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Thursday, February 22, 2018

Industry News

Will Idaho OK health plans that flout the ACA?

Blue Cross of Idaho has proposed five new “state-based” health plans that are lower cost, but exclude mandatory benefits and charge higher premiums for those with pre-existing conditions; both elements are not acceptable under the Affordable Care Act. The plans are in response to an executive order from the governor calling for more affordable plans to meet the needs of Idahoans who can’t afford ACA marketplace plans. All eyes are on newly-confirmed Secretary of Health and Human Services Alex Azar’s response, but Idaho didn’t ask for a federal waiver to offer the plans. Unless there’s a legal challenge, it’s unknown whether the Trump administration will offer an opinion. Legal experts who back the ACA say the plans would not stand up to a legal challenge. ( MedPage Today; Politico; The Washington Post; Commonwealth Fund Viewpoint)

Health spending projected to grow 1% faster than GDP

Health spending over the next several years is projected to grow at 5.5 percent per year, just 1 percent ahead of projected gross domestic product, and will consume almost 20 percent of the economy by 2026. That’s according to the Centers for Medicare & Medicaid Services Office of the Actuary—and assumes nothing changes in terms of policy or legislation to affect health care. The authors of a HealthAffairs blog emphasize that much, indeed, could happen over the next decade to change these projections. “Our fate is not sealed. ... We should not ask whether health spending growth will accelerate (or not). Instead we should ask if we will let it accelerate (or not).” ( Health Affairs Blog; article)

Innovation & Transformation

Health IT leaders support new exchange framework

Three leaders in health information exchange are ready to take up the draft Trusted Exchange Framework put forward by the Office of the National Coordinator for Health IT. Indiana Health Information Exchange, Colorado Regional Health Information Organization, and CliniSync of Ohio say they want to participate in the plan to improve interoperability for providers, patients and payers, although it will require cost increases and contract changes. The timeline could prove challenging, however; it calls on a fully operational system by the end of 2019. ( EHR Intelligence Intelligence)

Social health determinants gaining recognition

Eighty percent of payers say addressing the social factors that affect health is essential for population health programs. A new survey finds that 42 percent are integrating community programs and resources into their programs already, and more than a third are adding social factors to their health risk assessments. The changes may be tied to an increase in adoption of value-based reimbursement models that more holistically address population health. ( HealthPayer Intelligence)

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Consumers & Providers

NASA-style hospital command centers are here

Using analysis viewed on a NASA-style wall of data monitors, staff at Humber River Hospital in Toronto can address capacity, safety and quality issues and increase efficiency in real time. The “Digital Command Centre,” built in collaboration with GE Healthcare Partners, concentrates decision makers in a single space where they can use data to ease patient flow and reduce bottlenecks. ( Healthcare Informatics)

To privatize or not: VA's future direction uncertain

Two political factions have put the Veteran’s Health Administration’s future direction at the center of a tug-of-war. While both sides agree that veterans need some access to providers outside the current VA facility-based system, there’s fundamental disagreement about how provider “choice” should be implemented—and how that will change the structure and function of the nation’s largest health care system. David Shulkin, secretary of the Department of Veterans Affairs, is taking fire from both sides of this internal war. ( Politico)

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New & Noted

Cavities? Just grow new teeth: A London researcher has discovered a way to stimulate stem cells in the dental pulp of mice molars. After drilling holes in the teeth to simulate cavities, the research team successfully treated the teeth and restored them to their intact state. The effort holds promise for regenerating human teeth—once risk factors, such as brain tumors, are ruled out. ( Scientific American)

Fitbit acquires health coaching platform: Fitbit acquired Twine Health, a HIPAA-compliant health coaching platform. The union will give Fitbit a door into the employer-based health management sphere, and an opportunity to leverage its huge wearables customer base. The data collected by wearables may offer useful information for chronic health condition monitoring and health improvement. ( TechCrunch; Modern Healthcare)

PBM buys medical benefits management firm: In a move to better manage drug spend (and compete with UnitedHealth Group’s Optum), Express Scripts announced it's buying eviCore, a medical benefits management firm, for $3.6 billion. The acquisition is envisioned to position the PBM for value-based patient benefit management. ( Forbes)

Multi-media

$17,850 urine test draws questions

Kaiser Health News has started a consumer awareness series highlighting out-of-sight medical bills. They kick off the podcast series with the story of a 28-year-old student who received a $17,850 bill for what she thought was a standard urine test after back surgery. The lab—which was out of her insurance network—claimed the charges were reasonable. The commentators recommend that consumers “don’t write the check” when they’re intimidated by ridiculous charges. ( Kaiser Health News)

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