The need for outpatient facilities in particular is expected to increase as the industry adapts to the ongoing health reform and a move toward accountable care organizations. Outpatient facilities generally provide more access at the local level, and at a lower-cost care overall.

Another driver behind that activity is an expected increase in mergers and acquisitions. The company said that the anticipated activity — of both hospital mergers and the acquisition of physician practices — will create real estate dilemmas for the organizations involved.

The suit was filed by the Arizona Hospital and Healthcare Association in the U.S. District Court in Phoenix.

The suit claims that the 5% rate cut will limit patient access to health care providers in violation of federal law that requires Medicaid payments to hospitals be sufficient to ensure “that beneficiaries have equal access to services.”

The Medicaid rate cut is expected to save the state $95 million this year.

The report, State Trends in Premiums and Deductibles, 2003-2010, found that 62% of people live in states where health insurance premiums are equal to 20% or more of earnings for a middle income worker under 65.

On average, premiums for an employer-sponsored family plan increased by 50% between 2003 and 2010, to $13,871 annually. Even in the five “lowest-cost” states, premiums ranged between $11,379 and $12,409.

And employers aren’t picking up as much of the cost anymore. Since 2003, the employee-paid portion of health insurance has increased by 63% — far more than incomes have risen, and a higher proportion of the total cost.

But workers aren’t getting more for their money — they’re getting less. According to the report, only 52% of employees had a deductible in 2003; by 2010, it was 74%. And the size of the average per-person deductible has increased by a whopping 98% over the same time period.

The committee was set up to find a compromise on how to cut $1.2 trillion in federal spending over the next decade. Failure to do so — which the committee officially announced on Nov. 21 — means the back up plan of “sequestration” takes effect. That means automatic cuts of that $1.2 trillion is cut from domestic and defense programs starting with 2013 spending.

Most directly affecting the health industry are planned cuts to Medicare — capped at 2%. Understandably, providers are worried about the effect that’ll have on their bottom lines.

The American Medical Association released a statement by President Peter W. Carmel, M.D., noting that cuts triggered by sequestration, along with the planned Jan. 1 physician payment cut of 27%, mean physicians may be forced to limit the number of Medicare patients they serve.

Similarly, the American Hospital Association’s statement warned that the cuts to Medicare will affect not just the elderly and disabled who rely on Medicare but their families who have to pick up the slack, as well as hospitals’ ability to provide essential services. The statement is available here (downloadable PDF).

“Sequestration means that arbitrary reductions in resources for patient care under Medicare will now be set to take effect under the law for the remainder of the decade,” Richard Umbdenstock, president and CEO of the American Hospital Association (PDF), said in a statement. “This will have an impact not just on the elderly and disabled beneficiaries of the program, but on their families,” he continued. “It will also have an impact on the ability of hospitals to provide essential public services to the communities they serve given the impact that Medicare has on the entire healthcare system. It is likely that Congress will reconsider whether this approach should take effect in January 2013 as required under current law.”

That’s the takeaway of a new report by the Census Bureau (downloadable pdf). The report used a new experimental “supplemental poverty measure” to better determine the effect of health costs. The supplemental poverty measure adjusts for in-kind income, such as food stamps, as well as major costs like payroll taxes, in an effort to provide a more realistic picture of families’ incomes and expenses.

The measure indicates that when health care costs are subtracted from family incomes, another 10 million Americans would be classified as poor.

That translates into an increase of 3.3 percentage points of  the national poverty rate. And all age groups are affected: When health costs are taken into consideration, another 2 million children, 5 million working-age adults, and 3 million seniors fall below the poverty threshold.

That’s the conclusion drawn from a recent report by the General Accounting Office (GAO).

A number of factors, play a role, including the variety of insurance benefit plans, inability of physicians to know in advance if certain tests or additional procedures will be likely, how much of a deductible a specific patient has already met, as well as the secrecy that surrounds the negotiated rates of payment between insurers and providers.

The lack of transparency is more than an annoyance.  It makes it harder for patients — whether insured or not — to make decisions about which non-critical tests and procedures are worth performing.

To see the full report, click here.

According to the report, the company would offer a variety of plans, at different cost levels, through a health insurance exchange. The move would be allowed under health reform changes that take effect in 2014.

Walgreens wouldn’t confirm or deny the report, saying only that it was “looking into a number of options” to serve customers in the health system.

A number of companies — with or without prior experience in the health care industry — are expected to enter the market that’ll open up as more of the health reform provisions take effect.

Between the sluggish economy and the impact of health care reform, the coming years are going to require a lot of changes from the health care industry in general and hospitals in particular. Kaiser Health News polled industry experts for their predictions on the top five trends to watch:

1. Mergers and consolidations
2. Reduced readmissions
3. Comparative effectiveness research
4. Care coordination
5. Collaborative communication

Slow or not, Vermont’s law is ground-breaking and could serve as a model for other states. Green Mountain Care would make all residents of the state eligible to enroll in the plan, while allowing private insurers to continue to operate in the state.

Other states are weighing similar options — but making varied amounts of headway. California, for example, just reintroduced a bill that’s been passed twice before but vetoed by then-Governor Arnold Schwarzenegger. Under current Governor Jerry Brown, the bill is likely to receive a much friendlier welcome.

Illinois, Pennsylvania and Minnesota have also gotten single-payer-style bills through key committees, but none have yet passed the entire legislature.

Can an uninsured patient with a head injury refuse medical treatment he or she simply can’t afford?

That’s the question being raised by one patient after his recent hospital saga.

Last August, Terry Barth of Loomis, California, was out for a leisurely motorcycle ride when one wonky turn threw him off his bike. He hit his head and suffered other minor injuries. But when EMTs showed up on the scene, Barth refused treatment, telling the paramedics repeatedly that he didn’t have insurance and didn’t want to go to the hospital.

But because Barth had suffered at least one obvious head injury which might impede his decision-making ability, the paramedics loaded him up in the ambulance anyway. Barth was taken to the local hospital and then eventually flown to the nearest trauma center. He had a concussion and a broken eye socket.

His total cost for the treatment: $40,000. The hospital is working with him to reduce the bill and develop a payment plan.

But Barth says he feels like he was “kidnapped” and forced to receive treatment he didn’t want — and therefore shouldn’t have to pay any of the bill. The paramedics said that while patients do have a right to refuse treatment there are some cases, including head trauma and diabetic shock, where they are authorized to make the call for the patient because they may not be in state of mind to make decisions for themselves.