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Coming together to support the Agency for Healthcare Research and Quality, 195 medical associations, providers, universities and other health care organizations signed letters to both houses of Congress to plead for the agency, which potentially faces defunding. "[D]eep cuts to AHRQ in the current fiscal environment are pennywise and pound foolish," they wrote. Signatories include the American Hospital Association, American Academy of Family Physicians, HIMSS and American College of Physicians. "AHRQ is the only federal research agency with the sole purpose of producing evidence to make health care safer; of higher quality; more accessible, equitable, and affordable; and to ensure that the evidence is understood and used." ( Healthcare IT NewsSenate letterHouse letter)

The price of the benchmark silver HIX plans will jump by 7.5 percent on average next year, according to data released Monday. The premium increase is far more than last year's 2 percent. There's little consistency among the 34 states. For example,  The Hill  points out that while Oklahoma will see an increase of 35.7 percent, Indiana will see a decrease of 12 percent. Maine, Mississippi and Ohio will also see a drop. ( The Hill )

In the face of hospital consolidations, hospitals are increasingly enamored with the idea of becoming insurers themselves, keeping more of their patients' health care spending in house. Reuters interviewed more than a dozen hospital executives and industry consultants, and found they are concerned about the impact of consolidation in their local markets and are considering offering their own insurance plans. "Providers are starting to realize, we don't know how exactly it is going to unfold, but we need to control our own destiny," said Frank Williams of Evolent Health, which helps hospitals set up insurance plans. (Reuters)
Government Accountability Office investigators announced last week they discovered many errors in eligibility decisions under the Affordable Care Act that led the government to pay for duplicate coverage for some people and to an excessive share of costs for others. ( The New York Times)
Innovation & Transformation  
A Robert Wood Johnson Foundation-sponsored program called Data Across Sectors for Health (DASH) will study the integration of social determinant data sources and explore the challenges and opportunities in connecting information systems and sharing data across sectors, which range from public health to government to social service agencies. DASH will fund eight to10 pilot projects starting next year, and form a learning community among pilot sites. ( Healthcare Informatics)
CCMC issue brief: Aligning engagement and evidence
Patient-centered care generates considerable conversation and attention. The basic question is this: How do we fully engage patients in their care while ensuring they receive evidence-based therapies? There have been concerns expressed that the two don't align. And yet, well-informed patients are better prepared to make the best decisions. A new issue brief from the Commission for Case Manager Certification explores this tension. The union of evidence with empowerment: Case Managers guide patients to wise choices features Alaina Fournier, PhD, from the Office of Communications Knowledge and Transfer of the Agency for Healthcare Research and Quality. ( brief)
Consumers & Providers
Docs leave care coordination fees on the table
This year, Medicare began paying an average of $42 per-patient per-month for non-face-to-face chronic-care management services, but doctors aren't availing themselves of the bonuses,  Modern Healthcare reports. CMS estimates 70 percent of Medicare beneficiaries--roughly 35 million--would be eligible, but it has received reimbursement requests for only 100,000. One possible reason: Doctors need permission from patients, who are responsible for a 20 percent copayment each time their provider bills for the services. Others said CMS didn't provide enough information on how to properly bill under the codes. And it could just be that the codes are new. ( Modern Healthcare )
Primary care death and resurrection
Earlier this month, Steven Corwin, CEO of New York Presbyterian, and Dr. Lee Goldman, dean of Columbia's medical school, decided to shutter the joint family-medicine residency program. After an outcry, they reversed the decision. Members of the residency program relate the experience in an  AAFP News guest editorial. "[W]e do expect large, well-endowed academic institutions like Columbia to play a leading role, to use their enormous resources to pilot and pioneer new ways of delivering primary care, to fund family medicine departments adequately and...to inspire some of their...students to become brilliant leaders in primary care." ( AAPF News )
In a recent blog post, Sandy Mau, vice president at Health2 Resources, shares her disdain for the "princess-pretty" pink of breast-cancer awareness. "October pink ribbons are a crass component of the marketing calendar. I'm not saying we should ignore a disease that strikes 12 percent of American women," she writes. "But more pink hasn't drastically improved treatment or long-term survival rates. The  incidence of invasive breast cancer hasn't budged since 1975." ( blog)

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New & Noted   
Poverty shortens lives:  Life expectancy for those in the poorest neighborhood of Brooklyn is 11 years shorter than those living around Wall Street, according to data released by New York City. ( The Telegraph )
VPB payments: In FY 2016, more than 1,800 hospitals will receive a positive payment adjustment under The Medicare Hospital Value-Based Purchasing Program, which is intended to encourage hospitals to provide high-quality care more efficiently. ( Becker's Hospital Review )
MU3 not a done deal: CMS and the Office of the National Coordinator for Health IT may have issued the rule implementing Meaningful Use Stage 3, but many are still calling for a delay. For instance, more than 1,900 American Academy of Family Physician members have done so, according to the organization. ( AAFP News )
The American Academy of Pediatrics has added food insecurity to pediatricians' screening list during routine care for children. The new AAP policy statement also recommends pediatricians have handy a list of community resources, such as food banks. ( NPR)
MarketVoices...quotes worth reading
"We have now seen that even in big-city academic medicine, family medicine can prevail. Indeed, for the sake of cost, quality and accessing our nation's health care system, we must prevail." -- Members of the Columbia University/NewYork-Presbyterian's Family Medicine Residency Program, in a guest editorial for AAPF News

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Roxanna Guilford-Blake
Sandy Mau




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Wednesday, October 28, 2015

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