Alex Azar, former Eli Lilly pharmaceutical executive and general counsel for the Department of Health and Human Services under the George W. Bush administration, was nominated to lead DHHS Monday. Azar, who left Lilly USA in January, has sterling conservative credentials and a history of critiquing the Affordable Care Act. Recent speeches reveal his expertise with the regulatory process. Democrats are expected to challenge the nomination when it comes to the Senate floor. (
The Hill;
The Washington Post)
The House passed a bill enabling Veterans Health Administration doctors with a license to practice in one state to perform telehealth visits in other states, but the Senate version remains in committee. The bills mirror current VA credentialing practices allowing doctors to offer face-to-face care across state lines. In 2016, 12 percent of veterans used telehealth services. Expanded use of telehealth could provide more convenient behavioral and physical health services to veterans in rural areas. (
Fierce Healthcare)
To truly improve the way health care is delivered, we must examine and change the way physicians are paid. Medicare’s physician fee schedule, which sets the amount the agency pays physicians and is the basis for most commercial health plan fees, is fundamentally flawed and needs a major overhaul, according to Suzanne Delbanco, who leads a nonprofit focused on value-based care. The fee schedule incentivizes procedures, contributes to a surplus of specialists and pays little to nothing for services that add value, like care coordination, she says. (
Fortune)
Community pharmacists spending eight hours a week in a patient-centered medical home helped lower A1C levels for those with diabetes and improved the population’s immunization rates. The one-year study demonstrated the benefits of putting a pharmacist in the practice for medication therapy management and patient education. (
American Pharmacists Association release;
study)
Consumers eligible to buy a health plan on the Affordable Care Act insurance marketplaces have more reasons to purchase coverage than ever. More than half of those eligible for subsidies on the marketplaces will pay no premium at all for coverage, according to a Kaiser Family Foundation study. Signups for the first few open enrollment days were up 79 percent this year over last year’s numbers. (
USA Today;
Kaiser Family Foundation)
Behavioral economics may well nudge consumers to buy at Starbucks, but it doesn’t always work in health care. Efforts to improve medication adherence using the techniques with patients haven’t panned out. One recent study that included electronically-monitored pill bottles and potential monetary reward, plus social support services and behavioral nudging, failed to achieve any difference in adherence or outcomes in the research group. (
TheUpshot in The New York Times)
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Maine votes to expand Medicaid:The first state to put Medicaid expansion to a vote of the people passed the referendum Tuesday. Maine’s ballot initiative came after the state’s legislature voted five times to expand the program; Republican Governor Paul LePage vetoed it each time. LePage said Wednesday that expanding Medicaid enrollment still requires the legislature to fully fund it; supporters say Maine has no choice but to do so after the referendum results. (
The Washington Post;
ABC News)
Genetic testing poised for huge growth: Ubiquitous access to personalized genetic testing will likely act as a disruptive force. A new report from Arthur D. Little projects the rapid growth of the genetic testing industry will affect clinical trials, payer decisions about which tests they’ll cover and patient confidence in outcomes. Some health plans are already recommending preferred vendors to members. (
report;
FierceHealthcare)
Microsoft co-founder Bill Gates announced he is starting a new research fund to look at alternative pathways to solve the Alzheimer’s puzzle. The disease affects as many as 50 percent of individuals who reach their 80s, yet its cause, how the disease unfolds and how to diagnose it and treat it are still unknown. The funds will go to research outside the two pathways currently under study to broaden diversity of approaches and accelerate progress. (
Bill Gates blog and video)
MarketVoices...quotes worth reading
“He understands the process and he knows the levers and how you make it work and where the potential roadblocks are. I think he would be of particular value given the fact that ... so far a repeal bill has not occurred and they're going to need to make their imprint on existing laws through replacing the ideology underpinning it.”– Former HHS Secretary Mike Leavitt's observation about Alex Azar, the administration's new nominee for the HHS secretary post, as quoted in
The Hill.
The next issue of H2RMinutes will be published November 29, 2017.
