ACHP Media Monitoring Report – June 15, 2017

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Cassidy breaks down health care costs

Sen. Bill Cassidy’ office has broken down the cost of ACA coverage explaining how average prices increased from $279  before the ACA to $436 per member per month under the ACA in 2015, with a sicker marketplace being the biggest contributor to increased costs. Cassidy’s proposal to offset these costs by adding $15 billion to the marketplace is being considered.

Deductibles increase under GOP bill
According to an HHS Office of the Actuary report, deductibles and copayments could be more than 60 percent higher under the House Republican health care bill. With less government assistance, the amount consumers pay would climb even though the sticker price of premiums would be lower than under the ACA. The report also finds that the legislation would shrink the life of the Medicare hospital trust fund by two years.

Essential health benefit waivers could lead to coverage limits
Reports indicate the Senate health care bill may include provisions that allow states to waive coverage of essential health benefits. According to an analysis from the Center for American Progress (CAP), these provisions could lead to a return of annual and lifetime limits on coverage. CAP reports that under the bill, as many as 20 million Americans could face lifetime limits on coverage, and up to 27 million consumers could face annual limits. That’s because employers that operate in multiple states could use which state’s benefit rules they want to use — and there’s a good chance they would pick the states that loosened the rules.

Pilot program that displays network reach will continue but not expand
CMS will continue a pilot program that shows consumers how many providers are offered under an ACA plan – but will not expand it to other states. The pilot is active in Maine, Ohio, Tennessee and Texas. The program, which launched during open enrollment for 2017, tells consumers whether health plans have narrow networks (labeled “basic”), standard networks or broad networks.

Accidental payments may have been routine
Between 2011 and 2014, CMS mistakenly paid about $729.4 million to providers who did not meet meaningful use criteria for EHRs. According to some experts, the 12 percent in overpayment could be comparable to other CMS programs or the result of the program being new. Better audits or compliance tests could help prevent overpayments in the future. Beyond the overpayment of funds, not meeting meaningful use requirements could have a negative impact on patient safety.

Wearable tech enables hospital to deliver care at home
The emergency department at Brigham and Women’s Hospital in Boston will be expanding its “home hospital” program, where a physician and nurse send patients home with equipment and medicine necessary to their care. The hospital uses VitalPatch, an adhesive patch with an integrated sensor, to track heart rate, respiratory rate and motion, among other capabilities. The program allows patients to recover in a comfortable and familiar environment, while ensuring medical professionals can properly monitor their status and progress.