September 2, 2021 | MMSP ACOs save $4.1B, deliver quality

INDUSTRY NEWS

Vaccine mandates increasing, as expected

Following full approval of the Pfizer COVID-19 vaccine, vaccine mandates are increasing. In addition, support seems to be growing. About half of American workers now favor vaccine requirements at their workplaces, according to a new poll from The Associated Press-NORC Center for Public Affairs Research. It shows that roughly 59% of remote workers favor vaccine requirements in their own workplaces, compared with 47% of those who are working in person. About one-quarter of workers—in person and remote—are opposed. (AP; Kaiser Health News; GTMRx report)

ACA news: More navigators, more options

HHS announced plans to quadruple the number of navigator organizations that assist consumers with finding Affordable Care Act coverage. It announced plans to provide $80 million in grant awards to 60 navigator organizations, which will be able to hire more than 1,500 navigators to aid consumers. Meanwhile, Cigna announced plans to enter the markets in Pennsylvania, Georgia and Mississippi and new counties in Florida, Arizona and Virginia. Open enrollment begins Nov. 1. (Fierce Healthcare-navigators; Fierce Healthcare-Cigna)INNOVATION & TRANSFORMATION

INNOVATION & TRANSFORMATION

Embedding palliative care alongside dialysis

Northwest Kidney Centers, a Seattle-based operation with clinics throughout the region, founded the first dialysis center nearly 50 years ago. Today, it houses the first-in-the-nation palliative care/dialysis program. Dialysis patients typically face distressing physical, emotional and spiritual symptoms, but 4% or fewer ever receive specialized palliative care that can effectively target those issues, according to Dr. Daniel Lam, the University of Washington nephrologist and palliative care expert who launched the program. In addition, dialysis patients must choose between continuing dialysis or receiving hospice services because of how the Medicare hospice benefit is structured. (Kaiser Health News)

MMSP ACOs save $4.1B, deliver quality

The Medicare Shared Savings Program saved Medicare $4.1 billion in 2020, and $1.9 billion after accounting for shared savings payments, according to the National Association of ACOs. Participating ACOs also hit an average quality score of 97.8%, and 60 ACOs earned a perfect score of 100. NAACOS also points to analyses that indicate ACOs are lowering Medicare spending by 1% to 2%, which translates into tens of billions of dollars when compounded annually. (Healthcare Finance)

Study: Combine ACOs, bundled payments for better outcomes

Combining ACOs and bundled payments can save more money and deliver better outcomes for patients than bundled payments on their own, according to a study published in JAMA Health Forum. “Simultaneous inclusion in both ACOs and bundled payment programs was associated with lower institutional post-acute care spending and readmissions for medical episodes and lower readmissions but not spending for surgical episodes,” researchers report. They call on the CMS innovation center to revisit how it handles overlap between ACOs and bundled payments. (Modern Healthcare*; JAMA Health Forum)

CONSUMERS & PROVIDERS

Survey: Pediatric care delayed due to COVID

Many families—about 20% of those surveyed—delayed necessary care for their children out of worries about COVID exposure, according to data from the Urban Institute Health Reform Monitoring Survey. Most commonly delayed or missed: dental care (5.3%), followed by well-child visits (4.0%) and general or specialist visits (3.2%). About 3% of parents said their child had missed immunizations. The survey also found that parents with incomes below 250% of the federal poverty level were more likely than those with higher incomes to have put off care for their children in the past 30 days. (Medscape Medical News)

NEW & NOTED

Chamber withdraws suit: The U.S. Chamber of Commerce and a Texas affiliate have withdrawn a lawsuit filed to block part of a federal rule requiring insurers and employers to disclose prices they pay for health care services and drugs. The move comes after the Biden administration delayed enforcement of the offending provisions. (Wall Street Journal*)

Cause and effect? Philip Morris has bought 22.61% of U.K.-based respiratory drug/inhaler developer Vectura. According to the Financial Times, it’s part of a larger takeover effort. (Financial Times*; CNBC)

Docs can encourage deprescribing: Older patients and nursing home residents would be open to deprescribing on the advice of a physician even though most did not have an intrinsic desire to deprescribe, according to a small study out of Denmark. (Medscape; Journal of the American Geriatrics Society)

MULTI-MEDIA

Video: COVID-19 virus in action

A microscopic video shows the coronavirus causing cell fusion and death in bat brain cells. Filmed over 48 hours with an image recorded every 10 minutes, the footage shows an array of cells, which appear as gray blobs, interspersed with red dots, which are the cells dying after being infected with the virus. The infected cells fuse with neighboring ones to form larger masses. Then they explode, signaling cell death. (New York Times*)

MARKETVOICES...QUOTES WORTH READING

“They provide mental support, and they inform you what you need to do to do things properly, and they’re your liaisons. […] Do I feel scared? At one point, I did. But they are assuring me that my rights will be honored, they will be advocates for me when it happens. By having that support, it gives me my time to live.” —Vonita McGee, a patient who is participating in a novel program that provides specialized palliative and hospice services for patients with kidney disease—without making them forgo dialysis, quoted in Kaiser Health News