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Donald Trump says the ban on insurers denying coverage to people who are sick and the provision allowing young adults to stay on their parents' coverage are "the strongest assets" of the Affordable Care Act. In fact, in some respects, the replacement for the Affordable Care Act may look something like the original, according to  Kaiser Health News . ( Kaiser Health News )

Millions of low-income Americans on Medicaid could lose their health coverage, Kaiser Health News reports. Reducing the number of people on Medicaid while ensuring that only the most needy--such as children and pregnant women--remain eligible will be a goal for Trump and the new Congress, says Brian Blase, senior research fellow at the conservative Mercatus Center at George Mason. "If we do not have fewer people in Medicaid in four years, then we have not reformed health policy in a good direction." ( Kaiser Health News)

"For the most part, the nation's major healthcare payer and provider associations are serving up predictable good-faith pledges to the president-elect, who has promised to upend the healthcare landscape," reports  HealthLeaders Media . It noted that  Institute for Healthcare Improvement CEO and President Derek Feeley was among the few health care leaders to publicly voice uncertainty and anxiety. "At the same time, we are reminded that IHI's mission to improve health and healthcare worldwide can act as a beacon ... during unsettled times." ( HealthLeaders Media )

A federal judge has blocked a new CMS rule that prohibits nursing homes from forcing residents to settle disputes through arbitration instead of the courts if theythat accept Medicare or Medicaid funds. Judge Michael Mills of the U.S. District Court for the Northern District of Mississippi issued an order to stop the rule while it's being challenged in court. (The Hill )
Innovation & Transformation    
U.S. Department of Veterans Affairs announced plans to launch online appointment scheduling in January. Patients will be able to schedule primary-care appointments through an app on their phones, tablets or computers, the  San Diego Union Tribune reports. The VA plans to add mental health, optometry and audiology. "Do I think this is a huge step forward for the VA? Absolutely," said Dr. Neil Evans, chief of the office of connected care for the Veterans Health Administration. "I think this is really, really, really important for us to be able to offer." ( San Diego Union Tribune )

A recent survey by the Aloft Group found that 47.7 percent of health care consumers were not familiar with the term "telemedicine." However, 51.4 percent have received an email or text message from a doctor or other clinician. In addition, 78.5 percent would be at least somewhat comfortable interacting with a physician via online video or online chat, according to Aloft's "State of Telemedicine: 2017 Telemedicine Industry Growth Forecast." (Becker's Hospital Review; announcement )
Consumers & Providers
American Academy of Family Physicians President John Meigs, MD, sent a letter to President-elect Donald Trump with specific recommendations about what his incoming administration can do to help family physicians better care for their patients. Among the priorities: expanding access to care, ensuring delivery and payment reform, improving affordability, building the primary care workforce, and promoting wellness and prevention. "Primary care--and particularly family medicine--is foundational to continued progress in reforming the health care system," Meigs wrote. "The complexity of care provided by family physicians is unparalleled in medicine." (AAFP News; letter )
Only a week into the enrollment window, there was a virtual online waiting area just to sign up for health insurance. HealthCare.gov created these holding areas to avoid crashing the sign-up system.  "Last season, we encountered these types of delays around the Dec. 15 and Jan. 31 deadlines, but not this early in the season," says Elizabeth Colvin,   director of Insure Central Texas. And it's probably only going to get worse. The  Los Angeles Times reports that more people signed up for Obamacare the day after Trump was elected than any other day this enrollment period. ( Wall Street Journal ; Los Angeles Times )
Use of electronic patient-to-provider messaging through online portals could actually increase provider-patient telephone calls, according to research published in the  Journal of the American Board of Family Medicine . "While practices are increasingly making the decision of whether to implement a patient portal..., it is important that the motivation behind such a change not be based on the idea that it will alleviate clinical workload," the study authors wrote. ( Journal of the American Board of Family Medicine ; Becker's Health IT and CIO Review )

While the Drug Enforcement Administration plans to reduce the quantity of narcotics produced in 2017 by 25 percent to slow the opioid crisis, others are implementing alternatives such as monitoring programs and medication-assisted therapy. Medication-assisted therapy may hold more promise. "We're also seeing a shift in treatment philosophy. For so long, it has been dominated by [the Alcoholics Anonymous] philosophy of no medications. We're gradually seeing a shift to using meds to decrease cravings and save lives," says Jane Maxwell, a research professor at the University of Texas. (The Texas Tribune )
New & Noted   
HIEs and behavioral health:  Health information exchanges are making progress with connecting with behavioral health providers, according to two briefs released by the Office of the National Coordinator for Health IT. (Healthcare Informatics )

MLR rebates:  For the second year in a row, Blue Shield of California will issue tens of millions of dollars in rebates to its customers because it didn't spend enough money on medical care to comply with the Affordable Care Act's medical loss ratio provision. ( FierceHealthCare )

ACO and social determinants:  A study of 32 ACOs found that 16 were working to address patients' non-medical needs. Housing instability, food security and transportation were among the most common needs addressed, with various methods being used for each. (MedPage Today )
The November issue of  Health Affairs explores where action is most needed to successfully build a culture of health and identifies how we might start. This month's DataGraphic provides a pictorial view of key facts about how population well-being affects life expectancy. ( Health Affairs )
MarketVoices...quotes worth reading
"Although health reform may now face some major challenges, IHI feels more determined than ever to work with partners, old and new, to demonstrate that change is necessary and that improvement is achievable."-- Institute for Healthcare Improvement CEO and President Derek Feeley, quoted by HealthLeaders Media

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Roxanna Guilford-Blake
Sandy Mau




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Wednesday, November 16, 2016