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.
Flurry of Health Care Deals Reflects Shift away from Hospitals
A recent burst of deal-making among health-care companies is set to accelerate the shift in how and where Americans get medical care—away from hospitals and toward clinics, doctors’ offices, surgery centers, and even drugstores. Potential mergers disclosed since early December involve companies with more than $550 billion in cumulative revenue, a sign of how much of the industry is caught up in efforts to reshape the landscape. Via Wall Street Journal.
GOP Tax Bill Passes Senate as House Prepares to Send It to Trump
Republicans are on the verge of passing the most significant overhaul of the tax code since 1986, after the Senate passed the GOP plan morning and House leaders scheduled a vote to quickly send it to President Trump. Via Washington Post.
U.S. Lifts Moratorium on Funding Controversial, High-Risk Virus Research
The federal government announced that it is lifting a three-year moratorium on funding controversial research that involves genetically altering viruses in ways that could make them more contagious, more deadly, or both—and that critics say risks triggering a catastrophic pandemic. Via STAT.
New HIPAA Guidance Clarifies Data Sharing for Mental Health and Substance Abuse Patients
New guidance issued by the Department of Health and Human Services offers some pointed clarifications about when HIPAA allows providers to share information about patients with a mental health condition or a substance abuse disorder. Via Fierce Healthcare.
Doing More Harm Than Good? Epidemic of Screening Burdens Nation’s Older Patients
But a growing chorus of geriatricians, cancer specialists. and health system analysts are coming forth with a host of reasons: Such testing in the nation’s oldest patients is highly unlikely to detect lethal disease, hugely expensive. and more likely to harm than help since any follow-up testing and treatment is often invasive. And yet such screening—some have labeled it “overdiagnosis”—is epidemic in the United States, the result of medical culture, aggressive awareness campaigns, and financial incentives to doctors. Via Kaiser Health News.
Hospital Giants Vie for Patients in Effort to Fend off New Rivals
As health care is rocked by deals aimed at shattering traditional boundaries between businesses, some of the nation’s biggest hospital groups are doubling down on mergers that seem much more conventional. Skeptics say some of these hospital deals are more of the same: systems seeking to increase their leverage with insurance companies and charge more for care. In just the last few weeks, several of the nation’s largest nonprofit hospital systems have announced plans to become even larger behemoths. Dignity Health and Catholic Health Initiatives said they planned to become a national chain of Catholic hospitals and clinics that spanned 28 states. Two Midwestern systems want to combine to become one of the country’s largest nonprofits, and Ascension, which is already the nation’s largest nonprofit health system, is said to be in talks to become even bigger, according to The Wall Street Journal. Ascension declined to comment. Via NY Times.
Senate GOP Pushes off Obamacare Bills until January
Senate Republicans are punting two Obamacare bills into next year as lawmakers scramble to avoid a government shutdown. GOP Sens. Susan Collins (Maine) and Lamar Alexander (Tenn.) said they have asked Senate Majority Leader Mitch McConnell (R-Ky.) to not bring the bills up this week. Via The Hill.
GOP Fails to Pressure Hospitals on Community Benefits
Despite Republicans’ boasts about closing tax loopholes, there’s one sector that the sweeping tax reform bill mostly leaves alone: The tax-exempt hospital sector, which enjoys billions of dollars in tax breaks even as big hospitals raise prices and perform less free care. Mayo Clinic, a nonprofit health system, cleared more than $1 billion in profit between 2015 and 2016. Cleveland Clinic, another nonprofit hospital, topped more than $715 million in profits in that span. Via Politico.
Children’s Health Insurance Program Still in Limbo after Yet another Patch
A critical government program that provides health-care coverage to 9 million low-income kids received yet another patch to help stretch it out a few more months—with still no long-term fix in sight. Congress passed short-term legislation that includes $2.85 billion to help fund the program, known as CHIP, through the end of March. The measure will help cover the estimated 1.9 million children across 24 states and Washington, D.C., that stood to lose coverage for care such as doctors visits and hospitalizations in January as states have dipped into reserve funds. But the temporary relief still leaves CHIP and families that rely on it in a state of uncertainty. Via Bloomberg.
Medicare Penalizes Group of 751 Hospitals for Patient Injuries
The federal government lowered a year’s worth of Medicare payments to 751 hospitals to penalize them for having the highest rates of patient injuries. More than half also were punished last year through the penalty, which was created by the Affordable Care Act and began four years ago. The program is designed as a financial incentive for hospitals to avoid infections and other mishaps, such as blood clots and bed sores. Via Kaiser Health News.