WEEKLY E-BULLETIN


Should Hospitals Be Exempt from Local Property, Income Taxes?  Debate Rages in Illinois

An Illinois appeals court decision has reopened a statewide dispute over whether hospitals should be exempt from paying millions of dollars in income taxes and property taxes to local governments. The Illinois 4th District Appellate Court ruled lat week that part of a 2012 law that allows hospitals to avoid taxes is unconstitutional.  Five hospitals have applications for tax exemptions before the revenue department: Peoria-based Methodist Services Inc. (two applications), NorthShore University Health System in Lake Forest, Mercy Hospital and Medical Center in Chicago and Swedish Covenant Hospital in Chicago.  Click here for the report from the Chicago Tribune.

2016 Brings Changes to Medicare Policies
Medicare is changing in 2016, with a number of new programs impacting patients and providers alike.  New payments for end-of-life counseling, ACO expansions, mandatory bundled payments for joint replacement are a number of the major changes going into effect this year.  Click here for a brief summary from the Washington Post.

  • A NYTimes report outlines the “hidden” financial incentives that result in shorter hospital stays.  Click here.

 S&P Report Casts Shadow on Health Insurance Mergers

Insurance mega mergers could present credit risks for the companies involved, according to a new report by Standard & Poor’s. Specifically, Anthem and Cigna could see their credit ratings downgraded by up to two notches, while Aetna could face a one-notch downgrade. That’s because the companies are taking on significant debt to finance the deals.  Click here for the S&P report.

  • Fitch is out with a report on its thoughts about the impact legislation that passed late last year will have on health insurers – and it’s not favorable.  Click here.

Shake-Up Continues at Nation’s Leading Health Insurance Association

Aetna becomes the second giant insurer to leave the America’s Health Insurance Plans (AHIP), the health insurance industry’s largest trade group, following UnitedHealth Group’s departure last June.  Aetna, the third-largest U.S. health insurer, said it wouldn’t renew its membership for 2016 with the  national association with almost 1,300 companies.  For more from the Wall Street Journal, click here.

Health Exchange Sign Up Surges


The Obama administration said late last week that 11.3 million people had signed up for health insurance so far during the Affordable Care Act’s third open enrollment period, with indications of a strong desire for coverage among young adults and others who were not enrolled last year.  About 8.6 million people have signed up or been automatically re-enrolled in the 38 states that use HealthCare.gov, the website for the federal insurance marketplace, federal officials said. In states running their own exchanges, 2.7 million people have signed up.  Click here for a state-by-state breakdown.  Click here for a good NYTimes report.

  • A UnitedHealth executive says New York’s health exchange could be in some trouble this year.  Click here.
  • The NYTimes reports that Obama Administration policies that create special enrollment categories are driving up the cost of care for insurers.  Click here.

 

Long-Term Care Liability Costs Increasing; LTC Economic Impact Growing

The cost of liability continues to increase in the long-term care sector, and tort reform has led to mixed results in terms of loss rates, according to a report from the American Health Care Association.  The overall national long-term- are loss rate is expected to increase by 5 percent annually, according to the report, which provides loss rates, or the cost of liability to skilled nursing care centers on a per-bed basis. The projected national 2016 loss rate, which is a combination of claim severity and frequency, is expected to increase from $2,030 to $2,150 per occupied bed. This means that a nursing center with 100 occupied beds can expect approximately $215,000 in liability expenses in 2016. Click here for the report.  To view the economic impact of long-term care facilities in your state, click here for a very good interactive national map.

CMS Launches $157 Million Demo to Connect Social Services and Providers

CMS will begin testing whether paying third parties to line up beneficiaries with social services improves care and reduces spending on clinical services. CMS hopes the demo convinces provider organizations, such as ACOs, to include social services in their strategies for keeping patients healthy. The pilot does not direct Medicare and Medicaid to pay for social services.  The five-year program, called the Accountable Health Communities Model, goal is to make a connection between social problems, such food insecurity, violence at home, poor transportation and housing issues with people’s health and have health care providers connect patients to social services.  Click here for the CMS announcement.  Click here for instructions on how to apply for the funds.

Mental Health Legislation on the Move in Congress

Two congressional committee mark ups and one hearing are expected on comprehensive mental health reform this month. The House Energy and Commerce Committee is planning to hold a full committee markup on Rep. Tim Murphy’s (R-PA) bill, H.R. 2646, the Helping Families in Mental Health Crisis Act of 2015.  The Senate Health Committee is expected to take up Sens. Bill Cassidy (R-LA) and Chris Murphy’s (D-CT) reform bill, S. 1945, the Mental Health Reform Act of 2015. The Senate Judiciary Committee is also expected to hold a hearing on Sen. John Cornyn’s (R-TX) mental health and criminal justice reform bill, S. 2002, the Mental Health and Safe Communities Act of 2015. For a good summary of H.R. 2646, click here.  For S. 1945, click here.  For S. 2002, click here.

CMS Finalizes Prior Authorization Process For Durable Medical Equipment

CMS last week issued a final rule establishing a prior authorization program for certain durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) items that are frequently subject to unnecessary utilization. CMS says the rule will require the same information that Medicare already requires to approve payment for DMEPOS, but that information will now be required earlier in the process.  Click here for a CMS summary.  Click here for the final rule.

Obama Vetoes Affordable Care Act Repeal Bill, Readies State of the Union

The President vetoed only his eighth bill, which was a GOP effort to repeal major elements of the Affordable Care Act. The measure (HR 3762, the Restoring Americans’ Healthcare Freedom Reconciliation Act of 2015), cleared the Senate before the holidays and the House on Wednesday.  The bill is the first health care related measure vetoed by President Obama. Click here for a summary of the legislation.  Meantime, the President will deliver his final budget on February 9th, missing the statutory deadline by about one week.  He will then outline his budget Tuesday evening’s State of the Union.  Click here for a preview from the White House.

Hospitals Safer than Home for Birthing Babies: Study

A new study, which involved more than 75,000 low-risk births in the state in 2012 and 2013, found the risk of death for the baby appears to be twice as high when mothers planned to deliver at a birthing center or at home compared with when delivery was intended for a hospital. But in any location the overall risk to the child is very low, the study showed.  Out of every 1,000 babies whose mothers planned to deliver at home or at a birthing center, 3.9 died just before, during or in the month after labor, the study found. In comparison, 1.8 out of every 1,000 babies died when the births were planned for a hospital.  Click here for details.

Hospitals’ Mobile Health Apps Could Be Big Revenue Producers

While 66 of the 100 largest hospitals in the United States offer consumers’ mobile health apps, only 2-percent of patients are actually using them, according to a report published last week.  The analysis also found that failure to focus apps on services consumers want most could cost each hospital more than $100 million a year in lost revenue.  Click here to read the report from Accenture.

Cancer Deaths Fall to Lowest Rate in 20 Years

Cancer deaths have fallen to their lowest rate since the numbers peaked in 1991, according to new research from the American Cancer Society.  The 2012 cancer death rate in the United States was 166 deaths per 100,000 people, compared to a high of 215 deaths in 1991, and experts said there’s a number of factors that play into that. The smoking rate in the United States has dropped dramatically in recent decades, and, at the same time, medical advances mean some cancers can be caught earlier or treated more effectively.  Click here for more.

Sugar Is Out, Red Meat Is Spared: New Gov’t Dietary Guidelines Released

Many New Year’s resolutions involve diet.  So, just in time, the Obama administration has just released its much-anticipated update to the Dietary Guidelines. The guidelines, which are revised every five years, are based on evolving nutrition science and serve as the government’s official advice on what to eat. One important change: Americans are being told to limit sugar to no more than 10 percent of daily calories. However, bucking an earlier advisory committee recommendation that advised telling Americans to cut back on red and processed meats — after a vigorous challenge from the meat industry — the final dietary guidelines do not include any specific advice to cut back on these sources of protein.  Click here for the new guidelines from HHS.

CDC:  We Consume Too Much Salt

An analysis appearing in last week’s CDC Morbidity and Mortality Weekly report reveals that 89 percent of U.S. adults were consuming more than the recommended 2,300 milligrams of sodium a day in the years 2009-2012.  On average, men between the ages of 19-51 consumed about 4,400 mg a day, while women were getting about 3,100 mg a day, according to the CDC report. The numbers were slightly lower for adults 51 and over. Some 90 percent of U.S. children of all ages also far exceeded the recommended daily amounts for their age groups. For example, boys and girls ages 9-13 consumed about 3,300 mg and 3,000 mg respectively, well above the 2,200 mg a day deemed healthful for them.  Click here for the CDC report.

Financial Incentives for Employees Didn’t Result in Weight Loss: Study

Promising workers lower health insurance premiums for losing weight did nothing to help them take off the pounds, a recent study found. At the end of a year, obese workers had lost less than 1.5 pounds on average, statistically no different than the minute average gain of a tenth of a pound for workers who weren’t offered a financial incentive to lose weight.  The study, published this month in the journal Health Affairs, reported the results of a year-long randomized controlled trial to test the effectiveness of financial incentives to encourage weight loss among 197 obese employees of the University of Pennsylvania health system.  Click here for details.

The Future of the Stethoscope in Doubt?

The future of the stethoscope is now in question.  Technology advances are now raising questions as to whether the historic medical tool will begin to fade away.  Click here for this interesting story.