Health and Human Services Secretary Alex Azar confirmed the administration’s commitment to move from fee-for-service payment to value-based models. “We are unafraid of disrupting existing arrangements simply because they're backed by powerful special interests,” he told a hospital leadership group this week. He also championed change that will increase price transparency, make it easier for patients to access health records and remove barriers to innovation. (
Modern Healthcare
;
Becker’s Hospital Review
)
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As plan choices dwindle on the Affordable Care Act marketplaces and premium costs rise, Democrats are thinking the next plan may be to expand access to Medicare coverage to get more people insured. The Center for American Progress released a “Medicare Extra for All” system that would be open to all Americans. Two Democrat senators are cosponsoring a bill for “Medicare X,” a public insurance plan for individuals and small businesses. Both ideas would use Medicare-approved providers and provider payment schedules. (
Center for American Progress;
Becker’s Hospital Review)
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Innovation & Transformation
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Pharmaceutical companies got the Food and Drug Administration’s nod (via the 21st Century Cures Act) to use real-world data to support new drug approvals. That’s the impetus for pharma companies to make deals and gain access to large swaths of patient data, like Roche's recent purchase of cancer data giant Flatiron Health. Critics wonder whether pharma’s intentions are pure, or whether this is a grab to identify patients for drug marketing purposes. (
Reuters)
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The promise of artificial intelligence to enhance health care delivery is great, but organizations are just beginning to put algorithms to work on discrete projects to improve clinical care. Early wins are in radiology and imaging, where machine learning helps doctors detect anomalies. Accessing the right data for machine learning is a barrier to many clinical applications thus far; electronic health records aren’t structured to easily extract clean data. For now, AI is largely contributing to better efficiency by automating scheduling, speech-to-text records and other applications with a clear return on investment. (
Modern Healthcare)
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The CEO's Guide to Restoring the American Dream offers a behind-the-scenes look at how public and private employers and unions across the U.S. are reducing their spending by 20 percent or more while improving care quality and access. The book uses real-life examples to outline how top-performing benefits purchasers take control of the purchasing process, align economic incentives and apply simple, practical and proven approaches. The new edition also unpacks how employers have been the key (unwitting) enabler of the opioid crisis and how smart employers are going upstream to solve the opioid problem before it happens. Now available to H2RMinutes subscribers as a free download
here.
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Health care providers lose about $150 billion a year to missed appointments. Often, ready transportation is the reason patients don’t show up for appointments. Providers can now tap into Uber Health to offer a ride. The online platform includes scheduling, destination tracking and the ability to input billing codes for providers who want to bill payers for the cost after the fact. Lyft also announced a deal with Allscripts to integrate requests for non-emergency transportation into its Sunrise EHR platform, which serves roughly 180,000 providers nationwide. (
USA Today;
Fierce Healthcare)
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Expanding access to association health plans could mean 3.2 million current enrollees in the Affordable Care Act marketplaces would exit. The association plans are lower priced, but can offer leaner coverage, too. Because those left behind would likely need more care, those remaining in the ACA plans could see premiums jump 3.5 percent, according to an analysis by Avalere. (
Avalere)
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Albertsons merges with Rite Aid: The grocery store and retail pharmacy chains are merging, creating a huge national footprint, including 4,350 pharmacy counters and 320 in-store health clinics. The merger positions the organizations to compete against Amazon and Whole Foods. Albertsons bought Plated (the subscription meal kit company) last year, contributing to discussion about the company's future plans to deliver a range of health-related services directly to consumers.(
HealthPopuli)
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Kentucky may tax opioids
: Kentucky’s House of Representatives passed a proposal to tax opioid prescriptions. The money raised by the tax would be used to close a state general budget gap rather than fund drug treatment or changes to its Medicaid program. If its senate approves the measure, Kentucky will become the first state to target opioid prescriptions for a special tax. Critics say the extra 25 cents per dose will punish patients who need pain relief. (
The New York Times;
Courier Journal)
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A new role for medical home "godfather"
: Paul Grundy, MD, founding president of the Patient-Centered Primary Care Initiative, will serve as HealthTeamWorks’ global director of healthcare transformation. He previously served as chief medical officer for IBM’s healthcare and life sciences division. (
press release)
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Ambulatory surgery centers, touted as a low-cost alternative to hospitals for low-risk surgeries, may pose significant risks to patients.
USA Today and
Kaiser Health News' investigative report finds some centers have expanded business by taking on more risky procedures, or by accepting patients with underlying health risks that may require more care—leading to complications and sometimes death. No national authority tracks mortality data linked to the centers, but more than 260 patients have died after surgery at ambulatory surgery centers in the last five years, the authors found. (
Kaiser Health News)
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MarketVoices...quotes worth reading
"If you're going to let a machine make a decision for you, you better be darn sure that the data you're feeding it are good. I think healthcare is kind of in a transition, because we've worked for years and years to get EHRs in place, and really, those are just transactional systems. How do we begin to bring all the data together to make educated decisions and have the cleanliness of data?" Theresa Meadows, CIO of Cook Children's Health Care System, Forth Worth, Texas, as quoted by
Modern Healthcare
.
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Editor
Sandy Mau
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