DCMedical News: Monday, December 3, 2018
DCMedical News-DCMN
Washington, D.C.
Monday, December 3, 2018
DCMedical News is published every day either the House or the Senate is in session.
THE BIG STORY TODAY IN HEALTH CARE
Thumb on the Medicare Scale: The New York Times reports (here) that the Administration is favoring Medicare Advantage enrollment over traditional Medicare during the sign up period which ends this Friday. The article does not speculate, however, on any reasons for favoritism (possibilities might include corporate influence; ability to modify Medicare rules within contracts, not through rule making; reliance on narrow networks for cost control, etc.).
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
Casalino and Co-Authors Write on Professionalism and Incentive Payments: “These efforts, such as Medicare’s Value-Based Payment Modifier and many commercial performance-based payment programs, often use pay-for-performance (P4P) and other financial incentives. Overall, these programs have not been shown to consistently improve patient outcomes or reduce costs, and, in some cases, have distracted attention from other important areas of health care, such as improving patient experience and minimizing low-value care, and possibly exacerbated health disparities by penalizing physicians and health care organizations who care for more socially or medically complex patients.” In JAMA, here.
MEDICARE, MEDICAID AND COMMERCIAL HEALTH INSURANCE
From Medicaid.gov: The Centers for Medicare & Medicaid Services (CMS) released the September 2018 monthly report on state Medicaid and Children's Health Insurance Program (CHIP) eligibility and enrollment data. The full report is available at https://www.medicaid.gov/medicaid/program-information/medicaid-and-chip-enrollment-data/report-highlights/index.html.
A summary chart (here) shows that among the 49 states reporting comparable enrollment data for both September 2018 and the July-September 2013 baseline period (CT and ME did not report baseline data), total Medicaid and CHIP program enrollment increased over the baseline period by more than 27.1 percent for all states reporting; by nearly 36 percent for expansion states that were covering newly eligible adults in September 2018; and by nearly 10 percent for non-expansion states.
Medicaid and Financial Health: Aaron Carroll writes on Medicaid and financial health in the JAMA Forum, here, citing an NBER paper on that subject, here.
DRUGS AND DEVICES
MEDCAC Membership Nominations: The Medicare Evidence Development & Coverage Advisory Committee (MEDCAC) is looking for 20 good men and women. Nominations (Federal Register notice here) are due January 7, 2019. “Among other duties, the MEDCAC provides advice and guidance to the Secretary of the Department of Health and Human Services (the Secretary) and the Administrator of the Centers for Medicare & Medicaid Services (CMS) concerning the adequacy of scientific evidence available to CMS in making coverage determinations under the Medicare program. The MEDCACs fundamental purpose is to support the principles of an evidence-based determination process for Medicare’s coverage policies.” A profile: “MEDCAC consists of a pool of 100 appointed members including: 90 at-large standing members (10 of whom are patient advocates), and 10 representatives of industry interests. Members generally are recognized authorities in clinical medicine including subspecialties, administrative medicine, public health, biological and physical sciences, epidemiology and biostatistics, clinical trial design, health care data management and analysis, patient advocacy, health care economics, medical ethics or other relevant professions.”
READINGS & REFERENCES
HELP Report: CBO reports (here) that “On November 29, 2018, the Senate Committee on Health, Education, Labor, and Pensions ordered reported S. 2076, BOLD Infrastructure for Alzheimer’s Act, which would authorize grants to support public health awareness and evidence-based practices related to Alzheimer’s disease and related dementia; S. 3657, Traumatic Brain Injury Program Reauthorization Act of 2018, which would reauthorize the Traumatic Brain Injury program, including grants to states through the Administration for Community Living and data collection and analysis through the Centers for Disease Control and Prevention; H.R. 315, Improving Access to Maternity Care Act, which would direct the Health Resources and Services Administration to identify geographic areas experiencing a shortage of health professionals practicing in maternity care; and S. 3482, Emergency Medical Services for Children Program Reauthorization Act of 2018, which would reauthorize a grant program that aims to improve outcomes for children in emergency departments. Enacting those bills would not affect direct spending or revenues; therefore, pay as-you go procedures do not apply. Three of the health bills would authorize specified amounts to be appropriated each year over the 2020-2023 period as follows: S. 2076, $20 million; S. 3657, $23 million; S. 3842, $22 million. These authorizations would be subject to appropriation of the specified amounts. Implementing H.R. 315 also would result in spending subject to appropriation, but CBO has not completed an estimate of those amounts.”
Profit Among the Non-Profits: Modern Healthcare provides a list (here) of the most profitable non-profit health systems.
EVENTS & MEETINGS (Events Newly Added to This List Noted in Bold)
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
10:30 a.m.: Senate Health, Education, Labor and Pensions Committee marks up S.2076 (here), on dementia and Alzheimer’s; H.R.315, “Improving Access to Maternity Care” (here); reauthorization of “Emergency Medical Services for Children” (here) and reauthorization of the “Traumatic Brain Injury Program” in Room 430 Dirksen SOB.
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. 5
9:00 a.m., Health Affairs and CMS’ National Health Expenditure Accounts Team hold a media briefing on "National Health Spending in 2017: Growth Slows to Pre-Great Recession Rates and Share of GDP Stabilizes,” National Press Club.
3:00 p.m., The Commonwealth Fund releases a state-by-state report, "The Cost of Employer Insurance is a Growing Burden for Middle Income Families,” conference call briefing, information at 301-280-5739, malexander@burness.com
Dec. 6
9:00 a.m., to 5:45 p.m., MedPAC, 1300 Pennsylvania Avenue, agenda here.
Dec. 7
8:00 a.m., to Noon, MedPAC, 1300 Pennsylvania Avenue, agenda here.
Dec. 10
The American Bar Association (ABA) holds the 16th annual Washington Health Law Summit, December 10-11, information at 202-662-1090 at 202-662-1000, registration at https://www.americanbar.org/events-cle/mtg/inperson/332144284/.
12:30 to 5:00 p.m., PTAC (Physician-Focused Payment Model Technical Advisory Committee) meeting, shortened to one day, Federal Register notice here.
Dec. 11
2:30-4:00 p.m., Bipartisan Policy Center, Financing Public Health Infrastructure, panel, 1225 Eye Street NW, Suite 1000, Washington, 202-204-2400
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), 2019 House Calendar (here).
PUBLICATION SCHEDULE FOR DCMEDICAL NEWS
December publication dates: 4, 5, 6, 7, 10, 11, 12, 13, 14
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com