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Industry News

Opposition to Cadillac tax turns foes into allies

The next big Affordable Care Act battle is brewing, and business and labor are on the same side. At issue? The "Cadillac" tax, which goes into effect in 2018. This 40 percent excise tax on the health benefits companies provide their workers above a certain threshold is already an issue for companies trying to plan employee benefits, Politico reports. (Politico)



Feds issue rules for mental health parity in Medicaid, CHIP

Monday, federal officials released a long-awaited rule proposing how the mental health parity law will apply to Medicaid managed care and the Children's Health Insurance Program. It may be easier said than done: The new rule "will not be enough to overcome all of the barriers that patients face in accessing care, including an insufficient number of in-network providers," warns Emily Feinstein, the director of health law and policy at substance abuse and addiction center CASAColumbia. (Kaiser Health News; the rule)



For consumers, cost growth is anything but slow

Overall, national spending on health care and premiums has risen more slowly than in the past, but consumers aren't feeling it, according to a Wall Street Journal blog post by Drew Altman of the Kaiser Family Foundation. Only 3 percent said health costs had been rising slower than usual; 52 percent said they had been growing faster, he reports. It's not their imaginations: Premiums for those with employer-based insurance have risen 212 percent in the last 15 years. Wages have risen 54 percent, inflation 43 percent. Deductibles and other forms of cost-sharing have also risen steadily, as have drug prices. (WSJ blog )


Innovation & Transformation

Pilot program aims to improve diabetes management

UnityPoint family medicine has initiated a pilot program to help diabetes patients better manage their blood sugar on their own, working with a care manager. Using electronic health records, the program targeted patients whose A1C levels were out of control despite receiving quality care. Results to date have been positive and the program is being expanded. (The Des Moines Register)


Pilot uses social services to eliminate avoidable hospitalizations

More than 11 million Americans have become eligible for Medicaid since the Affordable Care Act went into effect, and health systems are vying to find a way to manage costs. A pilot program in Hennepin County, Minn. is focusing on about 10,000 "super-utilizers," all of whom are poor; many are homeless. The program seeks to eliminate avoidable hospital use by using social services to help people before they require hospitalization: for example, treating eviction as an emergency and helping the homeless find a place to stay. (The New York Times)


Gilfillan on importance of aligning public, private VBP efforts

Richard Gilfillan, MD, president and CEO of Trinity Health in Livonia, Mich., recently discussed the impetus behind the Health Care Transformation Task Force, which he chairs. This group of providers, payers, purchasers and patient groups seeks to align private and public sector efforts to advance value-based purchasing."We felt there was a real opportunity to bring together a group of organizations from multiple segments and work together," he tells Hospitals & Health Networks. "We think it's critical to align the efforts of both the public and private sectors. By working together, we could actually accelerate the timeline and become more successful." (Hospitals & Health Networks) 


Consumers & Providers

New AHRQ paper explores health IT in primary care

The Agency for Healthcare Research and Quality has issued a white paper on health IT best practices for primary care practices to bolster adoption of the technology and to improve quality of care. Currently, health IT is underused for supporting quality improvement in primary care; one factor is that users have not mastered advanced functions. The paper offers recommendations to overcome that failing. "The effective use of health information technology by primary care practices to facilitate quality improvement can help practices improve their ability to deliver high quality care and improve patient outcomes," according to the paper. (Health Data Management; AHRQ paper)


Paper looks at the downside of HDHPs--care avoidance and financial ruin

The Charlotte Observer recently looked at the increased prevalence of high-deductible health plans. HDHPs are, in theory, supposed to turn patients into savvy health care consumers. But even though such cost-sharing does reduce spending, patients are just as likely to skip necessary treatment as they are to avoid unnecessary or overpriced care, according to experts, the Observer reports. And for some, the high deductibles end up being a financial disaster. (Charlotte Observer

Despite increased cost-sharing, HSA contributions on the decline
Consumers are taking on an increased share of health care costs, but they're contributing less to health savings accounts, according to research from the Employee Benefit Research Institute. Between 2011 and 2014, the percentage of people who said they contributed nothing to their HSAs more than doubled, to 23 percent. The percentage who said they contributed $1,500 or more dropped to 30 percent from 44 percent. Employer contributions dipped as well, with 67 percent of workers saying they received employer contributions to an HSA or a health reimbursement arrangement in 2014, vs. 71 percent in 2013. (Kaiser Health News; EBRI study)


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New & Noted   

Nebraska NPs win: In March, Nebraska became the 20th state to grant full practice authority to nurse practitioners. Several other states are considering similar legislation, including California, Illinois, Kansas, Maryland, Texas, South Carolina and Pennsylvania. (HealthLeaders Media)



MedPAC to CMS: Lose the two-midnight rule: CMS should withdraw its two-midnight policy and target Recovery Audit Contractor reviews to hospitals with the most short inpatient stays, the Medicare Payment Advisory Commission said in final recommendations approved last week. (AHA News Now)



Documentarian travels the country looking at health care transformation

In this 90-minute documentary, filmmaker David Grubin--the son of a general practitioner--takes his camera across America to focus on the challenges and triumphs in our country's health care delivery system. The four segments that comprise Rx: The Quiet Revolution introduce us to a diverse group of doctors, nurses and health care professionals who are transforming the way we receive our medical care: lowering costs by placing the patient at the center of their practice. (Rx: The Quiet Revolution)

MarketVoices...quotes worth reading


"I think these high-deductible plans are going to become more the norm. They do reward folks who take good care of themselves," -- Joseph Piemont, chief operating officer for Carolinas HealthCare.


"I'm still a skeptic. It penalizes those who don't have the money to go to the doctor or get that prescription filled." -- Cathy Graham, benefit services director for The Employers Association, a Charlotte-based human resources firm


--two employer/HR perspectives on HDHPs, quoted in The Charlotte Observer  

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Wednesday, April 8, 2015































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