ACHP Media Monitoring Report: June 1, 2017

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The National Center for Healthcare Leadership is accepting nominations for the Gail L. Warden Leadership Excellence Award recognizing exemplary leaders from across the health care industry. The deadline for nominations is June 9.

Under GOP plan, coverage gaps could be costly
Under the Republican health care bill, insurers are required to raise premiums by at least 30 percent for any applicants who previously lacked health insurance for more than two months. The rule is intended to encourage people to maintain coverage and would replace the individual mandate. Some health experts are worried consumers who have allowed their insurance coverage to lapse for any reason may find themselves priced out of the market when they attempt to reenroll.

Washington state serves as case study for national health debate
In 1995, Republicans in Washington state repealed a law expanding health coverage in the state. The legislators promised to make health care more affordable and rid residents of government mandates, but the repeal did not have the desired results. It sent the market into chaos, increasing premiums and causing health insurers to leave the state. Five years later, state legislators passed a rescue bill to stabilize the market. This could serve as a warning as Republicans look to repeal the ACA.

ACO doctors qualify for MACRA option
Some physicians worry that value-based payment models will create a large financial risk for their practices. However, doctors have an option that doesn’t punish them for low scores in MACRA performance categories. The track helps physicians shift to value-based care without incurring financial losses. Only doctors who participate in Medicare accountable care organizations are eligible.

Senators look to ease restrictions on Medicaid reimbursement for substance abuse treatment
A bipartisan group of Senators has drafted legislation lifting restrictions on substance abuse treatment centers to file for Medicaid reimbursement. Such centers are not covered under current Medicaid rules. Despite bipartisan support, it’s unclear if the bill will move forward; President Trump and House Republicans cut Medicaid spending by more than $800 billion in the House-passed health care reform bill and are unlikely to approve additional costs for the program.

GAO asks CMS to track health status along with disenrollment
The Government Accountability Office (GAO) is recommending that CMS track the health status of enrollees who drop out of managed care plans. In a report released this week, GAO said that enrollees in Medicare Advantage plans who were in poorer health were more likely to leave their health plans, with access to care often cited as the reason for dropping the contract. In its response, CMS said that disenrollment data is included in quality ratings and that plans are evaluated to make sure they do not encourage disenrollment.

Fewer doctors are independent
For the first time, a majority of physicians do not own their own practice. According to a study from the American Medical Association, about 47 percent of doctors had stake in a practice, down from about 53 percent in 2012. Increasing compliance costs and changes in payment models are driving the ownership and employment shift.