DCMedical News: Thursday, April 12, 2018
DCMedical News
Washington, D.C.
Thursday, April 12, 2018
DC Medical News is published every day either the House or the Senate is in session. Want to subscribe? See below. Add our new domain (dcmedicalnews.org) to your white list. Trial subscriptions end tomorrow, April 13.
THE BIG STORY TODAY IN HEALTH CARE
Government spending: Retirement announced by House Speaker Ryan will place focus on which (if any) candidate to replace him will assume the mantle of “entitlement reformer.” For seven years Mr. Ryan pursued restructuring of mandatory benefits (non-discretionary, non-appropriated funds distributions). Among his proposals, a "premium support" program for Medicare, that is, a fixed contribution against (presumably) increasing costs.
DOCTORS, NURSES, HEALTH PROFESSIONALS
Physician Burnout: What to Do? Recommendations from the AMA/AAMC/ABIM/ACP, here.
What’s Happening with Envision and United? The “out-of-network surprise bill” issue has divided the two, the former a physician staffing firm with ambulatory surgery centers, the latter the nation’s largest health insurer. United has cut off its contract with Envision, in the wake of scandal over out-of-network payments. Envision, in turn, has alleged (complaint here) that United lowered its contracted payments, refused to add new Envision providers, and therefore set the stage for more out-of-network billing.
Heart disease, progress slowing: Another study on the “burden of disease” in JAMA (here, see also DCMN of 4-11) shows “Despite large declines in CVD [cardiovascular disease] mortality in the late 20th century attributed to advances in public health and health care, improvements in US life expectancy have slowed for some groups, and CVD mortality is no longer improving.” How common is disability from cardiovascular disease? Depends on where you live: the greatest age-standardized prevalence rate for heart failure in 2016 was in New York, with 1319 cases per 100,000 persons, compared to a low in Minnesota (760). The study was funded by the Gates Foundation.
HOSPITALS AND HEALTH CARE FACILITIES
More on spending: infographic from Modern Healthcare raises questions on CMS and commercial focus on limiting inpatient hospital utilization. The chart, here, says 19% of healthcare spending in the U.S. is for inpatient care, the second lowest in a multinational comparison, just above Canada’s 17%, and much lower, for example, than the Netherlands’ 32%. Outpatient care, on the other hand, professional and institutional, was 42% of all healthcare spending, the highest among the countries studied, compared to the Netherlands, for example, at 22%. The study from which the chart is produced is found here.
HEALTH INSURANCE, MEDICARE, MEDICAID
Medicaid: The President signed an executive order (“Reducing Poverty in America by Promoting Opportunity and Economic Mobility,” found here) to promote work requirements in welfare programs, directing HHS and other agencies to review “safety net” assistance. The order is accompanied by a “fact sheet” (here).
PHARMA
Opioid progress: 34 bills in the House (Energy & Commerce), 29 in the Senate (Health, Education, Labor, Pension), many ideas, not yet focused.
Breakthrough drugs? Many have tried for this designation since 2012, says a report in the New England Journal of Medicine, here, but only a small proportion of drug approval applications represent “breakthroughs.” The resulting problems: “The attachment of the [breakthrough] designation to approved drugs can also promote the use of drugs that do not live up to expectations, even if less expensive or equally effective alternatives are available” and “numerous studies showing a higher incidence of safety-related label changes and other risks associated with expedited premarket testing of new drugs.”
EVENTS & MEETING
April 16
8:45 a.m. (continuing through April 18), National Advisory Committee on Rural Health and Human Services, The Saratoga Hilton Saratoga Springs, NY, notice here.
May 6
American Hospital Association Annual Membership Meeting (Washington, DC), through May 9.
June 19
AHIP Institute & Expo, San Diego, through June 22.
June 24
HFMA Annual Conference, Las Vegas, through June 28.
FOR REFERENCE
Members of the Senate (here) and Members of Senate Committees (here), Senate Calendar (here).
Members of the House with their House Committees (here), House Calendar (here).
PUBLICATION SCHEDULE FOR DCMEDICAL NEWS
DCMedical News is published every day that either the House of Representatives or the Senate is in session.
Past issues can be accessed by clicking on “View this email in your browser.” Subscription information is found at the bottom of these pages. Trial subscriptions may end without notice.
April publication dates: 13, 16, 17, 18, 19, 20, 23, 24, 25, 26, 27.
May publication dates: 7, 8, 9, 10, 11, 14, 15, 16, 17, 18, 21, 22, 23, 24, 25.
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com