Reports and Studies Worth Reading – January 21, 2013

Reports and Studies Worth Reading – January 21, 2013:

 

Detroit Future City: Detroit Strategic Framework PlanDetroit Works Project Long Term Planning Steering Committee

“In 2010 an ambitious effort to re-imagine a better future for one of the world’s most important and storied cities was launched. The project has been both an exciting and, at times, challenging journey. It has also been a collective journey,  inviting diverse input from technical experts within Detroit and around the world and, most importantly, the community experts and everyday citizens who would be most affected by its recommendations. Each has played a critical role in forming what we hope will become a living framework for change and development in Detroit.”

$3 billion General Obligation Bond Proposal: Los Angeles Emergency Local Street Safety and Traffic Improvement MeasureLA City Council members Mitch Englander and Joe Buscaino

“Street repair in Los Angeles was underfunded from the 1950’s to 1990’s, allowing many streets to deteriorate.  Funding of pavement preservation was steadily increased from 2005 to present, preventing further decline in road system quality.  Annual funding focuses on streets in A, B, and C condition.  The Los Angeles Emergency Local Street Safety and Traffic Improvement Measure is needed to finance repair of streets in D and Failed condition.”

Economic Outlook and Revenue Estimates for Michigan FY 2012/13 through FY 2014/15Michigan House Fiscal Agency

“This report includes a national and State economic forecast for calendar year 2012 through calendar year 2015.  It also presents preliminary final General Fund/General Purpose (GF/GP) and School Aid Fund (SAF) revenue for FY 2011-12., revised revenue estimates for FY 2012/13 and FY 2013/14 and initial estimates for FY 2014/15. Estimates reported herein will be presented to the Consensus Revenue Estimating Conference on January 11, 2013 and will be used to facilitate the consensus estimating process.”

ASPE Issue Brief: Growth in Medicare Spending per Beneficiary Continues to Hit Historic LowsUS Department of Health and Human Services

“Medicare spending per beneficiary grew just 0.4% per capita in fiscal year 2012, continuing a pattern of very low growth in 2010 and 2011. Together with historically low projections of per capita growth from both the Congressional Budget Office and the Centers for Medicare and Medicaid Services (CMS) Office of the Actuary, these statistics show that the Affordable Care Act has helped to set Medicare on a more sustainable path to keep its commitment to seniors and persons with disabilities today and well into the future.”

NY Rising: 2013 State of the State  – Governor Andrew M. Cuomo

“Two years ago, I said we were at a crossroads; that New York needed to chart a new course and begin a journey to rebuild our state. It was imperative that we restore the public trust and renew the dream and reverse decades of decline. We started a New York comeback. The core elements of a New NY are: attract good jobs and economic growth; create a world-class education system that prepares the next generation for the future; establish fiscal integrity and discipline; and restore New York as the progressive capital of the nation.”

2013 is a Good Year to Repair State Rainy Day FundsCenter on Budget and Policy Priorities

“The last decade’s roller-coaster economy has highlighted the importance of state “rainy day funds” — budget reserves for when recessions or other unexpected events cause revenue declines or spending increases. States with rainy day funds were able to avert over $20 billion in cuts to services and/or tax increases in the recession of the early 2000s. Rainy day funds also helped states avoid service cuts and tax increases in the most recent recession.”

Financial Challenges Facing Local Governments: Federal and State Aid Shrink as a Share of Revenues NY State Office of the Comptroller

“From 2001 to 2011, total federal and state aid combined, grew at an average rate of 2.2 percent annually, slower than the rate of inflation (2.4 percent). To cover expenses, local governments have been forced to rely more heavily on revenues generated through sales taxes and real property taxes, which grew at annual rates of 5.9 percent and 4.2 percent, respectively. Federal aid to local governments grew by $932 million from 2001 to 2011, or by 3.5 percent annually on average. However, this increase is largely attributable to the infusion of temporary funds from the American Reinvestment and Recovery Act (ARRA) of 2009.”

2013-14 California Governor’s Budget SummaryGovernor Edmund G. Brown, Jr.

“California today is poised to achieve something that has eluded us for more than a decade — a budget that lives within its means, now and for many years to come. We are in this favorable position both because of the huge budget reductions that you have made in the last two years, and because the people voted for Proposition 30. Under this budget, K‑12 school districts will see an increase in funds. School districts serving those students who have the greatest challenges will receive more generous increases — so that all students in California have the opportunity to succeed. This budget also focuses more responsibility and accountability on those who are closest to our students.”

Governor Brown Proposes Balanced Budget Highlighted by New Revenues, Investments in Education, and Expanded Health CoverageCalifornia Budget Project

“The Governor proposes to increase General Fund spending by 5 percent, from $93 billion in 2012-13 to $97.7 billion in 2013-14. The Governor’s proposed budget includes increased funding levels for K-12 schools and higher education and calls for the expansion of Medi-Cal, the state’s health care program for low-income families, as part of the state’s implementation of federal health care reform. The Governor’s proposal also includes a $1 billion reserve and pays down $4.2 billion in budget-related debt.”

 

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Medicare’s cost controls can’t control an aging population (Washington Post)

January 10, 2013  – Below is a chart, published by Health and Human Services, that shows how quickly the agency expects Medicare costs to grow over the next two decades. Most of the growth above and beyond overall economic growth has to do with the Medicare population getting older and bigger. That’s what you see in the blue bars. It’s also worth looking at the red bars, which represent the “excess cost growth,” essentially medical prices growing faster than the rest of the economy. This report projects that Medicare cost growth will actually be slower through 2022.

Link to Full Article: http://www.washingtonpost.com/blogs/wonkblog/wp/2013/01/10/medicare-doesnt-think-its-own-cost-controls-will-work/

US Department of Health and Human Services

‘Doc Fix’ In ‘Fiscal Cliff’ Plan Cuts Medicare Hospital Payments (Kaiser Health News)

January 2, 2013 – Legislation passed by Congress New Year’s Day to avert the dreaded “fiscal cliff” would stop a scheduled payment cut in Medicare physician payments. But hospitals, which have to bear a major part of financing for that “doc fix,” are not happy. The bill would require that, over the next decade, hospitals pick up nearly half  of the approximately $30 billion cost of stopping a 26.5 percent payment cut for Medicare physicians, scheduled to begin today. The 26.5 percent reduction for doctors comes from a payment formula created in a 1997 deficit reduction law. For the first few years, doctors received modest pay increases.

Link to Full Article: http://capsules.kaiserhealthnews.org/index.php/2013/01/doc-fix-in-senate-fiscal-cliff-plan-cuts-medicare-hospital-payments/

Medicare Discloses Hospitals’ Bonuses, Penalties Based On Quality (Kaiser Health News)

December 20, 2012 – Medicare on Thursday disclosed bonuses and penalties for nearly 3,000 hospitals as it ties almost $1 billion in payments to the quality of care provided to patients. The revised payments, which will begin in January, mark the federal government’s most extensive effort yet to hold hospitals financially accountable for what happens to patients. In what amounts to a nationwide competition, Medicare compared hospitals on how faithfully they followed rudimentary standards of care and how patients rated their experiences. In many regions, the hospitals that did the best are not the ones with the most outsized reputations, but regional and community hospitals.

Link to Full Article: http://www.kaiserhealthnews.org/Stories/2012/December/21/medicare-hospitals-value-based-purchasing.aspx

Uwe Reinhardt: Medicare Spending Isn’t Out of Control (NY Times)

December 21, 2012 – It’s the season of holiday cocktail parties, demanding intelligent chit-chat over Chardonnay. In such data-free environments it is always safe to say, “Medicare spending is out of control!” Wise heads will nod, because it is a credo with wide currency. After all, as I explained in my previous post, traditional Medicare, which still attracts about 75 percent of all Medicare beneficiaries, affords its enrollees free choice of providers and therapy. In the jargon of health-policy wonks, it is “unmanaged.” Thus, it would not be surprising if unmanaged Medicare spending were, indeed, out of control.

Link to Full Article: http://economix.blogs.nytimes.com/2012/12/21/medicare-spending-isnt-out-of-control/

Surprise!: Investigators find Medicare paying 4x the average cost for off-the-shelf back braces (Wash. Post)

December 20, 2012 – A federal report released Wednesday offers a look at how wasteful spending drives up health care costs as investigators found that Medicare paid $919 on average for back braces that cost suppliers an average of $191 each. “The program and its beneficiaries could have paid millions of dollars less if the Medicare reimbursement amount … more closely resembled the cost to suppliers,” according to the report from the inspector general of the Department of Health and Human Services. It’s estimated that the health care system squanders $750 billion a year, about 30 cents of every medical dollar, through unneeded care, wasteful spending and fraud.

Link to Full Article: http://www.washingtonpost.com/business/investigators-find-medicare-is-paying-4-times-the-cost-for-off-the-shelf-back-braces/2012/12/19/46435afe-49b3-11e2-8af9-9b50cb4605a7_story.html

Hospitals Fear They’ll Bear Brunt of Medicare Cuts (NY Times)

December 18, 2012 – As President Obama and Congress try to thrash out a budget deal, the question is not whether they will squeeze money out of Medicare, but how much and who will bear the brunt of the cuts. Republicans say that some of the savings should come from beneficiaries, and they are pushing proposals like raising the eligibility age or increasing premiums for people with high incomes, who already pay more than the standard premium. Even President Obama has proposed higher premiums, increasing the likelihood that the idea could be adopted.

Link to Full Article: http://www.nytimes.com/2012/12/19/business/medicare-cuts-how-deep-and-where.html