The new year also brings new leadership to the federal health bureaucracy. At press time, President Bush named Michael O. Leavitt as his pick to lead HHS. Mr. Leavitt served as the administrator of the Environmental Protection Agency in the president's first administration and was previously governor of Utah. Mr. Leavitt must be confirmed by the Senate before assuming his new duties.
At the Centers for Medicare and Medicaid Services, much effort will be focused this year on getting ready to launch the new Medicare prescription drug benefit just 1 year from now.
This will be the final year for the drug discount cards that were instituted as a bridge to Medicare drug coverage. The lessons of the drug card should prompt Congress to simplify the Part D drug benefit, said Robert M. Hayes, president of the Medicare Rights Center. But conventional wisdom is that Congress won't do anything to address it this year, and will wait until next year to address problems.
Congress should act to ensure that there is one clear Medicare-run drug plan in every region of the country and that Medicare automatically enrolls low-income seniors. Also, Congress should standardize the benefit packages, he said.
A lot of beneficiary education will be needed this year, said John Rother, director of policy and strategy at AARP (formerly the American Association of Retired Persons), especially since the choices will be different across the country.
Priorities for 2005 At the ACC
Maintaining cardiovascular specialists' ability to provide imaging services to their patients in the office will be one of the top priorities for the American College of Cardiology in 2005, according to Barbara Greenan, the group's senior director of advocacy.
Recently, the radiology community has been pursuing efforts at both the federal and state levels to restrict imaging services performed by nonradiologists by claiming that the growth in imaging services is linked to inappropriate self-referral.
Although ACC is concerned about any inappropriate growth in imaging services, Ms. Greenan said, the group believes that imaging procedures have come under attack unfairly. ACC wants first to investigate the reasons for and the effects of such growth to ensure that there is no reduction in patients' access to quality diagnostic services. The growth in cardiac imaging has also paralleled the increased use of imaging as part of overall ongoing patient care, as well as growth in the prevalence of heart disease.
The best way to address this concern is through an examination that focuses on quality issues, she said.
ACC, which is part of a coalition called Physicians for Patient-Centered Imaging, is working with physician groups, public and private payers, and other health care organizations on these quality efforts and is in the process of developing appropriateness criteria for imaging modalities.
This year, ACC will also be working to get changes made to the Medicare physician fee schedule. ACC plans to work with congressional leaders and the administration, but the tight federal budget situation will make finding solutions difficult, Ms. Greenan said.
ACC will continue to push to enact medical liability reform. Ms. Greenan said they continue to favor reform that would place caps on noneconomic damages.
Mary Ellen Schneider
This Month's Talk Back Question
What do you see as the most important health policy issues in the year ahead?