Welcome to the first edition of IMPAQ Health News. Delivered from our health experts to your inbox every two weeks, you can count on us for the latest, high-impact policy insights and health news stories. We look forward to sharing new editions and learning together with you.
P.S. Don't forget to scroll to the cartoon at the end of each edition!
Best,
Adaeze Enekwechi
President, IMPAQ
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Beginning in January 2021, hospitals must disclose the discounted rates that they negotiate with insurers for a list of 300 services, which include “shoppable” services patients can schedule in advance.
Kaiser Health News
(11/15)
- In a companion proposal, the White House announced that it is planning to require health insurers to define the out-of-pocket costs for all services before they are provided. This measure is now open for public comment. (11/15)
- Update: Hospitals file a lawsuit against the Price Transparency Rule. They argue it violates the First Amendment by compelling speech and reaches beyond the intended definition of “standard charges” transparency in the Affordable Care Act. The Hill (12/4)
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In 2018, US health care spending rose by 4.6 percent and the number of uninsured increased by 1 million people. CMS attributes the spending increase to rising insurance costs and the reinstatement of the health insurance fee paid by insurers.
The Wall Street Journal
(
12/5)
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Health Insurance Marketplaces & Health Law
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The individual mandate of the Affordable Care Act (ACA) has been struck down by a federal appeals court, with the court sending the case back to a federal judge in Texas to determine whether the remainder of the legislation is valid without the mandate. This decision makes it less likely that the Supreme Court will render a final verdict on the ACA before the 2020 elections.
Politico
(12/18)
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The deadline to enroll in ACA marketplace insurance was pushed back from December 15 to December 18 due to computer glitches over the weekend. Historically, the last day of open enrollment is the busiest. ACA enrollment is projected to slightly decrease in 2020.
The Wall Street Journal
(12/16)
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In a year-end government spending package, Congress will repeal the Cadillac Tax (a fee on overly generous insurance policies), a 2.3 percent medical device tax, and an insurer-paid health insurance fee. These three taxes were created to help fund the ACA and have been fought by many in the health care industry since their inception. In addition to these repeals and other provisions, Congress will raise the legal age for tobacco sales to 21.
CNN
(12/16)
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Quality Measurement & Value-Based Care
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Though more than half of private insurance payments were marked as value-based or alternative payments in 2017, the overwhelming majority were structured using the typical fee-for-service model. Thus, providers faced little to no financial penalties for wasteful spending or suboptimal care.
Healthcare Dive
(12/6)
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One plan would allow states, drug wholesalers, and pharmacies to apply to import specific drugs from Canada. The other would permit pharmaceutical companies to import their own products that they sell in other countries.
STAT
(12/18)
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Over the past few years, the FDA has approved drugs to enter the market at record pace. A growing list of new drugs have been approved ahead of FDA deadlines by weeks and sometimes months. While some are hailing the agency’s pace, others stress caution, citing that medicines approved at an above-average pace may result in safety issues when they become more readily available to the public.
Bloomberg News
(12/6)
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A provision that would have ensured ten years of market exclusivity for biologic drugs was removed from the United States-Mexico-Canada Agreement (USMCA) on trade. In the United States, biologics account for a large portion of drug spending and biologic exclusivity is set at 12 years.
Modern Healthcare
(12/10)
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Opioid Crisis & Mental Health
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Although Purdue Pharma cut its sales force in June 2018 to help address the opioid crisis, the company had already calculated “carry over” sales from its past aggressive marketing. OxyContin sales are projected to generate hundreds of millions in profits for the company through 2022. State attorneys general argue that this discovery should be used to compel Purdue to protect consumers even while in bankruptcy.
Bloomberg News
(12/9)
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A
recent study published in U.S. Pharmacist
found that people ages 65 to 69 take roughly 15 prescriptions a year, with this number jumping to a yearly average of 18 prescriptions for people ages 80 to 84. Many of these therapies can be unnecessary and possibly dangerous. Polypharmacy, as this practice is called, is the result of a fragmented health care system and the promotion of drugs to patients who are not able to make rational decisions about their care.
The New York Times
(12/16)
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Social Determinants of Health
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Large hospitals systems are investing in community-based initiatives that address housing, nutrition, and economic growth to reduce health disparities. This shift is in response to vast research establishing that socio-economic factors affect a person’s health significantly more than medical care.
Modern Healthcare
(12/14)
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A
study published in Health Affairs
found that among rural Medicare beneficiaries with complex conditions, attending at least one specialist visit reduced both preventable hospitalization rates and mortality rates by approximately 16 percent. Increasing access to specialist care may be an important part of the solution for improving rural health, in addition to focusing on primary care.
Modern Healthcare
(12/3)
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Additional Eye-Catching Headlines
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In 2016, 3.9 million Americans received letters from the IRS notifying them that they had paid a fine for not having health insurance and recommending methods to enroll. Health insurance coverage increased among those who received these notices, and according to the authors, reduced premature deaths. As compared to those who did not receive a letter due to a budget shortfall, their analysis concluded that one less death occurred for every 1,648 who had, saving roughly 700 lives in total.
The New York Times
(12/10)
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The US Indian Health Service (IHS) is at a critical tipping point. After years of leadership turnover, staffing shortages, and facility breakdowns, the care provided to 2.6 million Native Americans across the United States is at risk. However, Rear Admiral Michael Weahkee, Interim Director of the IHS, is trying to solve the agency-wide challenges.
The Wall Street Journal
(12/10)
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An evaluation of Virginia’s Medicaid program found that more than half of the 16,000 recipients who visited emergency departments in 2019 were treated for non-traumatic dental conditions, which could have been prevented or treated at a dentist’s office. Adult Medicaid recipients in the state do not qualify for preventive dental coverage.
Washington Post
(12/11)
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Spotlight on IMPAQ Health
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In an
article on the Health Affairs Blog
, IMPAQ researchers share findings from an IMPAQ study funded by
MACPAC
, which aimed to determine the effects of a 2016 law authorizing Nurse Practitioners and Physician Assistants to prescribe buprenorphine for opioid use disorder.
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Health Policy - Upcoming Events, Trainings, Tools, & Webinars
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Explore the scientific underpinnings of what enables people to understand data quickly and effectively. Deep dive into the neuroscience of the human visual system works and learn methods for effectively telling compelling data stories.
Listen here
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This webinar explains the Fifth Circuit Ruling on the ACA, and what to expect in the coming weeks from various stakeholders (e.g., Congress, courts, and the health care market).
Listen here
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This is the third webinar in a series that will focus on how to address social isolation. The series is based on a white paper that presents a case for why cross-sector collaboration is needed to address complex issues that limit health in the United States.
Register here
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This webinar will discuss factors for successful participation in Medicare Advantage, which is one of the fastest-growing health plan options today.
Register here
.
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NOTE:
The information, analyses, and opinions expressed in the articles, publications, or comments contained therein are those of the authors and should not be considered verified or endorsed by IMPAQ or any of our partners or clients.
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