DCMedical News: Thursday, Sept. 6, 2018
DCMedical News
Washington, D.C.
Thursday, Sept. 6, 2018
DCMedical News is published every day either the House or the Senate is in regularly scheduled session.
THE BIG STORY TODAY IN HEALTH CARE:
MedPAC: “Meeting Briefs” prepared for the MedPAC meetings today and tomorrow (agenda here) in Washington, D.C., include (1) a “context” for Medicare decisions (here); (2) bundled post-acute care payment (here); (3) clinician payment (here); (4) a report on long term acute care hospitals (here); and replacing existing quality and value measurement programs with a “Hospital Value Incentive Program” (HVIP, (here). Not in town? DCMN is there for you, see tomorrow’s edition.
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
Doctors in Hospital-Owned Practices: Health Affairs reports (here) that prices go higher. “The percentage of physicians in practices owned by a hospital increased from about 25 percent in 2010 to more than 40 percent in 2016. The estimated impact of the increase in vertical integration from 2013 to 2016 in highly concentrated hospital markets was found to be associated with a 12 percent increase in Marketplace premiums. For physician outpatient services, the increase in vertical integration was also associated with a 9 percent increase in specialist prices and a 5 percent increase in primary care prices.”
HOSPITALS AND OTHER HEALTH CARE FACILITIES
Maternal Mortality: AHRQ’s Healthcare Cost and Utilization Project (H-CUP) has a new summary of “Trends and Disparities in Delivery Hospitalizations Involving Severe Maternal Morbidity, 2006–2015,” here. Dr. Aaron Carroll has gathered a bibliography of links on that subject, published in yesterday’s “The Incidental Economist,” here.
Transitional Care in Focus: A report in JAMA Network (here) on transitional care is optimistic. By way of background, “Medicare adopted transitional care management (TCM) payment codes in 2013 to encourage clinicians to furnish TCM services after beneficiaries were discharged to the community from medical facilities. To bill for the 30-day service, a care team member must communicate with the beneficiary or the caregiver within 2 business days after the discharge and the clinician must provide an office visit within 14 days.” Results of this study? The seven per cent of Medicare discharges which used TCM in 2015 showed that “Transitional care management services were significantly associated with reduced costs and mortality in the month after the service was provided.”
We Knew This: A Dutch study of sleep disturbance in hospitalized patients (here) found that “duration and quality of sleep in hospitalized patients were significantly affected and revealed many potentially modifiable hospital-related factors negatively associated with sleep.”
MEDICARE, MEDICAID, COMMERCIAL HEALTH INSURANCE
Medicaid MLR Offset in HR6: HR6, the popular opioid bill passed in the House (here, 259 pgs.), awaits action in the Senate, complicated by health-related funding offsets, including (1) an incentive to states to enforce an 85% Medical Loss Ratio (expenditure of funds on actual medical care, versus administration and profit) by managed Medicaid plans; (2) an extension from 30 to 33 months of the time that employer-sponsored health insurance would be primary for end-stage-renal-disease care, such as dialysis; and (3) a requirement for group health plans to report enrollees with drug coverage, again to identify Medicare as a secondary payer,
EVENTS & MEETINGS
Sept. 10
9:00 a.m., continuing September 11, Advisory Committee on Training in Primary Care Medicine and Dentistry (ACTPCMD). Information about ACTPCMD and the agenda for this meeting can
be found on the ACTPCMD website at: https://www.hrsa.gov/advisory-committees/primarycaredentist/
index.html. Details here.
Sept. 11
1:00 p.m., “A new Ebola epidemic in the Democratic Republic of the Congo is shaping up to be the most dangerous and difficult test of the world’s ability to contain the disease since the catastrophic West African outbreak in 2014 and 2015.” STAT “Live Chat,” information at www.statnews.com.
Sept. 26
9:00 a.m. to 4:00 p.m., continuing September 27, meeting of the National Advisory Council on Nurse Education and Practice. Details here.
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
September publication dates: 7, 12, 13, 14, 17, 18, 20, 21, 24, 25, 26, 27, 28.
October publications dates: 1, 2, 3, 4, 5, 9, 10, 11, 12, 15, 16, 17, 18, 19, 22, 23, 24, 25, 26
November publication dates: 13, 14, 15, 16, 26, 27, 28, 29, 30
December publication dates: 3, 4, 5, 6, 7, 10, 11, 12, 13, 14
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com