February 20, 2020 | One in seven families has trouble paying medical bills

INDUSTRY NEWS

Public option no longer anathema to big business

Politico reports that large businesses are beginning to warm to the idea of a public option for health care. In fact, 30 of the 90 member companies the National Alliance of Healthcare Purchaser Coalitions surveyed indicated a public option would be helpful; about a quarter criticized the idea. The change is driven by frustration that insurers haven’t been able to control costs “and instead allowed hospitals and doctors to profit at employers’ expense.” (Politico)

Spending up for those with employer-based coverage

Average health care spending for people with employer-sponsored insurance rose to an all-time high in 2018, $5,892 per person per year, according to a new Health Care Cost Institute study. From 2014 to 2018, spending grew 18.4%, and about three-quarters of the increase was due to growth in service prices. Per-person spending for those with employer-sponsored insurance increased 4.4% vs.4.2% in 2017. The report is based on more than 2.5 billion claims from between 2014 and 2018 for 40 million people with employer coverage. (Healthcare Dive; study)

INNOVATION & TRANSFORMATION

AAFP opposes proposed CMMI changes

Proposed bipartisan legislation intended to enhance transparency and accountability within the Center for Medicare and Medicaid Innovation would instead stifle progress and undermine the move to value-based care, according to the American Academy of Family Physicians. AAFP President Gary LeRoy, MD, warned the legislation “would fundamentally alter CMMI’s authority by imposing a level of bureaucracy that would stifle care transformation through requiring congressional approval at all phases of a model, arbitrary model parameters and expansion requirements and burdensome reporting requirements.” (Healthcare Innovation; AAFP statement)

CONSUMERS & PROVIDERS

One in seven families has trouble paying medical bills

More than 14% of people in the U.S. live in families that have problems paying their medical bills, down from past years. The percentage of individuals who were in families having problems paying medical bills in the past 12 months decreased from 19.7% in 2011 to 14.2% in 2018, according to a data released by the CDC. Looking at Medicare, seniors on traditional Medicare were more likely to be a part of a family that had such problems compared to those on Medicare Advantage (MA). (Fierce Healthcare; study)

Planning doesn’t prevent surprise bills

Roughly 20% of patients who schedule elective surgery at an in-network facility with an in-network primary surgeon are nevertheless subjected to surprise medical bills, according to research published in JAMA. The reason? Other members of the surgical teams were out-of-network. The average bill was $2,011. (Modern Healthcare; JAMA)

PCPs appreciate digital tools more than other docs

Physician use of digital health tools has grown from 2016-2019, according to a new AMA report, with the largest increases seen in tools that enable remote care: telehealth (14% to 28%) and remote monitoring and management (13% to 22%). The survey also asked physicians about their attitudes around these tools. A greater percentage of primary care physicians cited a definite advantage to using digital health tools compared with specialists. The percentage of those who see no advantage is getting smaller and is concentrated in the age 50+ segment. (AAFP News; AMA)

NEW & NOTED

Small ACOs need support: Small physician-led ACOs need more support from CMS if they are to continue to lower costs and improve quality, according to a new report from the Duke-Margolis Center for Health Policy. It included three specific recommendations: reduce regulatory burdens, provide more support for ACOs to develop technical capabilities and simplify program rules. (Fierce Healthcare; report)

Defeating the purpose: More than half of children under age five poisoned by prescription pills ate them after an adult removed the childproof packaging. (CNN)

Adverse experiences linked to dementia: Children who had three or more adverse experiences growing up were more likely to develop dementia in old age, according to research out of Japan. (JAMA)

MULTI-MEDIA

Violence and the physician: three stories

The recent “Weaponized” episode of MedPage Today’s Anamnesis podcast features three stories about violence, including postpartum psychosis and violence against physicians. (Anamnesis)

MARKETVOICES...QUOTES WORTH READING

“Everybody’s doing too damn well while we’re paying the damn bill. […] I don't think government action is the first choice, but it may be our only remaining choice.”—Mike Thompson, CEO of the National Alliance of Healthcare Purchaser Coalitions, on the financial strain health care costs put on employers and workers, in Politico.