ACHP Media Monitoring Report: November 10, 2016

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Uncertainty for insurers after presidential election
Following the election of Donald Trump to the presidency, hospital company stocks have fallen. Medicaid expansion has increased the number of patients at hospitals and reduced unpaid bills, benefitting health care providers and insurers. Based on Trump’s stated call to roll back expansion, stocks for hospital companies have fallen. Melanie Evans, Anna Wilde Mathews and Melinda Beck of The Wall Street Journal share some executives are hopeful Trump will expand Medicaid further; analysts acknowledge ambiguity around possible alternatives to the Affordable Care Act (subscriber’s content).

In the wake of Tuesday’s election results, stock prices for health insurers remain mixed. Carolyn Y. Johnson of The Washington Post outlines how several sectors of the health care industry are faring. Hospitals are facing a large amount of uncertainty, as many consumers rely on the Affordable Care Act (ACA) for health coverage. Drug companies saw a bump in stocks post-election, and a California ballot initiative aimed at curbing high drug costs in the state was defeated. For health insurers, confusion remains about how and when the ACA will be altered.

Future of Medicaid unclear under Trump presidency
Medicaid expansion may continue during a Trump administration. Some state officials who increased eligibility for constituents under the health law have committed to preserving coverage levels. Virgil Dickson at Modern Healthcare explains the legislation that replaces the Affordable Care Act could permit states to modify, instead of cancel, the programs.

On the campaign trail, Trump made conflicting promises regarding Medicaid. Trump has promised to shift to a block-grant model for Medicaid programs, which would cut and limit funding for the program. He also told daytime health show host Dr. Oz the federal government would provide Medicaid to those who cannot afford insurance — a central provision of the Affordable Care Act. Some experts believe Trump may move toward a per-capita system proposed by Speaker of the House Paul Ryan, which allows federal funding to rise with the number of beneficiaries, according to Andrew Joseph and Casey Ross of STAT.

Senate rules complicate Republican attempts to repeal ACA
Senate Majority Leader Mitch McConnell plans to move quickly to repeal the Affordable Care Act once the new Congress and President-Elect Donald Trump are sworn into office. McConnell declined to say whether Republicans would use budgetary reconciliation, a complicated legislative maneuver, to avoid a Democratic filibuster, reports Alexander Bolton of The Hill. National Republican Senatorial Committee Chairman Roger Wick, a key McConnell ally, has expressed hope Senate Democrats would be willing to work on a compromise bill to avoid the need for such tactics.

Repealing the Affordable Care Act could be a challenge for Republicans. Use of budgetary reconciliation may be necessary, as Democrats still hold enough seats to effectively mount a filibuster explains Julie Rovner of Kaiser Health News. Even using the maneuver, Republicans would not be able to enact a full repeal because of limitations to reconciliation. Congressional Republicans and President-Elect Trump would also likely need to develop and agree on a replacement for the law, which may prove more complicated than anticipated.

The Obama administration is dedicated to retaining the health law and driving enrollment, despite concerns about its future. Sarah Ferris of The Hill shares health care advocacy groups are taking steps to reassure consumers about the fate of their coverage.

Studies of Note

In this feature, the Media Monitoring Report shares a selection of notable research studies within the health care industry.

Changes in Insurance

Insurance Churning Rates for Low-Income Adults Under Health Reform: Lower Than Expected but Still Harmful for Many
Health Affairs
October 2016
Reporter Reed Abelson and domestic correspondent Margot Sanger-Katz explore what the return of a public option could mean for the health care industry. The discussion focuses on different models for a government-run insurance program, the benefits and drawbacks of those models and how the market might respond to a public option.

Care Coordination

Care Coordination and Population Management Services Aare More Prevalent in Large Practices and Patient-Entered Medical Homes
Journal of the American board of Family Medicine
November-December 2016
Researchers analyzed data from the American Board of Family Medicine and find care coordinators are more common in large practices or facilities with a patient-centered medical home certification. Primary care practices often have difficulty coordinating care for patients, according to study authors.

Prevalence of Chronic Illness

Study Shows More than 50% of Americans Have at Least 1 Chronic Health Condition, Mental Disorder, or Substance Use Issue
Pharmacy Times
November 8, 2016
A study from Psychology, Health and Medicine finds about 40 percent of adults have at least one chronic medical condition. Almost 20 percent reported mental illness, and a little less than 10 percent had a substance abuse disorder. These conditions tend to overlap, according to study authors Emory University Researcher Elizabeth Lee Reisinger Walker, PhD, and Rosalynn Carter Chair Benjamin Druss, M.D., MHP. Editorial Intern Logan Ryan reports.

Funding for PAO

Industry Funding of Cancer Patient Advocacy Organizations
Mayo Clinic Proceedings
November 2016
A study examining the financial disclosure documents for cancer patient advocacy organizations (PAO) finds a majority receive funding from biopharmaceutical companies. Researchers reviewed financial disclosures for almost 70 different PAOs and found that more than 50 of the organizations had received money from biopharmaceutical sponsors. The researchers did not explore if the funding created a conflict of interest. Case Western Reserve University School of Medicine Medical Student Matthew Abola and Oregon Health and Sciences University Assistant Professor of Medicine Vinay Prasad, M.D. MPH performed the study.

Chronic Medical Conditions

Cumulative Burden of Comorbid Mental Disorders, Substance use Disorders, Chronic Medical Conditions, and Poverty on Health Among Adults in the U.S.A.
Psychology, Health and Medicine
November 2016
Almost 40 percent of Americans have a chronic medical condition. Researchers at Emory University analyzed responses to the National Survey on Drug Use and Health, an annual, in-person survey carried out by the federal government. The study also found almost 20 percent of Americans had a mental illness in 2014 and 15 percent of Americans were living in poverty. The research was conducted by Assistant Research Professor Elizabeth Reisinger Walker, PhD, and Professor of Health Policy and Management, both of Rollins School of Public Health.