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ACHP in The News: ACHP President and CEO Ceci Connolly encourages policymakers to stabilize the markets in 2018 in an opinion piece in The Hill. Connolly suggests smart reforms that prioritize cost-saving measures for patients and improvements to the quality and availability of care – including tackling drug costs and supporting innovation in value-based treatment.
Connolly tells the Washington Examiner that insurers need to know if cost-sharing payments will continue in order to set prices.
Possible ACA changes without Congress
Through regulation, the Trump Administration can affect the marketplace. The Administration has the ability to cutoff subsidies, weaken the individual mandate, redefine essential health benefits, allow for experimentation at the state level or redirect funds away from the ACA. Read more from NPR.
An inquiry from the Office of Inspector General may cause HHS to be more cautious in taking actions to undermine the ACA. Law360 reports the OIG is looking into the decision to cancel advertising at a critical period in ACA enrollment.
Insurers remain uncommitted to exchanges in 2018
Following the defeat of the Republican health care bill, insurers are unsure what steps Congress and the Administration will take to stabilize the market, according to The Hill Extra. The three most pressing items for insurers include: funding for cost-sharing reduction subsidies; reassurances the individual mandate will be enforced; and the finalization of the stabilization rule (subscriber’s content).
Price faces questions about Trump’s HHS budget and ACA
Lawmakers from both parties expressed concern about President Trump’s proposed budget cuts to HHS during a hearing with HHS Secretary Tom Price on Tuesday. Trump has proposed more than $12.5 billion in cuts to the department. Lawmakers worry the cuts could undermine responses to public health crises like Zika and pushed back against steep cuts to NIH. Democrats also pressed Price on his plans for carrying out ACA provisions, including the essential health benefits requirements and low-income subsidies.
Senators introduce bill to aid communities without insurers
On Wednesday, Sens. Lamar Alexander (R-TN) and Bob Corker (R-TN) introduced legislation allowing individuals in areas without marketplace exchange providers to use their federal subsidies to purchase coverage outside the exchanges. Roughly one-third of counties nationwide currently have just one insurer selling plans on the exchange.
Inmates have greater access to telemedicine than Medicare patients
A Texas prison that has been offering telemedicine has seen significant improvements in the health of inmates. Yet, Medicare has been hesitant to embrace telehealth, only offering the service under specific circumstances. The Hill Extra reports (subscriber’s content).
Complex billing systems drive up health costs
While many factors contribute to the high cost of health care, an oft-understated factor is the nature of billing itself. Elisabeth Rosenthal of The New York Times explores how complicated billing systems contribute to health care costs, as bill coding has become a specialized profession. Rosenthal explains how coding obscures charges, raises overhead and even affects proscribed treatments.
Cost of Care
Costly Doctors Don’t Provide Better Care
New York Times
March 28, 2017
A study in JAMA Internal Medicine finds doctors who spend more money when treating patients do not see better outcomes than those who spend less. The researchers report that even within the same hospital, patients bills varied significantly, and high bills did not guarantee better care.
Shifting From Fee-for-Service
For Truly Affordable Health Care, We Need to Pay For Outcomes, Not Services
March 29, 2017
Health costs can be brought down by shifting from volume to value, according to dean of the Jefferson College of Population Health David B. Nash, M.D., and president of Numerof & Associates Rita E. Numerof. The pair argue fee-for-service medicine creates an incentive for doing more tests, which may not be necessary and drive up the cost of care.