DCMedical News: Friday, April 13, 2018
DCMedical News
Washington, D.C.
Friday, April 13, 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 today.
THE BIG STORY TODAY IN HEALTH CARE
Spending: CBO director Keith Hall testifies (here) on spending projections. Majority Leader McCarthy (favorite to succeed Speaker Ryan) on the Balanced Budget (Constitutional) Amendment, HJR 2: “No matter what, we know that if the structure set up by the Congressional Budget Act of 1974 has only worked to completion four times in 44 years, we have nothing to lose by making big changes.” The vote fell short of the two-thirds needed, 233-184. After the vote, Ways and Means Chairman Brady said: “Washington does not have a revenue problem, it has a spending problem . . . With tax reform, we now have an engine to ignite this economy . . . But even this enhanced growth will not be enough to restrain rapidly rising government spending and associated deficit.”
Rescissions are unlikely in the FY 2018 budget, but that fiscal year ends September 30. The last rescission bill approved took place under President Clinton. CBO report for March (here) on spending to date in FY 2018, Medicaid up 10%, ytd deficit $600 billion.
DOCTORS, NURSES, HEALTH PROFESSIONALS
eConsults by specialists for primary care physicians working in safety net hospitals? Study (here) in JAMA Internal Medicine finds “While associated with improved specialty care access, eConsult systems simultaneously created new challenges for PCPs, such as an increased burden of work in providing specialty care,” and carried the strong possibility of exacerbating burnout (here).
Retail clinics: Dr. Christine Cassel opines in JAMA (here) that: “Research on the performance of retail clinics has shown mixed results. Measured quality and patient satisfaction are generally as good or better than traditional clinics or emergency departments. Cost savings have been elusive, however, as most evidence points to increased use rather than substitution for more expensive care.”
Street talk: the best of Doximity, KevinMD, Rebel.md, SERMO, SkepticalScalpel and other prominent physician blogs: at newsletter@kevinmd.com, Thursday’s edition includes nurse dissatisfaction with communication, doctor discovery of how much communication with patient takes place without their knowledge, especially on social media, and survey showing physicians spending four hours per day on cell phones. From another recent edition, “Doctors and nurses are being overloaded with menial tasks” and “Let’s celebrate nurses by reining in patient satisfaction.”
HOSPITALS AND HEALTH CARE FACILITIES
Center for American Progress weighs in (here, earlier study here) on maternal and infant mortality among African-American patients in the U.S.: “Maternal mortality rates in the United States plummeted over the 20th century; however, non-Hispanic white women experienced a steeper decline in maternal mortality than did African American women—introducing a racial gap that persists today. After decades of dramatic progress, maternal mortality in the United States is once again climbing for women of all races, increasing nearly 27 percent from 2000 to 2014. Importantly, the United States is the only developed country for which this is true.” The statements and studies echo other recent studies, especially those of ProPublica/NPR.
HEALTH INSURANCE, MEDICARE, MEDICAID
CY 2019 Benefit and Payment Parameters rule (here, CMS fact sheet here) unpacked by extensive, informed Katie Keith features at Health Affairs, in three parts, here, here and here.
How good are CMS numbers? At the April 5 session of MedPAC an extensive presentation involved the integrity of Medicare Advantage plan numbers collected by and available to CMS. The slides (here) from that presentation note: plans are not submitting some data, some data includes enrollees from the wrong plan, and “encounter” data differ substantially from some other data sources. The faulty data is used to calculate risk scores, estimate risk adjustment models and “support program administration and integrity.”
PHARMA
Opioids: many bills in the House (some say too many), hearing (here) on West Virginia pill dumping (see Events below) coming, also Senate hearing.
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: 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