Thursday, December 20, 2018
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Federal Judge Reed O’Connor declared the Affordable Care Act invalid last week, finding that the 900+-page act hinges on the personal coverage mandate and the tax penalty attached to it—which Congress eliminated in 2017. The decision is likely headed to an appeal (eventually to the Supreme Court). O’Connor’s summary judgment stopped short of the plaintiffs’ request for a court order blocking the ACA’s continued operations, and the administration released a statement that the ACA will remain in force until appeals are complete. (
Axios
;
The Commonwealth Fund
)
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If upheld, Federal Judge Reed O’Connor’s decision would roll back the entire Affordable Care Act, including the ACA’s most popular elements, like allowing young adults to keep health coverage through age 26 on their parent’s plan and coverage for pre-existing conditions. It would also eliminate expansion of state Medicaid programs and the federal and state-run insurance marketplaces. The ACA created numerous programs across the health care landscape—from the Food and Drug Administration to creation of the Centers for Medicare & Medicaid Innovation—the future of which are now in question. Sen. Chuck Schumer is calling for Congressional intervention in the case. Doctors, insurance plans and hospitals—all of whom have financial risk at stake in an ACA rollback scenario—are urging the appeals courts to reject the ruling.
(
Politico
;
Forbes
)
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Innovation & Transformation
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The nation needs a modern-day health care reinvention, à la the 1946 Hill-Burton Act, says Susan Dentzer, president and CEO of the Network for Excellence in Health Innovation. In this opinion piece, Dentzer says a new plan would repurpose and restructure the nation's hospitals—especially those struggling to fill beds—to push more care outside their walls. Hospitals facing closure should embrace virtual visits and home-based care, in collaboration with enhanced primary care and integrated behavioral health delivery models.
(
Modern Healthcare
)
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CrossFit, the high-intensity exercise company, is targeting doctors for weekend training courses. The idea is to empower doctors to consider prescribing CrossFit-style exercise to patients, or to open CrossFit gyms themselves. Some 340 doctors have attended the weekends. Noting that doctors have few tools for treating obesity and other lifestyle-related health issues, the company’s founder, Greg Glassman, says doctors who have tried CrossFit themselves are the best means to persuade patients to abandon a sedentary lifestyle and poor nutritional choices. Critics note that CrossFit is a pricey program and the company has plenty to gain from the venture.
(
Vox
)
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Vaping has skyrocketed among high schoolers. Twenty percent of high school seniors have vaped in the past 30 days, a new report finds. That’s nearly double the rate from one year ago. Vaping represents the lion’s share of the increase in tobacco use overall among high schoolers, with 1.3 million new users since the 2017 survey—the biggest leap in use for any substance (drugs, alcohol or tobacco) in the survey’s 44 years. Surgeon General Jerome Adams issued a rare advisory Tuesday, urging parents, teachers and doctors to get informed about teen vaping and try to keep the products away from teens.
(
Time
;
Los Angeles Times
)
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The highest achievers in the first year of Medicare’s pay-for performance program (MIPS) earned a fairly small bonus on services they bill in the future (less than 2 percent). As a budget-neutral program, bonuses are based on penalties paid by providers who perform poorly, and there weren’t many of them. CMS could respond by making it harder to earn a bonus, but it would be better if the agency simply made it easier to participate in the program. In this blog post, Mathematica Associate Director Jeff Ballou recommends CMS adopt standard scoring methodology for measures and drop measurement categories that are less likely to drive improvement. (
Mathematica
)
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Patients routinely monitor their medical records online or request copies from doctors. Sometimes they find errors, too, and it’s not always easy to get them corrected. Practices may hesitate to make a change for fear of being sued over an error that could have resulted in patient harm. The problem may soon become even bigger, notes one patient who found a different patient’s medical information in her record. “I hope that companies in tech don’t start looking at the text in physician notes and making determinations without a human or someone who knows my medical history very well,” she said. “I’m worried about more errors.”
(
CNBC
)
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Regulators approve Cigna-Express Scripts merger:
Last week, California and New York regulators approved Cigna Corp.’s buyout of Express Scripts, the pharmacy benefits management company. Both approvals came with strings: The combined company can’t raise premiums to pay for the merger and must keep premium increases in check. New York also wanted assurance that Express Scripts wouldn’t exclude independent pharmacies from its network.
(
Modern Healthcare
)
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Amazon targets home medical testing:
The retail giant is looking to buy a company in the home health testing market; talks to buy Confer Health broke down earlier this year, however. Moving into the health diagnostics arena would add a new link in Amazon’s medical supply acquisition chain.
(
CNBC
)
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Since 2014, dozens of people in New York with disabilities, including mental illness, were moved out of group homes and into subsidized housing with support from private case management services. The state did not track their outcomes, but an investigation reveals that many weren’t ready to make the move to independence. Many couldn’t successfully manage medication regimens, keep food on hand and perform other activities of daily living. Some have lost their lives. (
ProPublica
)
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MarketVoices...quotes worth reading
“For me, the best combination of this would be to have an office, see patients, and have them all meet me for a workout at 5.”-- Lauren Vigna, a Highland, New York-based doctor who has been doing CrossFit for a decade, as quoted by
Vox.
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Editor
Sandy Mau
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