HHS Secretary Alex Azar’s policy agenda is taking shape in speeches over the past two weeks. He urged the health care industry to step up and modernize payment and delivery to a value-based system. He also pushed for new standards for EHR interoperability and to allow patients greater access to their own records. He called for price transparency in the industry, indicating Medicare will take the lead to make its prices more transparent and lauding UnitedHealthcare’s effort to give drug rebates back to consumers. (U.S. News & World Report; Bloomberg Health Care Blog)
Idaho’s play to allow insurance plans that don’t include essential benefits and protections for people with pre-existing conditions—required under the Affordable Care Act—was rejected by the Centers for Medicare & Medicaid Services. CMS Administrator Seema Verma affirmed the agency’s commitment to working with states to give them flexibility to provide affordable care, indicating in the ruling that Idaho’s proposed plans may be modified to meet requirements as short-term insurance plans. (Reuters; HealthcareDIVE)
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“Right to Try” legislation allowing very sick patients access to experimental treatments--referenced in the State of the Union address—will be taken up by the House this week. A Senate version of the bill was approved last summer, but patient advocacy groups objected that it lacked some patient protections on issues like informed consent and reporting adverse events. The House legislation updates that language; it also more clearly defines eligible patients as those with a disease or condition with a “reasonable likelihood that death will occur within a matter of months” or would result in “significant irreversible morbidity that is likely to lead to severely premature death.” (The Hill)
A majority of consumers are comfortable contacting their physician digitally and are already doing so, according to a new survey by Ernst & Young. A third of respondents are interested in using a smartphone to share data, 36 percent want to do at-home testing, and 21 percent would do video consultations. Among physicians, two-thirds say adoption of digital technology would reduce the burden on the health care system and reduce costs, and almost as many think it would help reduce clinician burnout. (Modern Healthcare)
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It’s paternalistic for doctors to think patients aren’t ready for their own health data, according to top officials with the Office of the National Coordinator for Health IT. ONC leaders reacted last week to comments from a doctor saying patients wouldn’t be able to understand data from electronic health records. ONC is working closely with the Centers for Medicare & Medicaid Services on these issues; last week, CMS announced initiatives for patient access to health data and to punish organizations that engage in data blocking. (Fierce Healthcare; Healthcare Informatics)
UnitedHealthcare says its value-based contracts are so successful that it will tie $75 billion in provider payments to these arrangements by 2020. UHC compared 2017 quality and cost outcomes for 15 million health plan members getting care from providers under value-based contracts to those in traditional payment arrangements. Across employer plans, those enrolled in accountable care arrangements showed a 17 percent decrease in hospital admissions, 14 percent fewer ER admissions and 10 percent more primary care visits—with 12 percent lower associated costs. Medicare and Medicaid plans showed positive results as well. (Becker’s Hospital Review; the report)
FDA approves at-home gene testing for breast cancer: 23andMe received approval from the Food and Drug Administration to offer genetic testing for three breast cancer gene mutations common in Ashkenazi Jews as part of its $199 Health and Ancestry product. 23andMe must offer customers statements that explain the test’s limitations (there are many more gene mutations associated with increased cancer risk) and urge them not to substitute results for consultation with a clinician. (The New York Times)
The CEO search is on:The Amazon/Berkshire Hathaway/JP Morgan health care joint venture will need a stellar leader, and the search is on. The new CEO will likely help set the course for the organization, and must be able to navigate the intersection of technology, medical delivery, health insurance and pharmacy benefits management. Among those on the short list are health plan executives and former U.S. chief technology officer Andy Slavitt. (CNBC)
Cigna, Express Scripts have a $52B deal:Health plan Cigna and pharmacy benefits manager Express Scripts announced a planned merger, a move expected to bring increase profit margins but not to lower consumer costs. If this and the CVS Caremark-Aetna deal are approved by regulators, the three largest pharmacy benefits managers controlling most of the U.S. market will now be aligned with health plans. (Los Angeles Times)
In a startling series of maps, Perry Wilson, MD, examines research from the University of Washington on the regional distribution and “deaths of despair,” or mortality due to drugs, alcohol, suicide and interpersonal violence. Hot spot maps show a 58-fold range of difference in the death rate from the lowest and highest counties. He then compares the map to opioid prescribing rates by county. The correspondence is remarkable. “Sometimes a picture is worth 1,000 statistical tests,” Wilson says. (Medpage Today)
“It’s a paternalistic attitude on the part of doctors like me to think that patients don’t want the data or aren’t ready for it. There’s a lot of folks that are ready and eager and really irritated that they can’t get their data.” Jon White, M.D., deputy national coordinator at ONC, as quoted by Fierce Healthcare.