Weekly E-bulletin

Top 100 Hospitals Names by Truven

Truven Health Analytics has released its annual study identifying the 100 Top U.S. hospitals based on their overall organizational performance. The annual five-year trend analysis found significant improvement for U.S. hospitals on a number of key quality measures, such as inpatient mortality and complication rates, 30-day readmissions, and lengths of stay. It also found costs were held flat for the majority of U.S. hospitals. The time period analyzed, 2011 through 2015, coincides with the hospital industry’s initial adoption of value-based care. Click “here”:http://100tophospitals.com/studies-winners/100-top-hospitals/year/2017 for the top hospital lists. Click “here”:http://100tophospitals.com/news-events/detail/prid/205/truven-health-analytics-ibm-watson-health-announces-100-top-hospitals-award-winners for Truven’s press release.

  • Healthgrades released its top hospital list a few weeks ago.  Click “here”:http://www.healthgrades.com/quality/top-hospitals-2017 to review.
24-Hour Work Shift OK’d for 1st Year Docs by ACGME

First-year doctors will be allowed to work 24-hour shifts in hospitals across the United States starting July 1, when a much-debated cap that limits the physicians to 16 consecutive hours of patient care is lifted, the organization that oversees their training announced Friday.  Click here to read the ACGME announcement.  Click “here”:http://www.washingtonpost.com/news/to-your-health/wp/2017/03/10/first-year-doctors-will-be-allowed-to-work-24-hour-shifts-starting-in-july/?utm_term=.742321ea665e for the Washington Post story.

CBO Score This Week Could Dramatically Alter Health Care Repeal Effort

The Congressional Budget Office is set to release as early as today its analysis of the House GOP’s legislation to repeal and replace the Affordable Care Act.  The CBO “score” is likely to show millions of Americans losing their coverage if the American Health Care Act becomes law.  It could also show an additional cost to taxpayers because the legislation repeals almost all the taxes included in the ACA.  The Brookings Institute says it calculates that 15 million Americans will lose coverage.  Click here for their analysis.  Click here for a very good NYTimes report on the growing political complications in moving the legislation.  Click here for another report on why many in the GOP are leaning against the bill.
Assuming all Democrats will vote against the repeal bill, Republicans can lose only 21 votes in the House and still pass it.  Click here for the current list of those against or leaning against the legislation.
Interactive Map Shows Differences Between ACA and Replacement Plan
Kaiser Family Foundation set up a new set of interactive maps contrasting county-level estimates of premium tax credits that would be available under the Affordable Care Act in 2020 with what they’d receive under the GOP replacement legislation. To view the interactive map, click here.

Major Health Care Organizations Announce Position on ACA Repeal Bill – Most Oppose

American Hospital Association – Click here for their letter.
American Medical Association – Click here for their letter.
American Nurses Association – Click here for their letter.
AARP – One of the senior group’s biggest concerns is the change in the age rating from a 3:1 ratio to a 5:1 ratio. This will, according to their analysis, significantly increase premiums for AARP members. Click here for the letter.
Some GOP senators have raised serious concerns – Click here for their letter.
Some GOP governors have announced their opposition.  Click here.
Conservative groups are opposing the bill because it doesn’t fully repeal the ACA – Click here for the statement from Heritage Action.
The only major organization announcing its support is Anthem – click here for their letter.  However, the nation’s leading trade association for the insurance industry is opposed to the bill.  Click here.
The bed tanning industry also supports the bill.  Click here.
– In one of its lesser known provisions, the bill would also drop the addiction treatment mandate covering 1.3 million Americans. Implications for the opiate epidemic would be significant. Click here for the story.

HHS Secretary Promises Regulations for State Medicaid Flexibility

HHS Secretary Tom Price in an interview Friday promised that he will use regulatory power to provide states with more flexibility to change their Medicaid programs. His statement is seen as a assurance to help appease conservatives who are unhappy that the GOP’s ACA repeal doesn’t provide states with greater authority to tailor their Medicaid programs. The Trump administration and GOP leaders say their repeal bill is limited by strict budget rules and have promised to make additional changes through regulatory action and future legislation. Click here to view the full interview.

Tort Reform Legislation Moving Forward

House Republicans have moved forward a series of bills that would make changes to the civil justice system long sought by doctors and U.S. corporations, including a cap on some medical malpractice awards and new roadblocks for classes of people seeking to sue jointly to address harm. Civil rights and consumer groups oppose the measures, saying they would severely limit the ability of average Americans to pursue legal remedies from powerful institutions. Click here for the report.

House Committee Moves More Health Reform Bills

The House Education and Workforce Committee last week advanced, along party lines, three health care bills separate from the GOP’s ACA repeal effort however, the health care law repeal dominated the discussion. The measures include:
H.R. 1101, Small Business Health Fairness Act of 2017, would allow small businesses to group together and offer health coverage through association plans;
H.R. 1304, Self-Insurance Protection Act, would clarify rules on employee wellness programs; and
H.R. 1313, Preserving Employee Wellness Programs Act, a bill intended to protect self-insured plans from federal regulation.  Click here for the NYTimes report.
All three measures were opposed by Democrats, who used the majority of the debate time to blast the ACA replacement marked up by the Energy and Commerce and Ways and Means committees. Click here to view the markup for H.R. 1101, here for H.R. 1304 markup, and here for H.R. 1313.

CMS Nominee Slated for March 13th Confirmation Vote

Seema Verma’s nomination to be the next CMS Administrator cleared a major procedural hurdle in the Senate last Thursday on a 54-44 vote. The Senate is scheduled to vote on her confirmation at 5:30 p.m. today, when she’ll likely be approved to run the expansive federal agency. As an Indiana-based health consultant, If confirmed as CMS administrator, Verma would also oversee efforts to work with states on revamping their Medicaid programs, as well as major changes to Medicare payment policy under MACRA. For more from The Hill, click here.

Insurers, Rx Companies Fight Over Cost of Drugs

Prescription drugs are the single largest expense of a consumer’s health care monthly premium, according to a new report. The nations largest insurance association (AHIP) says prescriptions account for more than 22 percent of every dollar including drugs purchased at the pharmacy and those administered by doctors, but not for drugs administered during a hospital stay.  To counter those claims, the Biotechnology Innovation Organization launched a new interactive website, disputing those facts. For example, BIO’s interactive tool calculates the impact a prescription drug has on private insurance rates by demonstrating that a new drug that costs $1,000 per month and is taken by 100,000 U.S. patients would only increase premiums $0.56 a month. Click here for the AHIP site, and here for the BIO site.

New CMS Requirement Would Curtail Morphine Prescriptions to Seniors

A group of pain and addiction specialists are pushing back against the federal opioid crackdown by asking CMS to withdraw a notice that would make it extremely difficult for Medicare patients to get painkiller prescriptions above a certain strength. More than 80 physicians, including four who helped create the 2016 CDC guidelines on opioid prescribing, wrote to CMS about the notice, which would require pharmacists to refuse prescriptions over 90 milligrams of morphine or its equivalent unless the patient first went through a complex, time-consuming review. Click here to read the CMS notice that was published in February.

White House Calls for Preliminary Costs of Upcoming Regs by End of March

The White House has asked federal agencies to submit a preliminary estimate of total costs or savings for fiscal 2018 regulations to be included in the spring 2017 Unified Agenda as yet another step to revamp the regulatory system. In a memorandum signed by acting Office of Information and Regulatory Affairs, the White House also asked agencies to limit their regulatory entries to those rules they expect to act on in the following 12 months. Pointing to the President’s Executive Order on ‘Reducing Regulation and Controlling Regulatory Cost,’ the memo states that agencies should ensure the total costs of significant regulations are fully offset. Click here to view the memo.

Health Care Adds Nearly 27,000 Jobs Last Month

Just over 10 percent of total job growth in the month of February was in the health care sector or about 26,800 health care jobs. Physician offices and hospitals saw the largest employment growth, accounting for nearly half of all new jobs. The home health industry also added more than 4,000 workers to the rolls. Health care job growth was actually down slightly, from an average of 30,000 jobs added over the last year. To see the jobs report, click here.

Hospital Medical Surplus Could Be as Much as $765 Billion a Year

A surprising source adding to the costs of health care is the “medical surplus,” or usable supplies that hospitals throw out, according to a new report. Medical supplies that are in perfect, usable condition are often put out in the trash by health care facilities, reports ProPublica. The waste adds up to an estimated $765 billion a year, according to a 2012 report by the National Academy of Medicine. According to the report, materials are often thrown away as soon as updated models come into the industry, if a hospital changes vendors, or if certain supplies reach their expiration dates and are thrown away due to infection control regulations. Click here for the full report.

Sites Rating Physicians Don’t Make the Grade

Patients increasingly consider online reviews important when they’re choosing healthcare providers, but research published in JAMA finds that the websites they’re using aren’t very good. Searches for physicians were conducted on 28 commercial physician-rating websites, and the average and median number of reviews per physician per site were calculated. The researchers found that in general, these websites’ search mechanisms are cumbersome and reviews are scarce. The researchers acknowledge that the study has limitations. To read the study in JAMA, click here.

Thyroid Cancer Patients Who Forgo Treatment Face Stigma: Study

According to a new study from the Dartmouth Institute, a rising proportion of thyroid cancer patients are choosing not to receive treatment and are feeling spurned and isolated as a result. Researchers examined 22 individuals who are foregoing treatment, due to the fact that the cancer is unlikely to progress, with most reporting that they kept the diagnosis a secret for fear of being criticized. Only three of the subjects said they enjoyed a good support system to help deal with their cancer experience. To view the study, click here.

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