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ACHP in the news: ACHP President and CEO Ceci Connolly discussed fee-for-service medicine with NBC News.
Presidential Transition Brief
– President-elect Donald Trump has nominated former Georgia Governor Sonny Perdue as Secretary of Agriculture.
– Confirmation hearings for President-elect Trump’s cabinet nominees continue. Politico has created an annotated schedule of the hearings. Rep. Tom Price, Donald Trump’s nominee for Health and Human Services Secretary, will also attend hearings with the Senate Finance Committee next Tuesday, January 24.
– Mike Allen of Axios profiles figures to watch in a Trump administration.
Price discusses ACA repeal in confirmation hearing
Yesterday the Senate Health, Education, Labor and Pensions Committee held its first confirmation hearing with Rep. Tom Price (R-GA), Donald Trump’s nominee for Secretary of Health and Human Services. Price reiterated his commitment to repealing the Affordable Care Act (ACA) and promised no Americans would “fall through the cracks” as a result. Price did not discuss the specifics of his vision for replacing the ACA, note Robert Pear and Thomas Kaplan of The New York Times. Price will have another confirmation hearing with the Senate Finance Committee next Wednesday, January 24.
Automatic enrollment option to expand health coverage
Some Republican lawmakers are considering automatic enrollment as a tactic for expanding health coverage. Republicans anticipate that signing up individuals in basic health plans, unless they opt out, will help provide coverage for everyone. Greg Ruben of Axios explains automatic enrollment will act as a substitute for the individual mandate and cover those with pre-existing conditions.
Governors weigh in on ACA repeal
Several Republican governors have cautioned Congress about a quick repeal of the Affordable Care Act in comments and letters to House leaders. Nine governors are attending Thursday’s Senate Finance Committee Republican round table on the future of Medicaid expansion. Jennifer Levitz and Jon Kamp at The Wall Street Journal have the story (subscriber’s content).
Medicaid block grants could shrink program
Some lawmakers have expressed interest in changing Medicaid, including shifting program funding to a block grant model. This funding plan would allot a set amount of money to states, capping total spending and leaving states to decide how to disburse the grant. Ryan LaRochelle at The Washington Post shares data that suggest block grants could lead to a decline in funding for Medicaid without reducing program costs.
Health plans asked to correct directory errors
Medicare Advantage insurers lacking updated online network directories could face penalties if the errors are not corrected by February 6, according to federal officials. The Centers for Medicare and Medicaid Services recently reviewed Medicare Advantage provider directories and found incorrect information for nearly half of the doctors listed. Phil Galewitz and Susan Jaffe at Kaiser Health News have the story.
CMS ends pass-through payments
The Centers for Medicare and Medicaid Services (CMS) has approved a rule designed to phase out pass-through payments to Medicaid provider groups. Virgil Dickson of Modern Healthcare explains the pass-through payments often serve as supplemental income to health care providers who serve a disproportionate share of Medicaid or uninsured patients needing complicated or expensive treatment. CMS representatives assert that since the payments are not tied to contracted services, the payments are not actuarially sound.
Studies of Note
In this feature, the Media Monitoring Report shares a selection of notable research studies within the health care industry.
Funding of Advocacy Groups
Patient Advocacy Organizations, Industry Funding, and Conflicts of Interest
JAMA Internal Medicine
January 17, 2017
Researchers from Cleveland Clinic, the University of Chicago and the University of Pennsylvania find patient advocacy organizations receive significant amounts of funding from for-profit industry groups. The pharmaceutical, device and biotechnology sectors accounted for close to half of industry funding sources.
Effect of Mergers on Cost
Market Share Matters: Evidence of Insurer and Provider Bargaining Over Prices
August 22, 2016
Health insurance mergers could potentially lower prices paid to providers, according to researchers from Harvard Medical School. The study analyzed multi-payer claims for physician services.
Personal Health Care Spending
US Spending on Personal Health Care and Public Health, 1996-2013
December 27, 2016
Health care spending accounts for nearly 20 percent of the United States’ economy. Institute for Health Metrics and Evaluation Assistant Professor Joseph L. Dieleman, PhD, and colleagues broke down the more than $3 trillion Americans spent on personal health care between 1996 and 2013 by 155 conditions, age, sex and type of care.