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Daily Rounds: Harvard Faces $1B For Retiree Health; State Mental Health Cuts Loom; Nevada Looks To MA Transparency

Retiree expenses constrain colleges - The Boston Globe
Harvard’s liability for medical coverage will approach $1 billion next year, exceeding the obligations of a mid-size city. And like many local governments, elite schools could face a host of difficult choices as they try to meet these obligations, from reneging on promised benefits and cutting spending to raising tuition.
“They’re going to have to get out of that business,’’ said Joseph Mercurio, executive vice president of Boston University, which does not have a retiree medical plan. “It’s just too expensive.’’
A Globe review of financial reports at numerous private and public schools showed that retiree health benefit liabilities, which have received relatively little public attention, are enormous. In fiscal 2010, Harvard University’s obligation for retiree medical benefits exceeded its pension obligations for the first time. (boston.com)

Massachusetts mental health care funding cutbacks worry counselors | masslive.com
“There's a waiting list for virtually every service the department or its vendors offer. There's people waiting for housing, treatment, clubhouse services. When people with serious mental illnesses are not being treated, it's not a good thing for anyone.” Yet, things could soon get worse. A proposal by Gov. Deval Patrick would shave an additional $21.4 million from DMH's budget in fiscal 2012, leaving that department to operate on $606.9 million - its smallest budget in the last six years and more than $39 million less than its peak funding period in 2008. If approved by the legislature, $2 million will be cut from child and adolescent mental health services, a reduction that is expected to affect 165 Bay State families. Some $3 million more will be slashed from adult mental health services, impacting 2,000 adults The biggest cut, however, is reserved for DMH's inpatient account where a $16.4 million reduction will wipe out 160 beds for those in need of hospitalization. (MassLive.com)

Admitting harm protects patients - Sunday, March 27, 2011 | 2 a.m. - Las Vegas Sun
BOSTON — As Nevada legislators debate this week whether to require hospitals to publicly report when they harm patients, they could learn a lot from Paul Levy’s experience in pulling back the veil of hospital secrecy. Levy became a revolutionary figure in medicine when, as CEO of Beth Israel Deaconess — then the weak sibling among Harvard University’s teaching hospitals — he began blogging about injuries and infections suffered by his hospital’s patients. His competitors eventually followed suit and now, with Massachusetts law imposing transparency, they acknowledge openness has brought greater accountability and a more focused commitment to protecting patients. (lasvegassun.com)

Health Procedures’ Costs Vary Widely Across Texas - NYTimes.com
The cost of common medical procedures paid for by Medicaid — the joint state-federal health care program for indigent children, the disabled and the very poor — varies dramatically by hospital and region, according to a Texas Tribune analysis of claims by and payments to hundreds of hospitals statewide. State health officials, seeking ways to curb Medicaid costs and address the concerns of hospitals on the lower end of the payment spectrum, have proposed a single base rate for all hospitals — with a variety of allowances for expensive-to-operate facilities. Such a formula, they say, would save Texas, which faces an enormous budget shortfall, an estimated $74 million over the next two years — and up to $2.8 billion if lawmakers set the rate at the bare minimum. (nytimes.com)

Patrick's Reform Effort Fuels Health Care Community Debate | Worcester Business Journal
Dr. H. Eugene Lindsey, president of Atrius Health in Boston, which owns Southborough Medical Group and a handful of other Central Massachusetts doctors’ offices, told Patrick he wholeheartedly supports the effort to phase out fee-for-service, which pays doctors by the number of services delivered.But he’s slightly skeptical about the governor’s approach. One of the methods being pushed by the governor is a global-payment system in which doctors and hospitals are paid a fixed amount per year to take care of a patient.Hospitals that adopt the new global-payment structure will be subject to a number of new reporting requirements, and that doesn’t sit well with Lindsey.“If by making the switch I’m subjecting myself to closer scrutiny and possibly more costs, why would I do it?” Lindsey quipped during a phone interview the day after Patrick’s visit. (Worcester Business Journal Online)

Benefit Caps Could Pose Problems For Young Adults | Worcester Business Journal
When it comes to a number of plans for individual young adults available through the Health Connector, one feature could leave 18- to 26-year-olds in a lurch: benefit caps on some of the plans as low as $50,000 per year. That is 15 times lower than the $750,000 minimum annual cap required under the federal law, which mandates a $1.25-million minimum cap by September and the elimination of benefit caps altogether by 2014. (Worcester Business Journal Online)

This program aired on March 28, 2011. The audio for this program is not available.

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