What’s New in Health Care Reform: Sept. 16


What's New in Health Care Reform provides an overview of the past week’s news, updates, and commentary in health care reform and utilization management.

Health, Economics, And Preparedness: Considerations And Paths Forward

Last month marked the 10th anniversary of Hurricane Katrina, which killed nearly 2,000 and displaced more than 250,000 people from Louisiana to Florida. This anniversary and more recent events like Hurricane Sandy, the West Texas explosion, the Boston bombing, and the Ebola outbreak remind us of the importance of maintaining health and health care delivery during and after disasters. In this period of continued threats, health care delivery reform, and fiscal austerity, disaster preparedness requires a clear value proposition that encourages the U.S. delivery system to invest in preparedness. Via Health Affairs Blog.

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Regulators Need to Scrutinize Health Insurance Mergers

Two proposed mergers involving four of the nation’s biggest health insurers could reduce competition in an important industry. That’s why federal and state regulators need to closely study these deals and, if necessary, force the companies to sell some parts of their businesses. Earlier this summer, Anthem agreed to acquire Cigna for $48 billion, and Aetna announced a $37 billion takeover of Humana. The antitrust division of the Justice Department and state governments are reviewing the deals. If regulators approve both transactions, the number of big national health insurers would drop from five to three. Via NY Times. 

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Employers Renew Struggle to Change Health Reform

With lawmakers back in Washington after the August recess, employer groups are renewing their drive to convince Congress to make significant changes to the health care reform law, but they know they face an uphill battle. Much of the employer lobbying effort will be focused on a Patient Protection and Affordable Care Act provision that, when it takes effect in 2018, will impose a 40 percent excise tax on group health plan premiums that exceed $10,200 for single coverage and $27,500 for family coverage. Via Business Insurance.

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Americans Value Health Care Access As Moral Responsibility

It looks like a vast majority of Americans believe that having access to health care is a matter of morality. Furthermore, it appears that this population believes citizens of this country should be able to afford universal health care, particularly if other developed countries can manage the same. But while it appears we agree on this, Americans are also still heavily divided over several of the provisions found within the Affordable Care Act, only five years after the health-reform legislation went into law. Via Pioneer News.

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Medicare Alternative Payment Models Offer Value to Patients and Health Care Providers

Earlier this year, the U.S. Department of Health and Human Services (HHS) announced the success of a three-year timeline for shifting Medicare alternative payment models to focus not on the volume of patient care, but on the value providers delivered to patients. This was primarily due to the fact that the health care system was organized around providing care for more people, as opposed to quality care in general. Via Samsung Business Insights.

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Lawmakers, Industry Leaders Clash Over Effects of Health Care Consolidation

While politicians and industry experts who spoke at a congressional hearing were divided about whether the Affordable Care Act is driving health care industry consolidation, nearly all agreed on one point: They are deeply concerned about the pending health insurance mergers. Via Fierce Health Payer.

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Obamacare and the Health Care Sector

Medical services companies have performed better in the stock market from 2014. Stocks of companies like SPDR S&P Health Care Services, Fidelity Select Medical Delivery Portfolio, and iShares US Healthcare Providers have increased by 35 percent from the beginning of 2014 and continued until August 2015. In contrast the S&P 500 advanced only 10 percent. Although the medical service companies were initially lukewarm towards health care reform, the new Patient Protection and Affordable Care Act (PPACA) has helped to considerably grow their earnings. Via Financial Buzz.

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Proposed Legislation Seeks to Reform Mental Health Care

Senators Bill Cassidy (R, La) and Chris Murphy (D, Conn) have proposed a bipartisan mental health reform bill with an 8-point agenda intended to shore up the nation’s mental health care system. Among other measures, the bill proposes to designate an Assistant Secretary for Mental Health and Substance Use in the U.S. Department of Health and Human Services, require audits on health parity law implementation, and establish new grants for early mental health intervention. Via The Journal of American Medicine Association.

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What We Know About How Health Insurance Affects Health

One of the most basic assumptions underlying the Affordable Care Act is the compelling idea that people with health insurance will be healthier. It follows, right? People who learn they have diabetes will be prescribed drugs to manage their disease. People who find out they have high cholesterol or blood pressure early will get the medical advice and treatments to prevent heart disease. A study published in Health Affairs reports new evidence of health insurance's salutary effects on chronic disease, quantifying those effects down to changes in blood sugar control, blood pressure, and a slight drop in cholesterol. Expanding coverage to half the number of non-elderly uninsured people, the authors estimate, will mean 1.5 million additional people will be diagnosed with chronic diseases and 659,000 will gain control of their illness. Via Washington Post.

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Why Aren't Physicians Part Of The Health Reform Conversation?

While at a party recently, the question came up, as it often does, about how physicians feel about the Affordable Care Act – now better known as Obamacare. We pointed to our Physicians Foundation national survey in 2014 where 75 percent gave it a grade of C, D, or F. Only 3.7 percent of physicians thought the legislation warranted an A grade. Several more people, not physicians, then joined the discussion and the conversation switched to the general subject of physician influence in the health reform debate. Via Forbes.

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Kelley Luedke

Kelley Luedke is a Marketing Channel Manager at Mayo Clinic Laboratories. She is the principle editor and writer of Insights and leads social media and direct marketing strategy. Kelley has worked at Mayo Clinic since 2013. Outside of work, you can find Kelley running, traveling, playing with her kitty, and exploring new foods.

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