Wednesday, March 22, 2017
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In addition to reducing Health and Human Services’ budget by 18 percent, President Donald Trump’s budget cuts $6 billion from the National Institutes of Health while merging the Agency for Healthcare Research and Quality into that agency.
Vox warns that bringing AHRQ into the NIH--as the NIH is being dramatically cut--could be the death knell for AHRQ. The budget also cuts more than $400 million earmarked for physician and nurse training programs, claiming there’s no evidence those programs improve the workforce. (
Healthcare IT News;
Vox)
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Monday, CMS announced it has delayed the expansion of Comprehensive Care for Joint Replacement (CJR), and the implementation of its bundled payment initiatives for cardiac care. The start date has been moved from July 1 to Oct. 1, 2017,
Modern Healthcare reports. The agency also moved the effective date of the implementation of CJR and other bundled payment programs, from March 21 to May 20, 2017. The delays could mean that CMS plans to make the programs voluntary,
Ashish Jha, MD, MPH, says. (
Modern Healthcare)
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As reported last week, an estimated 24 million people over the next decade may not be insured under the GOP’s American Health Care Act, according to Congressional Budget Office calculations. This week,
The
New York Times added context to those numbers. It reported that an earlier CBO report determined that simply repealing the Affordable care Act would cost 23 million Americans their health insurance; the variance is who loses insurance. The proposed AHCA would cause more people to lose employer insurance and would be worse for older Americans. A straight repeal bill would likely cause more people who buy their own coverage to become uninsured; it would also be worse for Americans with pre-existing conditions. (
The New York Times)
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With Thursday’s vote looming, House Republicans are working on changes to their health care overhaul bill to meet concerns of some moderate Republicans, House Speaker Paul Ryan told
Fox News Sunday. Among those moderates is Maine’s Sen. Susan Collins, who told
Meet the Press, “We have to do something about the fact that the House bill disproportionately affects older, rural Americans.”
Kaiser Health News offers a roundup of the coverage. Meanwhile,
Modern Healthcare reported Monday the plan could be detrimental to many of the 11 million “dual eligible” beneficiaries who are covered by both Medicare and Medicaid. (
KHN;
Modern Healthcare)
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Innovation & Transformation
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A community-based, interdisciplinary palliative care approach could be a model for the future of palliative care. The program, described in a recent Health Affairs Blog post, is being evaluated by a Center for Medicare & Medicaid Innovation. Delivering palliative care further upstream in the disease progression--before patients require inpatient care and before they reach a hospice election decision point--may unlock the potential for realizing even greater improvements in patient outcomes and reductions in cost. (Health Affairs Blog)
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Seventy-nine percent of patients and 74 percent of clinicians say allowing patients to type agendas into the EHR visit notes improved communication between patients and clinicians, according to research published in the Annals of Family Medicine. “[That] may facilitate communication of health concerns," authors note. The article addressed results of a pilot study on feasibility and perceptions of patient-typed visit agendas among a vulnerable patient population at a safety-net clinic. (Healthcare Informatics; Annals of Family Medicine)
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Recent research indicates only a small percentage primary care providers do depression screenings. Current screening practices may exacerbate existing disparities in depression care, the authors warn; they also point out that EHR systems may be an effective tool to improve screening rate. “Primary care settings are an opportune location for early identification of depression, as many depressed patients’ contact with the healthcare system is through primary care,” author Ayse Akincigil, PhD, of Rutgers, tells
Medscape Medical News. (
Medscape Medical News;
Psychiatry Online)
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U.S. patients are more likely to experience gaps in coordination among health care providers than their counterparts in other high-income nations, according to research published in the
Annals of Family Medicine. Roughly one in 10 U.S. patients experiences numerous gaps in care coordination--about double the proportion across all 11 countries in the study. The likely culprit: unaffordable health care, says Harvard’s
Asaf Bitton MD, MPH. “Care coordination assumes that a person has some sort of minimal access to affordable health care,” he tells
Medscape Medical News. “When a person is uninsured or underinsured, they will avoid often necessary care.” (
Medscape Medical News;
Annals of Family Medicine)
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The College of Healthcare Information Management Executives and 15 other health care organizations have sent a letter to Health and Human Services Secretary Tom Price asking the department to indefinitely delay Stage 3 of the Meaningful Use program and similar requirements under MACRA’s Merit-based Incentive Payment System. “We believe more time is needed at this stage to offer stability to the clinicians using the technology and to enable innovation in the marketplace,” they wrote. (
FierceHealthCare;
letter)
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The cost of that tan: The use of tanning beds led to roughly 263,000 skin cancer cases in the U.S. in 2015; treatment costs topped $340 million. (
STAT News)
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DOJs agree on Anthem/Cigna: Last week, the U.S. Justice Department and several states urged a federal appeals court not to overturn a decision blocking Anthem and Cigna’s proposed $54 billion merger. The DOJ position alleviated concerns that the Trump administration would take a softer stance than did the previous administration. (
Modern Healthcare)
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Tying work to Medicaid: A group of conservative House Republicans are pushing to add work or education requirements for Medicaid. Amending the legislation, they hope, would help it get more conservative support, making passage more likely. (
Morning Consult)
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In this
Health Affairs Narrative Matters piece, Aroonsiri Sangarlangkarn, MD, discusses her relationship with her friend Roger. They met when she was a first-year med student; he was part of the Seniors as Mentors Program, and he was her mentor. Years, later, she helped him make his final care decisions--as a friend and as a doctor. (
podcast;
text)
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MarketVoices...quotes worth reading
“What is surprising is that we keep investing in the fragmented parts of care--delivery of individual commodities of disease-specific health care--and then expect the whole--the integrated care and health of people and families--to get better.”--Kurt C. Stange, MD, PhD, a researcher at Case Western Reserve University, commenting on a care coordination study in Medscape Medical News
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Copyright 2009-2017,
H2R Minutes
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