What’s New in Health Care Reform: June 21

The Week in Review provides an overview of the past week’s top health care content, including industry news and trends, Mayo Clinic and Mayo Medical Laboratories news, and upcoming events.


Medica Intends to Stay in Iowa's Health Insurance Market, at 43% Higher Price

The last carrier standing in Iowa’s individual health insurance market said that it intends to keep selling such policies here next year, but it would need to charge much higher premiums than it's collecting now. Even after the announcement, Medica still could pull out of the Iowa market, as many experts feared. That could leave no options for up to 72,000 Iowans who now buy their own insurance instead of obtaining it via an employer or government program, such as Medicare or Medicaid. Via Des Moines Register.

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Without an All-in-One Solution, Health Systems Vary in Their Approach to Population Health IT

Health care organizations that have successfully integrated population health management tools have paved the way for other providers. But even with a basic roadmap, no two approaches are the same. Although health systems can benefit from a core set of guidelines, population health initiatives also rely on a degree of flexibility, according to a recent report published by Chilmark Research. Via Fierce Healthcare.

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In Just One Year, Nearly 1.3 Million Americans Needed Hospital Care for Opioid-Related Issues

The coast-to-coast opioid epidemic is swamping hospitals, with government data published showing 1.27 million emergency room visits or inpatient stays for opioid-related issues in a single year. The 2014 numbers, the latest available for every state and the District of Columbia, reflect a 64% increase for inpatient care and a 99% jump for emergency room treatment compared to figures from 2005. Their trajectory likely will keep climbing if the epidemic continues unabated. The report, released by the Agency for Healthcare Research and Quality (AHRQ), puts Maryland at the very top of the national list for inpatient care. The state, already struggling with overdoses from heroin and prescription opioids, has seen the spread of the synthetic opioid fentanyl, which can be mixed with heroin or cocaine and is extraordinarily powerful. Gov. Larry Hogan (R) this year declared a state of emergency in response to the crisis. Via Washington Post.

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Exclusive: White House Task Force Echoes Pharma Proposals

President Donald Trump repeatedly talks tough about reining in the pharmaceutical industry, but his administration’s efforts to lower drug prices are shrouded in secrecy. Senior administrative officials met Friday to discuss an executive order on the cost of pharmaceuticals, a roundtable informed by Trump’s “Drug Pricing and Innovation Working Group.” Kaiser Health News examined documents that shed light on the workings of this working group. Via Kaiser Health News.

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Price Clashes with Senators over Path to Combat Opioid Crisis

Health and Human Services Secretary Tom Price says combating the opioid crisis is one of his top priorities, a goal that has bipartisan support on Capitol Hill. But at a hearing before the Senate Appropriations subcommittee focused on HHS, Price faced pushback from members of both parties who represent states that have been struck hardest by opioid addiction, who said the proposed HHS budget wouldn’t provide sufficient funding to fight the crisis. His argument that programs meant to address the issue aren’t working sufficiently because the number of deaths related to the opioid crisis continues to rise didn’t seem to resonate either. Via Morning Consult.

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Insurers Look to Ramp up Premiums in Health Law Exchanges

A growing number of major insurers are seeking premium increases averaging 20% or more for next year on plans sold under the Affordable Care Act, according to rate proposals in more than 10 states that provide the broadest picture so far of the strains on the marketplaces. As Republicans try to pass a health-care bill to overhaul the ACA, the attention has focused on insurers’ withdrawals from a few states that risk leaving some consumers with no exchange plans next year. But the rate requests by major insurers show stress on the marketplaces stretches beyond those trouble spots. Via Wall Street Journal.

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Trump Administration Prepares a Drug Pricing Executive Order, Sources Say

Top health and budget officials in the administration will meet to discuss the issue, according to the people, who asked not to be identified because the session is private. Trump sought recommendations from the nation’s health agencies on reducing medication costs, Health and Human Services Secretary Tom Price told senators last week. One policy being discussed for inclusion in the order is expressing support for value-based agreements, a drug industry-backed proposal in which pharmaceutical companies and health insurers develop arrangements to pay for products depending on how well they work, one of the people said. Via Bloomberg.

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States Lag in Keeping Medicaid Enrollees out of Nursing Homes

States are making tepid progress helping millions of elderly and disabled people on Medicaid avoid costly nursing home care by arranging home or community services for them instead, according to an AARP report. Via Kaiser Health News.

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GOP Health Care Law Could Cost Nearly 1 Million Jobs, Report Finds

The American Health Care Act, the GOP’s answer to Obamacare, could end up costing the U.S. economy close to 1 million jobs, researchers predicted. The bill, if passed as written by the House of Representatives, would start out boosting jobs and increasing economic output because it would cut taxes, the team at George Washington and The Commonwealth Fund found. But that would change fast, the experts forecast. “The AHCA would initially cause a brief spurt of economic growth from tax cuts, which primarily help those with high incomes,” said Leighton Ku, director of the Center for Health Policy Research at the Milken Institute School of Public Health at GW, who led the study team. “However, cuts in funding for Medicaid and health subsidies then begin to deepen, triggering sharp job losses and broad disruption of state economies in the following years,” Ku added. Via NBC News.

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Senate Democrats Try to Gum up Work over Affordable Care Act Repeal

Democrats vowed to slow work in the Senate to a crawl to protest the secrecy surrounding the Republican effort to repeal and replace the Affordable Care Act, as Republican leaders raced to prepare a bill for a vote as soon as next week. Without the votes to stop the majority party from passing a bill, Democrats can only draw attention to the way Republicans are creating their bill—behind closed doors without a single hearing or public bill-drafting session. Via NY Times.

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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.