DCMedical News: Wednesday, February 13, 2019
DCMedical News-DCMN
Washington, D.C.
Wednesday, February 13, 2019
The publication schedule and subscription information for DCMedical News will be found below.
THE BIG STORY IN HEALTH CARE:
The Monetary Value of Patient Information: These stories have all appeared this week: The President issues an Executive Order (here) directing federal agencies to promote artificial intelligence. CMS issues a proposed rule (here) which is presented in the media (here) as enabling citizens to have access to their own medical information, but which could also add to the monetization of medical information (see Facebook, etc.). In The New York Times (here) the AI directive is matched with a piece extoling the virtues of Chinese medical centers for efficient research (where presumably there is even less protection for privacy). (The word “China” appears in the print edition headline, but not in the online version linked here). UnitedHealth reported that Optum (here) now generates more than $100 billion a year, revenue based in significant part on claims data. Oh, and the “Office of the National Coordinator” has proposed a rule (724 pgs., here, fact sheet here, see also story below) articulating the exceptions to what would otherwise be prohibited blocking of the sharing of electronic health information. What these stories have in common: the value of medical data to whomever is holding, using or preventing others from using it.
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
HHS Secretary Azar at the AMA’s National Advocacy Conference: Remarks (here) spelling out drug price strategy, attacking Stark laws.
MEDICARE, MEDICAID, COMMERCIAL HEALTH INSURANCE
CMS Reports (see above) on Patient Data: “The CMS Interoperability and Patient Access Proposed Rule introduces new policies that will expand access to health information and improve the seamless exchange of data in healthcare. This will enable better care coordination, better patient outcomes and reduced costs. Our proposals will help to break down existing barriers to interoperability and empower patients by giving them access to their health information. The policies in this proposed rule touch on all aspects of healthcare, from patients to providers to payers and researchers. The technology and standards we identify spark new opportunities for industry and researchers, while improving healthcare quality for all Americans.” The National Association of Medicaid Directors summarizes the major provisions, here.
Information Blocking: One group opposed to the elimination of information blocking is the American Hospital Association, here. In particular, they object to this provision: “In addition to including ADT [Admission, Discharge, Transfer] notification use as a condition of participation for Medicare and Medicaid, the proposed rule includes a policy to publicly identify providers and hospitals who engage in information blocking.”
It’s Still the Prices: The 2017 Annual Report of the Health Care Cost Institute (here) found that “[A]verage annual health care spending for individuals with employer-sponsored insurance increased to an all-time high of $5,641 in 2017, despite little change in the utilization of services overall. While overall spending growth slowed in 2017 compared to 2016, the report finds that prices continued to drive rising costs.”
Additional findings from the report: “Professional services spending accelerated, growing 13 percent between 2013 and 2017. Inpatient spending grew 10 percent between 2013 and 2017 despite a 5 percent drop in utilization, driven primarily by rising prices for medical and surgical admissions. Spending, utilization, and prices for inpatient care for mental health and substance use increased. Per-person spending on outpatient visits and procedures grew more than 5 percent, higher than any other service category. Utilization of prescription drugs increased 3 percent in 2017, a year-over-year uptick after little change between 2013 and 2016.”
Being old (40% of adults 19-25 had no claims) and having chronic conditions increased the total: “Average spending for individuals with one of five chronic conditions reported in the study — hypertension, asthma, diabetes, attention deficit/hyperactivity disorder, and congestive heart failure — was $8,921 in 2017, compared to $3,603 for people with none of these conditions. Those with two or more chronic conditions had even higher spending, averaging $20,257.”
READING AND REFERENCE
U.S. House of Representatives:
Members at https://www.house.gov/representatives, Committees and Members at https://www.house.gov/committees
U. S. Senate:
Members at https://www.senate.gov/general/contact_information/senators_cfm.cfm, Committees and Members at https://www.senate.gov/committees/membership_assignments.htm
House and Senate 2019 Calendar of Regularly Scheduled Sessions, here.
PUBLICATION SCHEDULE FOR DCMEDICAL NEWS
Publication dates are the regularly scheduled days the House or the Senate is in session.
Remaining February publication dates: 14, 25, 26, 27, 28
March publication dates: 1, 4, 5, 6, 7, 8, 11, 12, 13, 14, 15, 25, 26, 27, 28, 29
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com.