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In his address to Congress last night, President Donald Trump outlined five principles to guide the Congress as it moves “to create a better health care system for all Americans.” The first: Provide those with preexisting conditions access to coverage, and ensure a stable transition for those enrolled in the Obamacare exchanges. The others: use of tax credits and expanded Health Savings Accounts, provide states with the "resources and flexibility" they need with Medicaid, lower the “artificially high price” of drugs, and allow insurance to be sold across state lines. (
transcript of speech)
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Draft legislation from House Republicans, leaked to
Politico, would largely dismantle the Affordable Care Act. It would abolish the individual mandate, income-based subsidies and all of the law’s taxes. It would significantly roll back Medicaid spending and give states money to create high-risk pools. The replacement plan would be paid for by limiting tax breaks on generous health plans people get at work--similar to the unpopular “Cadillac tax”--except it will hit employees with the richest plans, not employers. It doesn’t appear to repeal most of the ACA’s insurance reforms, such as the requirements that health plans cover preexisting conditions and the cap on out-of-pocket expenditures. (
Politico;
draft legislation;
Health Affairs)
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In an open letter, Ken A. Crerar, president of the Council of Insurance Agents & Brokers, asked Health and Human Services Sec. Tom Price to act upon an often-overlooked cost- containment mechanism in the ACA--development of a standard, streamlined benchmark national health plan. “Not only did the Obama Administration HHS affirmatively decide not to do so, but in the way it directed the states to establish their individual benchmark plans, it essentially ensured that allowing for less benefit-rich plans currently is prohibited.” (
Employee Benefit News)
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A report from Avalere Health and McKinsey & Company, presented at the National Governors Association meeting this past weekend, concludes that the “repeal and replace” changes under consideration by the House would significantly cut federal dollars for Medicaid and subsidized private insurance. It warns that federal spending cuts probably would create funding gaps for states and threaten many people with the loss of insurance coverage. (
AP)
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Innovation & Transformation
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Only 20 percent of consumers have received virtual health services, but 78 percent of those surveyed expressed interest in them, according to a survey from Accenture. This growing consumer demand puts pressure on providers and payers to expand delivery options, HIT Consultant reports. The research suggests health systems need to balance and integrate virtual and in-person services with the varying degrees to which consumers see themselves as being in charge of their own health. (HIT Consultant; Accenture)
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There’s a lesson for journalists in the collapse of the Watson/M.D. Anderson Cancer Center venture to expedite clinical decision-making. Namely, “uncritical media narratives can cause harm by raising false hopes and allowing costly and unproven investments to proceed without scrutiny,” according to
Health News Review. It’s not just Watson: “Artificial intelligence has been suffering from overhype since the 1970s and 80s,” says Steven Salzberg, a professor of biomedical engineering at Johns Hopkins School of Medicine. “Be skeptical and ask to see some evidence.” (
Health News Review)
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Long after research contradicts common medical practices, they
remain common practices, according to Pro Publica. The result: “an epidemic of unnecessary and unhelpful treatment.” It cites several examples, including a 2013 study published in
Mayo Clinic Proceedings. Researchers reviewed all 363 articles published in the
New England Journal of Medicine from 2001 through 2010 that tested a current clinical practice. They found 146 studies that proved or strongly suggested a current standard practice either had no benefit at all or was inferior to the practice it replaced, and 79 were inconclusive. But the practices persist. As the article concludes, "Ineffective cures can be long-lived." (
Pro Publica)
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Two studies indicate ACOs improve care and cut costs. Research published in
JAMA Internal Medicine showed Medicare Shared Savings Program ACOs likely reduced spending on post-acute care without sacrificing quality. Another study in the journal found that Oregon's global capitation Medicaid ACO
and Colorado's fee-for-service-based ACO produced similar savings and care quality improvements. (
Modern Healthcare;
JAMA Internal Medicine)
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Hospitals in Denmark are feeding preemies to octopuses. No, not really. But after discovering that snuggling with specially crocheted octopuses improved breathing, heart rate and oxygen levels of premature infants, hospitals are putting them in the incubators. The theory is that the tentacles have a calming effect because the babies are reminded of the umbilical cord. They're also distracted from pulling their tubes and cords. (
Modern Healthcare)
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Speeding opioid treatment: Aetna will soon allow doctors to prescribe drugs to assist with opioid withdrawal without prior approval. Anthem and Cigna have already dropped the prior authorization requirement for privately insured patients. (
Kaiser Health News)
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Making prior authorizations easier: Prior authorization remains a hassle for providers. But it’s getting better, according to speakers at the HIMSS annual meeting. Several organizations are exploring ways to streamline the process. (
MedPageToday)
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Medicaid Prime, a Medicaid payment reform experiment in W
estern Colorado, has managed to lower costs while providing better care. In a long-form interview with Colorado Public Radio, Patrick Gordon, associate vice president at Rocky Mountain Health Plans, offers insights into how and why the program works. (
CPR)
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MarketVoices...quotes worth reading
“Mandating every American to buy government-approved health insurance was never the right solution for America. The way to make health insurance available to everyone is to lower the cost of health insurance, and that is what we will do."
--President Donald Trump, speaking to a joint session of Congress, from the speech transcript
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Copyright 2009-2017,
H2R Minutes
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