Healthcare Roundup: Lobbying $$ Explode, AMA Shakes Down Senate, Physician-Owned Hospitals In Corner, and More

Lobbying Machine Goes Into High Gear - In the first nine months of 2009, $422 million was spent on healthcare lobbyists, 10 percent more than in the same period of 2008. That doesn't include the $122 million that health insurers lavished on lobbyists, or other amounts spent by groups like the U.S. Chamber of Commerce, which opposes healthcare reform and has historically spent more on lobbying than any other organization. The total cost of lobbying Congress and other branches of the federal government is on track to break last year's record of $3.3 billion. [Sources: Fierce Healthcare, Lehrer News Hour, Politico]

Interest Groups Belly Up To The Bar - The AMA says that it has won agreement from Senate leaders to pass a $250 billion "doc fix" that will eliminate planned Medicare payment cuts to physicians. That would pave the way for the House's similar measure to be reconciled with the Senate version. Meanwhile, pharmaceutical industry lobbyists tell the New York Times that they may have to renegotiate their deal with the White House, adding up to $20 billion to the $80 billion they earlier promised to fill the "doughnut hole" in Medicare drug coverage. Still, that wouldn't be such a bad deal considering that the Senate, with Administration support, has already beat back an effort to allow re-importation of prescription drugs from other countries where they cost less. [Source: New York Times]

Physician-Owned Hospitals Under The Gun - A provision in the Senate reform bill would prevent new physician-owned hospitals from being built and restrict the ability of existing specialty hospitals to expand. The provision would grandfather in the current specialty hospitals; if such a hospital is being built now, it must be completed and Medicare-certified by August 2010. While that deadline was extended six months from the original date after fierce lobbying, Physicians Hospital of America, a trade group, contends that 75 of the 127 hospitals currently under construction will not meet the August deadline. PHA seeks to shift the timeline to 2014, but don't bet on that happening, with traditional hospitals pumping for the specialty hospital ban. [Source: Becker's ASC Review] Minnesota Docs Like Value Purchasing - The AMA, some state medical associations, and a coalition of surgical societies all oppose the Senate reform provision that would have Medicare pay physicians more if they provided high-quality, cost-efficient care. But the Minnesota Medical Association favors the provision. Why? For the same reason that other societies oppose it: money. The MMA has long protested the fact that Medicare pays Minnesota physicians less than those in many other areas, and it hopes that the value-based purchasing initiative will help compensate for that geographical disparity. What's interesting about this stand is that Minnesota groups apparently believe they can demonstrate the value of the care they deliver. Could this be related to the fact that most Minnesota doctors belong to large groups and that they've been working on quality improvement for many years? [Sources: Fierce Healthcare, BNET Healthcare]

A Holiday Message - Happy holidays and best wishes for the new year to all of my faithful readers, regardless of your political persuasion. I look forward to your renewed attacks on my positions next year, although I do hope we can come to a meeting of minds on some issues. Let's not forget, we're all in this together!