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Industry News
In a recent report, Surviving seismic change: Winning a piece of the $5 trillion US health ecosystem, PwC explored where the U.S. health industry is headed over the next decade. It identified key trends, including consumerism, value-based payment, wellness and health management, and decentralization. Among the observations: Value-based payment will reduce traditional growth opportunities. But that's not the case for primary care. It's an ideal growth area--especially given the potential to use broadband and digital health tools to decentralize care delivery. (PwC; Health Populi)

Monday, the Centers for Medicare & Medicaid Services announced the Comprehensive Primary Care (CPC) initiative's second round of shared savings results. Ninety-five percent of practices met quality of care requirements and four of seven regions shared in savings. These results reflect the work of 481 practices that served over 376,000 Medicare beneficiaries and more than 2.7 million patients in 2015. CPC generated $57.7 million gross savings in Parts A and B expenditures. The four regions--the states of Arkansas, Colorado and Oregon, and the Greater Tulsa region--realized net savings and will share in those savings with CMS. (The CMS Blog)
Innovation & Transformation  
Medication management services provided by specially trained hospital and community pharmacists yielded dramatic results, according to research published in the Journal of the American Geriatrics Society. "The Pharm2Pharm model was associated with an estimated 36 percent reduction in the medication-related hospitalization rate for older adults and a 2.6:1 return on investment, highlighting the value of pharmacists as drug therapy experts in geriatric care." University of Hawaii and its partners designed Pharm2Pharm to reduce preventable medication-related hospital care by strategically deploying the medication expertise of pharmacists across the continuum of care. (Journal of the American Geriatrics Society)
Despite 70 percent of large companies offering telemedicine benefits and only 3 percent of their employees using the benefit in the first half of the year, more companies are adding telemedicine as a way to lower health care costs and increase worker productivity. Reasons why more don't take advantage include lack of awareness, concern about an accurate diagnosis and "some people are just more comfortable calling their doctor," says Laura Sears, chief administrative officer of Gould & Ratner. (Chicago Tribune)

To better align prescription drug plan and government financial interests and create incentives for investment and innovation, CMS has chosen six organizations--including CVS Health, UnitedHealth and Humana--to participate in a new Part D enhanced medication therapy management model. Drug plan beneficiaries can opt out of the enhanced therapy management services at any time but stand to benefit because the price or number of medications they are on could be lowered. The five-year model begins January 1, 2017 in selected regions of Virginia, Florida, Louisiana, Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota, Wyoming and Arizona. (Healthcare Finance)
Consumers & Providers
Most women in a new U.S. survey said their primary care physician was involved in their breast cancer care during treatment, and rated their doctor's engagement and communication levels as high. "[W]e were surprised that the majority of women in our study also reported high levels of engagement and communication with their PCP during cancer treatment, when the care is typically focused primarily on treating the cancer," says lead author Lauren P. Wallner of the University of Michigan in Ann Arbor. However, higher primary care physician involvement generally did not result in increased satisfaction with treatment decisions. (Reuters; Journal of Clinical Oncology)
Even though doctors are encouraging patients to talk about mental health issues, they aren't disclosing their own issues, according to research published in General Hospital Psychiatry. About half of the 2,100 female doctors surveyed said they met the criteria for a mental illness at some point in their career; two-thirds of them didn't report it out of fear of stigma. One participant went so far as saying, "I would never want to have a mental health diagnosis on my record." (FierceHealthcarestudy)
Consumers whose insurers have left the state and federal health insurance exchanges will have their replacement insurer chosen for them by the federal government unless they opt out of the ACA exchanges or actively choose their own plan. With so many insurers pulling out of the marketplace, there's concern that those who remain will not be able to deliver quality services. Kevin J. Counihan, chief executive of the federal insurance exchange, says this automatic switch will promote "continuity of coverage and the availability of subsidies through the marketplace." (The New York Times)
Between 2007 and 2015, hospice care spending by Medicare increased 52 percent mainly due to the increase in the number of hospice care patients. John Hargraves, social science research analyst, and Niall Brenna, chief data officer and director, Office of Enterprise Data and Analytics at the Centers for Medicare & Medicaid Services, reported in an October Health Affairs article that they found "significant geographic variation in hospice spending, with high-cost regions having average per patient spending more than three times that of the spending in low-cost regions. We also found that recent growth in hospice spending varied substantially by patient diagnosis." (Medscape; article)
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New & Noted   
ACA supporter voices concern: Democratic Gov. Mark Dayton of Minnesota last week stated that plans on the ACA exchanges are "no longer affordable" for many. His criticism comes as his state faces massive rate hikes and shrinking competition in the insurance exchanges. It's notable because he was, only a few years ago, a staunch supporter. (Politico)

Psych patients wait much longer:  Psychiatric patients wait much longer in emergency departments before receiving treatment compared to other patients, according to research from the American College of Emergency Physicians. (Modern Healthcare; ACEP)

MACRA release: Friday, CMS released the final rule for its Merit-based Incentive Payment System under a final rule the CMS issued for implementing the Medicare Access and CHIP Reauthorization Act. It also launched a site to help explain it: qpp.cms.gov/. (Healthcare Dive)
Zurich North America's 783,800-square-foot headquarters in Schaumburg, Ill., has been called "stunning." What's particularly notable is that the company says employee comfort, wellness and interaction helped drive design choices--which it believes will improve retention and recruitment. Features include sit/stand desks, an employee wellness center, healthful options in a large café and outside walking. (Daily Herald)
MarketVoices...quotes worth reading
"There has always been a stigma and a fear around mental illness, and that's what's reflected in many state licensing board questionnaires. There's a huge discrepancy between what states ask about physical conditions--such as whether those conditions affect their ability to practice--and what they ask about mental conditions, where the impact on their abilities is not asked about." --  Katherine Gold, MD, lead author of a study on mental  health issues among  health care professionals, quoted in FierceHealthcare

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Wednesday, October 19, 2016