In a new blog post, IMPAQ Health experts examine two new price transparency rules, explain how stakeholders are reacting to them, and explore what the rules mean for hospitals, insurers, and patients in the US health care system.
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CMS has released its annual
Benefit and Payment Parameter rules
for 2021. Of the many proposed changes in the rule, the most significant pertains to the automatic reenrollment process. CMS proposes to end automatic reenrollment for low-income healthcare exchange enrollees who receive $0 premium plans with tax credits. The proposed rule intends to ensure that CMS does not provide subsidies to those who are considered ineligible. CMS is accepting comments on the payment notice through March 2, 2020.
Modern Healthcare
and
Health Affairs
(1/31)
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CMS has proposed changes to Medicare Advantage that would increase plans’ revenue by 0.93 percent. The proposed rule intends to extend eligibility to individuals diagnosed with end-stage renal disease (ESRD), lower prescription drug cost-sharing, and increase transparency. In addition, the rule requires Part D plans to offer an online price comparison tool so beneficiaries can see real-time prescription drug benefits and estimates.
HealthPayer Intelligence
(2/6)
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Health Insurance Marketplaces & Health Law
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In a change in policy, the Trump Administration released guidance for the Healthy Adult Opportunity Initiative, which would allow states to cap Medicaid spending for low-income adults. This initiative would give states broader control over how to design coverage for their respective Medicaid populations. Specifically, states could apply for a fixed federal payment for able-bodied adults within each states' Medicaid program.
The Washington Post
and
The New York Times
(1/30)
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In a 5-4 ruling, the Supreme Court argued that the Trump Administration could deny immigrants entry to the United States if it was determined that they would primarily depend on the government for their income. This ruling stems from a decision by the Department of Homeland Security to expand the definition of a “public charge.” This would include noncash benefits such as Medicaid and supplemental nutrition.
NBC News
(1/27)
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Quality Measurement & Value-Based Care
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According to an analysis done by the Office of the National Coordination for Health IT (ONC), 40 percent of patients viewed their medical records electronically at least once in the past year, an all-time high. In addition, 20 percent of patients who accessed their records online transferred their personal information to a third party. This analysis comes as HHS tries to balance expanding patient access to medical records, while addressing privacy and security concerns.
HealthcareDive
(1/27)
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Under ACA guidelines, the federal government can cut payments to hospitals that have high readmission rates or high numbers of infections and patient injuries. Kaiser Health News developed an interactive tool to view hospital penalties by state. See if your hospital made the list
here
.
Kaiser Health News
(1/30)
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With consumers making fewer trips to fill prescriptions, and larger drugstore chains taking more control over the market, grocery stores across the country have begun closing or selling their pharmacy counters. Grocery store pharmacies tend to be too small to negotiate competitive reimbursement rates, are not connected to big medical networks, and lack walk-in clinics and other health services. As a result, grocery store pharmacies now play a lesser role in attracting customers.
The Wall Street Journal
(1/27)
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The FDA plans to survey 700 followers from multiple Instagram influencers to understand how the influencer’s endorsement of certain drugs impacts the decisions of consumers. This is part of the FDA’s ongoing effort to assess how pharmaceutical promotions impact patients.
Stat News
(1/28)
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In letters to state regulatory boards and in interviews with
The New York Times
, pharmacists at some of the biggest chains describe a work environment that has become so chaotic, they cannot perform their jobs safely. Competing priorities such as filling prescriptions, giving flu shots, and counseling patients, as well as the pressure of meeting corporate performance metrics, have led to an unsafe environment, pharmacists say.
The New York Times
(1/31)
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Opioid Crisis & Behavioral Health
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In 1996, the Truth Initiative developed a successful marketing campaign to decrease smoking among high school students. Now, organizations want to build on that initiative to spotlight the effects of opioid abuse. Can the results be replicated?
The New York Times
(1/28)
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In a new study published by the CDC, the suicide rate increased by 40 percent among blue collar workers from 2000—2017, with factors such as job instability and lack of access to services contributing to the increase. In its recommendations, the CDC suggests that professional associations in at-risk industries begin focusing resources on prevention.
The Philadelphia Inquirer
(1/27)
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Social Determinants of Health
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North Carolina has launched a ‘Healthy Opportunities Pilot’ program, which allows Medicaid funds to pay for a select offering of social services, including housing, food, and transportation. In late December, the North Carolina Department of Health and Human Services released a standardized fee schedule for these services; the hope is that the state can use the data to base payments for health-related social services on the value they provide.
The Commonwealth Fund
(1/27)
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A recent
Health Affairs study
highlighted that between 2017—2019, health systems across the United States have invested $2.5 billion dollars in social determinant programs in their respective communities. In all, 57 health systems comprising of more than 900 hospitals developed unique social determinant programs. These include housing interventions, education, food security, and transportation.
HealthcareDive
(2/4)
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According to Washington DC’s 2018 Health Equity Report, 17 of the District’s neighborhoods are considered “food swamps”—neighborhoods where the only grocery options are corner stores or fast food. However, a local nonprofit, DC Central Kitchen, is trying to change that. Since 2011, the organization has worked with corner stores around Washington to provide fresh fruits and vegetables to residents in food swamps and deserts. According to a recent report by the organization, 72 percent of residents within these neighborhoods indicated they were eating healthier foods thanks to DC Central Kitchen’s initiative.
The Washington Post
(2/4)
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Additional Eye-Catching Headlines
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For the first time in 50 years, the United States is imposing a quarantine due to the outbreak of the coronavirus. The Trump Administration has ordered anyone who has traveled to China’s Hubei province to be placed in quarantine for up to 14 days after arriving in the United States. As of February 6, 12 confirmed cases of the coronavirus have been identified in the United States.
The New York Times
(2/4)
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Multiple states have imposed new restrictions on flavored vaping purchases in an attempt to keep the products away from adolescents. However, the move has received strong pushback from the vaping industry. They argue that increased restrictions will cause the 3 million adults who use vaping as a smoking alternative to seek out more dangerous or unregulated products.
Pew
(1/28)
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With recent Medicaid changes, there is renewed interest in monitoring states’ use of Section 1115 Medicaid waivers. These waivers allow states to pilot and develop new initiatives for their existing Medicaid programs. Several states have used the waiver to adopt substance use disorder initiatives to expand treatment access. At the same time, some states are moving to limit the expansion of certain waiver initiatives. For example, Michigan, Virginia, and Kentucky recently paused the implementation of a work requirement waiver for their Medicaid programs.
AcademyHealth
(2/4)
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Spotlight on IMPAQ Health
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In our latest blog post,
African American Pioneers in Social Science
, IMPAQ recognizes the accomplishments of prominent African American researchers, economists, mathematicians, and sociologists, whose pivotal contributions to their fields make our work possible today.
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IMPAQ to Share Health Policy & Data Expertise at NHPC/Datapalooza
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IMPAQ Health experts will deliver 14 presentations at AcademyHealth’s
National Health Policy Conference
(NHPC) and
Health Datapalooza
, joint events taking place February 10–11, 2020, in Washington, DC. We invite you to speak with our experts at our exhibit booth and to join some of our sessions. Examples include:
- Applying Machine Learning Methods to Predict Nursing Home Abuse Using CMS form 2567 Data (Rapid fire session with IMPAQ Research Associate Luke Patterson
- Targeting Social Determinants of Health Using a SDoH Dashboard Action Tool (Rapid fire session with IMPAQ Data Analytics Lead Ann-Marie Akiwumi)
- Procrastination in Health Insurance Enrollment Decisions: Evidence from the Exchange Marketplace (Rapid fire session with IMPAQ Research Associate Siying Liu)
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In the session “Building Synthetic Healthcare Data for Research and Analysis,” the Agency for Healthcare Research and Quality (AHRQ) will share insights from its
Synthetic Healthcare Database project
, which IMPAQ is currently supporting with partners NORC and ASCEND.
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Interested in speaking with one of our experts?
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Health Policy - Upcoming Events, Trainings, Tools, & Webinars
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NASHP’s RAISE Family Caregiver Resource and Dissemination Center will host a webinar to discuss state and federal policies and initiatives to support family caregivers. The webinar will provide an overview of the Recognize, Assist, Include, Support and Engage (RAISE) Family Caregivers Act, and will feature state leaders from Tennessee and Washington State who will share their policies and innovations to support family caregivers.
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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