What’s New in Health Care Reform: Dec. 16


What's New in Health Care Reform provides an overview of the past week’s news, updates, and commentary in health care reform and utilization management.

The Experts Were Wrong About the Best Places for Better and Cheaper Health Care

Health care researchers who have seen the new findings say they are likely to force a rethinking of some conventional wisdom about health care. In particular, they cast doubt on the wisdom of encouraging mergers among hospitals, as parts of the 2010 health care law did. Larger, integrated hospital systems – like those in Grand Junction – can often spend less money in Medicare, by avoiding duplicative treatments. But those systems also tend to set higher prices in private markets, because they face relatively little local competition. Via NY Times.

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Obamacare Tax Delay Would Give Insurers a Win

Health insurers are set to lose when it comes to the year-end omnibus spending bill, but the industry will also score a win if a one-year Obamacare tax moratorium makes its way into a separate package of year-end tax provisions. If lawmakers do nothing on the health insurance tax, it expected to bring in $12 billion or more annually to the Treasury in 2017 and 2018. But members are discussing a one-year suspension of the tax, which could keep some of that money with the insurers. They could, in theory, pass the savings along to their customers, but there is no requirement that they do so. Via Morning Consult. 

Insurers Want to Nudge You to Better Health. So They’re Data Mining Your Shopping Lists

Insurance companies have always had access to your medical records, and in some cases your genetic data, too. Now, they’re paying data miners to sift through information on everything from what model car you drive to how many hours you sleep, from which magazines you read to where you shop and what you buy. Via Stat News.

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New Laws to Ease Doctor Shortage See Long Delays, Criticism

Universities have been launching new medical programs and expanding student enrollment in an attempt to meet an even larger projected doctor shortage caused by retirements and an increased demand for physicians under President Barack Obama's health insurance overhaul and state Medicaid expansions. Total U.S. medical school enrollment approached 110,000 this past year, up almost one-third over a decade ago. Residency programs, which provide an additional three to six years of post-graduate training needed for physicians to be certified, have also grown but have failed to keep up with demand. Via Associated Press.

Thousands of Pharmacies Join ObamaCare Sign-Up Efforts

The Department of Health and Human Services (HHS) announced partnerships with pharmacies across the country in an effort to boost ObamaCare enrollment as the sign-up deadline approaches. The pharmacies, including CVS and Walgreens, will hold enrollment events and have trained assisters available to help customers sign up for insurance under the health care law. Via The Hill.

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If It Ain't Broke, Don't Fix It: Health Care Reform and Medicare

“Faith lost in Obamacare as consumers look to alternatives.” “Why Obamacare co-ops are failing at a rate of 50 percent.” “Obamacare is failing to make care more affordable.” These are just a few of the recent headlines about President Obama’s troubled health care law. While there are over 16 million newly insured Americans because of it, there are also millions who have seen their premiums and copays go up exponentially, as well as individuals who have lost coverage altogether. Reports suggest that Obamacare could cost the domestic economy two million jobs over the next ten years. We’re also facing tremendous challenges in getting young people to sign up for insurance – the key demographic that the success of the program hinges upon. Via Forbes.

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Congress Ready to Give NIH its Biggest Increase in 12 Years

The National Institutes of Health will get a $2 billion funding increase in the federal spending bill, a big boost that could turn around the agency’s fortunes after years of stagnant budgets. It’s the first time the NIH budget would get such a large raise in more than 12 years — assuming the spending bill can get enough votes to pass Congress. And it comes after a year of growing momentum in which powerful Republicans and Democrats convinced their colleagues that medical science is ready to make good use of extra money. Via Stat News.

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Obamacare Sign-Ups Could Get Bump as Higher Penalties Kick In

Penalties for failing to buy insurance will roughly double. A family of four that makes $250,000 a year could face a fine when tax time rolls around in 2017 that approaches $10,000 if they don't get coverage for 2016. Kevin Counihan, CEO of the federal insurance exchange HealthCare.gov, says he thinks the high fines will induce people who didn't have insurance before to at least shop around before deciding to skip coverage again. Counihan, who was director of marketing for the Massachusetts health exchange 10 years ago, says it was when the fines approached $1,000 that sign-ups jumped. Via MPR News.

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Despite Hopes of Health Law Advocates, ‘Multi-State’ Health Plans Unavailable in Many States

A health law insurance program that was expected to boost consumer choice and competition on the marketplaces has slipped off course and is so far failing to meet expectations. Since just a few insurers, or sometimes just one, dominate the market for individuals and small businesses in some states, the law sought to increase competition in those areas by calling for “multi-state” health plans that would be offered by some insurers. Via Kaiser Health News.

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Health Reform's Escape Hatch May Be Too Narrow for States Seeking to Use It

The Obama administration may have disappointed anyone banking on an Affordable Care Act provision allowing states to duck many of the law's federal mandates by finding homegrown ways to ensure affordable coverage. Under Section 1332 of the Affordable Care Act, states can ask to opt out of most of the law's major insurance components—including the insurance exchanges, minimum benefit packages and the individual and employer mandates—but final guidance the administration issued late last week (PDF) included some significant barriers. Via Modern Healthcare.



Kelley Schreiber

Kelley Schreiber is a Marketing Channel Manager at Mayo Medical Laboratories. She is the principle editor and writer of Insights and leads social media and direct marketing strategy. Kelley has worked at Mayo Clinic since 2013. Outside of work, you can find Kelley running, traveling, playing with her new kitten, and exploring new foods.