DCMedical News: Thursday, May 10, 2018
DCMedical News
Washington, D.C.
Thursday, May 10, 2018
DCMedical 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. Welcome to our new “courtesy trial” recipients.
THE BIG STORY TODAY IN HEALTH CARE
Federal spending, and health care prices: President’s drug proposals coming Friday, appropriations bills moving through the House, see stories below. Dems to hold press conference on drug prices under Trump administration, today at noon, HVC 117 Capitol.
DOCTORS AND OTHER HEALTH CARE PROFESSIONALS
Doctors’ notes, EHRs and burnout: A report in Annals of Internal Medicine (here) finds that US physicians write four times as much as physicians in other countries for clinical notes, but not necessarily for the patient’s benefit. Rather, “Documentation in other countries tends to be far briefer,” containing only essential clinical information. The American add-ons are for compliance and reimbursement documentation, record bloat. Say the authors, “The highly trained American physician has become a data-entry clerk” required to document “increasingly low-value administrative data.”
Jobs: Now (here) in print (originally published by JAMA online April 16, see DCMN 4-19-2018), Skinner and Chandra on the relationship of health care employment growth and the future of US cost containment. Worth repeating from the original: for the ten years ending 12-31-2017 health care added 2.8 million jobs, almost one in three new jobs added during that decade. The authors repeat an adage original with Peter Drucker, that health care does not substitute capital investment for labor cost—rather, capital (and technologic advance) almost always increases labor cost.
What Patients Know, or Don’t: Blog in Sermo reporting on the 2018 Annual Meeting of the International Anesthesia Research Society: a “remarkable revelation,” that 73% of US surgical patients are prescribed opioids alone for post-operative pain, with no mention to them of NSAIDs, acetaminophen or hot pads.
HOSPITALS AND HEALTH CARE FACILITIES
VA Choice: The VA Choice program (which will run out of money by the end of May) would be funded under a bill approved by the House Veterans’ Affairs Committee (here). The bill would increase the number of Veterans who are eligible to see private physicians, and to entitle those enrolled in the system to see a private physician twice a year, without co-payment. The VA Choice program is in the middle of long-standing opposition between those who would privatize and those who would retain VA services as public. The opportunity for Veterans to see physicians under the VA Choice program takes place only in cases where they have had to wait more than 30 days for an appointment, or drive more than 40 miles to a facility. Also moving toward passage, the Military and VA appropriations bill for FY 2019, House Committee report here.
HEALTH INSURANCE, MEDICARE, MEDICAID
Medicare: House Ways and Means Committee examined quality in Medicare Advantage (MA) plans Tuesday. Testimony from Georgetown’s Jack Hoadley, here, focused on consumer health literacy, or lack of it, and the role of the Medicare Plan Finder. Testimony from UMiami’s Karoline Mortensen, here, discussed the 2000+ AHRQ (Agency for Healthcare Research and Quality) quality measures, largely process-based, “measurement cacophony”; the star ratings sought by the 185 organizations offering 3,300 plan options to 19 million Medicare beneficiaries; and the misleading results from contract consolidations, where below par plans are consolidated with high performing plans, to receive additional bonus payments, an issue addressed beginning in 2019 through the Bipartisan Budget Act. Additional testimony from commercial interests can be found here and here.
Proposals for individual state health insurance mandates: have disappeared, except for New Jersey, according to a report in Governing (here). Even the bill passed in New Jersey, awaiting the Governor’s signature, will require a federal waiver.
PHARMA
Drug prices: President’s speech and plan now set for unveiling Friday. Reference pricing may be part of the program, together with more authority for MA plans (part B drugs to be put under part D and MA plans). But state waivers to allow Medicaid limited formularies, much discussed, not anticipated.
EVENTS & MEETING
May 11
12:00 – 1:30 p.m., “State Opportunities to Address Prescription Drug Costs in Medicaid,” Alliance for Health Policy and Commonwealth Fund, 1 Constitution Avenue, NE, Washington, DC, sign up at http://www.allhealthpolicy.org/may-11-briefing/.
May 14
12:30 – 2:45 p.m., “Reimagining Health Care in America,” National Institute for Health Care Management, Room G50, Dirksen Senate Office Building.
CMS HCPCS Public Meetings for Drugs, Biologicals, Imaging Agents, continuing May 14 and 15.
Agendas here and here.
May 15
10:00 a.m., Senate HELP Committee, Oversight of 340B Drug Pricing Program, 430 Dirksen Building.
May 16
11:00 a.m., National Advisory Council on Nurse Education and Practice (Federal Register here).
Through May 18, “2018 Medicare Advantage Summit,” Better Medicare Alliance, Hyatt Regency on Capitol Hill, Washington, DC, three days’ agendas here.
May 22
9:30 a.m., Washington Post, “America’s Health Future,” Verma, Murthy, Eyles (AHIP), contact molly.gannon@washpost.com.
May 24
8:30 – Noon, Health Care Costs in America, Alliance for Health Policy, Kaiser/Jordan Conference Center, 1330 G Street NW, Washington, DC.
May 30
9:30 a.m. – 5:00 p.m., HHS Pain Management Best Practices Inter-Agency Task Force (open to the public), inaugural meeting, continuing on May 31 9:00 a.m. to 3:30 p.m., in the Hubert H. Humphrey Building, 200 Independence Avenue, S.W., Washington, D.C., Federal Register notice here, Task Force membership here.
June 19
AHIP Institute & Expo, San Diego, through June 22.
June 24
HFMA (Healthcare Financial Management Association) Annual Conference, Las Vegas, through June 28.
AcademyHealth, through June 26, Convention Center, Seattle, Washington.
Aug. 20
Meeting of Medicare Advisory Panel on Hospital Outpatient Program (through August 21), APCs, OPPS, the works. Evaluation of Advanced Primary Care (APC) groups; packaging of Outpatient Prospective Payment System (OPPS) services and costs; group weights, structure, appropriate level of supervision.
Further information here (Federal Register 5-3-2018), 7500 Security Boulevard, Baltimore, MD.
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.
May publication dates: 11, 14, 15, 16, 17, 18, 21, 22, 23, 24, 25.
June publication dates: 4, 5, 6, 7, 8, 11, 12, 13, 14, 15, 18, 19, 20, 21, 22, 25, 26, 27, 28, 29.
July publication dates: 9, 10, 11, 12, 13, 16, 17, 18, 19, 20, 23, 24, 25, 26, 27, 30, 31.
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com