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AARP has sued the administration over wellness program rules released in May by the Equal Employment Opportunity Commission. Those rules allow employers to offer workers incentives worth up to 30 percent of the cost of their cheapest plans (60 percent for couples) to participate in wellness programs. AARP says such incentives penalize workers who don't want to share medical information; this renders the programs involuntary in violation of federal law. "Congress enacted these protections to prevent employers from discriminating and to combat stigma in the workplace against individuals with disabilities," AARP's lawsuit says. (Reuters)

A new county-level analysis by the Associated Press and Avalere Health found about one-third of U.S. counties will have only one marketplace insurer next year. That's more than 1,000 counties in 26 states--roughly double the number in 2014. Most customers get financial assistance, but there's no comparable "safety valve" for disruptions caused by insurer departures. (Associated Press)

Rural hospitals outperformed urban hospitals in several Medicare value-based reimbursement programs in 2015, receiving fewer financial penalties, according to a recent report from the Department of Health and Human Services. Researchers stated the most likely drivers of the improved performance in rural hospitals were better care coordination, enhanced used of telehealth and patient experience improvement programs. (RevCycleIntelligencereport)

Patients who survived major trauma may not be a significant factor in the U.S. opioid epidemic, a new study suggests. Almost 75 percent of major trauma patients who were prescribed narcotic painkillers had stopped using them a month after leaving the hospital. "We were really surprised by how low the numbers were for long-term opiate use," says study senior investigator Dr. Andrew Schoenfeld. "It appears that traumatic injury is not a main driver for continued opioid use in patients who were not taking opioids prior to their injuries." (American College of Surgeons; HealthDay News)
Innovation & Transformation  
A telehealth platform can help patient with dementia or aphasia maintain and even improve their ability to communicate, according to research published in Alzheimer's & Dementia: Translational Research & Clinical Interventions. Researchers used the Communication Bridge platform developed at Northwestern to connect people with Alzheimer's dementia or aphasia to specially trained speech-language pathologists. After the eight-month pilot, researchers found significant improvement among the patients in recalling "lost" words or concepts. The platform also reduces time and money spent on traveling and lets specialists work with more patients. (mHealthIntelligence; abstract)
Consumers & Providers
The individual mandate penalty appears to be a powerful lever. A new Urban Institute analysis found 51.5 percent of non-poor adults surveyed this year said the penalty was very or somewhat important in their decision to enroll in a plan, compared to 44.1 percent in 2015. "Individual mandate penalties need to be large and visible enough to curb adverse selection by encouraging younger and healthier individuals to purchase coverage. These results indicate that an increasing share of adults with nongroup coverage, particularly those who purchased plans through the Marketplace, deemed the penalty very or somewhat important in their enrollment decision." (Urban Institute)
Driven by new Medicare penalties, hospitals have reduced readmissions. But a new analysis suggests Medicare should focus more on how well hospitals do at actually keeping those patients alive. If hospitals were also paid less when their patients died soon after a hospitalization, it would be a "game-changer" for one-third of hospitals, say researchers who published their findings in JAMA Cardiology. About 17 percent of hospitals are penalized for too many readmissions, but they are keeping patients alive more often than would be expected, researchers say. (JAMA Cardiology; announcement)
Fifty-eight percent of physicians are not worried about the security of their EHR data, according to Medical Economics' 2016 EHR Report. "It's not a lack of concern, but a sense that 'I have as much control over data security as I do over preventing a nuclear war, so I'm not going to dwell on it and I'm going to focus on more immediate concerns like: was I a good enough doctor to that patient who came in with a problem?'" says Steven J. Stack, MD, immediate past president of the American Medical Association. (Medical Economics)
As accountable care becomes mainstream, hospitals are raising expectations for value. But for individual hospitalists, their parent health system's participation in ACO contracts hasn't made a difference: The hospitalist might not even know whether a given patient is part of an ACO at the time of admission. "I don't know of any hospitalist group that has changed its financial incentives for members in response to ACOs," says Bradley Flansbaum, DO, MPH, MHM, a hospitalist at Lenox Hill Hospital in New York. But they will, says Ron Greeno, MD, MHM, senior advisor for medical affairs at Team Health. (Medscape)
New & Noted   
Minnesota rebates: Gov. Mark Dayton on Thursday proposed issuing rebates to an estimated 123,000 Minnesotans facing steep health insurance premium hikes but who make too much to qualify for federal tax credits. (Star Tribune)

E-scripts may improve patient compliance: E-prescribing may enhance patient prescription adherence, according to research published in JAMA Dermatology. "Compared with paper prescriptions, electronic prescriptions were associated with less primary nonadherence. Number of prescriptions, language, race/ethnicity, and age were associated with increased rates of primary nonadherence." (JAMA Dermatology)

MACRA, simplified: The American Academy of Family Physicians has created a five-page executive summary to help explain the most relevant parts of MACRA--the Medicare Access and CHIP Reauthorization Act--to family physicians. (executive summary)
In this California Health Care Foundation video, Diane Stewart, of the Pacific Business Group on Health and the California Quality Collaborative, will describe approaches that leading organizations use to understand patients' total cost of care, reduce unnecessary services and improve quality of care. Naomi Fuchs, CEO of Santa Rosa Community Health Centers, will share how her ACO used Medicare total cost of care data to improve services for patients and reduce costs. (HealthShare TV)
MarketVoices...quotes worth reading
"Rising premiums get all of the political attention, but lack of choice between insurers could be a bigger problem for consumers."--Caroline Pearson, a senior vice president with Avalere, quoted by the Associated Press
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Roxanna Guilford-Blake
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Wednesday, November 2, 2016