November 21, 2016

(NOTE:  Have a wonderful Thanksgiving holiday.  This report will not be published next week.)

GOP’s Obamacare Repeal Strategy “Difficult”

A Republican plan to quickly repeal most of ObamaCare but delay the effects for up to two years is gaining steam on Capitol Hill. The plan would allow Republicans to deliver on promises to repeal the law in the next Congress while buying them time to come up with a replacement. But there’s a problem: If insurers know the law is going away, they might drop out immediately, causing chaos for enrollees before any replacement plan has time to take shape. Plus, the GOP may need 60 votes in the Senate should Democrats filibuster the move and the Republicans don’t have the votes.  Click here for one report.  Click here for another.

  • Now, a national coalition is forming to save Obamacare from repeal.  Click here.

Block Grant Medicaid?  Maybe, But More Strings Coming for Beneficiaries

Block granting the Medicaid program will likely lead to states getting less federal money, meaning fewer poor people will receive health insurance, according to at least one analysis. And with the GOP takeover of the White House, more strings are coming for Medicaid beneficiaries. Previously, states that have sought to impose work requirements, premiums or co-payments found their requests denied by the Obama administration. That’s likely to change under a Trump administration.  Click here for the NYTimes report.

CMS: Medicaid Drug Costs More Than Double in 2015

CMS released data on Medicaid and Medicare costs last week which showed that 20 drugs saw their unit costs more than double for Medicaid in 2015. Drugs with high year-over-year price increases included both brands and generics. Nine of the 20 drugs with the highest per unit costs were generic drugs including the antimalarial treatment hydroxycholoroquine sulfate, which rose by 489 percent. It’s also used to treat autoimmune diseases like rheumatoid arthritis. The drugs in the dashboard represent just 70 of the more than 6,500 products in the Medicaid drug program but accounted for about 41 percent of Medicaid outpatient drug spending in 2015. The dashboard numbers are based on prices paid to pharmacies, without the rebates. Click here for more on the Medicaid Dashboard, and here for the Medicare Dashboard.

Preventable Deaths Rise from Opioid Epidemic

More people died prematurely from unintentional injuries amid a growing opioid epidemic, new CDC research shows, going against a broader decline in preventable deaths from stroke, cancer, and heart disease. The agency estimates that avoidable deaths from unintentional injuries rose 23 percent between 2010 and 2014. The CDC research attributes much of the rise to drug overdoses. The increase came as the number of potentially preventable deaths from diseases like cancer and heart disease fell significantly, with premature cancer deaths dropping by a 23 percent over the four-year period. Early heart disease deaths fell 4 percent between 2010 and 2014, while stroke deaths declined 11 percent. Click here for more from the CDC.

1 in 7 Expected to Develop Substance Abuse Disorder: Surgeon General

In a report that marks the first time a U.S. surgeon general has dedicated a report to substance abuse, U.S. Surgeon General Vivek Murthy, MD provides an in-depth look at the science of substance use disorders and addiction. The report calls for a cultural shift in the way Americans talk about the issue and recommends actions that could prevent these conditions and promote recovery. According to the report, one in seven people in the United States is expected to develop a substance use disorder at some point in their lives, yet only one in 10 receives treatment. Click here to read the report.

Cancer May Surpass Heart Disease This Year as Leading Cause of Death

A new CDC report estimates that cancer could surpass heart disease as soon as this year as the top cause of death in the U.S. The researchers project that more than 591,000 cancer deaths in 2016, compared with 587,329 heart disease deaths, topping a changeover over the past few decades. According to the report, heart disease ranked as the leading cause for much of the last century, but its death rate has declined considerably over time and while the cancer death rate has also fallen, it has been not nearly as fast. To read the report, click here.

More than 20 Percent of ED Patients Treated Out-of-Network

Patients treated in emergency departments are often cared for by out-of-network doctors, hindering efforts to stop surprise medical bills, according to a new study.. The nationwide study of 2.2 million ED visits found that 22 percent of patients who went to in-network hospitals in 2014 and 2015 were treated by out-of-network doctors. The researchers estimated when out-of-network doctors billed commercial insurance for emergency services, they charged 798 percent of Medicare rates on average, versus 297 percent of Medicare rates charged by in-network physicians. Click here for a good NY Times story. Click here to view the study.

Hospital Star Rating Program Methodology Flawed:  New Analysis

CMS’ Overall Hospital Quality Star Rating program is coming under new criticism, with experts saying patients will find the ratings “confusing at best and misleading at worst.”   Methodology appears to be the problem. CMS uses 64 quality measures in seven categories to calculate its ratings. Three of the categories — mortality, readmission and patient safety — are weighted more heavily than the other four (effectiveness of care, timeliness of care and efficient use of medical imaging). Hospitals have to have a minimum of three measures within at least three of the seven measure groups, including one of the outcomes groups, to receive a rating.  The issue is that 40 percent of the hospitals that earned a five-star rating from CMS in July did not report enough data on mortality or readmissions. Click here for the report.

Why Does It Take So Long to Hire a Nurse?

Despite a shortage of nurses in the health workforce, there is a growing pool of potential candidates to fill open slots. Yet it can take healthcare organizations as long as 50 days to hire a registered nurse. There are several reasons for the hiring delays, according to a new Pew report. Many hospitals and healthcare systems seek out nursing job applicants with a bachelor’s degree or other advanced degrees, as well as work experience. Yet in some states, many nurses entering the workforce may need only their nursing license to apply for jobs.  In states like New York, for instance, registered nurses outnumber the available positions, so providers have raised the bar and now require a bachelor’s degree. Click here for the report.

FDC to Enforce Homeopathic Drugs Marketing Standards

The Federal Trade Commission issued a new enforcement policy statement on marketing claims for over-the-counter homeopathic drugs. The statement says the FTC holds the efficacy and safety claims for homeopathic drugs to the same standards as similar claims for non-homeopathic drugs. For the full memo from the FTC, click here.

Teen Birth Rate Continues to Fall: CDC

The teen birth rate has had an unprecedented decline since 2007, according to new CDC data. The biggest declines are in large urban counties and the smallest declines in rural counties. The states with the largest drop were Arizona, Massachusetts, Connecticut, Minnesota, and Colorado, all seeing a drop of 50 percent or more. Click here for more from the CDC.

Near Record Number Sign Up for Health Plan Coverage

Underscoring the difficulties the GOP may have in repealing Obamacare next year, in the first two weeks of Open Enrollment for the Health Insurance Marketplace for 2017, millions of people came to and shopped for health plan coverage. Over a million people selected plans using the platform since Open Enrollment began on November 1, including about 250,000 new consumers and over 750,000 consumers renewing their coverage.  Click here for the details from CMS.

ACA Fines on Employers Expected to Climb this Year

Employers are anticipated to pay $31 billion in penalties stemming from the Affordable Care Act’s employer mandate this year, according to a new analysis. That’s approximately 50 percent more than the original estimate by the Congressional Budget Office, and is nearly triple the amount of fines in 2015. One big reason for the forthcoming increase of the penalties is that companies that offer qualifying coverage to employees fail to meet the IRS’ reporting requirements to prove they are in compliance. Click here for the report.

Republican Urge Administration to Halt All Regulations

House Republican leadership last week sent letters to all federal agencies requesting they halt movement on regulations until the Trump administration takes office in January. The letter states that President Obama, earlier this year, said his administration would “do audacious executive action throughout the course of the rest of the year,” citing a Christian Science Monitor report. Legislators state that they will use their power under the Congressional Review Act to make sure the current administration heeds the request. To read the letter, click here.

WHO No Longer Considers Zika a Global Threat

The World Health Organization declared that Zika is no longer a world health emergency, cautioning the virus linked to devastating birth defects requires a long-term approach. By downgrading the emergency status for Zika, the organization will now shift to a longer-term approach to fighting the virus that has spread across Latin America, the Caribbean and beyond. For the announcement from the WHO, click here.