Top 5 Health Reform Headlines: ER Shutdowns on the Rise; New Security Questions for EMRs

BY Sarah Clune  May 19, 2011 at 5:14 PM EDT

Here’s a roundup of what’s been happening in health reform this week:

Aggressive Defense of Health Care Law

The federal government sharpened its defense of the health care law this week in a reply brief filed in the 11th Circuit Court of Appeals on Wednesday.

It is a response to a multi-state lawsuit challenging the law. In the new filing, the government claimed that U.S. residents not purchasing health insurance passed billions of dollars in costs to taxpayers.


Politico reports:

The administration is asking the 11th Circuit Court of Appeals to overturn Florida Judge Roger Vinson’s decision to strike down all of President Barack Obama’s signature domestic policy accomplishment. It’s become the most high-profile and politically charged challenge to the law.

Government lawyers are defending the health care overhaul as merely a way of regulating how Americans pay for their health care, a completely constitutional use of Congress’s power.

And, according to The Associated Press:

The U.S. Justice Department’s filing said the states’ proposed solution would require that individuals obtain insurance or “risk being left on the street after a car accident.”

‘The penalty for failing to maintain minimum coverage — denial of treatment — would be far more draconian than the tax penalty that Congress enacted,’ the federal government argued.

HHS Steps Up Efforts to Curb Health Insurance Premium Hikes

The Department of Health and Human Services finalized regulations Thursday that will require insurance companies to disclose and justify rate increases above 10 percent.

According to The Wall Street Journal:

The U.S. government issued a rule Thursday requiring state or federal review of substantial health insurance rate increases for individual and small-group plans, prompting criticism from the managed-care industry.

The Department of Health and Human Services said the rule, arising from the health overhaul law, will moderate premium increases by bringing more transparency to the rate-setting process.

The announcement came days after The New York Times published a front page article on rising insurance premiums — and the rising number of Americans delaying or forgoing care because of concerns over cost.

JAMA: Number of ERs Decline As Emergency Visits Rise

A study out this week by The Journal of the American Medical Association showed the number of emergency departments declined over the last two decades, even as the number of emergency visits are rising.

And, ERs serving the urban poor were the most likely to close.

The New York Times reported:

In 1990, there were 2,446 hospitals with emergency departments in nonrural areas. That number dropped to 1,779 in 2009, even as the total number of emergency room visits nationwide increased by roughly 35 percent.

Emergency departments were most likely to have closed if they served large numbers of the poor, were at commercially operated hospitals, were in hospitals with skimpy profit margins or operated in highly competitive markets, the researchers found.

Report: Security Flaws in Electronic Medical Records

As the Obama administration pushes ahead with plans to increase the use of electronic medical records, two internal reports released Tuesday by the Department of Health and Human Services revealed “significant concerns” about security gaps in the system.

It was featured on the San Francisco Examiner’s “Daily Outrage” blog on Monday:

The investigation audited computer security at seven large hospitals in different states and found 151 major vulnerabilities, including easy passwords, unencrypted laptops and not automatically logging off inactive users.

And, according to the Associated Press

…the second audit examined computer security at seven large hospitals in different states and found 151 security vulnerabilities, from ineffective wireless encryption to a taped-over door lock on a room used for data storage. The auditors classified 4 out of 5 of the weaknesses uncovered as “high impact,” meaning they could result in costly losses, even injury and death.

The government is offering rewards and penalties to encourage hospitals and doctors’ offices to adopt electronic medical records. Incentive payments could total as much as $27 billion over 10 years. Providers who insist on clinging to paper records will eventually face cuts in Medicare payments.

Administration Offers New Path For ACOs

The federal government announced new regulations this week for accountable care organizations this week after facing mounting criticism over the amount of regulation and staggering first-year costs.

Last week, The Hill reported some of the growing discontent over ACOs:

One of the government’s key strategies for reforming the nation’s healthcare system is in trouble, after a second group of leading medical institutions voiced concerns Thursday. In a letter to Medicare administrator Don Berwick, the leaders of 10 clinics that Democrats praised throughout the debate — including world-class institutions such as Geisinger, Billings and Dartmouth-Hitchcock — said they “ALL have serious reservations about the economics and the complexity” of proposed Accountable Care Organization regulations.

This week, The Hill listed some of the changes put forth by the administration, in hopes of regaining support:

• “A Pioneer ACO Model aimed at organizations that have already started coordinating care for patients;

• “An Advanced Payment ACO Initiative that would allow certain participants in the program to get part of their expected savings up front to invest in care coordination; and

• “Free Accelerated Development Learning Sessions to help providers learn how they can improve care delivery and coordination.

“The new initiatives will be run out of the new Center for Medicare and Medicaid Innovation, which was created by the healthcare reform law.”

Find more coverage on our health reform page.