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ACA Round-Up: Robust Marketplace Enrollment, CBO On Defining Health Insurance, And More
As of December 19, 2016, the extended deadline for enrolling in coverage for January 1, 2017, 6,356,488 consumers were covered by plans selected on HealthCare.gov, the Department of Health and Human Services announced on December 21. This was over 400,000 more than last year when applications closed for January 1, 2016 coverage on December 17, 2015. This included 2,049,127 new consumers and 4,307,361 returning consumers. Over 2.3 million signed up between December 11 and 19.
These numbers include neither state marketplace enrollees nor 2016 enrollees who will be batch auto-enrolled for 2017 over the next few days. In 2016,...
Source: Health Affairs Blog - December 22, 2016 Category: Health Management Authors: Timothy Jost Tags: Following the ACA Insurance and Coverage Source Type: blogs
Why Do People Believe Drugs Are Too Expensive?
We have long heard from the media that the pharmaceutical industry “over charges” for prescription drugs and “makes money at the sake of those who can least afford it.” Public examples such as Turing, Mylan, and Valeant helped drive those narratives home. However, a poll done by the Kaiser Family Foundation (KFF) found that may not be the case. The polls were done throughout 2015 and 2016 and were related to public opinion on prescription drugs and their prices.
Perhaps one of the most interesting findings in the entire report was that seventy-seven percent of the public says the cost of prescription drugs ...
Source: Policy and Medicine - December 20, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
CMS Scraps Part B Demo
On Thursday, December 15, 2016, the Centers for Medicare & Medicaid Services decided not to go forward with the agency’s controversial Part B payment proposal, noting that “there was a great deal of support from some,” but there were “a number of stakeholders” who “expressed strong concerns about the model.” The spokesman continued, “While CMS was working to address these concerns, the complexity of the issues and the limited time available led to the decision not to finalize the rule at this time. We appreciate the robust dialogue with our stakeholders on this important topic and value the feedback on ...
Source: Policy and Medicine - December 19, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
Breaking Down The Final 2018 Letter To Issuers
Editor’s note: The final 2018 Letter To Issuers In The Federally Facilitated Maketplaces, discussed below, was issued in conjunction with the final 2018 Benefit and Payment Parameters rule, discussed here and here.
On December 16, 2016, the Centers for Medicare and Medicaid Services (CMS) at the Department of Health and Human Services (HHS) released its final 2018 Letter to Issuers in the Federally Facilitated Marketplaces (FFM). CMS releases a letter each year to insurers that offer coverage through the FFM or through state-based marketplaces that use the Healthcare.gov platform (SBM-FP), laying out the ground rule...
Source: Health Affairs Blog - December 19, 2016 Category: Health Management Authors: Timothy Jost Tags: Following the ACA Insurance and Coverage Payment Policy Source Type: blogs
21st Century Cures Act Becomes Law, Improves U.S. National Mental Health Efforts
When President Obama signed the 21st Century Cures Act on December 13th, he signed into law one of the most sweeping efforts to provide additional programs and funding for health conditions and innovation in America, including cancer, Alzheimer’s disease, opioid addiction, medical devices, access to new drugs, and mental health. The Cures Act includes the major provisions of the Senate mental health compromise bill, Mental Health Reform Act of 2016, as well as a few additional provisions from the House’s over-reaching Helping Families in Mental Health Crisis Act of 2016 bill.
While the bill goes a long way in h...
Source: World of Psychology - December 13, 2016 Category: Psychiatry & Psychology Authors: John M. Grohol, Psy.D. Tags: General Mental Health and Wellness Policy and Advocacy 21st century cures Helping Families in Crisis mental health reform act Mental Illness Source Type: blogs
What ’s The Story With Obamacare?
States, patients, and voters are wrestling with the pros and cons of dramatic changes in public health insurance coverage, including extending, maintaining, or rolling back Medicaid expansion under the Affordable Care Act (Obamacare) — an often emotional topic of debate. The stories that are told about the effectiveness—or lack thereof—of coverage in improving health and health care usually relate compelling personal experiences, putting a human face on an otherwise abstract argument.
Policies are not enacted in the abstract; they affect real people’s lives, and we should all be concerned with how polic...
Source: Health Affairs Blog - December 9, 2016 Category: Health Management Authors: Katherine Baicker and Amy Finkelstein Tags: Featured Following the ACA Insurance and Coverage Medicaid and CHIP Medicaid expansion Oregon Source Type: blogs
Moonshots, Opioids and Incentives
By MARSHALL CHIN, MD
Major disparities in health outcomes have stubbornly persisted throughout both democratic and republican administrations. If you have diabetes and you live in a predominantly African-American neighborhood of Chicago, you have a two-to-five times higher risk of having your leg amputated than if you live in one of the city’s white neighborhoods. If you are a Hispanic child with asthma, you are 50% more likely to be admitted to the hospital than if you are white. And if you are a Vietnamese woman, you are five times more likely to develop cervical cancer than your white counterpart. The incoming T...
Source: The Health Care Blog - December 8, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
Five Reasons The ACA Won ’t Be Repealed
In conclusion, there’s ample reason to believe that enough Members of Congress and maybe even the President-elect will eventually find it irresponsible to move forward in this haphazard, two-step fashion. Some are starting to demand the menu be hashed out before they are asked to sit and eat. That shouldn’t be too much to ask. If it is, well, that tells us all we need to know about the truth behind “repeal and replace.”
Source: Health Affairs Blog - December 7, 2016 Category: Health Management Authors: Billy Wynne Tags: Featured Following the ACA Affordable Care Act Obamacare Trumpcare Source Type: blogs
Colon cancer screening: Is there an easier, effective way?
Are you, or is someone you know, postponing their colonoscopy? Maybe it’s the idea of that prep. At best, it requires being home and near a toilet for a day. Worse, it can make people feel awfully ill. Or maybe it’s the invasiveness of the test. At best, it’s unpleasant. At worst, there can be serious complications, including an instrument puncturing the bowel, bleeding, and organ damage. It’s also time-consuming, requiring time off work for you and whoever will be driving you home.
Why is a colonoscopy worth the hassle?
Cancers of the colon and rectum are common, and lives can be saved with early detection. Colore...
Source: Harvard Health Blog - December 5, 2016 Category: Consumer Health News Authors: Monique Tello, MD, MPH Tags: Cancer Digestive Disorders Health Healthy Aging Screening Source Type: blogs
Medicaid, Meet Indiana
By JONATHAN HALVORSON
We will soon have a Vice President and a head of CMS who hail from the great state of Indiana, and are proud of what they’ve done with Medicaid there through the Healthy Indiana Plan. Seema Verma, the proposed CMS Administrator, is credited with being the architect of Healthy Indiana, and Mike Pence, the Vice President-elect, presents Healthy Indiana as one of the signature achievements of his term as governor of that state.
It is too early to tell if the program will be enough to raise Indiana up the ranks on health and healthcare from the bottom quintile (1, 2). However, since Republicans have r...
Source: The Health Care Blog - December 2, 2016 Category: Consumer Health News Authors: Jonathan Halvorson Tags: Uncategorized Source Type: blogs
The Uncertainty Bomb
By PAUL KECKLEY
I like certainty and routine. I like my daily Tall Dark Roast with no room for cream at 5 am at Starbucks. I like the same restaurants, the same suits and ties and the same TV shows. Holidays throw me off and I get bored quickly when I have down time.
For six years, the healthcare industry in the U.S. has been adjusting to its new normal based on the regulatory framework of the Affordable Care Act (ACA). It became routine to discuss the volume to value, accountable care organizations, bundled payments, Medicaid expansion and Healthcare.gov. We were certain they’d be around for years to come.
Then came th...
Source: The Health Care Blog - November 27, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
Congress Shouldn ’t Pass FDA Reform Bills Without Addressing Patient Safety and Drug Prices
By DIANA ZUCKERMAN
A major proposed law that alters the way the Food and Drug Administration (FDA) approves drugs and medical devices has been wending its way through Congress since 2014. Momentum is building on Capitol Hill to pass the legislation in the current “lame-duck” session of Congress.
That shouldn’t happen.
The House passed its version of the legislation—the 21st Century Cures Act (hereafter the Cures bill) —in July 2015. The Senate health committee created and passed 19 related bills, under the banner “Innovation for Healthier Americans,” this past spring.
Sen. Lamar Alexander (R-Tenn) pu...
Source: The Health Care Blog - November 23, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
What Does the Trump Presidency Imply for Healthcare and Healthcare IT?
Many organizations have asked me to comment on the impact of the Trump Presidency on Healthcare and Healthcare IT. I served the Bush administration for 4 years and the Obama administration for 6 years. I know that change in Washington happens incrementally. There is always an evolution, not a revolution, regardless of speechmaking hyperbole.What am I doing in Massachusetts? I ’m staying the course, continuing my focus on social networking for healthcare, mobile, care management analytics, cloud, and security while leaving the strategic plan/budget as is.I have no inside information and no inv...
Source: Life as a Healthcare CIO - November 16, 2016 Category: Information Technology Source Type: blogs
The Future Of The Affordable Care Act In A Trump Administration
This segment originally aired on The Diane Rehm Show on November 14, 2016.
The HealthCare.gov website, where people can buy health insurance, is displayed on a laptop screen. AP PHOTO/ANDREW HARNIK
Republicans in Congress have voted more than 50 times to repeal the Affordable Care Act without success. Now, they have an ally in President-elect Donald Trump, who promised on the campaign trail to “repeal and replace” the law. But over the weekend, Trump seemed to soften his stance. He told the Wall Street Journal he would consider leaving in place some provisions, including one that prohibits insurers from denying covera...
Source: Disruptive Women in Health Care - November 15, 2016 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Affordable Healthcare Act Consumer Health Care Cost Coverage Policy Election 2016 Health Reform Source Type: blogs
Symptoms of Cancer May Include Fatigue, Unexplained Weight Loss, Fever and Foreclosure
by Bridget BlitzAs a palliative care social worker, I provide home visits to patients and families to explore how they are coping with complex medical issues, which resources they need, how we might add services that could reduce caregiver strain, and talk to them about their goals of care and about their wishes for the life they have left. Startling to me, within these discussions, is the depth of fear and anxiety about finances that leave these individuals struck with more than a horrible illness. They now have to absorb the real possibility of being without a permanent home in addition to adapting to new treatments, sym...
Source: Pallimed: A Hospice and Palliative Medicine Blog - November 14, 2016 Category: Palliative Care Tags: bankruptcy financial social work social worker Source Type: blogs
