What’s New in Health Care Reform: May 11

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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.


Health Care Costs, End Of Reinsurance Drive Premium Changes

Underlying growth in health care costs and the sunset of the Affordable Care Act’s reinsurance program are the major drivers behind insurance premium increases this year, according to a new report from the American Academy of Actuaries. Insurers are now filing their premium rate requests, and early requests show potential double-digit increases. The Department of Health and Human Services has said customers shouldn’t be concerned by the proposed hikes, because the actual increases have not been as high as first expected in recent years. Via Morning Consult.

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Commercial Health Care Spending Grew Faster In 2015

National health care costs in the commercial market grew 6.5 percent in 2015, a 50 percent faster rate than they did the prior year, according to a new report from S&P Global. The increases were driven by a 15.83 percent increase year-over-year on prescription drug costs and a 4.3 percent increase year-over-year in medical services costs, the report says. The data from the report is drawn from the S&P health care claims indices. Via Morning Consult. 

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Raising Medicare’s Eligibility Age Could Trigger Gov’t Savings, But Tally Higher Total Health Spending

Health care spending for some services dropped by nearly a third when people turned 65 and switched from private insurance to Medicare, according to a recent study. The decline was driven by lower prices paid by the Medicare program to doctors and other providers rather than a drop-off in the volume of services seniors receive. Via Kaiser Health News.

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Insurers Signal Obamacare Rate Hikes, But Feds Say Don’t Believe It

With health insurance companies warning that losses from their Affordable Care Act plans are unsustainable, and large carriers leaving the so-called Obamacare exchanges in many states, industry analysts are expecting that monthly premiums will rise significantly in 2017. Not so fast, says the Obama administration. Via Miami Herald.

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Lawmakers Criticize Medicare Plan for Costly Drugs

An Obama administration proposal to reduce Medicare’s profit incentives to doctors who administer drugs is drawing such intense congressional criticism that some policy analysts question whether it will survive intact. Dozens of House Republicans are demanding the proposal be withdrawn, and Democrats on the Senate Finance Committee are raising concerns with the Centers for Medicare and Medicaid Services, which administers the program. Via Wall Street Journal.

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Get Ready for Higher Obamacare Rates Next Year

It already looks clear that many Obamacare insurance plans are going to raise their prices significantly. Over the last few years, average premium increases in the Obamacare markets have been lower than the increases for people who bought their own insurance in premiums before the Affordable Care Act. But several trends are coming together that suggest that pattern will break when plan premiums are announced in early November. Many plans may increase prices by 10 percent, or more. Via New York Times.

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As Time Runs Out, the Obama Administration Races to Reshape Health Care

As the clock ticks toward Jan. 20, 2017, the Obama administration is racing to burnish its health care legacy, introducing major new initiatives that will take full effect just weeks before the president leaves office. The ranks of the uninsured have dropped dramatically since the passage of the Affordable Care Act six years ago. But administration officials are now hustling to use other parts of the law to reshape how health care itself is delivered across the United States. Via Stat News.

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The Missing Patient Voice in Value-Based Care

While health care providers are getting ready to implement more value-based payment programs, such as the new Medicare reimbursement system for physicians, regulators are trying to improve and speed up feedback from providers and patients. Via Modern Healthcare.

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House Panel Dings Slavitt on Lack of Recouped ACA Grant Money

The House Energy and Commerce Committee Republicans can’t find most of the $200 million that the Obama administration claims it recouped from state-based health care exchanges as part of a federal grant program to help them set up shop, according to a new report obtained by Morning Consult. Centers for Medicare and Medicaid Services Acting Administrator Andy Slavitt told the committee in December that “over $200 million” had been returned to federal coffers from the state exchanges since the grant program went into effect. Via Morning Consult.

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HHS Launches Contest to Design New Medical Bill

The Department of Health and Human Services is launching a contest for health care organizations to design their own medical bills, with the hope of overhauling how medical billing works. The department will award the organization that designs the bill that’s easiest for patients to understand and the organization that designs the best transformational approach to the medical billing system. Six health care systems and organizations that together serve more than 10 million patients annually have committed to testing or implementing the winning systems. Via Morning Consult.

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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.