DCMedical News: Monday, March 4, 2019
DCMedical News-DCMN
Washington, D.C.
Monday, March 4, 2019
The publication schedule and subscription information for DCMedical News will be found below.
THE BIG STORY IN HEALTH CARE:
CMS Interoperability and Patient Access Proposed Rule, published today in the Federal Register, here:
The proposal “[W]ill 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.” A CMS “Listening session” is scheduled for tomorrow (March 5) at 2:00 p.m. EST, announcement and registration information here.
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
Private Equity and Physician Practice Acquisition:
Between 2010 and 2017, the total value of private equity deals in health care increased 187% while the total number of private equity deals in health care increased by 48%, reports (here) Bain Insights’ Report on Global Healthcare Private Equity. A comment on the implications of private equity acquisition of physician groups is in JAMA is here, supplemental graphic here. Specialty societies are exploring implications for their members and groups (ophthalmology, here; dermatology, here). A study of “hold times” (acquisition to flipping) for U.S. PE firms (here) shows a greater than six year average. An object lesson (among the very few peer-reviewed journal studies of PE firms in health services, here and here) was found in nursing homes; one guardian may be a decision by the Department of Justice (described here) to intervene in a qui tam action against a private equity firm whose “portfolio” company was implicated in a kickback scheme.
HOSPITALS, NURSING HOMES AND OTHER HEALTH CARE FACILITIES
Got Coding Input?
CMS has announced (here) a series of meetings May 13 – June 12 for “Healthcare Common Procedure Coding System (HCPCS) public meetings . . . to discuss our preliminary coding and payment determinations for all new public requests for revisions to the HCPCS.”
CMS Intends to Accredit Home Infusion Therapy Programs and has invited interested organizations to compete, here.
MEDICARE, MEDICAID AND COMMERCIAL HEALTH INSURANCE
MedPAC Meetings March 7, 8, Cover a Range of Pending Policy Changes:
Thursday’s meeting of the Medicare Payment Advisory Commission kicks off with a discussion (introduction to the questions presented here) of reference pricing and binding arbitration as payment strategies to improve price competition and value for Part B drugs. Next is a discussion (introduction here) of Medicare Advantage encounter data, followed (introduction here) by one to begin the afternoon session on options for slowing the growth of Medicare fee-for-service spending on hospital emergency department care. The remainder of Thursday afternoon’s program includes Medicare’s role in the supply of primary care physicians (introduction here) and a Congressionally mandated report on clinician payment in Medicare (introduction here).
The half day program on Friday includes evaluation of an episode-based payment system for post-acute care (introduction here) and another mandated report, this one (introduction here) on changes in post-acute and hospice care following the implementation of the long-term care hospital dual payment-rate structure.
Concentration of Health Expenditures, MEPS Reports:
In 2016, the top 1 percent of persons ranked by their health care expenditures accounted for 22 percent of total health care expenditures, with an annual mean expenditure of $110,003, and the top 5% accounted for half. So reports the Medical Expenditure Panel Survey from the Agency for Healthcare Research and Quality (here), published February 19. The bottom 50% accounted for 3% of spending. Inpatient hospital care accounted for 40% of spending for persons in the top 5% of the spending distribution.
READING AND REFERENCE
CBO Director on Budget and Debt, 2019 – 2029: A presentation (here) summarized as follows: “At the end of 2018, the amount of debt held by the public was equal to 78 percent of gross domestic product (GDP). In CBO’s projections, debt equals 93 percent of GDP by 2029 and about 150 percent of GDP by 2049. Even at its highest point ever, just after World War II, debt was far less than that—106 percent of GDP. Debt is on an unsustainable course in CBO’s projections. To put it on a sustainable one, lawmakers will have to make significant changes to tax and spending policies—making revenues larger than they would be under current law, making spending for large benefit programs smaller than it would be under current law, or adopting some combination of those approaches.”
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
March publication dates: 5, 6, 7, 8, 11, 12, 13, 14, 15, 25, 26, 27, 28, 29
April publication dates: 1, 2, 3, 4, 5, 8, 9, 10, 11, 12, 29, 30
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com.