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Wednesday, August 30, 2017
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A federal judge told the Equal Employment Opportunity Commission to reconsider two regulations surrounding employer-sponsored wellness programs, noting the Commission failed to adequately explain its decision to permit incentives of up to 30 percent of the cost of self-coverage in exchange for an employee’s participation in a wellness program. The plaintiff, AARP, argued the incentives were inconsistent with ADA and GINA requirements that wellness plan participation be voluntary. The judge allowed the rules to remain in place to avoid disruption. (
Healthcare Dive;
Law360)
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Continuing churn among health plans and anxiety over threats to withhold subsidy payments to insurers have obscured one fact: Many of the companies participating in the exchanges are beginning to prosper,
The New York Times
reports. “Outside of the noise,” the surviving companies “are seeing a path forward in this marketplace,” says Deep Banerjee of Standard & Poor’s, noting that everyone is adjusting to what’s still a new market. One of the keys to thriving: the ability to offer low-cost plans. But the positive trajectory is unlikely to matter if the subsidies
cease or confusion continues to reign. (
The New York Times)
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Innovation & Transformation
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Scotland’s new pharmacy strategy,
Achieving Excellence in Pharmaceutical Care, seeks to transform the role of pharmacy. It calls for increased access to community pharmacy as the first step for managing self-limiting illnesses and supporting self-management of long-term conditions. It also recommends integrating pharmacists with advanced clinical skills and pharmacy technicians into primary care practices to improve care and contribute to the multidisciplinary team. (To learn more about such efforts in the United States, see
Get the medications right.) (
Pharmacy in Practice)
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Improvements in care and cost performance require time, hard work, an up-front resource investment and a shared commitment to data sharing. Those are among the takeaways from a recent
Health Affairs Blog post analyzing payment reform results. Another key point: Identifying target patients may be more important than building capacity to provide patient-centered care to all. The authors warn that stopping experimentation because of disappointing short-term results “could quickly negate the real progress that has been made on many fronts, and that is essential for our health care systems’ future affordability.” (
Health Affairs Blog)
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Congress isn’t debating the future of U.S. health
care
; the debate is about health
insurance
, Ashok Rai, MD, incoming AMGA chairman, writes in an op-ed piece. That must change, he says.
He points out the U.S. has the world’s costliest health care but only middling life expectancy and high infant mortality rates.
“
Bold, persistent experimentation is what we, as healthcare leaders, need to be asking of Congress. We know the healthcare system we have isn’t serving our best interests. The debate we should be having in Washington and throughout our country is about creating a system that will.” (
The Hill
)
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More than a quarter of cases of possible sexual and physical abuse against nursing home patients apparently went unreported to police, according to preliminary results from an audit by the Health and Human Services Office of the Inspector General. Because of the seriousness of the issue, the OIG issued an “Early Alert” entitled “The Centers for Medicare & Medicaid Services Has Inadequate Procedures To Ensure That Incidents of Potential Abuse or Neglect at Skilled Nursing Facilities Are Identified and Reported in Accordance With Applicable Requirements.” (
Associated Press
;
OIG Early Alert
)
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Privacy breach, old school:
Thousands of people with HIV received mailed letters from Aetna in July that may have disclosed their HIV status through a small window on the envelope. Aetna has apologized. (
Stat News
)
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All counties covered:
With Care Source agreeing to cover Paulding County, Ohio, insurance exchange coverage will now be available in every part of the United States, Timothy Jost reports in his Affordable Care Act roundup. However, he points out that more than 1,300 counties (2.6 million+ enrollees) will have only one exchange insurer. (
Health Affairs Blog
)
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Staff for Colorado Gov. John Hickenlooper (D) and Ohio Gov. John Kasich (R) are coming up with a plan to stabilize the health insurance markets. They also intend to get other governors to sign on, they tell Colorado Public Radio. The plan will flesh out a set of principles they wrote about in a
Washington Post op-ed. (
Colorado Public Radio;
Washington Post)
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MarketVoices...quotes worth reading
“People have been devastated. We've had a number of people tell us they had chosen not to disclose their HIV status to family members--but this is how their family members found out. [...] People with any private health conditions can just imagine, whether you're being treated for cancer or a behavioral condition, just imagine having that flat out on the front of an envelope for anyone to see. It should be a grave concern to everyone."--Sally Friedman, legal director at Legal Action Center, calling on Aetna to correct a mistake that may have revealed the AIDS status of thousands of patients, quoted in
Stat News
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Editor
Sandy Mau
Roxanna Guilford-Blake
703.394.5395
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Copyright 2009-2017,
H2R Minutes
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