November 29, 2017
Pay increase possible for Medicare Advantage insurers
CMS released a preview of Medicare Advantage (MA) payment rates, which could give MA insurers a pay bump. The government pays money to MA companies by way of a complex payment formula. The fee-for-service growth rate, which is a primary component of the formula, is projected to be more than 4 percent for 2019, up from the projected rate of about 2 percent for 2018. The 2019 expected growth rate, which is still a preliminary figure, would mean that MA insurers could receive about $248 billion in 2019.
Support for market stabilization bills
President Trump signaled to Republican Senators his support for two Senate market stabilization efforts in exchange for support for repealing the individual mandate as part of the tax bill. At a luncheon on Capitol Hill, the President offered support for the bill proposed by Sens. Lamar Alexander (R-TN) and Patty Murray (D-WA), which would continue CSR payments to insurers as well as the bill from Sens. Susan Collins (R-ME) and Bill Nelson (R-FL) to provide federal funding for state-run reinsurance programs to help insurers cover high-cost enrollees.
End of year coming fast for health measures
Congress is negotiating whether to attach several urgent health-related provisions to year-end bills, including funding for CHIP, the delay of certain ACA taxes and the bipartisan plan to stabilize insurance markets. The delay in passing the measures has had consequences for individuals and states. Even if the Alexander-Murray bill is passed, it could be too late to reduce premiums for next year, and the delay in reauthorizing CHIP funding is putting pressure on states, which may be forced to cancel services in the absence of funding.
Patient groups urge Congress to reject ACA individual mandate repeal
A coalition of 19 patient groups has urged senators to reject repealing the ACA’s individual mandate as part of tax reform. The coalition’s letter, signed by groups including the American Cancer Society Cancer Action Network, the American Diabetes Association and the American Heart Association, warns of coverage losses and higher premiums from repealing the mandate. The letter points to the nonpartisan Congressional Budget Office’s analysis that finds 13 million more people would be uninsured and premiums would rise 10 percent without the mandate.
Providers unsure CMS “meaningful measures” reporting will reduce burden
During a webinar on Tuesday, providers expressed confusion about the new CMS “meaningful measures” quality reporting program. CMS Administrator Seema Verma introduced the initiative last month as a way to ease physician’s regulatory burden. However, rather than replacing existing quality reporting programs, meaningful measures will be applied to the programs already in use. Some physicians already struggle to determine which quality measures should be reported and worry adding other components will increase the burden.
Health Activist Network looks to reform health care system
The Health Activist Network launched this fall to empower health professionals to engage in health policy debates and improve care delivery. The group hopes to create a “revolution” in the way care is delivered to improve outcomes on issues such as patient deaths from preventable medical errors, excess spending, over-treatment and promote greater use of evidence-based care.
Optum opens venture capital fund
Optum, a UnitedHealth company, is forming a $250 million fund to finance startups that improve health care delivery, payment systems and access to care. The venture firm has made four investments so far in data and analytics platforms and artificial intelligence companies. Optum joins other major health care companies, such as Blue Cross Blue Shield, Humana and Cambia Health Solutions, that have all begun to invest in startups.
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