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.
At Trump’s Urging, States Try to Tilt Medicaid in Conservative Directions
From Maine to Arizona, some states are seizing on an invitation by the Trump administration to redesign a program that was created as part of the 1960s Great Society and now covers 69 million Americans. Although President Trump and his advisers talk of tailor-made innovation to match need, the states’ strategies draw on a similar repertoire—monthly premiums for people below the poverty line, time limits for coverage and fees for emergency room visits, among others. All are influenced by more conservative values that long ago filtered into welfare and other anti-poverty programs. Via Washington Post.
House Health Care Bill Cuts Premiums but Saves Less Money, CBO Finds
The House Republicans’ health care bill to replace the Affordable Care Act reduces health insurance premiums, but also cuts the federal deficit less than thought, according to a highly-anticipated analysis from the Congressional Budget Office. The 23 million more Americans who would be uninsured under the legislation is largely unchanged from prior estimates, the CBO wrote, which is likely to contribute to Democrats’ criticism of the bill. Via Morning Consult.
Providers Want Trump to Stay out of Tort Reform
President Donald Trump's tort reform proposal is being met with skepticism by providers who are criticizing the effort as a broken promise for state flexibility. The Trump administration's proposed budget released proposed to cap medical malpractice awards for noneconomic damages at $250,000, instill a three-year statute of limitations for claims, and exclude provider expressions of regret or apology from lawsuit evidence. All in all, tort-related reforms outlined in the budget are estimated to save approximately $31.8 billion over 10 years. Via Modern Healthcare.
Trump Administration, House Set to Update Court in Obamacare Payments Case
The White House and the House of Representatives are set to give a status update to a U.S. Court of Appeals in an Obamacare-related lawsuit, but it’s unclear whether any developments would be good news for insurers. The update is an important step in the case, in which a district judge ruled the Obama administration unconstitutionally paid the Affordable Care Act’s cost-sharing reduction payments. It comes roughly a month before insurers must file their 2018 premium requests, and could offer more certainty for insurers about whether they would receive that crucial government funding. Via Morning Consult.
We’re Underestimating the Toll of Opioid Overdoses, CDC Says
Approximately 91 people die from an opioid drug-related overdose each day in the United States, but that estimate likely is low, according to CDC research detailed at the annual Epidemic Intelligence Service Conference. Via Advisory Board.
Medicare to Cover Supervised Exercise for Heart Disease
Following a request from cardiologists, the CMS will now offer national Medicare coverage of supervised exercise therapy for treating peripheral artery disease. The agency said in a coverage decision that research has shown supervised exercise therapy can help alleviate common symptoms of the cardiovascular disease, including pain and discomfort in a patient's legs. Via Modern Healthcare.
New Rules May Make Online Health Insurance Sales Simpler
Signing up for coverage on the health insurance marketplace should be easier for some people this fall because new federal rules will allow brokers and insurers to handle the entire enrollment process online, from soup to nuts. Some consumer advocates are concerned, though, that customers going this route won't get the comprehensive, impartial plan information they need to make the best decision due to the financial self-interest of insurers and brokers. Via NPR.
How Chronic Conditions Drive up Health Spending
We've heard a lot about how a small number of people with serious health problems drive a disproportionate amount of health care spending, but a new report by the RAND Corporation, prepared for the Partnership to Fight Chronic Disease, shows that reality in vivid detail. The big finding: 12% of people with five or more chronic conditions account for 41% of total health care spending. Via Axios.
Ryan Appoints Controversial Cancer Doctor to HHS Committee
Soon-Shiong joins a 25-member Health IT Advisory Committee that was authorized by the 21st Century Cures Act, signed into law by former President Barack Obama in December. The legislation gives congressional leadership the power to name eight of the members. Earlier in the day, it was reported that Senate Majority Leader Mitch McConnell named Steve Ready, CIO of Louisville, Kentucky, health system Norton Healthcare, to the committee, and House Minority Leader Nancy Pelosi chose Steven Lane, an informatics executive with Sutter Health in the San Francisco Bay Area. Via Politico.
Molina Healthcare Breached, Exposed Patient Data for over a Month
Molina Healthcare, a major Medicaid and Affordable Care Act insurer, shut down its patient portal in response to a security flaw that exposed patient medical claims data without requiring authentication, according to security researcher Ben Krebs. At the time, it’s unclear how long the vulnerability was in place. Via Healthcare IT News.