November 30, 2017
Senate holds first confirmation hearing for HHS nominee Azar
The Senate HELP committee held the first confirmation hearing for HHS Secretary nominee Alex Azar yesterday. Due to Azar’s background and controversy over insulin price increases during his time as a pharmaceutical executive at Eli Lily, the bulk of the hearing focused on high Rx drug prices and potential conflicts of interests Azar might face. Azar promised high drug prices would be a central focus of his tenure, and, under pressure, acknowledged lowering drugmaker list prices would have to be a part of any strategy to combat prices. Senators also questioned Azar about the administration of the ACA, including recent decisions to cut funding for enrollment outreach. Azar largely defended those decisions, citing previous outreach efforts as wasteful and ineffective. Azar also emphasized his support for better integration of EHRs and the wider use of analytics and big data for predictive analysis. Azar will next testify before the Senate Finance Committee.
HHS phasing out Office of Health Reform
Reports indicate that The Office of Health Reform, a small office tasked with implementing the ACA, has been quietly pared back by HHS. Most of the staff have either resigned or been assigned to other positions in the Administration, and one HHS staffer said the office has been closed. HHS officials are not commenting on changes to the office, nor are former staffers who have moved to different positions within the Administration. Under the Trump Administration, the office had been tasked with helping streamline and cut regulations, but its work often overlapped with CMS, creating confusion for the department (subscriber’s content).
Complications of repealing the individual mandate through the tax bill
Some lawmakers believe passage of two bipartisan health care measures — a $5 billion reinsurance program proposed by Sen. Susan Collins (R-ME) and an ACA stabilization bill to fund CSRs from Sens. Lamar Alexander (R-TN) and Patty Murray (D-WA) —would offset any negative effects of repealing the individual mandate. However, the nonpartisan CBO estimates that mandate repeal will lead to 13 million more uninsured Americans and a 10 percent spike in premiums on average, even with a stabilization package in place. Further complicating matters, the chairman of the House Freedom Caucus said yesterday that he and many colleagues oppose new reinsurance funding and it is not clear whether the Alexander-Murray plan could pass the House either.
Tax plan would hit Medicare funding
Passing a tax bill could result in massive cuts to federal funding due to a 2010 law designed to limit deficit spending. The Senate and House bills differ in specifics, but both bills would increase deficit spending by about $1.5 trillion over the next 10 years. That number is high enough to trigger automatic budget sequestration, which forces across the board cuts to a number of domestic spending programs. Medicare is the largest program that could be directly affected. The law does provide a threshold for how much Medicare spending specifically can be cut by setting a limit at 4 percent of the Medicare budget, which amounts to a loss of up to $25 billion in funding. Medicare is the only federal program with such a protection.
Practices with high-risk patients are vulnerable to value-based payment penalties
A new study found physician practices that cared for high-risk patients were more likely to receive financial penalties under the CMS Value-based Payment Modifier program because their patients had higher rates of hospitalization, mortality and Medicare spending. The report also found that outcomes did not improve among practices after the program went into effect, even though they were financially penalized if their performance didn’t improve. The results demonstrate the difficulty of implementing value-based care effectively, especially for providers serving low-income populations.
New study finds 57 percent of children and teens will be obese by age 35
Research published in the New England Journal of Medicine shows that 57 percent of the nation’s children and teens will be obese by age 35 if current trends continue. The study suggested that unhealthy childhood weights often lead to adult obesity. Heavy children face the highest risk but even those who make it to age 20 in good shape could face some risk. The current adult obesity rate, updated by U.S. government researchers, stands at a record 40 percent, and more than 18 percent of children are currently obese.
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