17 Feb February 17, 2020

Healthgrades Reveals Best Hospitals Award for 2020
Healthgrades last week announced the recipients of the America’s 50, 100 and 250 Best Hospitals Awards™ — which represent the top 1, 2 and 5 percent of hospitals in the nation.  Healthgrades analyzed the performance of nearly 4,500 hospitals nationwide across 32 conditions and procedures, including heart attack, heart failure, pneumonia, respiratory failure, sepsis and stroke. Overall, patients treated in hospitals named as America’s Best Hospitals have, on average, a 26.6 percent lower risk of dying than if they were treated in hospitals that did not receive this award. If all hospitals, as a group, performed similarly to America’s Best Hospitals, 161,930 lives could potentially have been saved, according to Healthgrades.  Click here to see the list of all hospital recipients.

Two Different Surprise Billing Bills Move Through Committees
Two House Committees – Ways and Means, and Education and Labor – voted two very different bills last week, while the White House weighed-in on the debate expressing concerns that “overusing” arbitration will raise healthcare costs. The House Ways and Means version would require insurers and providers to enter a 30-day negotiation period before moving to a baseball-style arbitration and does not include government rate setting. The House Education and Labor version uses a benchmark payment rate for out-of-network charges and allows providers and insurers to move to arbitration for charges above $750. Education and Labor has jurisdiction over ERISA (self-insured) plans and its version is very similar to the compromise reached in December between the Chairmen of the House Energy and Commerce Committee and the Senate HELP Committee. The Ways and Means and Education and Labor bills have an effective date of 2022. The Congressional Budget Office says the Ways and Means bill as saving $17.8 billion over 10 years. An estimate of the Education and Labor version saves approximately $24 billion over 10 years. House leadership has indicated they would like to bring surprise billing legislation to the floor week after next. There does not appear to be a decision about the contents of any final bill. The Senate has not indicated its intentions. Click here to review H.R. 5800, the Education and Labor bill and here for the CBO analysis. Click here for a link to the Ways and Means bill, H.R. 5826, and here for the CBO analysis.

• Sen. Bill Cassidy (R-La.), a physician and member of the Health Committee, said much of the current surprise billing legislation is too friendly to health insurers. Click here.
• A JAMA study finds 20.5 percent of patients who plan elective surgeries with in-network doctors at in-network facilities have received a surprise medical bill, click here.
• The number of people struggling to pay medical bills has fallen by 5.5 percent since 2011, but more than 14 percent of Americans still had problems in 2018 with women, children and black Americans more likely to struggle than males, adults and other racial and ethnic groups, click here.

HHS Finds 40% Jump in Diagnoses of Deadly Blood Infections
Diagnoses of deadly blood infections jumped 40 percent in Medicare patients over seven years, according to a major study released last week. Treating sepsis, in which the body emits a flood of toxic chemicals into the blood to fight an infection, cost Medicare more than $41.5 billion in 2018, up from $27.7 billion in 2012, according to the study, the largest ever done with Medicare claims data. Forty percent of patients with the most severe form of sepsis die in the hospital or within a week of being discharged.  Click here for the analysis.

5-Year Trend Shows Employer, Employee, and Family Health Care Spending at All Time High
Health care spending for people insured through their employers hit an all-time high of almost $6,000 per person in 2018 mostly do to higher prices for services, according to the Health Care Cost Institute’s utilization and cost report. The data shows that per-capita health spending for the 160 million Americans in employer-sponsored health plans grew by 4.4 percent in 2018, the third consecutive year of increases above 4 percent. Three-quarters of the rise in costs was directly linked to hospitals, doctors, drug companies and others raising prices. These statistics are based on analysis of more than 2.5 billion claims by about 40 million people that showed that utilization is also up by 3.1 percent over the five-year period reviewed. To read the report, click here.

• U.S. News has created the U.S. News Health Care Index which shows that though costs continues to rise each year, the rate of growth is slowing dramatically and unexpectedly, click here.

Court Strikes Down Medicaid Work Requirements Again
A federal appeals court last week ruled against Trump-approved Medicaid work requirements in Arkansas, the latest legal setback to the administration’s efforts to remake the safety net health care program. A three judge panel in a unanimous ruling said HHS didn’t have the authority to require some Medicaid enrollees to work in order to receive coverage.  The decision, which upheld a lower court ruling against the work requirements, brings the Trump administration’s Medicaid overhaul closer to possible review from the Supreme Court. Click here for the ruling.

Health Experts: Don’t Delay EHR Interoperability Rule
Pushing back against Epic’s push to delay the rule proposed by the Office of National Coordinator on interoperability, a group of health care experts is urging HHS to move forward with the rule. Over the past month, EHR giant Epic encouraged providers to contact HHS to seek a delay of the final rule that they contend will create privacy concerns for patient records and increase workloads for providers and health IT professionals. In a blog post, the experts conclude that the rule “will improve a patient or caregiver’s ability to obtain their total health record, and the ONC rule will not make the current consumer privacy protections worse.” Click here for the blog post, and here for the rule.

White House: Other Countries Suppress Drug Prices and Keep U.S. Prices Higher
Other countries are taking unfair advantage of American drug company research and U.S. consumers by artificially suppressing drug prices leading to higher costs,  according to a new report by the White House Council of Economic Advisers. The study compared prices of 200 top-selling brand drugs in U.S. and 15 other developed nations and found that European prices are 32 percent of U.S. prices and the difference has widened since 2003, when they were 51 percent of U.S. prices.  The report suggests that instead of the U.S. paying less, prices should be raised abroad, even as the Administration and Congress work to reign in prescription drug costs. Click here for the report.

Hospice Oversight Legislation Sent to the House Floor
With a unanimous vote, the House Ways and Means Committee sent, H.R. 5821, the “HOSPICE” Act, legislation intended to reform hospice by increasing the authority of HHS and CMS to penalize low-quality Medicare hospice providers, to the full House for a vote. The bipartisan bill would allow CMS to fine hospices $10,000 for each day they don’t meet Medicare requirements, and appoint temporary management of, suspend payments to, or, in the most extreme case — where Medicare beneficiaries are in jeopardy of harm — terminate the Medicare certification. To review the bill, click here.

Health Systems Spending More on Social Determinants
Social determinants of health such as housing, education and access to healthy foods, involved at least $2.5 billion of health system funds, the bulk of which focused on housing insecurity ($1.6 billion) and employment ($1.1 billion), according to a new study. However, because the recent trend of health systems getting involved in community programs is so new, it is difficult to measure the impact of these programs on health outcomes or on the collective return on investment. And only 57 of the country’s 626 health systems committed funds to address social determinants directly. Click here for the study.

• A new NIH study suggests that risk for type 2 diabetes may be lowered for women with gestational diabetes if they breastfeed, click here.
• CMS Administrator Verma announced a Request for Information seeking public comments on rural maternal and infant health care. Comments are due April 12, click here.

FCC’s $100 Million Telehealth Rule To Be Final Soon
The proposed three-year, $100 million telehealth pilot program will be finalized soon, according to FCC Commissioner Brendan Carr. The rule, proposed last summer, would direct funds to virtual care programs that target low-income patients, including those on Medicaid and veterans receiving cost-free care. The pilot is designed to support a “limited number of projects,” and would “measure and verify the benefits, costs, and savings associated with connected care.” To review the proposed rule, click here.

• CMS loosens restrictions on telehealth for ACOs participating in a Medicare Shared Savings Program that is under two-sided risk and that have selected prospective payment, click here.

Texas Group Petitions To Boost Hospital Transparency Regulation 
The Texas Public Policy Foundation has joined fellow conservative groups including Patient Rights Advocate in a petition to boost the Administration’s case for health care price transparency regulations. This petition has gained support to force hospitals to disclose their standard charges made to insurance companies. A press release is available here. The amicus brief is available here.

Ransomware Attacks Continue Against Hospitals
There have been 172 ransomware attacks in total affecting 1,446 hospitals, clinics, and other health providers as well as 6,649,713 patients, according to a new study.  Ransomware attacks are of growing concern to a number of sectors, but can be especially difficult for healthcare organizations that require access to records to treat patients. In the newest study, researchers determined the downtime caused by an attack could last months and came at a cost of $157.9 million for the 172 facilities attacked in recent years. The new study also found that California and Texas were hit with the most attacks. Click herefor the study.

Medtronic Recalls Insulin Pumps After Several Injuries and One Death
Medtronics recalled two types of their MiniMed 600 series insulin pumps due to device malfunctions. Medtronic stated these devices had missing or broken retainer  rings that were pumping incorrect insulin doses which could cause hyperglycemia or hypoglycemia. These retainer rings help lock the insulin cartridge in place and may break if hit against a hard surface. Last week, the FDA identified this as a Class I recall, the most serious type. The FDA says there have been 26,421 complaints of device malfunction, 2,175 injuries, and one death. The company has already recalled 322,000 devices. Click here for the FDA announcement.

• A new CDC study reveals that type I and type II diabetes have risen in recent years among youths especially those in ethnic and racial minority populations, click here.

FDA Calls for Withdrawal of Weight Loss Drug Belviq 
The weight loss drug, Belviq, by the company Eisai Co., has recently been pulled from the market after a trial finds a link between the drug and cancer. The U.S. Food and Drug Administration announced that after reviewing clinical trials results, they requested that Belviq and Belviq XR be removed from the market because of potential increased cancer risks. While the weight loss medication was approved by the FDA in 2012, the Administration continues to evaluate the drug. With this ongoing investigation, the FDA wanted to educate the public about the potential risks. Click here for the FDA’s announcement.

For Better Health: Keep Daylight Time or Scrap It?
State legislatures are increasingly seeking to end the annual clock change and choose one permanent time, with more than 200 state bills filed since 2015 to either keep summer hours or go to permanent standard time. The U.S time change, especially in the spring, has been blamed for increases in heart attacks and traffic accidents as people adjust to a temporary sleep deficit. A German study of autopsies from 2006 to 2015, showed a significant uptick just after the spring switch in deaths caused by cardiac disease, traffic accidents and suicides. Researchers have also noted a significant increased risk for heart attacks and strokes. The primary question with ending clock changes is — which time will become permanent in the U.S.  States have historically favored permanent daylight time while biological rhythm experts favor permanent standard time. Click here to read more.