olli

Gemma Collins breaks down as dream house purchase falls through in Diva on Lockdown

The episode also saw the star close her shop as the pandemic took hold




olli

Gemma Collins and James Argent's relationship timeline in full

The course of true love never did run smooth, after all




olli

Millie Small dead: My Boy Lollipop singer dies, aged 73

The singer was most famous for her hit single My Boy Lollipop




olli

‘PUBG Mobile’ 0.18.0 Is Rolling Out Now on iOS and Android with Mad Miramar, a New Results UI, and a Whole Lot More

Earlier this week, Tencent announced a big new update for PUBG Mobile (Free) on iOS and Android. The version 0.18.0 …




olli

Phil Collins helps Jimmy Greaves with 'substantial donation', reveals agent

Phil Collins has made a 'substantial donation' to help Jimmy Greaves, according to the Tottenham legend's agent.




olli

Former Liverpool transfer chief Damien Comolli raises fears about football restart – 'What if a player dies?'

Former Tottenham and Liverpool director Damien Comolli has raised fears over the safety of players if football returns behind closed doors during the coronavirus pandemic, asking: 'What happens if someone dies?'




olli

Tottenham must be 'very cautious' in transfer market, says former director of football Damien Comolli

Tottenham will have to be cautious in the transfer market with the financial impact of coronavirus compounding restrictions already in place thanks to the debt owed on their stadium, former director of football Damien Comolli has warned.




olli

Who is Nnamdi Collins? The lightning-quick German teenager linked with Chelsea

Nnamdi Collins is the latest talented young footballer linked with a Premier League switch, with Chelsea and Manchester City reportedly interested in the 16-year-old defender.




olli

France's Ligue 1 decision could put Premier League's 'Project Restart' on collision course with rest of Europe

The French government is pushing for the rest of Europe's top football leagues to follow Ligue 1's example and end the 2019-20 season, according to reports in France.




olli

Damien Comolli on Liverpool transfer strategy which helps them find value at top end of market

Liverpool are benefiting from an analytics-led transfer policy that helps them find value even at the top end of the market, the club's former director of football Damien Comolli has declared.




olli

Hair loss treatment: A mineral which strengthens hair follicles to stimulate hair growth



HAIR loss treatment: The quest for magic cure to help halt the process of hair loss produces numerous searches and theories. Taking this essential mineral helps strengthen hair follicles which stimulate hair growth.




olli

‘My Boy Lollipop’ Singer Millie Small Passes Away At 72



The Jamaican national reportedly suffered a stroke.




olli

Facebook's redesigned website finally starts rolling out to everyone

After the better part of a year, Facebook has started rolling out its redesigned desktop website to all of its users. The company announced today it plans to complete the rollout over the "next few weeks." Moving forward, "The New Facebook" will be t...




olli

Controlling quantumness: Simulations reveal details about how particles interact

A recent study at the Okinawa Institute of Science and Technology Graduate University has described new states that can be found in super-cold atom experiments, which could have applications for quantum technology.




olli

Galaxies collide in stunning picture

A NEW image captured by NASA Hubble space telescope shows ‘doomed duo’ galaxies colliding and then trying to destroy one another.




olli

Chez QUB Musique, Offenbach côtoiera les Rolling Stones

En quoi ce nouveau service d’écoute musicale en continu va se démarquer de ses gigantesques rivaux sur le marché. Explications en cinq points.




olli

The Women of Maine vs. Susan Collins

The senior senator faces an especially difficult reelection challenge. Did she change or did her voters?




olli

Who knows best? Mayors collide with governors over coronavirus lockdown

Ease up or clamp down: Differences over ending coronavirus lockdown turn into power struggle




olli

EMA starts rolling review of Gilead’s COVID-19 hope remdesivir

New crop of data suggests drug can speed recovery from COVID-19




olli

Justice Department Reaches Settlement with Philadelphia Regarding Polling Place Access for People with Disabilities

The Department announced a settlement under the Americans with Disabilities Act (ADA) with the city of Philadelphia to greatly improve accessibility for individuals with mobility disabilities at the city’s 1,200 polling places. Today’s settlement is the first settlement by the Department with a city focused solely on accessible polling places. Under the terms of the settlement, the city of Philadelphia recognizes that accessible polling places are the cornerstone of its voting accessibility program and will make its polling places accessible to persons with disabilities.



  • OPA Press Releases

olli

Former Army Contractor Charged with Involuntary Manslaughter and Assault After Collision in Kuwait Kills One Sailor and Seriously Injures Another

Morgan Hanks, 25, of Newport News, was arrested on charges contained in a two-count indictment returned by a federal grand jury on July 13, 2010, and unsealed today in the Eastern District of Virginia.



  • OPA Press Releases

olli

U.S. Files Lawsuit Against Bollinger Shipyards for Material False Statements Made to the Coast Guard

“Companies which make false statements to win Coast Guard contracts do a disservice to the men and women securing our borders,” said Tony West, Assistant Attorney General for the Civil Division of the Department of Justice.



  • OPA Press Releases

olli

Statement by Attorney General Eric Holder on the U.S. Government’s Filing in Hollingsworth v. Perry

Attorney General Eric Holder issued the following statement today on the U.S. government’s filing in Hollingsworth v. Perry.



  • OPA Press Releases

olli

Federal Grand Jury Returns 30-Count Indictment Related to Boston Marathon Explosions and Murder of MIT Police Officer Sean Collier

A federal grand jury returned a 30-count indictment against Dzhokhar A. Tsarnaev for his alleged role in using weapons of mass destruction at the Boston Marathon to kill three individuals and maim or seriously injure many others, as well as for using a firearm to intentionally kill Massachusetts Institute of Technology (MIT) Police Officer Sean Collier.



  • OPA Press Releases

olli

Justice Department Reaches Settlement with Blair County, Pa., Over Polling Place Access for Voters with Disabilities

The Justice Department today announced a settlement under Title II of the Americans with Disabilities Act (ADA) with Blair County, Pa., to greatly improve physical accessibility at the county’s polling places for individuals who use wheelchairs and other mobility aids and for individuals who are blind or have vision impairments.



  • OPA Press Releases

olli

Massapequa, N.Y., Man Pleads Guilty to Rolling Back Odometers in Scheme That Defrauded Dozens of Car Buyers

A Massapequa, N.Y., man pleaded guilty today in U.S. District Court in Allentown, Pa., to conspiracy to commit odometer tampering.



  • OPA Press Releases

olli

Controlling angular dispersions in optical metasurfaces




olli

Vettel sorry after Button collision

Jenson Button admitted the collision which ended his Belgian Grand Prix was a "massive blow" adding that he "did not know what he [Sebastian Vettel] was doing"




olli

Vettel insists he was not to blame for collision

Sebastian Vettel insisted he was not to blame for the collision with team-mate Mark Webber that put him out of the Turkish Grand Prix




olli

Webber blames Vettel for collision

Mark Webber has blamed Sebastian Vettel for the accident that saw Red Bull lose the lead of the Turkish Grand Prix




olli

Mosley blames Webber for collision

Former FIA president Max Mosley thinks Mark Webber is to blame for the incident that coast Red Bull Racing the chance of victory in Turkey




olli

Do voters want to hear from party leaders? Some intriguing new polling

What happened in this year’s Democratic nominating contest? To the surprise of many, a relatively moderate establishment candidate, former Vice President Joe Biden, won. Why didn’t the Democratic primary process in 2020 follow the chaotic course that the Republican process took in 2016? Why did the party establishment prevail? An important new paper by the…

       




olli

New polling data show Trump faltering in key swing states—here’s why

While the country’s attention has been riveted on the COVID-19 pandemic, the general election contest is quietly taking shape, and the news for President Trump is mostly bad. After moving modestly upward in March, approval of his handling of the pandemic has fallen back to where it was when the crisis began, as has his…

       




olli

Polling shows Americans see COVID-19 as a crisis, don’t think US is overreacting

As soon as the novel coronavirus began spreading across the country, some pundits—and on occasion President Trump—alleged that health experts and the media were exaggerating the problem and that policy makers were responding with measures that the American people would not tolerate. The high-quality survey research published in recent days makes it clear that the…

       




olli

A once-in-a-century pandemic collides with a once-in-a-decade census

Amid the many plans and projects that have been set awry by the rampage of COVID-19, spare a thought for the world’s census takers. For the small community of demographers and statisticians that staff national statistical offices, 2020—now likely forever associated with coronavirus—was meant to be something else entirely: the peak year of the decennial…

       




olli

New polling data show Trump faltering in key swing states—here’s why

While the country’s attention has been riveted on the COVID-19 pandemic, the general election contest is quietly taking shape, and the news for President Trump is mostly bad. After moving modestly upward in March, approval of his handling of the pandemic has fallen back to where it was when the crisis began, as has his…

       




olli

A once-in-a-century pandemic collides with a once-in-a-decade census

Amid the many plans and projects that have been set awry by the rampage of COVID-19, spare a thought for the world’s census takers. For the small community of demographers and statisticians that staff national statistical offices, 2020—now likely forever associated with coronavirus—was meant to be something else entirely: the peak year of the decennial…

       




olli

A once-in-a-century pandemic collides with a once-in-a-decade census

Amid the many plans and projects that have been set awry by the rampage of COVID-19, spare a thought for the world’s census takers. For the small community of demographers and statisticians that staff national statistical offices, 2020—now likely forever associated with coronavirus—was meant to be something else entirely: the peak year of the decennial…

       




olli

New polling data show Trump faltering in key swing states—here’s why

While the country’s attention has been riveted on the COVID-19 pandemic, the general election contest is quietly taking shape, and the news for President Trump is mostly bad. After moving modestly upward in March, approval of his handling of the pandemic has fallen back to where it was when the crisis began, as has his…

       




olli

A once-in-a-century pandemic collides with a once-in-a-decade census

Amid the many plans and projects that have been set awry by the rampage of COVID-19, spare a thought for the world’s census takers. For the small community of demographers and statisticians that staff national statistical offices, 2020—now likely forever associated with coronavirus—was meant to be something else entirely: the peak year of the decennial…

       




olli

New polling data show Trump faltering in key swing states—here’s why

While the country’s attention has been riveted on the COVID-19 pandemic, the general election contest is quietly taking shape, and the news for President Trump is mostly bad. After moving modestly upward in March, approval of his handling of the pandemic has fallen back to where it was when the crisis began, as has his…

       




olli

A once-in-a-century pandemic collides with a once-in-a-decade census

Amid the many plans and projects that have been set awry by the rampage of COVID-19, spare a thought for the world’s census takers. For the small community of demographers and statisticians that staff national statistical offices, 2020—now likely forever associated with coronavirus—was meant to be something else entirely: the peak year of the decennial…

       




olli

New polling data show Trump faltering in key swing states—here’s why

While the country’s attention has been riveted on the COVID-19 pandemic, the general election contest is quietly taking shape, and the news for President Trump is mostly bad. After moving modestly upward in March, approval of his handling of the pandemic has fallen back to where it was when the crisis began, as has his…

       




olli

Controlling carbon emissions from U.S. power plants: How a tradable performance standard compares to a carbon tax

Different pollution control policies, even if they achieve the same emissions goal, could have importantly different effects on the composition of the energy sector and economic outcomes. In this paper, we use the G-Cubed1 model of the global economy to compare two basic policy approaches for controlling carbon emissions from power plants: (1) a tradable…

       




olli

When climate activism and nationalism collide

There is an overwhelming consensus among scientists that this decade will be the last window for humanity to change the current global trajectory of carbon dioxide emissions so that the world can get close to zero net emissions by around 2050, and thus avoid potentially catastrophic climate risks. But although the massive technological and economic…

       




olli

Three cheers for logrolling: The demise of the Sustainable Growth Rate (SGR)


Editor's note: This post originally appeared in the New England Journal of Medicine's Perspective online series on April 22, 2015.

Congress has finally euthanized the sustainable growth rate formula (SGR). Enacted in 1997 and intended to hold down growth of Medicare spending on physician services, the formula initially worked more or less as intended. Then it began to call for progressively larger and more unrealistic fee cuts — nearly 30% in some years, 21% in 2015. Aware that such cuts would be devastating, Congress repeatedly postponed them, and most observers understood that such cuts would never be implemented. Still, many physicians fretted that the unthinkable might happen.

Now Congress has scrapped the SGR, replacing it with still-embryonic but promising incentives that could catalyze increased efficiency and greater cost control than the old, flawed formula could ever really have done, in a law that includes many other important provisions. How did such a radical change occur?  And why now?

The “how” was logrolling — the trading of votes by legislators in order to pass legislation of interest to each of them. Logrolling has become a dirty word, a much-reviled political practice. But the Medicare Access and CHIP (Children’s Health Insurance Program) Reauthorization Act (MACRA), negotiated by House leaders John Boehner (R-OH) and Nancy Pelosi (D-CA) and their staffs, is a reminder that old-time political horse trading has much to be said for it.

The answer to “why now?” can be found in the technicalities of budget scoring. Under the SGR, Medicare’s physician fees were tied through a complex formula to a target based on caseloads, practice costs, and the gross domestic product. When current spending on physician services exceeded the targets, the formula called for fee cuts to be applied prospectively. Fee cuts that were not implemented were carried forward and added to any future cuts the formula might generate. Because Congress repeatedly deferred cuts, a backlog developed. By 2012, this backlog combined with assumed rapid future growth in Medicare spending caused the Congressional Budget Office (CBO) to estimate the 10-year cost of repealing the SGR at a stunning $316 billion.

For many years, Congress looked the costs of repealing the SGR squarely in the eye — and blinked. The cost of a 1-year delay, as estimated by the CBO, was a tiny fraction of the cost of repeal. So Congress delayed — which is hardly surprising.

But then, something genuinely surprising did happen. The growth of overall health care spending slowed, causing the CBO to slash its estimates of the long-term cost of repealing the SGR. By 2015, the 10-year price of repeal had fallen to $136 billion. Even this number was a figment of budget accounting, since the chance that the fee cuts would ever have been imposed was minuscule. But the smaller number made possible the all-too-rare bipartisan collaboration that produced the legislation that President Barack Obama has just signed.

The core of the law is repeal of the SGR and abandonment of the 21% cut in Medicare physician fees it called for this year. In its place is a new method of paying physicians under Medicare. Some elements are specified in law; some are to be introduced later. The hard-wired elements include annual physician fee updates of 0.5% per year through 2019 and 0% from 2020 through 2025, along with a “merit-based incentive payment system” (MIPS) that will replace current incentive programs that terminate in 2018. The new program will assess performance in four categories: quality of care, resource use, meaningful use of electronic health records, and clinical practice improvement activities. Bonuses and penalties, ranging from +12% to –4% in 2020, and increasing to +27% to –9% for 2022 and later, will be triggered by performance scores in these four areas. The exact content of the MIPS will be specified in rules that the secretary of health and human services is to develop after consultation with physicians and other health care providers.

Higher fees will be available to professionals who work in “alternative payment organizations” that typically will move away from fee-for-service payment, cover multiple services, show that they can limit the growth of spending, and use performance-based methods of compensation. These and other provisions will ramp up pressure on physicians and other providers to move from traditional individual or small-group fee-for-service practices into risk-based multi-specialty settings that are subject to management and oversight more intense than that to which most practitioners are yet accustomed.

Both parties wanted to bury the SGR. But MACRA contains other provisions, unrelated to the SGR, that appeal to discrete segments of each party. Democrats had been seeking a 4-year extension of CHIP, which serves 8 million children and pregnant women. They were running into stiff head winds from conservatives who wanted to scale back the program. MACRA extends CHIP with no cuts but does so for only 2 years.  It also includes a number of other provisions sought by Democrats: a 2-year extension of the Maternal, Infant, and Early Childhood Home Visiting program, plus permanent extensions of the Qualified Individual program, which pays Part B Medicare premiums for people with incomes just over the federal poverty thresholds, and transitional medical assistance, which preserves Medicaid eligibility for up to 1 year after a beneficiary gets a job.

The law also facilitates access to health benefits. MACRA extends for two years states’ authority to enroll applicants for health benefits on the basis of data on income, household size, and other factors gathered when people enroll in other programs such as the Supplemental Nutrition Assistance Program, the National School Lunch Program, Temporary Assistance to Needy Families (“welfare”), or Head Start. It also provides $7.2 billion over the next two years to support community health centers, extending funding established in the Affordable Care Act.

Elements of each party, concerned about budget deficits, wanted provisions to pay for the increased spending. They got some of what they wanted, but not enough to prevent some conservative Republicans in both the Senate and the House from opposing final passage. Many conservatives have long sought to increase the proportion of Medicare Part B costs that are covered by premiums. Most Medicare beneficiaries pay Part B premiums covering 25% of the program’s actuarial value. Relatively high-income beneficiaries pay premiums that cover 35, 50, 65, or 80% of that value, depending on their income. Starting in 2018, MACRA will raise the 50% and 65% premiums to 65% and 80%, respectively, affecting about 2% of Medicare beneficiaries. No single person with an income (in 2015 dollars) below $133,501 or couple with income below $267,001 would be affected initially. MACRA freezes these thresholds through 2019, after which they are indexed for inflation. Under previous law, the thresholds were to have been greatly increased in 2019, reducing the number of high-income Medicare beneficiaries to whom these higher premiums would have applied. (For reference, half of all Medicare beneficiaries currently have incomes below $26,000 a year.)

A second provision bars Medigap plans from covering the Part B deductible, which is now $147. By exposing more people to deductibles, this provision will cause some reduction in Part B spending. Everyone who buys such plans will see reduced premiums; some will face increased out-of-pocket costs. The financial effects either way will be small.

Inflexible adherence to principle contributes to the political gridlock that has plunged rates of public approval of Congress to subfreezing lows. MACRA is a reminder of the virtues of compromise and quiet negotiation. A small group of congressional leaders and their staffs crafted a law that gives something to most members of both parties. Today’s appalling norm of poisonously polarized politics make this instance of political horse trading seem nothing short of miraculous.

Authors

Publication: NEJM
     
 
 




olli

Ollie the jailbreaking bobcat on the lam from National Zoo

The 25-pound lady bobcat was last seen on Monday morning.




olli

Multi-tiered micro-apartment comes with a rolling staircase

This apartment's new design unifies the small space with a simple palette of materials over three levels.




olli

Ollies Wooden Blocks are like LEGO meets Tinkertoys meets Erector sets

These sets of precision-cut oak blocks and planks, combined with clever connectors, are intended to help spark creativity and imagination in kids, and to "make playtime more meaningful."




olli

Ollies Blocks encourage kids' imagination & creativity (Review)

Building with blocks and construction toys is a great unstructured activity for kids, and Ollies Wooden Blocks are a superb new addition to the category.