DCMedical News: Thursday, January 9, 2020
DCMedical News-DCMN
Washington, D.C.
Thursday, January 9, 2020
DCMedical News is published every day both the House and the Senate are in session.
THE BIG STORY IN HEALTH CARE
First Big Election Year Poll Shows Health Care the “Top Concern” of Voters. Now What?
The Bipartisan Policy Center reported (here) that “Improving the current health care system receives the most overall and bipartisan support of the tested health care reform plans. Health care is a top of mind issue for over half of voters heading into 2020 . . . A plurality of Democrats (46%) and independents (38%), and a third of Republicans (32%) support improving the current health care system . . . Support to improve the current health care system (39%) was nearly double that of repealing and replacing the ACA (23%) or transforming to a Medicare for All-style single payer health care system (22%). . . Over half of voters select out of pocket costs (64%), and prescription drug costs (57%) as their most significant health care concerns . . . voters oppose making cost-cutting changes to Medicare to fund health care programs.”
HOSPITALS, NURSING HOMES AND OTHER HEALTH CARE FACILITIES
Hospital Charge Increases Outstrip All Payment Increase Rates for Privately Insured Patients
A new study from AHRQ reported in Health Affairs (here) noted (see DCMN 1-8-2020) a narrowing of the payment gap between private and public third parties. However, the study also noted that “payments for privately insured patients in general grew at a more rapid pace relative to those for Medicare over the study period, hospital charges for all payment types grew even faster. For inpatient stays of all payment types, standardized charges rose from 170.0 percent of standardized Medicare payment rates in 1996 to a peak of 411.1 percent in 2012. For outpatient visits, charges as a percentage of Medicare payment rates rose from 217.4 percent in 1996 to a peak of 409.7 percent in 2012. For ED visits, charges as a percentage of Medicare payment rates rose even more quickly, from 220.4 percent in 1996 to 554.5 percent in 2016.”
Nurses Rated Tops by the Public in Honesty and Ethics
Gallup reports (here) that “For the 18th year in a row, Americans rate the honesty and ethics of nurses highest among a list of professions that Gallup asks U.S. adults to assess annually. Currently, 85% of Americans say nurses' honesty and ethical standards are very high or high."
Car salespeople rated lowest, with only 9% saying individuals in this field have high levels of ethics and honesty. Members of Congress, tied with car salespeople in 2018 (both at 8%), shot up to second from the bottom in 2019 (12%), although they trailed car salespeople (8% to 9%) in 2016.
MEDICARE, MEDICAID AND COMMERCIAL HEALTH INSURANCE
Commonwealth Fund Touts Value Based Care, But MA Savings in Study Are > ACO Savings
The Fund reports “Accountable care organizations (ACOs) and other plans that shift financial risk from insurers to those delivering health care aim to provide better, more coordinated patient care while saving money through eliminating unnecessary, duplicative services. In the American Journal of Managed Care, Commonwealth Fund–supported researchers report on their investigation into the effectiveness of Medicare ACOs compared to both traditional Medicare and private Medicare Advantage plans.” But the study (here, CF summary here) showed no such advantage for the ACO in the study, which consistently lagged the Medicare Advantage plan already in place.
DRUGS AND DEVICES
Innovation in Pricing Only
Drug prices are increasing without new clinical evidence, or “innovation.”
The regulation newsletter RAPs reports that “A new study from Harvard Medical School [summarized here] found that of the 27 active ingredients in 25 brand-name drugs with the highest Medicare spend in 2017, 11 (41%) of the ingredients had previously been approved by the US Food and Drug Administration (FDA) in other formulations or products.” Researchers Emily Jung, Ameet Sarpatwari and Aaron Kesselheim from Harvard’s Program on Regulation, Therapeutics, And Law reported their findings in the Journal of General Internal Medicine. The researchers also found that in 2016, 84% of Medicare Part D spending came from brand-name drugs, even though they made up just 14% of prescriptions overall.
A recent report from the Institute for Clinical and Economic Review (ICER, here) summarizes many of the innovation-free price jumps in 2019.
READINGS AND REFERENCES
Special Interest Government
Modern Healthcare savant Merrill Goozner decries special interest government in health care, here.
Integrating Social Services in to Medical Care
A new report on this issue (here) from the National Academies of Science, Engineering and Medicine.
U.S. House of Representatives:
Members at https://www.house.gov/representatives
Committees and Members at https://www.house.gov/committees
U. S. Senate:
Committees and Members at https://www.senate.gov/committees
CQ 2020 Calendar of Regularly Scheduled Sessions, here.
PUBLICATION SCHEDULE FOR DCMEDICAL NEWS
January 10, 13, 14, 15, 16, 27, 28
February 4, 5, 6, 7, 10, 11, 12, 13, 25, 26, 27, 28
March 2, 3, 4, 5, 9, 10, 11, 12, 23, 24, 25, 26, 27, 30, 31
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com.