$1 Billion for New Health Care Jobs

ObamaCare seeks more participants’ involvement in Medicare and Medicaid.

Because Obama’s “can wait” Jobs Act fell flat, the White House will pour $1 billion into jobs for health workers.

If you can’t create green jobs with multi-million dollar loans to outfits such as solar failure Solyndra, and if you can’t entice business with temporary tax relief to sign up employees, or pay local governments to hire more cops and teachers, with the $474 million Jobs Act, you just buy health care workers for $1 billion.

Anything to fade the unemployment shadow hanging over re-election 2012.

On Nov. 14, the Centers for Medicare and Medicaid announced what it called a “funding opportunity” of up to $1 billion for “innovative projects across the country to deliver health care.” Importantly, “Priority will be given to projects” that hire people rapidly...” Get that jobless figure down before it kills us politically, the White House obviously is thinking.

The money for new health jobs will come, of course, from ObamaCare. The stated aim is to find new ideas for care to people in Medicare, Medicaid and CHIP (the children’s health program).

The new money will be handed out in grants to organizations and local governments that work with patients in those federal programs, a Washington Post article reported. The health care sector is one of the few areas where jobs already are growing.

According to the Bureau of Labor Statistics (BLS) “Health Care employment continued to expand in October 2011 (+12,000), following a gain of 45,000 in September. Offices of physicians added 8,000 jobs in October. Over the past 12 months, health care has added 313,000 jobs." Health care jobs are expected to grow by 3.2 million by the end of this decade, BLS said.

Undoubtedly many of these new job holders are bureaucrats connected to the expansive ObamaCare program, which may not even be alive, if the Supreme Court strikes it down. The high court decided to hear arguments in March for and against ObamaCare’s constitutionality. A decision may come before the 2012 election.

One portion of Obama’s $447 million “can’t wait”-pressure for Congress to act on his jobs plan finally won passage in the normally road-blocking Senate. The bill is designed to hire veterans by giving temporary tax credits to business employers.

The Obama administration probably believes a much larger health workforce will be required to deal with the health care insurance program when it is scheduled to begin to encompass millions of Americans in 2014. At least 32 million people are expected to be covered by insurance in 2016, if the law lives on.

The Association of American Medical Colleges estimates that in the next decade nearly one-third of current doctors will retire, and the country will face a shortage of more than 90,000 doctors. By 2025, the projected deficit of physicians will reach more than 130,000 in all specialties.

The country has a current population of 310 million. This number grows by 25 million every decade. Of the total, 37 million are 65 or older.

The Health Care Innovative Challenge, as it is called, will be a hustle-up program.  Grants will be given as early as this coming March. Applicants must have their “letter of intent” in by Dec. 19, with applications due by Jan. 27.

“Applications will be open to providers, payers, local government, public-private partnerships, and multi-payer collaboratives,” the CMS “Innovation” project said. “The Health Care Innovative Challenge will encourage applicants to include new models...to support their service delivery model proposal. All proposals “must be operational or capable of rapid expansion within six months."

Awardees “will provide regular updates” on their progress and data to CMS. “CMS will also collect from awardees a standard minimum set of performance indicators through its monitoring and coordinating contractors” -- federal "check-up" workers.

In other words, CMS will hire more people to act as “independent entities to assist in monitoring the programs...” That means piling on more employees. Create jobs at any cost seems the objective. “Awardees will also participate in learning sessions about how health care delivery organizations can achieve performance improvements quickly and effectively.” Apparently in the way bureaucrats have shown their remarkable prowess in “working effectively.”

The Innovative Center said it has received ideas from many including the Pioneers Accountable Care Organization model.

As the Disease Management Care Blog (DMCB) said earlier this year, “the Shared Savings Program's Accountable Care Organization (ACO) model is likened to an Edsel, ‘widely considered one of the worst cars of all time.’"

The Disease Management Care Blog updated a parallel ACO program launched by the CMMS Innovation Center on May 17 dubbed "Pioneer."

This three to five year Pioneer ACO Program is tailored to fast-track health providers organizations that already have care coordination programs up and running to what the Feds believe is the next level: ACO status.  During the first 2 years, the candidate organizations will operate under a shared savings arrangement.  If successful, payments will transition, as the DMCB understands it, to a "population-based payment model" that involves a mix of capitation and fee-for-service reimbursements.

Other insurers also have to join in and the number of their patients has to comprise more than 50% of the total. Much of the payment details are being left intentionally vague so that CMS can be flexible, it said.

At least 15,000 Medicare beneficiaries (or, if rural, 5000) have to be available in order for an organization to participate in Pioneer.  While the default is to assign patients prospectively, the organizations can ask for retrospective assignment.  Patients will not be locked into any network.

In the application process, these ACOs will also need to document how they are prepared to meet the needs and preferences of their patients with "patient centered care."  Patients will be notified that they can call a 1-800 number with any concerns.  The Innovations Center hopes 30 programs will eventually participate.

And so the bureaucracy builds and jobs are made, despite there’s only borrowed money to pay for them.

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