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.
There’s a Surprise in Government Funding Bill: More Tax Cuts
Congress is apparently not done cutting taxes, even after passing a $1.5 trillion tax overhaul last year. The deal struck by Democrats and Republicans to end a brief government shutdown contains $31 billion in tax cuts, including a temporary delay in implementing three health care-related taxes. Via NY Times.
Post-Acute Care Providers Upset over Being Left out of Bundled-Payment Test Program
A Trump administration initiative to change how Medicare pays health care providers excludes some of the most enthusiastic backers of a similar Obama-era program—post-acute care providers such as nursing homes and home health agencies. The Centers for Medicare and Medicaid Services on January 9 introduced a test program in which Medicare makes a single bundled payment to providers who provide care for a patient during a 90-day period for 32 kinds of clinical episodes, including stroke and congestive heart failure. The program is part of broader government efforts to transition providers from volume- to value-based care. Via Morning Consult.
Trump Administration Extending Opioid Emergency Declaration
The Trump administration is extending an emergency declaration for the opioid crisis after accomplishing little under the order since it was announced three months ago. A notice posted to the Health and Human Services website said acting Secretary Eric Hargan would extend the public health emergency, which was originally declared in late October. The order was originally set to expire in January. Via Politico.
Deportation Fears Have Legal Immigrants Avoiding Health Care
The number of legal immigrants from Latin American nations who access public health services and enroll in federally subsidized insurance plans has dipped substantially since President Donald Trump took office, many of them fearing their information could be used to identify and deport relatives living in the U.S. illegally, according to health advocates across the country. Trump based his campaign on promises to stop illegal immigration and deport any immigrants in the country illegally, but many legal residents and U.S. citizens are losing their health care as a result, advocates say. Via AP.
Trump Again Targets Drug Policy Office, Proposing 95% Budget Cut
President Donald Trump is planning to slash the budget of the Office of National Drug Control Policy, in what marks his administration’s second attempt to gut the top office responsible for coordinating the federal response to the opioid crisis. The plan would shift the office’s two main grant programs, the High Intensity Drug Trafficking Areas grant and the Drug Free Communities Act, to the Justice and Health and Human Services departments, respectively, multiple sources in the administration and others working with the government on the opioid crisis said. Via Politico.
Opioid Crisis Blamed for Sharp Increase in Accidental Deaths in U.S.
Accidental deaths in the United States rose significantly in 2016, becoming the third-leading cause of fatalities for the first time in more than a century—a trend fueled by the steep rise in opioid overdoses, the National Safety Council reports. Accidents—defined by the council as "unintentional, preventable injuries"—claimed a record 161,374 lives in 2016, a 10% increase over 2015. They include motor vehicle crashes, falls, drowning, choking, and poisoning, a category that encompasses accidental overdoses. Via NPR.
Delay of Obamacare Taxes in Spending Bill Will Cost about $31B
The delay of three of Obamacare's taxes will reduce federal revenue by $31.3 billion over 10 years, the Joint Committee on Taxation said. The taxes were delayed as part of the stopgap spending bill that Congress passed in order to end the three-day government shutdown. The medical device tax was delayed for two years, until 2020, while the "Cadillac" tax on high-cost health plans, which had been set to take effect in 2020, was delayed until 2022. The health insurance tax was suspended for 2019. Via The Hill.
U.S. Lets More Health Care Workers Prescribe Opioid Addiction Treatment
The U.S. Drug Enforcement Administration said it had changed a regulation to allow more health care professionals to prescribe a medication used to treat opioid addiction, opening up access in rural America where there are few doctors. Via Reuters.
Few Doctors See Medicare Pay Bumps for Care Quality
Few doctors will benefit this year from a Medicare pay-for-performance program that promised more money if they hit key quality metrics in patient care. Only 20,000 clinicians will receive a pay bump of 6.6% to 19.9% this year based on how they performed in the final year of the value-based modifier program, which ended in 2016. However, "the overwhelming majority of clinicians received neutral payment adjustments," the CMS said in a notice. There are roughly 1.1 million clinicians that bill Medicare annually. The CMS is withholding raises from some providers this year because they did not submit the data necessary to be evaluated. Via Modern Healthcare.
VA Proposal Looks to Ease EHR Exchanges with Private Providers
The Department of Veterans Affairs views the change as a way to remove barriers to care for veterans. Excessive wait times for VA care are well documented and the VA is looking for ways to reduce that burden. VA Secretary David Shulkin has said he wants private providers to play a bigger role in veterans' health care, so that veterans have more choices for treatment and the VA can focus on its strengths, like prosthetics and traumatic brain injury. With that in mind, President Donald Trump signed the VA Choice and Quality Employment Act last year. The plan provides $2.1 billion for the Veterans Choice Program, which pays for private-sector care for veterans who don’t have access to VA hospitals and clinics. Via Healthcare Drive.