House Members Pushing Delay of Mandatory Orthopedic Bundles

The chairman of a key House committee is circulating a letter to colleagues asking CMS to delay its proposed bundled payment program for hip and knee surgeries scheduled to start January 1, 2016. Representative Tom Price (R-GA), a physician, says providers need more time to prepare for implementation since this will be CMS’ first mandatory bundled payment model. Under the program, known as the Comprehensive Care for Joint Replacements, CMS will provide fixed payments for knee and hip surgeries to providers in 75 geographic areas over a five-year period. More than 800 hospitals will participate. Click here to read the letter. Price is giving other Representatives until close-of-business today to sign on before sending.


Study: Socioeconomic Status of Patients Significantly Impacts Hospital Readmissions

A new landmark study released last week shows that the socioeconomic status of patients really does cause higher hospital readmissions and negatively impact safety-net hospitals. The bottom line, the researchers said, is that hospitals treating the most vulnerable patients are being deprived of needed resources. For the fiscal year starting October 1, more than 2,600 hospitals will lose a combined total of $420 million, according to CMS. Click here for the study in JAMA Internal Medicine. Click here for the news report. Click here and here to see the summaries of legislation, Senate and House, designed to make adjustments for socioeconomic status to the readmissions penalty program.


NCQA Releases New Ratings for 1,300+ Health Plans

Health insurance plans in New England and the Great Lakes region received the highest rankings for performance and customer satisfaction under a new nationwide ratings system released last week by the National Committee for Quality Assurance. Using a new methodology, NCQA’s Health Insurance Plan Ratings 2015–2016 compare the quality and services of more than 1,300 health plans that collectively cover 138 million people—more than 43% of the nation’s population. NCQA ranked 1,358 health plans and rated 1,016: 491 private, 376 Medicare and 149 Medicaid. Click here to review the ratings.


Another Rural Hospital to Close; Health Centers Receive Another $500 Million

Mercy Hospital in Independence, Kansas is expected to be the 58th rural hospital to close in the last five years, according to an analysis by the National Rural Health Association. It is planning to close October 10 (click here for details.) Four rural hospitals closed in Tennessee over the past two years. (Click here.) Earlier this year, the NRHA identified 283 rural hospitals in danger of shutting down. That is ten percent of all rural hospitals in the nation. Click here for a map of closings since 2010. Most closings have happened in states that have not expanded their Medicaid programs as allowed under the Affordable Care Act.

  • While Congress has no plans to provide aid to help the plight of struggling rural hospitals, the Obama Administration continues to pour hundreds of millions of dollars into supporting Community Health Centers and Federally Qualified Health Centers. CMS announced last week another $500 million for CHCs. Click here for the announcement. Click here to see who got the money.
  • With an eye towards a permanent fix in the near future, the Senate last week unanimously passed a bill that would extend the moratorium on the requirement that supervising physicians be physically present in critical access and small rural hospitals at all times when Medicare beneficiaries receive outpatient services. Click here to read the 1-page bill. The House is working to pass a similar bill.


Physicians Urge Delay in Stage 3 Meaningful Use; Congress Chimes In

The American Medical Association and 41 medical societies are urging HHS to pause the rule implementing Stage 3 of the Meaningful Use program. In letter sent last week, the provider groups said they are “extremely concerned” with the current direction of the Meaningful Use program and are “extremely dismayed” at reports that the rule implementing Stage 3 has been combined with the rule softening some of the requirements of the program for 2015-2017, known as the modifications or alterations rule. The letters point out that while 80 percent of physicians are using electronic health records, less than 10 percent have successfully participated in Stage 2 of the program. Click here for the AMA’s press release.

  • Several members of Congress are calling for a delay of meaningful use Stage 3. That includes a bill introduced in July by Rep. Renee Ellmers, R-NC Click here to read the bill.
  • Last week, Senate Health Committee Chairman Lamar Alexander, R-TN, called for a delay in making Stage 3 rules final until 2017. Click here for details.

CBO: Repealing Individual Mandate Lowers the Deficit but 14 Million Would Lose Insurance

The Congressional Budget Office last week released a report on the effect of repealing the Affordable Care Act. Looking at the next ten years, the report said that by repealing the individual mandate the federal deficit would decrease by $305 billion; however, the number of uninsured would reach 14 million people by 2025. Eliminating the mandate is a key goal for Republicans in Congress but it could also increase premiums by 20 percent, according to the report. Click here for the report.


Not All Medicare ACOs Are Alike: Premier

Accountable care organizations participating in Premier, Inc.’s population health management collaborative outperformed other participants in the Medicare Shared Savings (MSSP) and Pioneer programs, reporting higher than average scores in 22 of the 33 quality measures, with year-over-year improvements nearly double the national rate — according to a Premier analysis released last week. As a result, a larger percentage of their ACOs achieved shared savings payments from Medicare when compared to national results. Click here for details.


340B Program Gaining Importance with Safety-Net Hospitals: Study

The 340B drug discount program for safety-net hospitals is apparently much bigger than previously thought, according to the Community Oncology Alliance (COA), which commissioned the Berkeley Research Group to conduct a study on the topic. The hospitals participating in the 340B program accounted for 58 percent of all Medicare Part B outpatient hospital reimbursements in 2013, up from 43 percent in 2010, according to the COA. And for cancer drugs alone, 340B hospitals accounted for more than 60 percent of all Part B reimbursements in 2013, up from 47 percent in 2010. Click here for the complete report.


Influential Think Tank Unveils Plan to Reign In Rx Prices

The Center for American Progress last week unveiled a series of proposals to address high prescription drug prices, which would empower third-party organizations to assess drugs’ effectiveness and recommend payment ranges. The report calls for using an independent organization to rate drugs based on their relative health benefits and for requiring companies to use star ratings of comparative effectiveness in drug labeling and marketing. Recent polling has identified drug prices as a top priority for most Americans. Click here for CAP’s report.


Report: Hospital Acquisitions Focus on Doc Practices, Digital Resources

Competition and the transition to value-based care are two reasons for the dramatic increase in the number of health systems that have acquired physician practices, retail clinics and digital resources in the last nine years, according to a new report from management consulting firm Accenture. Acquisition volume among healthcare providers reached an all-time year-to-date record of $241 billion in the first five months of 2015, according to the report. Click here for the report.


CDC Says New Flu Vaccine Will Be More Effective

The CDC last week predicted that this year’s flu vaccine will be far more effective than last year. After a year of high infection rates due to a mismatch of the strains within the vaccine that led to an House Energy and Commerce hearing, this year’s vaccine will target the substrains that were missed in the vaccine produced for 2014-2015 season. Last flu season 145 children died from the virus and more seniors were hospitalized with influenza than ever before. Click here for details from the CDC on the status of the flu worldwide.


Physicians Concerned About GOP Presidential Candidates Linking Vaccines and Autism

Physicians watching last week’s GOP presidential debate are expressing concern about the discussing involving vaccine use and autism. A variety of health care groups sounded the alarm after several GOP candidates questioned the impact of vaccine use on the development of autism. Click here and here for the news reports. Click here for the CDC reports on the issue.


Nursing Homes Urged To Change Antibiotics Use

The CDC has called on nursing homes to boost their efforts to monitor the improper use of antibiotics to address the rising cases of superbug infections in the US. The agency’s recommendations are focused on nursing homes because a recently published study said inappropriate antibiotic use is prevalent at the facilities. Click here for the CDC report.


Recommendations Made to Boost National Precision Medicine Initiative

A group of tech and science leaders last week issued recommendations to NIH that envision recruiting a million participants for the Precision Medicine Initiative, and growing from there. The recommendations presume a certain facility with moving vast amounts of data across institutions. They assume that many participants will travel to health provider organizations and have their genetic and clinical information taken and uploaded, for later use by researchers. Click here for the report.


NIH: eCigarette Use by Teens Leads to Higher Use of Traditional Tobacco Products

A new study by the National Institutes of Health of high school students found that those who reported using electronic cigarettes by the time they started high school were more likely to report later use of traditional tobacco products. 31% of those who used e-cigarettes started smoking tobacco products as opposed to only 8% of teenagers who had not used e-cigarettes in the first 6 months of the study. The following 6 months found 25% and 9%, respectively, reported that they started smoking. Click here for the study. The National Park Service last week announced that e-cigarettes are now banned in any national park area where traditional smoking is prohibited. Click here.


Administration Launches First Food Waste Reduction Program

The Obama Administration last week announced an initiative to cut down on the amount of food American throw out. Spear-headed by the Department of Agriculture, the announcement called for the first-ever national food waste reduction goal program, calling for a 50-percent reduction by 2030. An average family of four leaves more than 2 million calories, worth nearly $1,500, uneaten each year. Click here for details.


Hospitals Leading the Way in Healthcare Hiring

The healthcare jobs market is booming, with hiring at hospitals leading the way, according to new data from the Altarum Institute’s Center for Sustainable Health Spending. The healthcare sector added 40,500 jobs in August. Adjustments to July added another 12,500 hires to that month’s figures. Through the first eight months of 2015, the healthcare sector has added 314,000 jobs–nearly double the 166,000 jobs it added during the first eight months of 2014. Click here for the report.


Poverty Rate Dropping in Most States

New Mexico almost surpassed Mississippi last year as the state with the highest percentage of its population living in poverty, although both states were among 34 along with the District of Columbia that experienced a drop in poverty rates. In Mississippi, 21.5 percent of the state’s nearly 3 million people lived in poverty, according to figures from the U.S. Census Bureau’s annual American Community Survey, out last week. New Mexico, with a population of nearly 2.1 million, followed at 21.3 percent. Click here to see how your state ranks.