Annual premiums for employer-sponsored insurance rose only 3 percent this year, but it’s still faster than the rate of inflation and worker wages. On average, workers are paying a greater share of family premiums—32 percent this year, compared to 14 percent in 2012, according to the annual Kaiser Family Foundation Employer Benefits Survey. More than half of covered workers were in a plan with an annual deductible of more than $1,000 for single coverage. (
Kaiser Family Foundation;
HealthAffairs)
Senate Republicans hoping to push Graham-Cassidy over the finish line are regrouping after Sen. Susan Collins (R-Maine) announced Monday she wouldn’t back the Affordable Care Act repeal-and-replace bill. She joined Sen. Rand Paul (R-Ky.) and Sen. John McCain (R-Ariz.), who also declared their opposition to the bill. With three Republicans against it and zero Democrats in favor, Senate leaders postponed what would be a losing vote. Sen. Lindsey Graham (R-S.C.) said he’s not giving up; he expects the health care debate will resume in due time. Sen. Lamar Alexander (R-Tenn.) says he's rebooting his bi-partisan reform effort. (
The Hill;
Bloomberg)
Also Monday, the Congressional Budget Office released its limited analysis of the Graham-Cassidy bill, noting it would reduce the budget deficit by $133 billion in the next decade. But it would also add millions to the uninsured rolls because of lower Medicaid enrollment, reduced premium subsidies and repeal of the individual mandate. (
Congressional Budget Office analysis)
In a
Wall Street Journal op-ed last week, Centers for Medicare & Medicaid Services Administrator Seema Verma said the agency’s Innovation Center will increase flexibility for local providers to innovate. Verma said CMS wants to continue the shift away from fee-for-service payment towards value-based care because these models have encouraged consolidation and limited patient choice. CMS released an RFP Sept. 20, receiving a warm reception from health care providers who like the idea of a waiver-based funding model with greater flexibility. (
Healthcare Finance;
The Wall Street Journal (subscription required);
CMS RFP)
Patients achieve better quality of life and access to care in a medical home, according to community health center administrators. That’s why they’re sticking with the model, despite results from a RAND study of Medicare beneficiaries that found the model didn’t save the government money. Some community health centers say they’re saving plenty—even without Medicare’s monthly care coordination fee. Critics of the RAND study say most of the health centers in the three-year demonstration were not certified as patient-centered medical homes until the end of the evaluation, so results are flawed. Better care coordination, preventive care and care for chronic conditions—all hallmarks of the medical home-- yield lower costs over time. (
Modern Healthcare)
A new survey shows almost half of physicians blame insurance companies for health care costs, while about one in three consumers blame drug and device companies. The national survey by the Texas Medical Center Health Policy Institute found respondents believe penalizing unhealthy behaviors and allowing people to buy catastrophic health coverage—illegal under the ACA—could lower costs. Nearly half (49 percent) of consumers said they’ve had to cut spending elsewhere to pay for health care. (
HealthcareDIVE;
survey report)
The Department of Health and Human Services gave notice last week of its Healthcare.gov maintenance schedule, which includes a 12-hour shutdown—from 12 a.m. to 12 p.m. Eastern—for five of the six Sundays of open enrollment. The site will also be closed overnight on its opening day, Nov. 1. The news was not welcomed by groups that help Americans in 36 states navigate the site to buy health insurance, especially since the administration has already shortened the enrollment window and cut funding for outreach in half. “I could see this really impacting the ability of people to complete an application sign-up in a single sitting, which is so important,” said Jason Stevenson, a spokesman for a Utah-based navigator group. (
Kaiser Health News)
New & Noted
Epic empowers patients to share health records:EHR vendor Epic announced its November rollout of a new product that allows patients to open their electronic health records to any provider—whether or not they have an EHR system—with internet access. Share Everywhere puts access to the medical record firmly into patients’ hands. (
Becker’s Health IT and CIO Review)
Minnesota gets nod for reinsurance program:The federal government approved a Minnesota tactic designed to lower rates for those who buy coverage in the individual market. The state will buy reinsurance to cover the few in the market who have catastrophic health costs, so the 5 percent of Minnesotans who buy their own insurance don’t bear the full burden. The reinsurance cushion will lower premium rates for these residents by about 20 percent and stabilize the private market. (
StarTribune)
That tingle that tames pain:Medtronic received FDA clearance for a device that wirelessly delivers neurostimulation to reduce spine pain. Using a Samsung tablet, a patient’s caregiver adjusts the level of neurostimulation to deliver. Medtronic described it as a “non-opioid treatment option” for pain. (
Mobihealthnews)
In one chart, see how the House health bill compares to the now-shelved Graham-Cassidy plan, and compare them both to key elements of the Affordable Care Act. (
Roll Call)
MarketVoices...quotes worth reading
“We must shift away from a fee-for-service system that reimburses only on volume and move toward a system that holds providers accountable for outcomes and allows them to innovate."
– Centers for Medicare & Medicaid Services Administrator Seema Verma in an op-ed in
The Wall Street Journal