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Wednesday, August 23, 2017
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An unidentified hospital has lost its nonprofit tax status for failing to conduct and make available a community health needs assessment. Affordable Care Act charity-care reporting requirements went into effect last year; the hospital’s status was revoked in February. The IRS released a redacted copy of the tax status letter this month. Industry advisers worry many hospitals could be vulnerable to IRS enforcement under the new requirements, the Healthcare Financial Management Association reports. (
HFMA;
tax status letter)
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With 2018 open enrollment around the corner and 10 million people enrolled in the insurance exchanges, it’s time to aim for stability, former Health and Human Services secretaries Kathleen Sebelius (D), Mike Leavitt (R) and Tommy Thompson (R) tell the Associated Press. The three don’t agree on everything, but they all say Republicans can still put their mark on the Affordable Care Act--even if “repeal and replace” is dead. “They can make changes that signal a new ideological direction without generating a logistical and political mess,” says Leavitt. (
AP)
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Innovation & Transformation
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Community health workers are more than worth their cost, according to research published in the
American Journal of Public Health. Patients receiving support from community health workers had 30 percent fewer hospital admissions in one year and saw reductions in smoking, obesity, diabetes severity and mental illness. The findings suggest community health worker programs provide a 2:1 ROI. This is the second study to support their use. “We now have evidence for state Medicaid programs or health systems looking for proven strategies to improve health and lower hospital use,” says senior author Shreva Kangovi, MD. (
HealthLeaders Media;
AJPH)
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As value-based payment programs continue to increase in size and scope, practices that disproportionately serve high-risk patients may be at particular risk of receiving financial penalties, according to analysis published in
JAMA. Practices that served more socially high-risk patients had lower quality and lower costs, and practices that served more medically high-risk patients had lower quality and higher costs. These patterns were associated with fewer bonuses and more penalties for high-risk practices. Investigators looked at the first year of the Medicare Physician Value-Based Payment Modifier Program. (
JAMA)
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Astronomical prices for new drugs often make headlines, but hundreds of older, common drugs are driving up Medicaid spending, costing billions of extra dollars in 2016 vs. 2015, according to a
Kaiser Health News analysis. Drugs include common asthma medicines like Ventolin, over-the-counter medications like the generic form of Aleve, and antidepressants. “People always thought, ‘They’re generics. They’re cheap,’” said Matt Salo, who runs the National Association of Medicaid Directors. But with drug prices going up “across the board,” generics are far from immune. (
Kaiser Health News)
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The return of the Affordable Care Act’s health insurance tax--which insurers have long lobbied against--will likely increase premiums by an average of 2.6 percent in 2018, according to analysis by Oliver Wyman, commissioned by UnitedHealth. The ACA’s tax on fully insured health coverage was in effect from 2014 to 2016; its purpose was to help offset the cost of the tax credits for ACA exchange enrollees. Congress passed a one-year moratorium on the tax for 2017, but it expires in 2018. (
Fierce Healthcare)
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$40k+ per doc on regs:
Nearly half of the group practices responding to an MGMA survey said they spend more than $40,000 annually per full-time physician to comply with federal regulations. The practices rated the Medicare Quality Payment Program as the most burdensome. (
Healthcare Dive;
survey)
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Ad hoc approach to social determinants:
Hospitals and health systems acknowledge the importance of including social needs in their organizational mission. Many are making strides, but most lack the sustainable funding to actually address patients’ social issues, according to a recent Deloitte report. As a result, much of the activity is ad hoc, leaving many gaps. (
executive summary)
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If the administration ends ACA cost-sharing subsidies, it will lead to 20 percent increases in premiums for low-income Americans in 2018, and add $194 billion to the deficit over the next decade, the nonpartisan Congressional Budget Office reported. Mary Agnes Carey and Julie Appleby of
Kaiser Health News, Sarah Karlin-Smith of
Politico and Margot Sanger-Katz of
The New York Times discuss this issue. They also look at the state of play on Capitol Hill and in the states concerning efforts to lower prescription drug costs. (
podcast;
CBO report)
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MarketVoices...quotes worth reading
“The resources it will take to comply with MIPS are absurd, and the only thing that program measures is the ability to meet documentation requirements."--a respondent to an MGMA survey, quoted in
Healthcare Dive
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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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