What’s New in Health Care Reform: Feb. 24


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.

Dueling Star Ratings May Confuse Some Home Health Patients

Patients looking for home health care services will be impressed if they check out the federal government’s ratings of Brookdale Senior Living. Four of the company’s home health agencies — in Florida, North Carolina, Ohio and Rhode Island — each earned five stars, the top quality score, primarily based on Medicare’s assessment of how often patients got better. But further research may lead to confusion. Medicare also posts stars to convey how patients rate agencies after their care is over. There, these same four Brookdale agencies earned no more than two stars. Via Kaiser Health News.

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Health Officials Push FDA to Add ‘Black Box’ Warnings About Using Opioids, Benzodiazepines Together

Dozens of public health officials and academics across the country are pushing the Food and Drug Administration to warn people about the potential dangers of taking powerful prescription painkillers alongside common anti-anxiety drugs known as benzodiazepines. Via Washington Post. 

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White House Presses Congress for Emergency Funds for Zika

The White House said it needs the U.S. Congress to deliver emergency funding to address the Zika virus, and said redirecting some money set aside for Ebola-related projects would not be enough given the scope of the outbreak. President Barack Obama has asked Congress for more than $1.8 billion to fight mosquito-borne Zika, which has been linked to birth defects in Brazil and spread to at least 31 other countries and territories, mostly in the Americas. Via Reuters.

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HHS Failed to Heed Many Warnings That HealthCare.Gov Was in Trouble

During the two years before the disastrous opening of HealthCare.gov, federal officials in charge of creating the online insurance marketplace received 18 written warnings that the mammoth project was mismanaged and off course but never considered postponing its launch, according to government investigators. Via Washington Post.

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U.S. Proposes Hike in Medicare Advantage Payments; Insurer Shares Rise

The U.S. government proposed raising payments by 1.35 percent on average next year to the health insurers who offer Medicare Advantage health benefits to elderly and disabled Americans. Payments to insurers will vary under the 2017 Medicare Advantage proposal, based on the region the plans are sold and on the size of bonus payments insurers can receive based on quality ratings, the government said. Shares of health insurers rose in after-hours trade. Analysts said the proposal looked positive for insurers at first glance, but cautioned that they needed to parse it fully. Via Reuters.

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Medicaid Premium Hikes May Leave Many Children Uninsured

Premium increases for Medicaid, the government health program for the poor, may leave many U.S. children uninsured, a new review suggests. Higher premiums for the national Children’s Health Insurance Program (CHIP), which also provides coverage to low-income kids, may have a similar result. Via Reuters.

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Healthcare.Gov ‘Passive’ on Heading Off Fraud

With billions in taxpayer dollars at stake, the Obama administration has taken a "passive" approach to identifying potential fraud involving the president's health care law, nonpartisan congressional investigators say in a report due out. Via AP.

TurboTax: Most Uninsured Escaped Obamacare Penalty

Nearly three in four people who lacked health insurance last year were exempt from the penalty under Obamacare, according to data from the tax-filing software TurboTax. Via The Hill.

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Bad Debt is the Pain Hospitals Can't Heal as Patients Don't Pay

Hospitals have long struggled to collect bills when patients aren’t covered by insurance -- creating delinquent accounts. The Affordable Care Act was supposed to relieve some of that strain by helping pay for coverage for millions of Americans and expanding Medicaid in some states to cover the poor. Yet while millions of people have gained coverage since Obamacare became law in 2010, there’s also been an increase in insurance that comes with high deductibles and cost-sharing. Under those plans, the first few thousand dollars of annual medical expenses come out of patients’ wallets. Via Bloomberg.

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Senators Push to Keep Seniors From Doctor Shopping for Opioids

Bipartisan legislation aimed at blocking Medicare recipients from shopping for doctors and pharmacists likely to prescribe opioids could help address the national prescription drug abuse epidemic, Senate Finance Committee Democrats said at a hearing. But they urged Republicans to broaden their approach to encourage more addiction treatment. Via Roll Call.

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Andy Tofilon

Andy Tofilon is a Marketing Segment Manager at Mayo Medical Laboratories. He leads strategies for corporate communications, public relations, and new media innovations. Andy has worked at Mayo Clinic since 2003. Outside of work, Andy can be found running, hiking, snapping photos, and most importantly, spending time with his family.