Insurers relieved but now face uncertainty

Health insurers overall were relieved at the failure of the GOP’s “skinny” repeal, but now the industry faces increased uncertainly as insurers make decisions about participating in the ACA exchanges, The Wall Street Journal reports. Insurers had already been pressing for legislation aimed at stabilizing the marketplaces, an idea that’s now likely to gain traction. According to the The Hill, there are three paths forward: bipartisan committee work, stabilizing the insurance markets and administration action to change the law. ( The Wall Street Journal; The Hill)

But is it really dead?
Reports of the GOP health care replace/repeal efforts may be premature. The White House is trying to rebuild momentum, and it’s looking at legislation crafted by Sens. Bill Cassidy and Lindsey Graham, Politico reports. The proposal would end the medical device tax, provide block grants to states, kill the individual mandate and maintain the requirement to cover pre-existing conditions. Meanwhile, President Trump has tweeted several threats about what happens if there’s no bill. Among them: eliminating cost-sharing reduction subsidies insurers receive to lower the price of health coverage for low-income Americans. ( Politico; Reuters)

Millions for defense, but not one cent for tribute—EHR edition

Erie County Medical Center in Buffalo, NY, was the target of a cyberattack this spring. But instead of paying the $30,000 ransom, it spent $10 million--mostly for hardware, software and expert advice. That accounted for about $5 million. The rest? Expenses such as overtime pay and lost revenue. Officials expect to spend at least $250,000 more per month on upgrades and employee education. “What happened to us was a wake-up call for the entire community,” says CEO Thomas Quatroche Jr. “Any major institution that wants to improve cybersecurity will have to make investments just like this.” ( Hospital Safety Insider; The Buffalo News)

H.R. 3331 offers payments for behavioral health ERH adoption
Proposed bi-partisan legislation incentivizes behavioral health providers to adopt EHRs in the same way Meaningful Use has enticed primary care and other physical health providers to do so. H.R. 3331 offers incentive payments to behavioral health providers—including private psychiatric hospitals, community health centers and even individual practitioners--for adopting certified EHR technology. “This is another step forward in our work to put mental health on a level playing field with physical health care,” says bill co-sponsor Doris Matsui (D-CA).  ( Healthcare Informatics)

Pediatricians endorse telehealth SOPs
The American Association of Pediatrics has endorsed a core framework for providing telehealth services, with a distinct focus on patient privacy and integration with the medical home. The Operating Procedures for Pediatric Telehealth were developed over three years in collaboration with the American Telemedicine Association. The standard procedures aren’t clinical guidelines; rather, they are designed to give broad guidance on areas such as legal and regulatory considerations, privacy and appropriate patient followup. (AAP Gateway; Operating Procedures for Telehealth)

Promising cancer therapy will create tough choices for docs
CAR-T, a new cancer treatment coming to market this year, creates wrenching dilemmas for oncologists. It can’t be stockpiled: It involves re-engineering a patient’s cells in a specialized lab. The logistics of getting CAR-T to the thousands of eligible patients is “uniquely daunting,” Bloomberg reports. Access issues notwithstanding, CAR-T has the potential to become a blockbuster for Novartis AG and Kite Pharma. (Bloomberg)

Medicaid ACOs: In an overview of the evolution of the Medicaid ACO, the Center for Health Care Strategies reported that programs are now operational in 10 states. Of those, six have used or currently use a shared-savings model: Massachusetts, Maine, Minnesota, Rhode Island, New Jersey and Vermont. ( Center for Health Care Strategies)