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08/18/2014

Weekly E-Bulletin


New S&P Reports Say Some Hospitals Face Mounting Pressure

Small and stand-alone nonprofit hospitals are facing mounting pressure from weak operating margins and lower patient volumes, with more signals of stress on the way, according to two reports released last week from Standard & Poor’s Rating Services. Click here for those reports.

Senate Report Details Impact of For-Profit Health Care on Medicare

The impact of for-profit health care on Medicare spending has been substantial, according to a new report from U.S. Senator Chris Murphy (D-CT) released Friday. The report details how the growth in for-profit hospitals, LTCHs and other institutional providers has driven up the cost of care. Click here for this very interesting report.

Some Hospitals Consider Their Own Premium Assistance Programs

Some hospitals want to start their own premium-assistance programs, kicking in a share of the cost for especially poor, especially sick patients to get insurance. It’d probably be cheaper for hospitals than providing uncompensated care, but they’re meeting resistance from insurance companies, who fear such a scheme would lead to a sicker overall risk pool and higher premiums for everyone. Click here for the story.

Welcome to WalMart: The Doctor Will See You Now

As its retail business matures into slower growth, Wal-Mart Stores wants to disrupt another mass market: health care. The company is piloting what it hopes will be a broad network of primary-care clinics. The company already has urgent-care clinics in about 100 stores, but the new facilities will provide much broader services such as chronic-disease management that are normally provided at a doctor’s office. Click here for the Bloomberg report. Click here for the Washington Post story. Click here for a video report.

• Walmart’s own health care costs have seen a steep increase this year. Click here for the WSJ report.

Hospitals Taking Innovations to Market

Some hospital systems are working hard to supplement their revenue by taking innovation to market, according to a report last week in the Washington Post. Click here for the story that focuses on MedStar and the Cleveland Clinic.

GAO Slams RAC Management

The GAO last week released a new report on RACs and other auditors. It says CMS isn’t doing enough to prevent duplication and other prohibited activities. This may give Congress more support to pass the RAC reform bill later this year. The NY Times reported that GAO report also says the government is finding it difficult to battle Medicare fraud. Click here for the GAO report. Click here for the NY Times story.

Drug Compounders Fighting Insurer’s Efforts to Trim

What do a $1,600 custom-made diaper rash treatment, $8,500 scar-reduction cream and a $2,300 pain-relieving salve all have in common? Their price tag, and more often than not, healthcare insurers are left to pick up the expensive bill for compounded medicines, reports the New York Times last week. Some insurers like Harvard Pilgrim are taking steps to reign in the spending on compounded drugs. Click here for more.

Reinhardt Takes Non-Medicaid Expansion States to Task

Noted health care economist Uwe Reinhardt is out with new criticism for states that have refused to expand their Medicaid programs. In the NY Times he writes last week, “If the governor and the legislature refuse to accept the federal deal — as 24 states have so far — they in effect vote against one of the most fantastic cash-flow deals ever offered them. And it gets worse. The state’s citizens are paying taxes to the federal government to help cover the federal payments made to other states who do accept the new deal, but the state gets nothing in return. Click here for the commentary.

CMS Makes Sunshine Act Changes

Doctors and teaching hospitals will have an additional 12 days to review data about payments they received from drug and device manufacturers following a week of outages on the Open Payments website. However, CMS announced Friday that it was not pushing back the date the data would be made public — September 30 — as part of the Sunshine Act. Click here for the CMS announcement.

VA Turns More to Private Sector

Increasingly challenged to meet the health care needs of veterans, the Veterans Administration announced last week that it is increasing the number of private sector providers it has under contract. Click here for the report.

This Is the Last Week for Hospital Corrections to Readmit and HAC Data

Hospitals may preview and submit corrections to their readmissions data through August 19 and their hospital-acquired conditions data through August 21. The data are used in calculating fiscal year 2015 payment penalties under the Hospital Readmissions Reduction Program and Hospital-Acquired Condition Reduction Program. Hospitals that are unable to review their readmissions or hospital-acquired conditions data on QualityNet (click here) due to technical difficulties accessing their hospital-specific reports should submit a ticket to the Help Desk (click here) before the preview period ends, CMS said last week.

Leading Conservative Health Advisor Proposes Obamacare Alternative

The Manhattan Institute last week published 68-page health reform proposal entitled from the health care advisor to Mitt Romney’s presidential campaign, Avik Roy, that represents a novel approach to health reform: neither accepting Obamacare as is, nor requiring the law’s repeal to move forward. He claims to permanently solve our health care entitlement problem, while also expanding coverage for the uninsured. Click here for the report. Click here for a very good news summary.

300,000 Need to Document Citizenship for Obamacare

More than 300,000 people who haven’t documented their citizenship or legal residency in the U.S. face a September 5 deadline to prove their eligibility or lose their Obamacare health coverage, according to an announcement from the government last week. Texas and Florida have the greatest number. Click here for the report.

Analysis: Medicaid Waivers Take Too Long

States may be the incubators of health care reform initiatives through their Medicaid programs, but getting a federal waiver allowing the state to make changes can be a major impediment, according to a report released last week by the American Action Forum. It can easily take half a year or longer to work Medicaid waivers through the federal process. Click here for the study.

Largest Health Plans See Enrollment Growth

From 1st quarter 2013 to 1st quarter 2014, six of the seven leading health plans in the United States realized net gains in the total number enrolled in Commercial, Medicare and Medicaid plans, according to a new Mark Farrah analysis released last week. Aetna, Cigna, Health Care Service Corporation , Humana, UnitedHealth and WellPoint all reported aggregate membership gains on their total books of business. Kaiser Permanente was the only leader to experience a year-over-year membership loss but the decrease was minimal at less than one percent. Click here for the analysis.

Survey: Large Employers Keeping Health Costs In Check

Large employers are keeping 2015 health costs in check through plan changes that put employees in the “driver’s seat,” according to the head of the National Business Group on Health. The organization released a survey last week that shows employers are implementing consumer-directed health plans and expanding wellness initiatives, as well as increasing employee cost sharing and encouraging spouses to get coverage from their own workplaces. Click here for the survey.

CDC: 40% of Americans Will Develop Diabetes

Approximately two out of every five Americans will develop type 2 diabetes at some point during their adult lives, according to new U.S. government estimates. The ongoing diabetes and obesity epidemics have combined with ever-increasing human lifespans to increase lifetime risk of type 2 diabetes to about 40 percent for both men and women. Click here for the study. Click here for the news report.

Rural Facilities To Get $25,000 Grants

More than 60 rural hospitals, clinics, education centers and other organizations are receiving a $25,000 grant from HHS’ Office of Rural Health Policy to help finance sign up outreach efforts for the next Affordable Care Act enrollment period beginning November 15. Click here for the HHS announcement with the list of recipients.

Telemedicine Could Save Companies $6 Billion

Telemedicine has the potential to deliver more than $6 billion in healthcare savings per year to U.S. companies, according to global analytics company Towers Watson. Click here for the story.

Hospitals Everywhere Preparing for Ebola

Hospitals nationwide are preparing for the first traveler from West Africa who arrives in the emergency room with symptoms of infection with the Ebola virus. The CDC has said such a case is inevitable in the United States, and the agency this month issued the first extensive guidelines for hospitals on how recognize and treat Ebola patients. Click here for the story.

FDA Issues Ebola Scam Warning

The FDA is advising consumers to be aware of products sold online claiming to prevent or treat the Ebola virus. Since the outbreak of the Ebola virus in West Africa, the FDA has seen and received consumer complaints about a variety of products claiming to either prevent the Ebola virus or treat the infection. Click here for the FDA announcement.

Partnership for Patients Have Saved Billions of Dollars

An interim report released last week by the Health Services Advisory Groups said hospitals participating in the federal Partnership for Patients program have clearly reduced early elective deliveries, readmissions, adverse drug events, ventilator-associated pneumonia, and central line-associated bloodstream infections, while saving $3.1-$4 billion since 2010. Click here to see the report.

Americans Oppose Sugar Tax

Only 20 percent of Americans are in favor of levying a tax on sugar to help fund diabetes and obesity programs, according to a new Rasmussen Reports survey. The survey, which also included questions about the role of government and taxation more broadly, indirectly referred to U.S. Rep. Rosa DeLauro’s proposal to tax sugar-sweetened beverages. Click here for the survey.

NEJM: Salt Helps, Hurts

Pour on the salt? Several new studies in the New England Journal of Medicine say that a low salt diet could actually be harmful. Click here for the report. However, another study in the same Journal says researchers estimate 1.65 million people die annually from cardiovascular disease attributable to excess sodium. Click here for that report.

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