DCMedical News: Thursday, October 18, 2018
DCMedical News
Washington, D.C.
Thursday, October 18, 2018
DCMedical News is published every day either the House or the Senate is in session. See scheduled sessions at the bottom of this newsletter. To ensure continued receipt of your copy please subscribe.
The Big Story in Health Care: Prices.
Why Are Prices so High in U.S. Health Care? “We have no budgets.” So said Stuart Altman, Chairman of the Massachusetts Health Policy Commission at the second day of HPC’s “Annual Cost Trends Hearing 2018.” Altman said that the compensation of doctors, salaries of employees and number of employees are all increasing, with almost all organizations having “no budgets.” Altman said lower spending in other advanced countries comes because they have less money to spend. First day slides here, Attorney General Healey’s slides Wednesday here, National Association for State Health Policy’s Executive Director Trish Riley’s slides here, introduction to the drug price panel discussion here. Especially valuable: Ms. Riley’s presentation, link to audio file when available.
How Hard is it to Afford American Medical Care When you are Sick? The Commonwealth Fund, Harvard’s Chan School of Public Health and The New York Times undertake a new joint effort (introduction here) with a first report (here) and a Times report, “1,495 Americans Describe the Financial Reality of Being Really Sick,” here.
MEDICARE, MEDICAID AND COMMERCIAL HEALTH INSURANCE
CMS Announces 2019 Hospital Deductibles and Co-Payments: “For CY 2019, the inpatient hospital deductible will be $1,364. The daily coinsurance amounts for CY 2019 will be: $341 for the 61st through 90th day of hospitalization.” Federal Register notice here. Part B (outpatient) premium and deductibles also announced, Federal Register notice here.
ACOs in Association Oppose Risk Revision Rule: The National Association of Accountable Care Organizations released a survey (here) indicating that “27 percent of respondents report favoring the rule while more than 60 percent report opposing the proposed rule.” The proposal (“Pathway to Success”) from the August 17 Federal Register is here. But MedPAC checks in (letter here) in a generally supportive statement, as follows: “The proposed redesign of the MSSP program is broadly consistent with the Commission’s position that ACOs should eventually transition to two-sided risk. It provides a gradual path to risk and stronger incentives for ACOs to change practice patterns and invest in care coordination. As the proposed rule notes in the regulatory impact analysis, there would be fewer ACOs than otherwise might be anticipated under current policy in the MSSP, but those that are in the MSSP would be more likely to control expenditures for the Medicare program and make real efforts to improve care. As we have stated in the past: ‘The goal of the MSSP should be to create the conditions that will reward efficient ACOs that can create real value for the Medicare program, its beneficiaries, and the taxpayers—not to maximize the number of ACOs or to ensure that every provider can join an ACO.’ The Commission therefore supports the proposed glide path.”
Kaiser Family Foundation takes a “first look” (here) at the access of Medicare beneficiaries to Medicare Advantage offerings for 2019, consisting of 2,734 plans, 417 more than last year, with most growth in Florida. Also, the 21 million Part D prescription drug plan enrollees will have more choice, as shown in this second Kaiser “first look,” here.
DRUGS AND DEVICES
Cash for Congress: Kaiser Family Foundation unveiled its tracking web site for campaign donations to Members of Congress, at https://khn.org/news/campaign/. Follow the “Million dollar club,” the “Just Say No” group and the biggest gainers and losers. By company, the site tracks the “Ten-year champ” (Pfizer), the “Most Partisan” (Purdue) and the most effective company in “Spreading the wealth” (Amgen, contributing to 57 Senators and 158 Representatives).
READING AND REFERENCE
Twenty-six page section by section summary of H.R. 6: The Substance-Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (aka the SUPPORT for Patients and Communities Act, the omnibus opioid bill). Prepared by the majority and minority committee staff, here.
UnitedHealth Group Inc. 8-K for the period ending 10-16-2018, here.
Statista, C-section rates by country, here.
EVENTS & MEETINGS
Oct. 18
3:00-4:40 p.m., CMS Administrator Seema Verma at Brookings on Medicare Part D, followed by a panel (Kavita Patel, Samuel Nussbaum and others).
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. 22
8:00 a.m., Health Care Payment Learning and Action Network (LAN) holds its 2018 fall summit, top speakers (McClellan, Azar, Verma, Boehler and Conway, former and current CMS, HHS and CMMI leaders), information at https://www.lansummit.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.
Nov. 8
Through Nov. 13, 2018 AMA Interim Meeting, Gaylord Convention Center, National Harbor, Maryland
Nov. 27
9:00 a.m., Duke Margolis Center on “Root Causes of Drug Shortages and Finding Enduring Solutions,” Washington Marriott Metro Center, (McClellan, Gottlieb, FDA panel), agenda here.
Nov. 29
The “Office of the National Coordinator” annual meeting, continuing November 30, two day tentative agenda (Jared Kushner!) here.
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). 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
These publication dates are the days the House or the Senate is in Session.
October publications dates: 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