WEEKLY E-BULLETIN


Election Results Have Big Impact on National Health Policy

Like it or not, the Affordable Care Act is here to stay. House Speaker John Boehner (R-OH) said last week Obamacare “is the law of the land.” Now, that doesn’t mean there won’t be meaningful attempts to tweak the two-and-a-half year old law. Discussions have already begun on how best to modify the law. Click here for the USA Today story. One major change was announced Friday when the Obama administration said it would extend the deadline for states to submit plans for health insurance exchanges, the online markets where millions of Americans are expected to obtain private coverage subsidized by the federal government. Click here for the NY Times story. Click here for a copy of the brief letter from HHS Secretary Sebelius to the governors. Interestingly, most  GOP governors appear ready to leave exchanges to the feds. Click here to read why.

Medicare Changes, Spending Cuts on the Table

For those of you thinking that Medicare spending has somehow dodged a bullet with Obama’s reelection. You may want to reconsider. In a public statement Friday afternoon, President Obama said he’s open to a deficit reduction deal that includes reducing the cost of health care “to strengthen programs like Medicare and Medicaid for the long haul” citing his $4 trillion deficit reduction plan last year. Meantime, at a press conference before the President’s, Speaker John Boehner declared that “2013 should be the year we begin to solve our debt through tax reform and entitlement reform.” He said, “This is just the second year of the 25-year baby boom bubble. It’s not like there’s money in Social Security or Medicare. This has to be dealt with, so everything on the revenue and spending side has to be on the table.” Click here for a complete (but brief) transcript of the President’s remarks. Click here for the Speaker’s remarks.

Moody’s Reviews Election Impact on Hospitals

Moody’s Investor Service said last week that Obama’s reelection is “credit neutral” for not-for-profit hospitals. Click here to see their one-page analysis.

“Fiscal Cliff” Issues Loom Large Over Medicare

A lot of what happens over the next six weeks will be driven by congressional and public perception of the looming “fiscal cliff” and its impact on the economy. The CBO issued a widely reported analysis of the pending “fiscal cliff.” Click here to see a summary and a complete report.

Cantor, Conservatives Speak Out on Health Care After Election

House Majority Leader Eric Cantor (R-VA) sent a letter to Republican colleagues last week pledging a bill in the new Congress to repeal IPAB, the 15-member board intended to propose ways to control Medicare spending if it exceeds a certain rate and Congress fails to act. Click here to read a copy of the letter. Conservatives began admitting defeat in their war against Obamacare, according to one Capitol Hill report last week. Click here.

Health Coalition Proposes Plan to Reform Health Care

The National Coalition on Health Care, a broad national alliance of consumers, providers and payers, released a plan for health and fiscal policy last week. The plan pairs nearly $500 billion in spending reductions and health related revenues with longer term policy changes designed to make health care affordable in the public and private sectors. The plans also includes several potentially controversial proposals such as a new penny-per-ounce federal tax on sweetened beverages and tougher penalties on under-performing hospitals. Click here for the story. Click here for the 56-page plan.

17 Docs In Next Congress; 2 New

While 27 physicians ran for Congress this election, only 15 were reelected and 2 were newly elected. Charles Boustany (R-LA) will face a run-off election in December, and if he wins as expected, there will be the same number of physicians in the 113th Congress as in the 112th- 20. Click here for a good  two page summary of the newly elected physicians.

More Money Spent Treating Patients by Less Experienced Physicians: Study

Physicians with the least experience spend significantly more money treating patients than physicians who have the most experience, according to a new RAND Corporation study released last week. Researchers say the findings could have significant implications for less-experienced physicians, who might be excluded from contracting networks or face lower payments as both private insurers and government programs look to reward health care providers who deliver quality care at a lower cost. Click here for more.

Doc Groups, Other Trades Speak Out on Issues 

The American Geriatrics Society is praising CMS for beginning to pay physicians for coordinating Medicare beneficiaries’ care transitions during the 30 days after their discharge from hospitals. CMS will adopt CPT codes for Transitional Care Management services. Click here for a summary of the major health care trade associations activities over the past week.

Aetna, Coventry Deal Under New DOJ Scrutiny

Antitrust regulators at DOJ have asked the companies, which announced in August that Aetna would buy Coventry, for more information related to the deal, according to a Reuters report late last week. It’s the second time DOJ has asked for information. Click here for the story.

Rx Company Drops Cancer Drug Price After Hospital Objection

An international pharmaceutical company announced last week it would effectively cut in half the price of a new cancer drug after a leading hospital cancer center (Memorial Sloan-Kettering) said it would not use the drug because it was too expensive. Click here for the story.

ONC Wants Comments on Stage 3 Meaningful Use

The Federal Health IT Policy Committee is set to issue a request for public comments on its suggestions for the proposed meaningful use standard for stage 3 of the EHR incentive payment initiative, according to published reports late last week. Also, last week, the Office of the National Coordinators released a pair of “quick reference grids” to compare the Stage 2 Meaningful Use objectives, measures and exclusions created by CMS rule makers and their correlated 2014 EHR certification criteria and standards for both Stage 1 (updated from the 2011 criteria) and Stage 2. Click here for all the details. Click here for a good explanatory article.

Supreme Court to Review Key Hospital Merger Issues

Hospitals will be closely watching a case involving a Georgia hospital that will be argued in the Supreme Court later this month that might have an impact on the future of hospital mergers at a time of increasing consolidation in the industry. For a summary of the issues at stake, click here.

West Nile Virus May Be Mutating

The West Nile virus epidemic of 2012, the worst in a decade, may be notorious for yet another reason: the virus, in some cases, is attacking the brain more aggressively than in the past, raising the specter that it may have mutated into a nastier form, say two neurologists who have extensive experience dealing with the illness. Click here for the Washington Post story. Click here to see the latest from the CDC.

States Favor PCMHs for Medicaid

The states have almost implemented patient centered medical homes for their Medicaid populations, according to a report in Health Affairs last week. Click here to review the abstract. Reading the full report requires a subscription.

Policy Documents

-For a 5-page executive summary of the 2013 OPPS final rules, click here.
-For a 6-page summary of MedPAC’s Nov. 1-2 meetings on therapy caps, Medicare Advantage SNPs, site-neutral payment adjustments and several other issues, click here.