Wednesday, September 20, 2017
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The Graham-Cassidy-Heller proposal is the latest Republican effort to pass reform in the Senate this year. But the clock is ticking; with nothing in the bill to attract Democratic support, its backers are hoping to pass it under budget reconciliation with a simple majority vote. That must occur before September 30, when the window for a budget reconciliation bill closes. The legislation favors states that didn’t expand Medicaid, rolls back the individual coverage mandate and gives states broad control over Medicaid programs. But it doesn’t repeal many of the regulations that have caused problems in the individual insurance market, and some Republicans, including Rand Paul, say they won’t support it. (
Bloomberg;
New York Magazine;
HealthAffairs
Blog;
Washington Post)
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The government finances 29 percent of all health care spending, which now commands 17.8 percent of gross national product. A new report from the California Health Care Foundation says overall health spending tallied up to $3.2 trillion in 2015, or $9,990 per person. Prescription drug spending and Medicaid increased nearly 10 percent year over year. Looking forward, expect Baby Boomers to push Medicare spending up as they age into the program. (
California Health Care Foundation)
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Innovation & Transformation
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Want to lower employee health care costs? Start with pharmacy benefits. According to a new report from the Midwest Business Group on Health, employers can reduce costs and drive efficiency by working with a middleman. Strategic steps—like requiring transparency, eliminating rebates, adopting value-based design and basing formularies on clinical efficiency, can open a new, better world of pharmacy benefits. According to the Kaiser Family Foundation, 75 percent of adults in the U.S. believes the cost of prescription drugs is unreasonable, but it’s a predictable cost because of employer health coverage. (
Benefits Pro;
MBGH report;
Listening In podcast)
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Can the new Apple Watch accurately, consistently monitor heart rhythms? During the latest Apple reveal extravaganza, the company announced its partnership with American Well and Stanford University to test that scenario. Apple Watch Series 3 comes with a revamped heart monitor that designers hope will accurately collect data like post-workout heart rate and abnormal rhythm spikes. The data could help detect new cases of cardiac arrhythmias, if the Apple Heart Study bears fruit. (
Fortune;
Fierce Healthcare)
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Patients combating a health care issue often fight additional battles--to find the right care, wade through paperwork and pay the bills. A new role, the patient advocate, has emerged to help them coordinate care, do in-depth clinical research, find doctors and negotiate lower bill payments. “Nobody teaches us to be smart patients and advocate for ourselves,” says Trisha Torrey, who founded a health advocate organization. “We’re boots on the ground.” (
The New York Times)
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Too many Americans receive hospital bills they don’t understand and didn’t expect. Surprise bills come for doctors that patients don’t remember seeing. Hospital chargemaster printouts list services in jargon alongside shockingly expensive prices that bear no resemblance to what health plans actually pay. It’s a system designed for insurance company negotiation, not consumer clarity--and a market ripe for change, writes Robert Pearl in this tale of predatory pricing. (
Forbes)
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Cerner convenes brain trust for VA reboot:
A former Veterans Administration chief information officer, a former national coordinator for health IT, a technology entrepreneur and a retired general are among the advisors Cerner has invited to offer guidance on a new VA electronic health records system. Former U.S. Senator and Nebraska Gov. John Kerry will chair the prestigious group. (
HealthData Management)
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The pharmacy industry defends high price tags for new drugs based on the cost to develop and test them. But a new study that looked at cancer drug development found cost of R&D is about a quarter of what the industry estimates--$650 million per drug, rather than $2.6 billion. Experts at Tufts Center for the Study of Drug Development (which conducted the industry’s analysis and cost estimate of $2.6 billion) says the new analysis doesn’t adequately account for the drugs that fail before coming to market. (
National Public Radio
recording;
article)
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MarketVoices...quotes worth reading
“The health care bureaucracy is crippling. There are lots of layers to get to the right person. So you end up paying bills just because you've run out of energy"--Elsa Newmyer, retired teacher, quoted in
The New York Times
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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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