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.
CMS Launches New Voluntary Bundled-Payment Model
The CMS announced a new voluntary bundled-payment model that will be considered an advanced alternative payment model under MACRA. The Bundled Payments for Care Improvement-Advanced Model includes 32 clinical-care episodes that providers can choose from, 29 of which are in the inpatient setting and three in the outpatient setting. The new model is the first advanced APM to be introduced by the Trump administration. The first cohort will begin October 1. The model performance period will run through December 31, 2023. Via Modern Healthcare.
In States That Didn’t Expand Medicaid, Hospital Closures Have Spiked
In recent years Obamacare’s Medicaid expansion has created a financial fault line in American health care. Hospitals in states that enacted the expansion got a wave of newly insured patients, while those in states that rejected it were left with large numbers of uninsured individuals. A new study released reports a crucial consequence of that divide: Nonexpansion states have suffered a significant increase in hospital closures. States that expanded benefits, on the other hand, saw their rate of closures decline. Via STAT.
Despite Prod by ACA, Tax-Exempt Hospitals Slow to Expand Community Benefits
The federal health law’s efforts to get nonprofit hospitals to provide more community-wide benefits in exchange for their lucrative tax status has gotten off to a slow start, new research suggests. And some experts predict that a recent repeal of a key provision of the law could further strain the effort. The increased emphasis on community-wide benefits was mandated by the Affordable Care Act. The health law required hospitals that meet federal tax standards to be nonprofits to perform a community health needs assessment every three years, followed by implementing a strategy to deal with issues confronting the community, such as preventing violence or lowering the rates of diabetes. A study released in the journal Health Affairs shows spending in these areas has remained relatively stagnant. Via Kaiser Health News.
Cost of CHIP Renewal Smaller Than Projected
Lawmakers will have to come up with only less than $1 billion to renew the Children’s Health Insurance Program, according to a new Congressional Budget Office analysis released Friday. That estimate, far lower than previous projections, should ease lawmakers’ task of passing legislation this month. In a four-page letter to Senate Finance Chairman Orrin G. Hatch, CBO Director Keith Hall said the Senate CHIP bill would cost $800 million over 10 years. Prior to this, the CHIP bill needed to be offset by about $8 billion over 10 years. The total cost of CHIP over 10 years would be $48.4 billion, but decreases in Medicaid and health care marketplace spending would offset much of that amount. Via Roll Call.
Health Care Companies Are Thrilled about Tax Overhaul
Health care firms—many of which have a vast majority of their business in the U.S., if not all of it—expect to see billions of dollars in corporate tax savings. Companies plan on using that money to pay down debt, buy back stock, or acquire competitors—not to funnel higher wages back to workers. Via Axios.
Charity Care Spending Flat among Top Hospitals
The years long decline in free or discounted care that hospitals provide to patients may have reached its floor. The 20 largest U.S. health systems dedicated 1.4% of their collective operating revenue in fiscal 2016 to charity care—about the same as the previous year, a Modern Healthcare analysis of financial data shows. That's noteworthy considering the significant declines in charity care spending that followed the 2014 implementation of the Affordable Care Act, a law credited with insuring nearly 24 million people through expanded Medicaid eligibility and subsidized commercial plans. Total uncompensated care fell to a 25-year low in 2015 and held steady in 2016, according to the American Hospital Association. Via Modern Healthcare.
Hospitals Nationally Hit Hard by Medicare's Safety Penalties
As the federal government penalizes 751 hospitals for having too many infections and patient injuries, some states are feeling the cuts in Medicare payments more than others. This year's punishments landed the hardest in Connecticut and Delaware, where Medicare penalized half of the evaluated hospitals, federal records show. In New York and Nevada, 4 in 10 hospitals were penalized. A third were punished in Rhode Island and Georgia. (These figures do not include specialty hospitals automatically exempted from penalties: those serving veterans, children and psychiatric patients, and "critical access" hospitals that are the only institutions in their area.) Via NPR.
Trump Administration Rule Paves Way for Association Health Plans
The Department of Labor released proposed new rules that proponents say will make it easier for businesses to band together in “associations” to buy health insurance. These rules, supporters say, will lead to more affordable choices for some small businesses and sole proprietors, likely starting in 2019. Via Kaiser Health News.
White House: Trump Hasn't Shifted on Not Cutting Entitlements
President Trump has not changed his position on protecting entitlement programs from funding cuts, White House press secretary Sarah Huckabee Sanders said. After last month's GOP victory on tax reform, many Republicans are calling for changes to the social safety net as a way to cut government spending. But, asked about Trump's repeated campaign pledge to protect Social Security, Medicare, and Medicaid, Sanders said he doesn't support cuts to the programs. Via The Hill.
Physicians Generate $2.3 Trillion in Economic Output
U.S. physicians generated a collective $2.3 trillion in economic activity and nearly 12.6 million jobs in 2015, according to a new American Medical Association report designed to push back against states the group says are creating difficult practice environments. Via Modern Healthcare.