ACHP Media Monitoring Report – August 29, 2017

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Uninsured rate falls to almost 9 percent
According to a new report from the CDC’s National Health Interview Survey, a little more than 28 million people, or 8.8 percent of the U.S. population, were uninsured at the end of the first three months of this year. About 48 million people — or 16 percent of Americans — were uninsured when the Affordable Care Act passed in 2010. These numbers show little to no difference from last year, barely dropping from the 9 percent uninsured rate in the same period of 2016. While this shows Americans remained insured through the uncertainty around the ACA, it also reveals a plateau in the number of insured in the country.

Governors come up with bipartisan plan
Govs. John Kasich (R-OH) and John Hickenlooper (D-CO) have drafted a bipartisan proposal to stabilize the ACA markets. The Governors hope to release details of their plan later this week after first sharing it with a bipartisan group of governors who opposed the repeal of the ACA. Hickenlooper is slated to testify along with other governors at the U.S. Senate Committee on Health, Education, Labor and Pensions (HELP) hearing on ACA stabilization next week.

Voters support Medicaid work requirements
Fifty-one percent of registered voters support job requirements for Medicaid eligibility, while 37 percent said they oppose the idea. No state Medicaid program currently includes work requirements, but the Administration is reviewing waiver applications from Arizona, Indiana, Kentucky and Pennsylvania that would require enrollees to work a certain number of hours per week or be enrolled in an educational, job training or employment search program. According to experts, only a small number of people would be impacted by work requirements, as most beneficiaries belong to a family with at least one worker, have a disability or care for a family member.

Advanced Alternative Payment Models near requirement deadline
Providers using Advanced Alternative Payment Models (APMs) must meet a set of requirements outlined by CMS by the end of August, or they will see a reduction in their 2019 Medicare payments. Those clinicians and providers that do meet the requirements will gain access to incentive payments as qualifying APMs, while those that fall short will be moved into a merit-based incentive payment system for the 2017 and 2019 payment years. The APM requirements are part of MACRA’s strategy to encourage physicians to provide optimal and efficient care.

CMS to cut federal funding for Medicaid DSH payments starting in October
CMS plans to cut billions in federal funding that helps hospitals with uncompensated care costs. Without the funding, hospitals may stop initiatives to improve care for Medicaid enrollees or scale back the number of Medicaid patients. The ACA requires that CMS cut Medicaid Disproportionate Share Hospital (DSH) payments by $43 billion from fiscal 2018 through 2025. There is concern that the new formula does not take into account the shortfall between Medicaid payment rates and actual cost of care. These cuts are slated to start October 1.

In 2018: More Medicaid patients and more revenue in Chicago’s county health system
Chicago-based Cook County Health & Hospital System’s Medicaid contract CountyCare is expected to generate more than $1 billion this fiscal year. The system will by relying on this revenue as its expenses are expected to climb about 24 percent, totaling more than $2 billion. This higher spending is mostly due to a projected boost in CountyCare enrollment, part of Gov. Bruce Rauner’s overhaul of a Medicaid cost-saving initiative, which further privatizes Medicaid programs. Cook County Health is one of the largest public hospital systems in the nation.