CMA Supports Physicians' Rights to Fair Peer Review, -AND- CMS: HEALTH CARE SPENDING REACHES $1.6 TRILLION IN 2002

[CAL/AAEM News Service]

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-----Original Message-----

From: cma_alert@cmanews.org [mailto:cma_alert@cmanews.org] 

Sent: Thursday, January 08, 2004 2:50 PM

3. CMA Supports Physicians' Rights to Fair Peer Review

CMA filed an amicus brief this week with the California Court of Appeal in San Diego, supporting physicians' fundamental rights to fair peer review hearings and procedures.

In this case, Penny Pancoast, M.D., v. Medical Staff of Sharp Memorial Hospital, Dr. Pancoast was summarily suspended from a hospital medical staff despite the fact she was on a voluntary leave of absence and was not admitting or treating patients at the hospital. Dr. Pancoast successfully obtained a trial court order that her privileges be restored. The hospital has petitioned the state court of appeal to reverse the trial court's ruling. 

According to state law (Business & Professions Code §809.5), summary suspension-the abrupt suspension of a physician's hospital privileges without first providing a fair hearing-should only be imposed when a physician poses an "imminent danger" to patients' health and safety. In the brief, CMA argued that hospitals must not be allowed to deny physicians their legal right to due process by ignoring the legal standard and summarily suspending physicians whose conduct does not pose an "imminent danger" to patients. Instead, the hospital and medical staff should be required to provide a notice of charges and opportunity for a hearing as required by the law, and the physician's privileges and membership should be unaffected during that process.

"Such a suspension and the subsequent reporting [to the Medical Board of California and the National Practitioner Data Bank] impose a severe professional stigma that stays with a doctor the rest of her professional career. Every application and biannual reapplication for hospital privileges, every application for malpractice insurance, every application for membership in a professional society and-most importantly-every application for economic participation as a provider in health plans, large medical groups and IPAs asks whether the doctor's privileges have been suspended," the brief stated. "Because of the irreversible consequences...the summary suspension mechanism cannot and should not be used except in cases where the medical staff can affirmatively demonstrate real imminent harm to identifiable patients." The court is not expected to make a ruling on the case for several months.

Click here <http://www.calphys.org/html/bb469.asp> for more information, including a copy of CMA's brief



========================================

-----Original Message-----

From: Ulric Wair [mailto:UWair@CMS.HHS.GOV] 

Sent: Thursday, January 08, 2004 6:22 AM

CMS NEWS - FOR IMMEDIATE RELEASE

CMS Public Affairs Office

Thursday, January 8, 2004

HEALTH CARE SPENDING REACHES $1.6 TRILLION IN 2002

Health care spending in the United States rose to $1.6 trillion in 2002, up from $1.4 trillion in 2001 and $1.3 trillion in 2000, according to a report issued today by the Centers for Medicare & Medicaid Services (CMS).

The growth rate of 9.3 percent for 2002, the latest year for which actual spending figures are available, compared to 8.5 percent in 2001 and marked the 6th consecutive year in which health spending grew at an accelerated rate.

Health expenditures per person averaged $5,440 in 2002, up $419 from $5,021 in 2001. Per person spending in 2000 was $4,670.

In 2002, health spending grew 5.7 percentage points faster than the overall economy as measured by growth of the gross domestic product

(GDP) - the total value of goods and services produced in the United States.

The health care share of GDP increased to 14.1 percent in 2001 and 14.9 in 2002, after nearly a decade in the 13.1 to 13.4 percent-of-GDP range, said an article by economists in CMS' Office of the Actuary that appeared today in the journal Health Affairs.

Prescription drugs continued to lead the rise in personal health care expenditures, with a 15.3 percent jump in 2002. However, this was down slightly from the 15.9 percent increase measured in 2001. Total spending for prescription drugs for the year was $162.4 billlion, compared with $140.8 billion in 2001.

While the growth in private health insurance spending for prescription drugs at 16.1 percent slowed in 2002, out-of-pocket spending for prescription drugs sped up to 14.4 percent as the effect of tiered drug formulaires shifted more of the cost to consumers.

Hospital spending increased by 9.5 percent in 2002 to $486.5 billion, marking the fourth consecutive year of accelerated growth and the first time the rate of hospital spending outpaced overall spending rate of growth since 1991.

The resurgence in hospital spending growth since 2000 followed a period of managed care expansion that dampened growth in inpatient hospital utilization. Recent spending trends reflect growing demands for services, rising compensation and other input costs as well as the increased ability of hospitals to negotiate higher prices from private payers.

Spending for physician services reached $340 billion in 2002, an increase of 7.7 percent that was slightly slower than the growth rate of 8.6 percent in 2001.

Expenditures for free-standing home health agencies grew by 7.2 percent in 2002, the second consecutive year of expansion driven primarily by a rebound in Medicare spending. A change in the statutory definition of "homebound" expanded the number of beneficiaries eligible for Medicare services.

Private payers funded more than half of national health expenditures in 2002, with private health insurance contributing $549.6 billion, 35 percent of the total. Out of pocket payments of $212.5 billion accounted for 14 percent of expenditures and continued to decline as a share of total spending. More than half the increase in out-of-pocket spending for all health services came from increases in out-of-pocket spending for prescription drugs.

The public sector accounted for the remaining 46 percent of health payments, with the Medicaid program, funding 16 percent of aggregate spending, or $249 billion, nearly equaling the 17 percent, $267 billion, spent by Medicare.




Brian Potts 
Managing Editor, CAL/AAEM News Service 
MS-IV, UC-Irvine

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<DIV>
<DIV><FONT size=2><FONT size=2>
<P></P>
<P></P>
<P>-----Original Message-----</P>
<P>From: cma_alert@cmanews.org [</FONT><A href="mailto:cma_alert@cmanews.org"><U><FONT color=#0000ff size=2>mailto:cma_alert@cmanews.org</U></FONT></A><FONT size=2>] </P>
<P>Sent: Thursday, January 08, 2004 2:50 PM</P>
<P>3. CMA Supports Physicians' Rights to Fair Peer Review</P>
<P>CMA filed an amicus brief this week with the California Court of Appeal in San Diego, supporting physicians' fundamental rights to fair peer review hearings and procedures.</P>
<P>In this case, Penny Pancoast, M.D., v. Medical Staff of Sharp Memorial Hospital, Dr. Pancoast was summarily suspended from a hospital medical staff despite the fact she was on a voluntary leave of absence and was not admitting or treating patients at the hospital. Dr. Pancoast successfully obtained a trial court order that her privileges be restored. The hospital has petitioned the state court of appeal to reverse the trial court's ruling. </P>
<P>According to state law (Business &amp; Professions Code §809.5), summary suspension-the abrupt suspension of a physician's hospital privileges without first providing a fair hearing-should only be imposed when a physician poses an "imminent danger" to patients' health and safety. In the brief, CMA argued that hospitals must not be allowed to deny physicians their legal right to due process by ignoring the legal standard and summarily suspending physicians whose conduct does not pose an "imminent danger" to patients. Instead, the hospital and medical staff should be required to provide a notice of charges and opportunity for a hearing as required by the law, and the physician's privileges and membership should be unaffected during that process.</P>
<P>"Such a suspension and the subsequent reporting [to the Medical Board of California and the National Practitioner Data Bank] impose a severe professional stigma that stays with a doctor the rest of her professional career. Every application and biannual reapplication for hospital privileges, every application for malpractice insurance, every application for membership in a professional society and-most importantly-every application for economic participation as a provider in health plans, large medical groups and IPAs asks whether the doctor's privileges have been suspended," the brief stated. "Because of the irreversible consequences...the summary suspension mechanism cannot and should not be used except in cases where the medical staff can affirmatively demonstrate real imminent harm to identifiable patients." The court is not expected to make a ruling on the case for several months.</P>
<P>Click here &lt;</FONT><A href="http://www.calphys.org/html/bb469.asp"><U><FONT color=#0000ff size=2>http://www.calphys.org/html/bb469.asp</U></FONT></A><FONT size=2>&gt; for more information, including a copy of CMA's brief</P>
<P></P>
<P></FONT>========================================</P>
<P>-----Original Message-----</P>
<P>From: Ulric Wair [</FONT><A href="mailto:UWair@CMS.HHS.GOV"><U><FONT color=#0000ff size=2>mailto:UWair@CMS.HHS.GOV</U></FONT></A><FONT size=2>] </P>
<P>Sent: Thursday, January 08, 2004 6:22 AM</P>
<P>CMS NEWS - FOR IMMEDIATE RELEASE</P>
<P>CMS Public Affairs Office</P>
<P>Thursday, January 8, 2004</P>
<P>HEALTH CARE SPENDING REACHES $1.6 TRILLION IN 2002</P>
<P>Health care spending in the United States rose to $1.6 trillion in 2002, up from $1.4 trillion in 2001 and $1.3 trillion in 2000, according to a report issued today by the Centers for Medicare &amp; Medicaid Services (CMS).</P>
<P>The growth rate of 9.3 percent for 2002, the latest year for which actual spending figures are available, compared to 8.5 percent in 2001 and marked the 6th consecutive year in which health spending grew at an accelerated rate.</P>
<P>Health expenditures per person averaged $5,440 in 2002, up $419 from $5,021 in 2001. Per person spending in 2000 was $4,670.</P>
<P>In 2002, health spending grew 5.7 percentage points faster than the overall economy as measured by growth of the gross domestic product</P>
<P>(GDP) - the total value of goods and services produced in the United States.</P>
<P>The health care share of GDP increased to 14.1 percent in 2001 and 14.9 in 2002, after nearly a decade in the 13.1 to 13.4 percent-of-GDP range, said an article by economists in CMS' Office of the Actuary that appeared today in the journal Health Affairs.</P>
<P>Prescription drugs continued to lead the rise in personal health care expenditures, with a 15.3 percent jump in 2002. However, this was down slightly from the 15.9 percent increase measured in 2001. Total spending for prescription drugs for the year was $162.4 billlion, compared with $140.8 billion in 2001.</P>
<P>While the growth in private health insurance spending for prescription drugs at 16.1 percent slowed in 2002, out-of-pocket spending for prescription drugs sped up to 14.4 percent as the effect of tiered drug formulaires shifted more of the cost to consumers.</P>
<P>Hospital spending increased by 9.5 percent in 2002 to $486.5 billion, marking the fourth consecutive year of accelerated growth and the first time the rate of hospital spending outpaced overall spending rate of growth since 1991.</P>
<P>The resurgence in hospital spending growth since 2000 followed a period of managed care expansion that dampened growth in inpatient hospital utilization. Recent spending trends reflect growing demands for services, rising compensation and other input costs as well as the increased ability of hospitals to negotiate higher prices from private payers.</P>
<P>Spending for physician services reached $340 billion in 2002, an increase of 7.7 percent that was slightly slower than the growth rate of 8.6 percent in 2001.</P>
<P>Expenditures for free-standing home health agencies grew by 7.2 percent in 2002, the second consecutive year of expansion driven primarily by a rebound in Medicare spending. A change in the statutory definition of "homebound" expanded the number of beneficiaries eligible for Medicare services.</P>
<P>Private payers funded more than half of national health expenditures in 2002, with private health insurance contributing $549.6 billion, 35 percent of the total. Out of pocket payments of $212.5 billion accounted for 14 percent of expenditures and continued to decline as a share of total spending. More than half the increase in out-of-pocket spending for all health services came from increases in out-of-pocket spending for prescription drugs.</P>
<P>The public sector accounted for the remaining 46 percent of health payments, with the Medicaid program, funding 16 percent of aggregate spending, or $249 billion, nearly equaling the 17 percent, $267 billion, spent by Medicare.</P></FONT></DIV></DIV><BR><BR><STRONG>Brian Potts <BR>Managing Editor, CAL/AAEM News Service</STRONG> <BR>MS-IV, UC-Irvine<p><hr SIZE=1>
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