November 7, 2019 | Meth case or mental illness?
November 6, 2019
INDUSTRY NEWS
Warren gives financial details of Medicare for All
Sen. Elizabeth Warren released details on how to pay for “Medicare for All.” It would require $20.5 trillion in new federal spending, which would come from a combination of sources. She plans to carry over almost all existing health funding from employers and state governments while also levying a variety of new taxes on the rich, corporations and high-earning investors. “We can generate almost half of what we need to cover Medicare for All just by asking employers to pay slightly less than what they are projected to pay today, and through existing taxes,” Warren wrote. (KHN)
Execs largely unaware of rules requiring better patient access to data
The 21st Century Cures Act includes regulations to prevent information blocking and expand how patients can access their health care information. This is slated for 2020, but there’s a problem: Most health care organizations are neither fully aware of nor adequately prepared for compliance, according to a new survey from Accenture. In fact, 17% of health care execs are “completely unaware” of the regs. Another 65% are only “somewhat” or “vaguely” familiar. The rules were promulgated earlier this year. (Fierce Healthcare; Accenture)
INNOVATION & TRANSFORMATION
Using Google Maps to locate the best care
Google Maps helps people get to their health care destinations, providing information on potential delays, such as accidents. But, writes, Kim Bellard, editor at Tincture, perhaps Google could take it a step further. For instance, for ERs and urgent care, it could show not only the closest, but the one where someone could be treated the most quickly. Or it could warn patients where they are more likely to face surprise bills or aggressive debt collectors. Some of this data is in the public domain, and some will require crowdsourcing, “both of which Google Maps have experience with.” (Tincture)
Governor proposes overhaul of how Ga. uses ACA
Georgia Gov. Brian Kemp unveiled a set of waiver proposals to overhaul individual health insurance. The goals: lower premiums, and state control of the ACA marketplace. If approved, Georgians could no longer use HealthCare.gov to enroll in ACA programs. The site would guide users to private web brokers or encourage them to register directly with insurance companies. By moving the ACA exchange market from federal to state control, the $2.7 billion in federal subsidies could be used to reduce costs to lower-income policyholders. Another part of the proposal would set aside more than $300 million in public money that the government could pay to insurance companies to cover high-cost claims. (Atlanta Journal-Constitution)
CONSUMERS & PROVIDERS
VBP results on par with last year
The eighth year of Medicare’s Hospital Value-Based Payment Program (VBP) shows not much has changed from year seven. About 55% of the roughly 2,700 hospitals participating in VBP will receive increased Medicare payments for fiscal 2020. Rural hospitals significantly outperformed their urban counterparts, according to data released Tuesday by CMS. Overall, 60% of participating hospitals will see a change—a tiny one—in their payments (between -0.5% and 0.5%), based on their performance. (Healthcare Dive; CMS announcement)
VA discharges 20% of vets with antibiotics
Nearly 20% of veterans received an oral antibiotic at hospital discharge from VA facilities, according to research published in Clinical Microbiology and Infection. Researchers identified all VA acute-care admissions from 2014 to 2016. “Antimicrobial-prescribing at hospital discharge provides an opportunity for antimicrobial stewardship. Hospital-level stewardship metrics need to include both inpatient and post-discharge antimicrobial-prescribing to provide a comprehensive assessment of hospital-associated antimicrobial use,” researchers conclude. (Becker’s Hospital Review; Clinical Microbiology and Infection)
NEW & NOTED
Alternative models grow a bit: Nearly 36% of U.S. health care payments in 2018 involved alternative payment models, compared with 34% in 2017. It’s worth noting, however, that only 14.5% of 2018 payments included some form of downside financial risk for providers, according to a new report from the Health Care Payment Learning & Action Network. (Healthcare Dive; HCP-LAN infographic)
Medicaid work requirements lose traction: Within two weeks of each other, Arizona and Indiana have backed away from the Medicaid work requirement. In an announcement Thursday, Indiana’s Medicaid agency joined Arizona in postponing plans to cut off benefits to people who do not meet new requirements. (Washington Post)
Dwindling marketplace enrollment? As Obamacare’s open enrollment period begins, experts and advocates are projecting the number of enrollees for 2020 will decrease for a fourth consecutive year, in large part because of actions taken by the Trump administration. At the same time, many people can expect to find lower premiums and more plan options. (The Hill)
MULTI-MEDIA
Police who need to know often can’t tell whether a person’s behavior is fueled by methamphetamines, mental health issues, or both. Roughly 9.2 million Americans cope with both a mental health problem and a substance use disorder. It makes a difference in how they treat a suspect. (NPR)
November 12 Congressional Briefing Puts Spotlight on Direct Primary Care
There is considerable policy activity now underway to advance direct primary care, with unanimous passage of the bipartisan Primary Care Enhancement Act out of House Ways & Means, inclusion of recommendations in the Republican Study Committee’s Health Care Plan and activities now underway at CMS. Join November 12 for a lunch briefing on Capitol Hill to hear about benefits, challenges and strategies for driving adoption from physicians, health systems, employers and states who are implementing this new model.
To learn more and RSVP: http://directprimarycareinnovation.org/events/
MARKETVOICES...QUOTES WORTH READING
“No one has done this yet. This is exactly what the Trump administration encouraged states to do, and no one yet has taken them up on it. So this is going to be a really big deal.”—Katie Keith, a professor of health law at Georgetown University, talking about Georgia’s new approach to the ACA in the Atlanta Journal Constitution