DCMedical News: Wednesday, December 5, 2018
DCMedical News-DCMN
Washington, D.C.
Wednesday, December 5, 2018
DCMedical News is published every day either the House or the Senate is in session.
THE BIG STORY TODAY IN HEALTH CARE
Administration Report on Competition and Choice: The Department of Health and Human Services has released a report (here) on competition and choice, accompanied by a presentation given by Secretary Azar (here) on that subject to the American Enterprise Institute. Mentions of “anti-trust” in the report are divided. Some statements in the report caution against “traditional” measures of concentration. Other statements caution against the effect of regulatory activity promoting concentration (Certificate of Need, Certificates Of Public Advantage). Other targets are hospital and physician groups using restrictive covenants (“non-compete clauses”) in employment agreements and “any willing provider” laws which break the lock of health insurance plan sponsors on network membership, requiring plans to contract with any health care provider willing to meet their terms of participation, including rates paid.
HOSPITALS AND OTHER HEALTH CARE FACILITIES
Some Children Left Behind? CMS announced Monday (here) the Hospital Value-Based Purchasing Program results applicable for reimbursement in Fiscal Year 2019. CMS is required to reduce a portion of the base operating Diagnosis-Related Group (DRG) payment amounts to hospitals by 2%, and take that sum and redistribute it to participating hospitals based on their performance. Some 55% of hospitals will have somewhat higher Medicare payments. The average net increase was .61%, and the average net decrease was .39%. The absolute “highest performing” hospital in FY 2019 will receive a net increase in inpatient payments of 3.67%, and the lowest performing a net decrease of 1.59%.
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
Statins for Prevention of Cardiovascular Disease? Not so Much: A new study in the Annals of Internal Medicine (here) calls into question guidelines for the use of statins for primary prevention of cardiovascular disease. The focus is on how side effects or harms were inadequately considered in the development of those guidelines. The study’s conclusion is that statins provide net benefits (benefits greater than harms) at higher ten-year risks than are reflected in current guidelines. The study, funded by the Swiss government, follows not dissimilar skepticism concerning excessive attempts to control moderate elevations in blood pressure (see DCMN of 11/14, here, citing a study in JAMA Internal Medicine, here, concerning increased risk of adverse events in treatment of low-risk, mild hypertension).
Primary Care, by The Lown Institute: A two-part series on the Health Affairs website (here and here) takes a new look at the shortage of primary care clinicians and the fact that such clinicians are “buried under a mountain of burdensome administrative regulations, with not enough time and resources.” According to the authors, our shortage is entirely what would be expected, based on the information given to medical students and residents in training. “Medical students also avoid primary care after watching primary care physicians struggle with short patient visits, large patient panels, increasing administrative burdens imposed by electronic medical recordkeeping and quality metrics, and significant night call responsibilities, all of which are disproportionate to the burden on specialists.” And quality measures? “Many of these quality measures have not been validated, are not supported by evidence, do not benefit patients, and can even lead to overuse; in other words they ‘serve mostly to distract from patient care.’”
MEDICARE, MEDICAID AND COMMERCIAL HEALTH INSURANCE
Thursday the 13th: The Congressional Budget Office will release its “Options for Reducing the Deficit: 2019 – 2028,” a report with 121 policy options (including Medicare, Social Security, the tax code, federal spending generally), last updated two years ago (here).
DRUGS & DEVICES
In the Journalists’ Spotlight: The International Consortium of Investigative Journalists (Panama Papers, hidden overseas bank accounts) has taken aim at medical devices. Their initial report (here) chronicles the “rising human toll of lax controls and testing standards pushed by a booming industry.” The findings focus on government policy. In the judgment of the journalist group, “Governments have allowed products on the market with little or no human testing that went on to cause great harm,” and “Devices pulled off the market in some countries over safety concerns remain for sale in others,” and “Manufacturers, doctors and others potentially linked more than 1.7 million injuries and nearly 83,000 deaths to medical devices in reports to U.S. regulators over the last decade,” with especially high rates involving products marketed to women. Twenty articles in the series are found at https://www.icij.org/investigations/implant-files/, with a searchable database of 70,000 recalls and safety alerts at https://medicaldevices.icij.org.
EVENTS & MEETINGS (Events Newly Added to This List Noted in Bold)
Dec. 5
(CANCELLED, New Date to be determined) 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.
Dec. 6
9:00 a.m., to 5:45 p.m., MedPAC, 1300 Pennsylvania Avenue, agenda here.
9:30 a.m., Bipartisan Policy Center, “Bipartisan Leadership in Health Care: Chronic Care Act of 2018,” with Senators Hatch, Wyden. Register at https://bipartisanpolicy.org/events/bipartisan-leadership-in-health-care-chronic-care-implementation.
1:00 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.
2:00 p.m. Business Roundtable CEO Innovation Summit: “America: The Innovation Nation.” 901 Wharf St., SW, Washington, Contact: Rayna Farrell rfarrell@brt.org, Agenda and Speakers here.
Dec. 7
8:00 a.m., to Noon, MedPAC, 1300 Pennsylvania Avenue, agenda here.
Noon, Alliance for Health Policy, “Aging in America,” information at 202-789-2300 info@allhealthpolicy.org
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: 5, 6, 7, 10, 11, 12, 13, 14
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com