people were enrolled as of early May.

PCIP is run by the federal government in 23 states and the District of Columbia; remaining states operate their own programs using funding from the ACA. HHS sent letters to those 27 state programs, encouraging them to consider similar reforms to their programs.

A 40% premium cut and simpler enrollment procedures are two changes the federal government is employing to increase enrollment in the Pre-Existing Condition Insurance Plan, Health and Human Services Secretary Kathleen Sebelius announced during a press briefing May 31.

Launched in July 2010 under the Affordable Care Act (ACA), the Pre-Existing Condition Insurance Plan (PCIP) provides an insurance option for people with pre-existing conditions who have been denied coverage and have been without insurance for 6 months or more.

To increase awareness for the program, HHS will offer payment for insurance brokers and agents for successfully connecting eligible enrollees with the PCIP program, said Richard Popper, deputy director of insurance programs in the Office of Consumer Information and Insurance Oversight.

Those seeking coverage under the PCIP will no longer have to wait to receive a denial letter from their insurance company in order to enroll. Instead, they can provide attestation of their condition from their physician, nurse practitioner, or physician assistant. Patients with pre-existing conditions still will be required to be without insurance for 6 months before they are eligible for coverage under the plan, said Mr. Popper. He added that HHS does not have the authority to waive the 6-month waiting period under the current health law.

Ms. Sebelius emphasized HHS’s priority to increase enrollment in the program.

"It’s encouraging to see more people who need health insurance the most getting it, but we know that’s not enough," Ms. Sebelius said.

The measures comply with the ACA provision requiring the PCIP to align premiums and benefits with the private insurance market, Mr. Popper said. However, he said there’s still plenty of room for new enrollees.

"We’ve been enrolling people at an increasing rate, but we know we have the capacity to cover even more people," Mr. Popper said.

He added that funding for the measures will fall under the original $5 billion set aside for the program through the health reform law, as well as existing member premiums.

Despite original HHS estimates that several hundred thousand people would benefit from the PCIP, 18,313 people were enrolled as of early May.

PCIP is run by the federal government in 23 states and the District of Columbia; remaining states operate their own programs using funding from the ACA. HHS sent letters to those 27 state programs, encouraging them to consider similar reforms to their programs.

A 40% premium cut and simpler enrollment procedures are two changes the federal government is employing to increase enrollment in the Pre-Existing Condition Insurance Plan, Health and Human Services Secretary Kathleen Sebelius announced during a press briefing May 31.

Launched in July 2010 under the Affordable Care Act (ACA), the Pre-Existing Condition Insurance Plan (PCIP) provides an insurance option for people with pre-existing conditions who have been denied coverage and have been without insurance for 6 months or more.

To increase awareness for the program, HHS will offer payment for insurance brokers and agents for successfully connecting eligible enrollees with the PCIP program, said Richard Popper, deputy director of insurance programs in the Office of Consumer Information and Insurance Oversight.

Those seeking coverage under the PCIP will no longer have to wait to receive a denial letter from their insurance company in order to enroll. Instead, they can provide attestation of their condition from their physician, nurse practitioner, or physician assistant. Patients with pre-existing conditions still will be required to be without insurance for 6 months before they are eligible for coverage under the plan, said Mr. Popper. He added that HHS does not have the authority to waive the 6-month waiting period under the current health law.

Ms. Sebelius emphasized HHS’s priority to increase enrollment in the program.

"It's encouraging to see more people who need health insurance the most getting it, but we know that's not enough," Ms. Sebelius said.

The measures comply with the ACA provision requiring the PCIP to align premiums and benefits with the private insurance market, Mr. Popper said. However, he said there's still plenty of room for new enrollees.

"We've been enrolling people at an increasing rate, but we know we have the capacity to cover even more people," Mr. Popper said.

He added that funding for the measures will fall under the original $5 billion set aside for the program through the health reform law, as well as existing member premiums.

Despite original HHS estimates that several hundred thousand people would benefit from the PCIP, 18,313 people were enrolled as of early May.

PCIP is run by the federal government in 23 states and the District of Columbia; remaining states operate their own programs using funding from the ACA. HHS sent letters to those 27 state programs, encouraging them to consider similar reforms to their programs.

A 40% premium cut and simpler enrollment procedures are two changes the federal government is employing to increase enrollment in the Pre-Existing Condition Insurance Plan, Health and Human Services Secretary Kathleen Sebelius announced during a press briefing May 31.

Launched in July 2010 under the Affordable Care Act (ACA), the Pre-Existing Condition Insurance Plan (PCIP) provides an insurance option for people with pre-existing conditions who have been denied coverage and have been without insurance for 6 months or more.

To increase awareness for the program, HHS will offer payment for insurance brokers and agents for successfully connecting eligible enrollees with the PCIP program, said Richard Popper, deputy director of insurance programs in the Office of Consumer Information and Insurance Oversight.

Those seeking coverage under the PCIP will no longer have to wait to receive a denial letter from their insurance company in order to enroll. Instead, they can provide attestation of their condition from their physician, nurse practitioner, or physician assistant. Patients with pre-existing conditions still will be required to be without insurance for 6 months before they are eligible for coverage under the plan, said Mr. Popper. He added that HHS does not have the authority to waive the 6-month waiting period under the current health law.

Ms. Sebelius emphasized HHS’s priority to increase enrollment in the program.

"It's encouraging to see more people who need health insurance the most getting it, but we know that's not enough," Ms. Sebelius said.

The measures comply with the ACA provision requiring the PCIP to align premiums and benefits with the private insurance market, Mr. Popper said. However, he said there's still plenty of room for new enrollees.

"We've been enrolling people at an increasing rate, but we know we have the capacity to cover even more people," Mr. Popper said.

He added that funding for the measures will fall under the original $5 billion set aside for the program through the health reform law, as well as existing member premiums.

Despite original HHS estimates that several hundred thousand people would benefit from the PCIP, 18,313 people were enrolled as of early May.

PCIP is run by the federal government in 23 states and the District of Columbia; remaining states operate their own programs using funding from the ACA. HHS sent letters to those 27 state programs, encouraging them to consider similar reforms to their programs.

A 40% premium cut and simpler enrollment procedures are two changes the federal government is employing to increase enrollment in the Pre-Existing Condition Insurance Plan, Health and Human Services Secretary Kathleen Sebelius announced during a press briefing May 31.

Launched in July 2010 under the Affordable Care Act (ACA), the Pre-Existing Condition Insurance Plan (PCIP) provides an insurance option for people with pre-existing conditions who have been denied coverage and have been without insurance for 6 months or more.

To increase awareness for the program, HHS will offer payment for insurance brokers and agents for successfully connecting eligible enrollees with the PCIP program, said Richard Popper, deputy director of insurance programs in the Office of Consumer Information and Insurance Oversight.

Those seeking coverage under the PCIP will no longer have to wait to receive a denial letter from their insurance company in order to enroll. Instead, they can provide attestation of their condition from their physician, nurse practitioner, or physician assistant. Patients with pre-existing conditions still will be required to be without insurance for 6 months before they are eligible for coverage under the plan, said Mr. Popper. He added that HHS does not have the authority to waive the 6-month waiting period under the current health law.

Ms. Sebelius emphasized HHS’s priority to increase enrollment in the program.

"It's encouraging to see more people who need health insurance the most getting it, but we know that's not enough," Ms. Sebelius said.

The measures comply with the ACA provision requiring the PCIP to align premiums and benefits with the private insurance market, Mr. Popper said. However, he said there's still plenty of room for new enrollees.

"We've been enrolling people at an increasing rate, but we know we have the capacity to cover even more people," Mr. Popper said.

He added that funding for the measures will fall under the original $5 billion set aside for the program through the health reform law, as well as existing member premiums.

Despite original HHS estimates that several hundred thousand people would benefit from the PCIP, 18,313 people were enrolled as of early May.

PCIP is run by the federal government in 23 states and the District of Columbia; remaining states operate their own programs using funding from the ACA. HHS sent letters to those 27 state programs, encouraging them to consider similar reforms to their programs.

A 40% premium cut and simpler enrollment procedures are two changes the federal government is employing to increase enrollment in the Pre-Existing Condition Insurance Plan, Health and Human Services Secretary Kathleen Sebelius announced during a press briefing May 31.

Launched in July 2010 under the Affordable Care Act (ACA), the Pre-Existing Condition Insurance Plan (PCIP) provides an insurance option for people with pre-existing conditions who have been denied coverage and have been without insurance for 6 months or more.

To increase awareness for the program, HHS will offer payment for insurance brokers and agents for successfully connecting eligible enrollees with the PCIP program, said Richard Popper, deputy director of insurance programs in the Office of Consumer Information and Insurance Oversight.

Those seeking coverage under the PCIP will no longer have to wait to receive a denial letter from their insurance company in order to enroll. Instead, they can provide attestation of their condition from their physician, nurse practitioner, or physician assistant. Patients with pre-existing conditions still will be required to be without insurance for 6 months before they are eligible for coverage under the plan, said Mr. Popper. He added that HHS does not have the authority to waive the 6-month waiting period under the current health law.

Ms. Sebelius emphasized HHS’s priority to increase enrollment in the program.

"It’s encouraging to see more people who need health insurance the most getting it, but we know that’s not enough," Ms. Sebelius said.

The measures comply with the ACA provision requiring the PCIP to align premiums and benefits with the private insurance market, Mr. Popper said. However, he said there’s still plenty of room for new enrollees.

"We’ve been enrolling people at an increasing rate, but we know we have the capacity to cover even more people," Mr. Popper said.

He added that funding for the measures will fall under the original $5 billion set aside for the program through the health reform law, as well as existing member premiums.

Despite original HHS estimates that several hundred thousand people would benefit from the PCIP, 18,313 people were enrolled as of early May.

PCIP is run by the federal government in 23 states and the District of Columbia; remaining states operate their own programs using funding from the ACA. HHS sent letters to those 27 state programs, encouraging them to consider similar reforms to their programs.

A 40% premium cut and simpler enrollment procedures are two changes the federal government is employing to increase enrollment in the Pre-Existing Condition Insurance Plan, Health and Human Services Secretary Kathleen Sebelius announced during a press briefing May 31.

Launched in July 2010 under the Affordable Care Act (ACA), the Pre-Existing Condition Insurance Plan (PCIP) provides an insurance option for people with pre-existing conditions who have been denied coverage and have been without insurance for 6 months or more.

To increase awareness for the program, HHS will offer payment for insurance brokers and agents for successfully connecting eligible enrollees with the PCIP program, said Richard Popper, deputy director of insurance programs in the Office of Consumer Information and Insurance Oversight.

Those seeking coverage under the PCIP will no longer have to wait to receive a denial letter from their insurance company in order to enroll. Instead, they can provide attestation of their condition from their physician, nurse practitioner, or physician assistant. Patients with pre-existing conditions still will be required to be without insurance for 6 months before they are eligible for coverage under the plan, said Mr. Popper. He added that HHS does not have the authority to waive the 6-month waiting period under the current health law.

Ms. Sebelius emphasized HHS’s priority to increase enrollment in the program.

"It’s encouraging to see more people who need health insurance the most getting it, but we know that’s not enough," Ms. Sebelius said.

The measures comply with the ACA provision requiring the PCIP to align premiums and benefits with the private insurance market, Mr. Popper said. However, he said there’s still plenty of room for new enrollees.

"We’ve been enrolling people at an increasing rate, but we know we have the capacity to cover even more people," Mr. Popper said.

He added that funding for the measures will fall under the original $5 billion set aside for the program through the health reform law, as well as existing member premiums.

Despite original HHS estimates that several hundred thousand people would benefit from the PCIP, 18,313 people were enrolled as of early May.

PCIP is run by the federal government in 23 states and the District of Columbia; remaining states operate their own programs using funding from the ACA. HHS sent letters to those 27 state programs, encouraging them to consider similar reforms to their programs.

A 40% premium cut and simpler enrollment procedures are two changes the federal government is employing to increase enrollment in the Pre-Existing Condition Insurance Plan, Health and Human Services Secretary Kathleen Sebelius announced during a press briefing May 31.

Launched in July 2010 under the Affordable Care Act (ACA), the Pre-Existing Condition Insurance Plan (PCIP) provides an insurance option for people with pre-existing conditions who have been denied coverage and have been without insurance for 6 months or more.

To increase awareness for the program, HHS will offer payment for insurance brokers and agents for successfully connecting eligible enrollees with the PCIP program, said Richard Popper, deputy director of insurance programs in the Office of Consumer Information and Insurance Oversight.

Those seeking coverage under the PCIP will no longer have to wait to receive a denial letter from their insurance company in order to enroll. Instead, they can provide attestation of their condition from their physician, nurse practitioner, or physician assistant. Patients with pre-existing conditions still will be required to be without insurance for 6 months before they are eligible for coverage under the plan, said Mr. Popper. He added that HHS does not have the authority to waive the 6-month waiting period under the current health law.

Ms. Sebelius emphasized HHS’s priority to increase enrollment in the program.

"It’s encouraging to see more people who need health insurance the most getting it, but we know that’s not enough," Ms. Sebelius said.

The measures comply with the ACA provision requiring the PCIP to align premiums and benefits with the private insurance market, Mr. Popper said. However, he said there’s still plenty of room for new enrollees.

"We’ve been enrolling people at an increasing rate, but we know we have the capacity to cover even more people," Mr. Popper said.

He added that funding for the measures will fall under the original $5 billion set aside for the program through the health reform law, as well as existing member premiums.

Despite original HHS estimates that several hundred thousand people would benefit from the PCIP, 18,313 people were enrolled as of early May.

PCIP is run by the federal government in 23 states and the District of Columbia; remaining states operate their own programs using funding from the ACA. HHS sent letters to those 27 state programs, encouraging them to consider similar reforms to their programs.