DCMedical News: Tuesday, June 11, 2019
DCMedical News-DCMN
Washington, D.C.
Tuesday, June 11, 2019
DCMedical News is published every day both the House and the Senate are in session. Subscription information below.
THE BIG STORY IN HEALTH CARE
House Appropriations Moves Forward on Health Bill. Other House and Senate Committees in Hearings
Funding for the Department of Health and Human Services (HHS) for FY2020 is contained in a spending bill (here, HR 2470, 667 pages) which appropriates funding also for the Departments of Labor and Education. The $1 trillion bill (including $99 billion for HHS) will be amended only by provisions calculated to avoid unnecessary conflict within and between political parties and houses of Congress, as determined by the House Rules Committee, meeting today at 3:00 p.m.
Tomorrow, Wednesday, the Energy and Commerce Health Subcommittee will hold a hearing on surprise medical bills (hearing announcement here, Chairman Pallone’s bill here, planned (generally, special interest) witness list here, Committee background staff memo here. Pre-filed testimony is available for Families USA, here; the ERISA industry committee, here; AHIP, here; the association of air ambulances, here; a physician advocacy group, here; a patient advocacy group, here; AHA, here; and ACEP, here).
Also Wednesday the House Ways and Means Committee will hold a hearing on Medicare for All and other paths to universal coverage, such as a Medicare buy-in or a public option, (hearing announcement here, witness list, a mixed group, here).
The Senate Judiciary Committee’s Subcommittee on Antitrust, Competition Policy and Consumer Rights will hold a hearing Wednesday afternoon on vertical consolidation within the health care industry; announcement and academic witness list here.
HOSPITALS, NURSING HOMES AND OTHER HEALTH CARE FACILITIES
5-Star Ratings but for Limited Services
A group from Johns Hopkins publishes findings this week (here) in JAMA Internal Medicine comparing “5-Star” (Medicare HCAHPS, patient experience) rated hospitals with non-5 Star hospitals. The major difference appears to be in the scope of services, and, inferentially, communication challenges (‘patient experience!’) attendant to such broader service offerings.
“Hospitals that provided broader clinical services were less likely to receive 5-star patient experience summary ratings. This remained true after specialty hospitals were excluded. Patients who seek ‘elite’ care and narrow their search to 5-star patient experience hospitals might therefore be surprised that many types of expected services (e.g., emergency department, cardiology, and neurology) may not be available. Hospitals that provide comprehensive services are more likely to receive “nonelite” ratings, in part because of challenges related to communication and responsiveness among more complex patient populations.”
Teaching Hospitals—More or Less Expensive, and Compared to What?
Harvard teaching hospital researchers assert (here) that Medicare patients treated at major (Council of Teaching Hospital member) teaching hospitals had lower Medicare spending at 30 days and similar costs at 90 days compared with Medicare patients at nonteaching hospitals. The authors contend that “These findings appear to raise doubts that care at teaching hospitals is necessarily more expensive than care at nonteaching hospitals.”
However, the study noted that “major teaching hospitals had higher initial hospitalization costs than nonteaching hospitals, but the total costs of care at 30 days were lower at major teaching hospitals largely because of lower costs for post–acute care services and readmissions.” (Readmissions savings were noted, but with no comparison of the incidence of “observation” status patients).
READINGS AND REFERENCES
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
June publication dates: 12, 13, 18, 19, 20, 21, 24, 25, 26, 27
July publication dates: 9, 10, 11, 12, 15, 16, 17, 18, 23, 24, 25, 26
August publications dates: None
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com.