Perspective: New England Journal Medicine
Perspective: New England Journal Medicine
of
MEDICINE
Perspective
april 12, 2012
oster Friess, a conservative political donor, recently discounted the importance of insurance
coverage for contraceptives, saying, Back in my
days, they used Bayer Aspirin for contraception.
The gals put it between their
knees, and it wasnt that costly.
Though his comment stunned
interviewer Andrea Mitchell, it at
least focused on the issue of contraceptives. Most critics of the
federal effort to ensure access to
contraceptives have reframed the
issue as a war on religion. And
as Georgetown University theologian Tom Reese told National
Public Radio in early February,
If the argument is over religious
liberty, the bishops win. If the
argument is over contraceptives,
the administration wins. Indeed, a 501(c)(4) advocacy group,
Conscience Cause, has already
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for patients with myocardial infarction, pneumonia, or heart failure using claims data. If a hospitals risk-adjusted readmission rate
for such patients exceeds that average, CMS penalizes it in the
following year for all Medicare
admissions in proportion to its
rate of excess rehospitalizations
of patients for the target conditions. Although the maximum
penalty is set at 1% for 2013,
eventually reaching 3% of a hospitals Medicare payments, the
CMS implementation reduces the
potential penalties in aggregate
to only 0.2% of national Medicare
payments in 2013.3 Payments for
hospitals with below-average rehospitalization rates for all three
conditions wont change. Eventually, CMS plans to expand this
program to include other common diagnoses for which readmissions are theoretically preventable, boosting the financial
effects.