Week of October 12-16, 2015


ACA Implementation
Before the Affordable Care Act went into effect last year, critics claimed it would lead to job losses and cuts in employee hours. But how is it really playing out? The dire predictions have so far proved to be unfounded, according to a new research paper from Federal Reserve Bank of New York economist Maxim Pinkovskiy. 
Read the research paper, The Affordable Care Act and the Labor Market: A First LookSecurity issues have been at the forefront of concerns about Healthcare.gov, and a recent government report highlighted problems with a massive federal database that stores exchange customers’ information.To address some of these concerns, Kevin Counihan, CEO of Healthcare.gov, announced that the marketplace is offering a new “Do Not Track” privacy management option, which allows users to opt out of any embedded third-party analytical trackers.  
Read this CMS announcement, Protecting Your Information at HealthCare.gov.

Weeks away from the Affordable Care Act’s third open enrollment period, a new Kaiser Family Foundation analysis finds nearly half (49% or 15.7 million) of the 32.3 million nonelderly people in the United States without health insurance at the beginning of 2015 are eligible for Medicaid or subsidized coverage through an ACA marketplace.
Read the report, Nearly Half of the Uninsured, or 15.7 Million People, Are Eligible for Medicaid or Subsidized Affordable Care Act Coverage, Analysis Finds. 

Health Care Operations and Management
This JAMA Viewpoint describes the shifts made by hospital networks toward a new type of surgical regionalization to improve surgical outcomes and overall clinical quality.Recently, 3 major medical centers—Dartmouth, Johns Hopkins, and the University of Michigan—declared a “volume pledge” that restricts performance of 10 selected procedures to surgeons and hospitals that meet volume criteria.  Hospital Networks and Value-Based Payment: Fertile Ground for Regionalizing High-Risk Surgery.  
Read the publication

Retail health clinics are one of several methods of health care delivery that challenge the traditional primary care delivery model. The positions and recommendations offered by the American College of Physicians in this paper are intended to establish a framework that underscores patient safety, communication, and collaboration among retail health clinics, physicians, and patients. 
Read this publication from the ACP, Retail Health Clinics: Executive Summary of a Policy Position Paper From the American College of Physicians, http://annals.org/article.aspx?articleid=2456135

CMS and Medicare/Medicaid
If currently enrolled beneficiaries stay in the same plan next year, average premiums are projected to rise to $41.46 per month, up from $36.68 this year. Many enrollees have access to plans that could lower their premiums or reduce their total drug costs. But, in a typical year, about 9 in ten Part D enrollees stick with the same plan rather than make a switch.
Read this research report from KFF,   Medicare Drug Plan Enrollees Would Face Average 13 Percent Premium Increase Unless They Switch Plans During Open Enrollment, New Analysis Finds

CMS’s voluntary and mandatory payment innovation programs are accelerating the transition to accountable payment models.  This infographic from the Advisory Board breaks down the 12 highest profile programs as of September 2015—learn how these programs disrupt the traditional fee-for service business model.  
View the field guide to Medicare payment innovation

CMS announced promising results of the first shared savings performance year for the Comprehensive Primary Care (CPC) initiative.  In 2014, CPC practices showed positive quality results, with hospital readmissions lower than national benchmarks and high performance on patient experience measures, particularly on provider communication with patients and timely access to care. CPC practices that demonstrated high quality care and reduced spending above a threshold shared in savings generated for Medicare.  
Read this announcement by Dr. Patrick Conway, CMS Deputy Administrator for Innovation and Quality and Chief Medical Officer, Primary care makes strides in improving quality and costs,

Population Health
This report from the New York Academy of Medicine charts trends in non-profit hospital spending on community health improvement as well as community building, and highlights investments that represent opportunities to advance population health, while assisting New York State in achieving the Triple Aim of improved care, reduced costs and better health.  
Read this research report “Community Benefit Investments by New York State Hospitals: 2012”   

Health Care Finance and the Market
Despite spending far more on health care than 13 other high-income countries in 2013, Americans had comparatively poor health outcomes, including shorter life expectancy and higher rates of chronic conditions.  Coauthors David Squires and Chloe Anderson of this Commonwealth Fund research found that higher spending appeared to be largely driven by greater use of medical technology and higher health care prices, rather than more frequent doctor visits or hospital admissions. In contrast, U.S. spending on social services made up a relatively small share of the economy relative to other countries. 
Read the research report, High U.S. Health Spending Likely a Result of More Technology, Higher Prices, New Analysis Finds

A jump in the number of new expensive drugs hitting the market — along with moves by drugmakers like Turing to raise the price on older and generic drugs — have helped make prescription drugs the fastest-growing segment of the nation’s health care tab. Two ideas for curbing that spending are surfacing:  Letting consumers buy products from other countries with lower prices set by government controls, and allowing Medicare administrators to negotiate drug prices.  
Read this article from Health Affairs, No Ready-Made Rx For Rising Drug Costs

Four companies running urgent care centers in New York have agreed to disclose more fully which insurance plans they accept, following an inquiry by the state’s attorney general that found unclear or incomplete information on their websites that could result in larger-than-expected bills for consumers.  
Read this article from KHN, N.Y. Attorney General Reaches Agreement With Urgent Care Clinics In First ‘Surprise Medical Bill’ Action

Quality in Health Care
One year ago, the author’s highlighted missed opportunities in diagnosis of a patient who presented with Ebola in Dallas, Texas; a harmful misdiagnosis with substantial public health implications. In this post, they speculate on possible scenarios if some of the recent IOM recommendations, specifically those related to EHRs, were in place before September 2014. 
Read this blog post from Health Affairs researchers, Time To Implement IOM Health IT Recommendations For Improving Diagnosis


Insurance Dropouts Present a Challenge for Health Law (New York Times)
State audit criticizes health exchange procurement practices (Baltimore Sun)
Baker would give hospitals the power to hold addicts.  (Boston Globe)
Brown OKs bill implementing state-paid healthcare for kids in U.S. illegally (Los Angeles Times) 
Health-Insurer Shutdown Jolts N.Y. Marketplace (WSJ)
Two more Obamacare health insurance plans collapse (Washington Post
The Wall Street Journal: New Push To Stop Overuse Of Antibiotics In Nursing Homes (WSJ)
A Focus on Falls: Hospitals Push to Improve Population Health (U.S. News and World Report) 
Little Growth Predicted on Health Exchanges (New York Times)
States That Declined To Expand Medicaid Face Higher Costs (NPR)
No Social Security Raises Even if Medicare Soars (New York Times)
UCF, HCA Partner For 550 New Residency Slots (Health News Florida)


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