DCMedical News: Monday, June 14, 2021
DCMedical News-DCMN
Washington, D.C.
Monday, June 14, 2021
DCMedical News is published every day both the House and the Senate are scheduled to be in session. Subscription information and archives from 2018 to the present at dcmedicalnews.org, here.
THE BIG STORY IN HEALTH CARE
Congress Returns Today
Congress begins eight session days in June today.
Up early: the President’s budget for FY 2022, summarized and critiqued (here) by the Healthcare Financial Management Association (HFMA). The group’s analysis: “The Budget includes very few proposals impacting mandatory health care programs and no Medicare proposals at all. It proposes two major initiatives. The American Jobs Plan addresses infrastructure . . . The America Families Plan includes proposals addressing education, child care, access to healthy meals, paid family and medical leave, and expands tax credits for families and workers. Those initiatives include several health proposals impacting Medicaid, coverage offered through health insurance Exchanges, as well as certain discretionary health programs and activities. Included are proposals to permanently increase premium assistance tax credits for individuals who purchase health care coverage through insurance Exchanges -- tax credits that were temporarily increased as part of the American Rescue Plan enacted in March of 2021. In addition, there are proposals to expand the availability of home and community-based services under Medicaid and expand funding for maternal health and pandemic preparedness.”
Further, the Budget document encourages Congress to act in these areas: lowering prescription drug costs by permitting Medicare to negotiate prices; adding dental, vision and hearing benefits to Medicare; giving people age 60 and older the option to enroll in Medicare with their financing separated from the financing for existing Medicare enrollees; strengthening incentives for value-based care in Medicare; addressing the financing of the Medicare health insurance trust fund; lowering Medicare costs for beneficiaries and the Federal government; reducing deductibles for health insurance purchased through state health insurance exchanges; creating a public option for people purchasing coverage through exchanges; making it easier for people to enroll in and stay enrolled in Medicaid; closing the Medicaid coverage gap that exists for people whose income is in between Medicaid eligibility levels and eligibility levels for subsidies for coverage sold through state exchanges. No money is provided in the budget for any of these proposals.
With regard to agency funding, HFMA says “The budget includes $131.8 billion in FY 2022 discretionary funding for HHS, about $25 billion (24%) higher than the FY 2021 level . . . Two of the agencies seeing the largest increases in funding would be the National Institutes of Health (NIH) with a 21% increase above 2021 levels, the Substance Abuse and Mental Health Services Administration (SAMHSA) with a 63% increase, and the Administration for Children and Families with a 24% increase. The budget includes funding for major priorities including the establishment of a new Agency within NIH called the Advanced Research Projects Agency to focus on speeding the availability of medical advances to market, and a boost in funding across several agencies for research, prevention, treatment and recovery for opioid use and to improve access to mental health care.”
Job Openings Highest Ever Since BLS Measure Began in 2000, Including in Health Care
The Bureau of Labor Statistics (here) reports that “The number of job openings reached a series high of 9.3 million on the last business day of April.” The number of healthcare and social assistance job openings rose to 1,319,000 from 1,287,000 in March. Separations in health care were down compared to last April, but are now due to employees quitting: seventy-two percent of “separations” in April were because the employee quit.
STAT Studies Pharma Donations to Legislators
STAT reports (here) that two thirds of the members of Congress cashed a campaign or other check from a pharmaceutical manufacturer in 2020. The interactive map (showing the member and the manufacturer and the amount) shows Congress in good company with state legislators, 2400 of whom (in another STAT study, here) received their own pharma checks.
HOSPITALS, NURSING HOMES AND OTHER HEALTH CARE FACILITIES
National Pediatric Care Emergency Department Readiness
A report in JAMA Pediatrics (here) from the National Pediatric Readiness Project, a US initiative to improve emergency department (ED) readiness to care for acutely ill and injured children, involved a 50-state retrospective survey of “the association between ED pediatric readiness, in-hospital mortality, and in-hospital complications among injured children presenting to US trauma centers.” The result: “Injured children treated in high-readiness EDs had lower mortality compared with similar children in low-readiness EDs, but not fewer complications.”
Drip and Ship v. Direct to Mother Ship: Alternative Models for Stroke Treatment
Reports of a Dutch study in Health Policy (here) note that “When acute stroke care is organised using a ‘drip-and-ship’ model, patients receive immediate treatment at the nearest primary stroke centre followed by transfer to a comprehensive stroke centre (CSC). When stroke care is further centralised into the ‘direct-to-mothership’ model, patients with stroke symptoms are immediately brought to a CSC to further reduce treatment times and enhance stroke outcomes.” Result: “Our findings provide support for the ongoing centralisation of acute stroke care in urban areas. Treatment times for patients with ischemic stroke decreased significantly, potentially improving functional outcomes.”
Grim Milestone in UK Hospitals
A report in the British Medical Journal (here) says “The number of people waiting for hospital treatment in England has topped five million for the first time, raising fresh alarm over impacts on patients. Doctors’ and trusts’ leaders warned of unrelenting pressures on NHS staff and services . . . The latest monthly performance data on NHS referral to treatment show that the waiting list rose by 171 720 in April to 5 122 017. Some 385 490 patients were waiting over a year for treatment—50 000 fewer than in March. At the end of April 2021, 64.6% of patients waiting to start treatment were waiting up to 18 weeks, missing the 92% standard.”
MEDICARE, MEDICAID AND COMMERCIAL HEALTH INSURANCE
Public Option Planned for Nevada, Joins Washington Initiative
The Nevada Independent reports (here) that “Nevada became the second state in the nation to enact a state-managed public health insurance option . . . [in] a bill that hadn’t even been made public until six weeks ago into law . . .Under the new law, Nevada’s public option plan won’t be available for purchase until 2026, giving state officials time to conduct an actuarial study of the proposal to determine whether it will accomplish proponents’ goals of increasing health care access and affordability and at what cost. It also provides time for state officials to transform the still relatively broad-strokes concept into a workable policy and return to the Legislature in 2023 with any changes that may need to be made to the law.”
Nevada joins Washington, the first state with a public option. A memorandum from the Washington State Hospital Association (here) summarizes the history: “In 2019, the legislature created public option health plans, which in 2021, were first made available . . . The goal of public option health plans is to provide consumers across the state with more affordable health plan choices . . . The primary way to achieve this is by reducing hospital and provider payment rates.”
Now, hospitals are mandated to participate in at least one public option plan, “upon receiving an offer to contract from a public option health plan. This provision is effective if in 2022 or any subsequent year, there are any counties [in which] a public option health plan is not available to consumers.”
READINGS & REFERENCES
Select Coronavirus Public Health Resources and References (alphabetical) may be found here.
2021 CQ Congressional Calendar here.
PUBLICATION SCHEDULE FOR DCMEDICAL NEWS
June 15, 16, 17, 22, 23, 24, 25
July 19, 20, 21, 22, 26, 27, 28, 29, 30
August - none
September 20, 21, 22, 23, 24, 27, 28, 29, 30
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com.