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Industry News

Senate unanimously passes Chronic Care Act

A bill that improves how Medicare pays for people with chronic conditions passed unanimously in the Senate last week. The CHRONIC Care Act expands the Independence at Home program, allows all Medicare Advantage plans to participate in value-based models, loosens ACO payment options, and allows for greater telehealth reimbursement. The House will consider the bill next. ( Beckers Hospital Review; The Hill)

Dr. Wright takes over at DHHS

With Tom Price’s resignation Friday, the White House immediately announced his replacement. Acting Secretary for Health and Human Services Don Wright, MD, MPH, has served both Republican and Democrat administrations over the past 10 years, most recently as the acting assistant secretary at DHHS. While the recent revelation that Price racked up more than a million dollars in private plane travel expense prompted his resignation, his tenure was marked by too many ethical missteps and too few legislative wins to overcome the latest scandal. Conjecture abounds about who will permanently replace Price, but the administration hasn't announced a candidate yet. ( USA Today; The Hill; Kaiser Health News)

Next salvo: Executive order allowing insurance sales across state lines

An executive order may be the next step towards lowering health costs, according to President Trump. State insurance regulations vary widely, and current laws require health plans to adhere to those in each state in which they sell plans. The reform idea, backed by Sen. Rand Paul (R-Ky.), Marsha Blackburn (R-Tenn.) and others, would allow insurers to sell policies in multiple states, while only required to adhere to the regulations of their home state. The idea is greater competition and lower costs for consumers. Critics say the move would split the market between the healthy—who would buy from plans in states with fewer required benefits—and the sick, whose rates would necessarily rise in the more regulation-heavy markets. ( CNN; Bloomberg; American Academy of Actuaries)

Innovation & Transformation

Mapping app uses IT to predict next wave of overdoses

A web application called ODMAP combines street-level data with digital mapping tools to help public health officials, police departments and first responders track and respond to overdoses in real time. As opioid overdoses take nearly 100 American lives each day, Washington/Baltimore area officials developed the nationwide tracking app to see where overdoses are happening and, using analytics, to predict where they’ll happen next. Officials can notify hospitals and ensure first responders have naloxone on hand to administer to overdose victims. ( Wired)

Health plans ramp up provider relationships for value-based payment

With top administration officials confirming support for accountable care development and voluntary value-based payment models, private sector health plans are advancing those models on the ground. Payers and providers are building new contracts, tweaking measures and revamping health IT platforms to facilitate these new models. Some call it a new social contract, with providers and payers coming together to develop trust and share financial risk. ( Healthcare Informatics)

Consumers & Providers

Who and why: The skinny on health care consumer trust

Consumers rely on physicians most when making decisions about care and coverage, but trust is all about the relationship. If consumers feel disrespected by doctors, they’re far less likely to trust doctors overall and are less likely to take their prescription medications as directed. A group of studies--funded by the Robert Wood Johnson Foundation on how consumers are navigating the health landscape--found wide variation consumer trust, based on consumer age, employment status and coverage source. ( HealthAffairs Blog)

Drug makers must fund education for prescribing opioids

The FDA informed 74 manufacturers of fast-acting opioids they will have to fund development of instructional courses for doctors, nurses and pharmacists that prescribe them. Providers won’t be required to take the courses—at least not yet. The administration is looking for ways to counteract opioid abuse and overdoses, thus the new guidance. The action last week brings this class up to the same standards in place for extended-release and long acting formulas. About 90 percent of all opioid prescriptions are for the fast-acting formulas. ( Reuters)

New & Noted

8 Governors asked to explain Medicaid costs: Illinois Medicaid costs exceeded estimates by 90 percent. Huge increases triggered an investigation by a Senate committee on greatly expanded costs there and in Ohio, New Hampshire, Michigan, California, West Virginia, New York and Hawaii, which all expanded coverage under the Affordable Care Act. ( Columbus Dispatch; Watchdog.org)

Casual DNA tests? Not in these states: Maryland and New York still don’t allow individuals to have their DNA tested without a prescription, despite rapid growth in the number of companies that now perform the swab-and-tell tests. Personalized testing companies promise to provide information on your skin, athletic ability, diet, intelligence and other factors.( Technology Review)

Multi-media

Can health care be healed? There's a bi-partisan way forward

In this interview, Kaiser Permanente CEO Bernard Tyson says he’s optimistic that bi-partisan legislation can stabilize health insurance marketplaces. State flexibility is the best way to allocate health dollars, but with some federal guidelines, or “guardrails,” to ensure essential health coverage remains for preventive care, maternity care and hospitalization. ( National Public Radio)