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Industry News
In 2015, per-capita health care spending grew by 5.0 percent and overall health spending grew by 5.8 percent, according to data from the CMS Office of the Actuary. Spending on prescription drugs increased 9.0 percent in 2015, lower than the 12.4 percent growth in 2014, yet significantly higher compared to 2.3 percent growth in 2013. The report also noted the share of the population with health coverage increased from 86.0 percent in 2013 to 90.9 percent in 2015. (Health Affairs; CMS announcement )

Senate Republicans may delay privatization of elements of Medicare,  Politico reports, citing interviews with several lawmakers. Among those expressing hesitancy is Sen. Orrin Hatch, Senate Finance Committee chair. Moreover, polls show seniors are skeptical about privatizing either Medicare or Social Security; Democratic lawmakers "looking to reclaim the populist mantle are already salivating over how they might exploit Republican efforts to privatize Medicare." (Politico)

President-elect Donald Trump likely won't let Medicaid disappear, but he will make big changes. The program is likely to have less federal funding, more state control, fewer participants and higher costs for those in the program. Trump has recently sent signals he may no longer see Medicare as untouchable, and his transition platform calls for maximizing state flexibility, enabling states "to experiment with innovative methods." (CNN )

The accountable care solutions market is expected to grow at a 16.6 percent compound annual growth rate over the next five years, reaching $18.86 billion by 2021, according to a new report from MarketsandMarkets. Among the factors driving growth: the need to adhere to regulatory guidelines, government initiatives for ehealth, high return on investment and rising needs to curtail escalating health care costs. The major players in the accountable care solutions market include Cerner, IBM, UnitedHealth Group, Aetna, Allscripts, Epic, McKesson, Verisk Health, Zeomega, eClinicalWorks and NextGen. (report summary)

In recent weeks, San Francisco, Oakland and Albany, Calif., Boulder, Colo., and Cook County, Ill., have approved soda taxes. That makes seven communities with such taxes, The  New York Times reports. "There's a momentum with these taxes that will be hard for the industry to stop," said Kelly Brownell, dean of the Sanford School of Public Policy at Duke University, who was met with ridicule when he first proposed a "sin tax" on junk food in 1994. "I expect a year or two from now that the taxes will be widespread."  (The New York Times)
Innovation & Transformation    
GOP lawmakers have complained the Health and Human Services secretary has too much authority to create and expand projects. But that broad authority may be precisely what Republicans want as they test their own ideas for reforming health care,  Kaiser Health News reports. As a result, the CMS Innovation Center may not be on the chopping block. Congressional Republicans generally support its cost-saving goals. ( Kaiser Health News )

The 21st Century Cures legislation--expected to be passed by the Senate this week--includes provisions supporting patient access rights to EHRs and to communicate electronically with providers. It also requires health IT interoperability. As  Health Data Management reports, vendors cannot have taken "any action that constitutes information blocking" or "that may inhibit the appropriate exchange, access, and use of electronic health information." They may not prevent interoperability and they must test the "real world use of the technology for interoperability." (Health Data Management )
Consumers & Providers
Physicians, dentists--even vets--in New Hampshire will, effective Jan. 1, have to consult the state's Prescription Drug Monitoring Program database each time they initially prescribe opioids. They'll also need to check it at least twice a year thereafter. Over the past year, more than 45 million doses of Schedule II painkillers were dispensed in New Hampshire, the New Hampshire Union Leader reports. Michelle Ricco Jonas, the program director, likens the database to an x-ray: "It's information that gives you an eye into your patient that you wouldn't have otherwise," she tells the paper. (New Hampshire Union Leader )
As ACOs progress, they are expanding relationships with community organizations and patients as a way to enhance population health management capabilities.  "Increasingly, providers understand how important the things that happen outside of the doctor's office or hospital are to improving and managing a person's health," said Andrea Ducas, program officer at Robert Wood Johnson Foundation. "To that end, some leading ACOs are expanding their services to include more upstream, preventive support for patients and are also expanding their work to reach entire communities, rather than just focusing on their assigned beneficiaries." (FierceHealthcare ; report)
New & Noted   
Apple moves deeper into health care:  Emails between Apple and the FDA, obtained by MobiHealthNews, indicate that Apple is crossing the line from the unregulated periphery of health care apps to the world of regulated devices. Based on the emails, it is seriously pursuing three regulated devices: an app for diagnosing Parkinson's disease and two related cardiac devices. (MobiHealthNews )
Not Blue enough: Anthem could face a $3 billion penalty from the national Blue Cross Blue Shield Association if it fails to derive most of its revenue from Blue-branded products after acquiring Cigna. To avoid that, 23 percent of Cigna's domestic revenue would need to be rebranded. ( Bloomberg )
In this 3.5 minute podcast,  Health Affairs editor Marc Berk describes a Robert Wood Johnson Foundation program that overcomes barriers to sports participation. It subsidizes school sports fees, increasing student participation. (Health Affairs podcastmore on the program)
MarketVoices...quotes worth reading
"You can dislike that authority, until you have the opportunity to use the authority."-- Rodney Whitlock, vice president at ML Strategies, a government consulting firm in Washington, D.C., and former Republican staffer, quoted in Kaiser Health News
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Roxanna Guilford-Blake
Sandy Mau




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Wednesday, December 7, 2016