DCMedical News: Friday, October 5, 2018
DCMedical News
Washington, D.C.
Friday, October 5, 2018
DCMedical News is published every day either the House or the Senate is in session. To subscribe, please see below.
THE BIG STORY TODAY IN HEALTH CARE
The Senate votes on confirmation of Judge Kavanaugh to the Supreme Court.
HOSPITALS AND OTHER HEALTH CARE FACILITIES
Cardiac Care Accreditation: The American Heart Association and The Joint Commission are combining their cardiac certification programs (announcement here), beginning January 1, 2019. The two organizations already collaborate on Primary Stroke Center Certification, Comprehensive Stroke Center Certification, Acute Stroke Ready Certification, Thrombectomy-capable Stroke Center Certification and Advanced Certification for Heart Failure. No mention was made in the announcement about any role for the American College of Cardiology.
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
MGMA Report on Regulatory Overload: The Medical Group Management Association reports (here) at its annual meeting on regulatory burdens as perceived by 426 medical group practices responding to its survey. 88% said Medicare Quality Payment Programs (Merit-based Incentive Payment System, MIPS, and Alternative Payment Models, APMs) were very or extremely burdensome. Prior authorization was found burdensome by 82%, lack of interoperability in Electronic Health Records 80%, government EHR requirements by 77% and audits and appeals by 68%. 86% report the regulatory burden increasing in the last year.
Predictions Concerning ACO Participation in a “Risk” Program Vary Widely: Predictions about which ACOs (Accountable Care Organizations) will stay in the Medicare Shared Savings ACO Program vary widely. In that program, risk is “one-sided”—bonus payments are possible, losses are not. At the annual meeting of the National ACO organization (NAACOS) the director of the Centers for Medicare and Medicaid Services “Innovation” program promoted the proposed rule (here) that would limit ACOs to just two years in the “bonus-only” model. The proposed rule would also reduce from fifty per cent of savings to twenty five per cent of savings the size of possible bonuses. CMS expects a quarter of the ACOs (more than 100 of the 460 in the program) to drop out. But a survey by NAACOS showed that as many as 70% of the groups will drop out if there are potential penalties for not achieving savings targets.
MEDICARE, MEDICAID AND COMMERCIAL HEALTH INSURANCE
Medicare Data Tracking Faulted in Management of Opioid Addiction: MedPAC (meeting in Washington yesterday and today) faulted CMS for the lack of opioid use tracking in hospitals. This lack makes it difficult to know when a patient is first exposed to an opioid. MedPAC staff reported that CMS doesn’t have the infrastructure or claims information to collect that type of data. They noted that Medicare Part D relies on health plans to track opioid use, but there are no such equivalents in other parts of Medicare. Notwithstanding, opioid use among Medicare patients appears to have fallen by 18%, since last measured, but one in three enrollees in the program filled at least one opioid prescription in 2016. The discussion took place in the wake of House and Senate passage of the bipartisan opioid package (see DCMN of 10-4, here).
READING AND REFERENCE
Wall Street Journal reports (here) on the Kaiser Family Foundation annual survey of employer health insurance bills.
“Payment and Delivery-System Reform—The Next Phase” (here), NEJM 10-3-2018. Ginsburg and Pham, “After nearly a decade of experimentation with value-based payment (VBP), U.S. health care payers, providers, and purchasers are confronting uneven adoption of new care guidelines, modest early results, and still unacceptable gaps in spending
and quality.”
EVENTS & MEETINGS
Oct. 15
4:05-5:45 p.m., HHS Secretary Azar on “Affordable Medicines: Access, Innovation and the Public Interest,” at the National Academy of Medicine, Washington, DC. Additional information here.
Oct. 16
1:30-2:45 p.m., Potential Midterm Election Implications for Health Care, Alliance for Health Policy Webinar, for information contact Ann Nguyen at anguyen@allhealthpolicy.org.
Oct. 18
3:00 to 4:40 p.m. CMS Administrator Seema Verma at Brookings on Medicare Part D, followed by a panel (Kavita Patel, Samuel Nussbaum and others). Introduction: “Today, 43 million Americans have prescription drug coverage through Medicare Part D, roughly double the number since the program’s introduction in 2006. In the wake of fast-growing drug prices and the rise of specialty drugs, renewed attention has focused on reforming Part D’s benefit structure and providing plans with more tools to obtain lower drug prices. The Trump administration has issued a series of recommendations in their Blueprint to Lower Drug Prices and the president’s budget, and the administration has already begun to advance several pricing reforms through regulation.”
Information at: https://www.brookings.edu/events/a-conversation-with-seema-verma/
Oct. 19
12:00-1:30 p.m. (lunch at 11:30 a.m.), Flexibility and Innovation in Medicaid, Congressional Briefing, Alliance for Health Policy, for information contact Ann Nguyen at anguyen@allhealthpolicy.org.
Oct. 24
9:00-10:15 a.m., Health Policy in the Polls, Reporter Breakfast, Alliance for Health Policy, for information contact Ann Nguyen at anguyen@allhealthpolicy.org.
Oct. 25
1:00 to 5:00, “Top Minds,” Chernew, Dafny and more, “Disrupting the Health Care Landscape: New Roles for Familiar Players,” NEJM Catalyst webinar, https://join.catalyst.nejm.org/events, also sign up for “New Marketplace Survey: Payers and Providers Remain Far Apart,” which reports that “health care stakeholders are not working together to achieve value-based care, but instead are waiting on government regulators to change the payment model – including, possibly, single-payer health care.”
Nov. 8
Through Nov. 13, 2018 AMA Interim Meeting, Gaylord Convention Center, National Harbor, Maryland
Dec. 4
9:00 a.m., CMS sponsors a “Town Hall” meeting “to discuss fiscal year (FY) 2020 applications for add-on payments for new medical services and technologies under the hospital inpatient prospective payment system (IPPS). Interested parties are invited to this meeting to present their comments, recommendations, and data regarding whether the FY 2020 new medical services and technologies applications meet the substantial clinical improvement criterion.” Registration required by 11-19-2018, Federal Register notice 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
October publications dates: 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