DCMedical News: Monday, November 26, 2018
DCMedical News-DCMN
Washington, D.C.
Monday, November 26, 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. Subscribe to ensure continued receipt of your copy.
THE BIG STORY TODAY IN HEALTH CARE
Congress Returns: Lame Duck session begins. Congress is in session (and DCMN publishing) four days this week, ten in December, budget cliff looms for December 7. Highlights: Democrats in the House weigh “Medicare-for-all,” multiple endeavors in drug prices, pre-existing conditions, tussle over who pays for the drug “donut hole” (see CQ Magazine, here). Waiting for the judge: Texas v. Azar (Texas v. U.S., attack on constitutionality of Patient Protection and Affordable Care Act, complaint here), where Federal District Court Judge Reed O’Connor promised a decision “as quickly as possible.” (See also DCMN 9-5-2018, here; DCMN 9-7-2018, here.)
Congress and the Budget: The Budget and Economic Outlook of the Congressional Budget Office provides economic and federal budget projections that incorporate the assumption that current laws governing federal spending and revenues generally remain in place. A summary (here) in a CBO presentation 11-28-2018 to the Southern Economic Association notes that the budget deficit as a percentage of GDP will rise to 100% by 2028.
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
Physician conflicts of interest and industry payments: The Open Payments Database (OPD) proved far more comprehensive for industry payments, compared to declarations of conflict of interest by physician authors in their publications. One hundred physicians’ publications were analyzed in a study, here, in JAMA Surgery. The one hundred were the top 10 payees from the top 10 surgical and medical device manufacturing companies: only in 37% of publications were conflicts of interest declared by the physician authors.
HOSPITALS AND OTHER HEALTH CARE FACILITIES
Maryland, Continued: Did the Maryland global budget experiment reflect actual changes in hospital utilization? Debate continues, here, with an exchange of letters in JAMA.
Same Day Discharge (SDD) following percutaneous coronary intervention (PCI): Another debate, here in JAMA Cardiology, examining death, bleeding and other complications after an average 6% of PCI patients were discharged on the same day, with “savings” in excess of $5,000 per procedure. Wide hospital variation (0% to 83% SDD) will provide another target for standardization.
READINGS AND REFERENCES
“Scandal and Fortune in China’s Hospitals”: A profile (here, New York Times of 11-19-2018) of the Putian network of 8,000 private hospitals (8 of 10 in the country) in China, describes the activities of families, their relatives and associates in developing a private hospital industry in Dongzhuang, the Nashville of China.
H-CUP on Inpatient Stays for Substance-Related Disease: The Hospital Cost and Utilization Project reports (here) on geographic and cost variation for alcohol-related, opioid-related, cannabis-related and stimulant-related stays. Highest rate for counties in the 31 states surveyed: Baltimore, for all but alcohol-related stays. Lowest: Texas. Alcohol-related stays in Rhode Island cost $98 per resident annually.
Medicare Program: Changes to Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs, a “final rule with comment period,” comments due December 3, published in the November 21 Federal Register, here.
Potential Spending on Veterans’ Health Care, 2018-2028. A report (here) from the CBO to the Southern Economic Association annual meeting, 11-19-2018. Useful history of benefits and spending, alternative scenarios for the future. Current spending: $69 billion for 9 million enrollees, 6 million veteran patients treated ($11,500 per veteran per year treated). With continuation of current policies, 2028 spending of $102 billion, 3.5% per year. Recent growth due to veterans receiving more of their total care through the VA; veterans entering late 50s and early 60s in larger proportion; VA transitioning from limited to comprehensive care.
EVENTS & MEETINGS (Events Newly Added to This List Noted in Bold)
Nov. 27
9:00 a.m., The American Enterprise Institute for Public Policy Research (AEI) holds a discussion on "The new Medicare physician payment regulation: What does it mean for physicians and patients?" Seema Verma, Robert Berenson, AHIP, AMA. Contact: 202-862-5829 mediaservices@aei.org
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. 28
10:00 a.m., Senate HELP Committee Hearing: Reducing Health Care Costs: “Improving Affordability Through Innovation,” 430 Dirksen Senate Office Building, announcement here.
12:00 to 1:30 p.m., Understanding the Role of Rebates in Prescription Drug Pricing, Alliance for Health Policy, (Stars: Gerard Anderson, Hopkins; Jack Hoadley, Georgetown), Dirksen Room G-50, 50 Constitution Ave NE, Washington. Open to public, lunch served at 11:30 a.m. www.allhealthpolicy.org.
1:00 to 2:00: CMS briefing on proposed rulemaking for Medicaid and CHIP managed care regulation Comments, due January 14, 2019, register here: https://meetings.cms.gov/orion/joinmeeting.do?MTID=a5c77db9a01b8e77f7d5d03ab672ef0e
Nov. 29
The “Office of the National Coordinator” annual meeting, continuing November 30, two day tentative agenda (Jared Kushner!) here.
8:00 a.m. to 11:00 a.m., STAT Plus correspondents in a discussion of drug pricing, at Hogan Lovells in Washington, information at https://www.statnews.com/conversation-drug-pricing-2019/?utm_source=STAT+Newsletters&utm_campaign=bb45b691af-STATPlus_1113_event_subs_COPY_01&utm_medium=email&utm_term=0_8cab1d7961-bb45b691af-149691333
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.
Dec. 18
First meeting, the HHS Deputy Secretary’s Innovation and Investment Summit. Program announced, here; participants selected, list here; FAQs 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
November publication dates: 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