What’s New in Health Care Reform: June 22


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.

$20M to Help Small Practices as Part of Provider Payment Reforms

The Department of Health and Human Services will direct $20 million for the training and education of Medicare clinicians at small group and individual practices, the department announced. The funding is part of the $100 million the department will provide to help small practices adapt to the Quality Payment Program under the Medicare Access and CHIP Reauthorization Act, which was signed into law last year. Via Morning Consult.


Report: Health Spending Projected to Be Lower than Original Estimates

National health spending between 2014 and 2019 will be lower than was anticipated in the Affordable Care Act’s 2010 baseline prediction, a report released by the Robert Wood Johnson Foundation projects. Throughout the five-year period, national health spending will be $2.6 trillion less than anticipated in 2010, the report says. However, cumulative spending throughout that time is projected to be $49 billion higher than the 2014 forecast. Via Morning Consult. 

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A Record Number of Americans Say They Can Indeed Afford Health Care

The annual cost of health care for a typical family of four with employer-sponsored insurance has skyrocketed over the past few years to over $25,000 in 2016—yet more Americans say they can afford the bills. Polling group Gallup reported that 15.5% of Americans say they couldn’t afford the health care or medicine they needed over the past year. That’s the lowest percentage reported since Gallup began tracking Americans’ health care insecurity at the head of the financial recession in 2008. Via Fortune.

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Some Democrats Aren’t Giving Up on Universal Health Care

Democrats should push for universal health coverage ahead of the November election, several health care advocates urged the committee drafting the Democratic National Committee’s platform at a recent session focused on health policy. Via Morning Consult.

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Medicare Commission Recommends Drug Pricing Changes

An independent congressional agency released recommendations for improving Medicare, including several proposals aimed at reducing how much the program spends on prescription drugs. The Medicare Payment Advisory Commission suggested changing the way Medicare pays for drugs under both its prescription drug benefit and the benefit covering hospital and physician care. The recommendations come amid intense controversy over a recent Obama administration proposal that would change the way Medicare reimburses doctors and hospitals for prescription drugs administered on their premises. Via Morning Consult.

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GOP Obamacare Replacement Will Leave out Key Dollar Figures

House Republicans’ Obamacare replacement plan will not include specific dollar figures on some of its core provisions, and will instead be more of a broad outline, according to lobbyists and aides. The plan will include a tax credit to help people afford insurance and a cap on the current exclusion of employer-based health insurance plans from taxation. However, it will not include specific dollar amounts on how large the tax credit would be, nor will it note which employer health insurance plans would be subject to taxation, lobbyists and aides said. Via The Hill.

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States Receive $22M to Help Control Obamacare Premium Hikes

The White House is giving $22 million to help states push back against steep premium hikes proposed by health insurers this year. The new Obamacare grants are intended to boost the built-in protection against premium hikes that most states already have in place, known as "rate review." Via The Hill.

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Health Costs to Grow at Constant Rate in 2017, PwC Report Projects

Medical costs will continue to grow at a mostly flat rate next year, PwC’s Health Research Institute projects in a report released. Costs will grow at roughly 6.5 percent in 2017, in line with 2016 trends, the report says. Growing use of convenience care and increased access to behavioral health services will increase costs, while an increased number of high performance networks and increasingly aggressive pharmacy benefits managers will counteract that. The study looks at spending for Americans with employer-sponsored health insurance. More than half of Americans are covered through employer-sponsored plans. Via Morning Consult.


House Republicans Unveil Long-Awaited Plan to Replace Health Law

Six years after promising a plan to “repeal and replace” the federal health law, House Republicans are finally ready to deliver. The 37-page white paper, called “A Better Way,” includes virtually every idea on health care proposed by Republicans going back at least two decades. It would bring back “high-risk pools” for people with very high medical expenses, end open-ended funding for the Medicaid program and encourage small businesses to band together to get better bargaining power in “Association Health Plans.” What the plan does not include, however, is any idea of how much it would cost, or how it would be financed. Via Kaiser Health News.

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HHS Targets Young Adults in 2017 Obamacare Enrollment Plan

Amid early signs that insurance premiums under the Affordable Care Act might rise significantly next year, administration officials previewed their plans to increase enrollment in the marketplaces, particularly among young adults who have been slow to sign up. Open enrollment starts Nov. 1 and ends Jan. 31. For the first time, the administration said it would send letters about marketplace coverage to uninsured people and to families who paid the individual mandate penalty for not having coverage or claimed an exemption from the health law requirement that they have coverage. Via Kaiser Health News.

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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.