CMS To Require Five-Star Quality Rating System For Plans On Health Insurance Exchanges

For the first time, the Centers for Medicare & Medicaid Services (CMS) will require the display of the five-star Quality Rating System available nationwide for health plans offered on the Health Insurance Exchanges beginning with the 2020 Open Enrollment Period November 1, 2019 to December 15, 2019. Star ratings are based on a number of important factors, including how other enrollees rate physicians in the plan’s network and the care they receive, how well the plan’s network providers coordinate with enrollees and other physicians to give members healthcare that achieves the best results, and overall administration of the plan including customer service and availability of information. 

Additional information can be obtained at https://www.cms.gov/newsroom/fact-sheets/health-insurance-exchange-quality-ratings-system-101.

Final “Public Charge” Rule Involving Immigration

Earlier this week, the Trump administration revealed its long-anticipated final “public charge” rule, a policy change that effectively would punish legal immigrants who use their Medicaid coverage to help pay for nonemergency medical care. A posting on the website of the Commonwealth Fund comments on the rule. 

The posting can be obtained at https://www.commonwealthfund.org/blog/2019/new-public-charge-rule-affecting-immigrants-has-major-implications-medicaid-and-entire?redirect_source=/blog/2018/new-public-charge-rule-affecting-immigrants-has-major-implications-medicaid.

IPEC Fall 2019 Faculty Institute Early Bird Pricing Ends Thursday

The Fall 2019 IPEC Institute, Strengthening Partnerships for IPE and Collaborative Practice, will provide health professions educators, administrators, practitioners, and other interprofessional partners the opportunity to advance their existing institutional interprofessional education for collaborative practice (IPECP) programs.

Space is limited, so register as soon as possible. Interested teams and individual learners are strongly encouraged to apply today for early bird pricing! Register before August 15 to save $100 off the regular rate. For more details or to enroll, visit the Fall 2019 IPEC institute website or contact IPEC Associate Director Shelley McKearney at smckearney@aacnnursing.org

CMS Reports On Declining Enrollment For The Unsubsidized Population

The Centers for Medicare & Medicaid Services (CMS) released two reports, the “Early 2019 Effectuated Enrollment Report” and “Trends in Subsidized and Unsubsidized Enrollment Report.” They provide information on the stability of the individual health insurance market during the 2018 plan year as well as offering preliminary insights into the market for 2019.  

The Early 2019 Effectuated Enrollment Report can be obtained at  https://www.cms.gov/newsroom/fact-sheets/early-2019-effectuated-enrollment-snapshot and the Trends in Subsidized and Unsubsidized Report can be obtained at  visit: https://www.cms.gov/CCIIO/Resources/Forms-Reports-and-Other-Resources/Downloads/Trends-Subsidized-Unsubsidized-Enrollment-BY17-18.pdf.

Projected Impact Of Increasing Hospital Prices

A new brief from UnitedHealth Group finds that hospital prices increasing at current rates could end up costing $250 billion over the next decade. The report indicates that prices set by hospitals for services, and not physician salaries or how much hospital services are used, are what’s driving up patients’ spending.  

The brief can be obtained at https://www.unitedhealthgroup.com/content/dam/UHG/PDF/2019/Hospital-Prices-Drive-Inpatient-Spending.pdf.

Explaining Support Or Opposition To Medicare For All

A new brief from the Urban Institute assesses public support for Medicare for All proposals and some incremental reforms for expanding health insurance coverage. The examination focuses on individuals with different characteristics as well as important factors to adults who support, oppose, or are ambivalent. 

The brief can be obtained at https://www.urban.org/sites/default/files/publication/100752/what_explains_support_or_opposition_to_medicare_for_all_final_v2.pdf.

Negative Impact Of A Medicare Public Option On Rural Hospitals

A government insurance program reimbursing at Medicare rates as a public option on the health insurance exchanges would have the potential to place as many as 55% of rural hospitals across 46 states at high risk of closure, according to a report by Navigant Consulting Inc.  

More information about the report can be obtained at https://www.navigant.com/insights/healthcare/2019/the-potential-impact-of-a-medicare-public-option.

Next Steps In Chronic Care

A new analysis released by the Bipartisan Policy Center demonstrates that providing non-medical benefits, such as home-delivered meals tailored to a targeted group of individuals with chronic conditions in Medicare fee-for-service, could help avert hospital readmissions. It also shows a possible savings of $1.57 per patient for every dollar spent on the meals program.  

The report can be obtained at https://bipartisanpolicy.org/wp-content/uploads/2019/07/Next-Steps-in-Chronic-Care.pdf.

Patient-Provider Communication Disparities By Limited English Proficiency

Using the Medical Expenditure Panel Survey, investigators found that provider-patient communication became worse for individuals with limited english proficiency (LEP) between 2006 and 2010, at a time when communication improved for the population overall. After 2010, a year that marked substantial efforts to reform the U.S. healthcare system, communication for individuals with LEP were better, although linguistic disparities persist. 

More information can be obtained at https://link.springer.com/article/10.1007%2Fs11606-018-4757-3.

Impact Of Work-Limiting Health Shocks On Employment And Income

According to a report from the Urban Institute, researchers found that that each year, on average, 4.2% of adults age 18 to 62 who are in the labor force report developing a new work-limiting health condition or experiencing a new health shock.  Within two years, these workers are three times more likely to have left the labor force than workers who did not experience a health shock. 

The report can be obtained at https://www.urban.org/sites/default/files/publication/100748/how_work-limiting_health_shocks_affect_employment_and_income_0.pdf.

Long-Term Trends In Health Insurance Coverage

As the airwaves and print media provide information about health insurance proposals by candidates seeking to be elected President of the U.S., data from the National Center for Health Statistics (NCHS) describe long-term coverage trends.

Data can be obtained at https://www.cdc.gov/nchs/data/nhis/health_insurance/TrendHealthInsurance1968_2018.pdf.

Two-Year Budget Agreement Sent To President By Congress

The Senate voted 67-28 today to pass and send to the president a two-year budget agreement, the Bipartisan Budget Act of 2019 (H.R. 3877), that increases discretionary funding limits and suspends the debt limit through July 31, 2021. This legislative package is partially offset, including with a two-year extension of mandatory sequestration.

The Budget Act can be obtained at https://www.congress.gov/bill/116th-congress/house-bill/3877.

New Resources On International Education

The American Council on Education (ACE) recently published three new papers covering international perspectives on attainment and inclusion, international student funding, and Intensive English Programs (IEPs). The first is the spring 2019 edition of International Briefs for Higher Education Leaders, which can be obtained at https://www.acenet.edu/news-room/Documents/ACE%20Brief_8_final_3_27.pdf. International Student Funding: Tuition, Fees, and Financial Aid can be obtained at https://www.acenet.edu/news-room/Documents/International_Student%20_Funding.pdf.   Intensive English Programs: Questions and Considerations can be obtained at https://www.acenet.edu/news-room/Documents/IEP%20Questions%20and%20Considerations.pdf.

ASAHP Supports the POST GRAD Act

On Friday, ASAHP joined numerous other associations as part of the Federation of Associations of Schools of the Health Professions (FASHP) in a letter supporting H.R. 3418, the Protecting Our Students by Terminating Graduate Rates that Add to Debt Act or POST GRAD Act. The letter thanks Rep. Judy Chu, the bill’s sponsor, for her leadership. The legislation, which was introduced in the House last month, would make graduate and professional students eligible for subsidized direct federal Stafford Loans.

The bill may be accessed here and the letter may be accessed here.

Promoting Health Equity For Children

A new report from the National Academies of Sciences, Engineering, and Medicine outlines steps needed to move children who are at risk for negative outcomes toward positive health trajectories and reduce health disparities.  

The report can be obtained at http://nationalacademies.org/hmd/Reports/2019/vibrant-and-healthy-kids.aspx.

HHS Invites Comments On Health Literacy Definition For Healthy People 2030

The Department of Health and Human Services (HHS) invites comments on a proposed new health literacy definition for Healthy People 2030, which sets health promotion goals for the nation. The proposed new definition is “Health literacy occurs when a society provides accurate health information and services that people can easily find, understand, and use to inform their decisions and actions.” The deadline for comments is August 5, 2019. 

Instructions on how to comment can be found at: https://www.federalregister.gov/documents/2019/06/04/2019-11571/solicitation-for-written-comments-on-an-updated-health-literacy-definition-for-healthy-people-2030.

Impact Of Erosion Of Employer-Sponsored Insurance On Medicare Beneficiaries

An Issue Brief from the Commonwealth Fund examines coverage trends for Medicare beneficiaries between 2010 and 2016, looking at rates of coverage under employer-sponsored insurance, Medigap supplemental plans, and private Medicare Advantage plans. The proportion of beneficiaries with supplemental employer coverage dropped between 2010 and 2016, particularly for those with low or middle incomes. 

The Issue Brief can be obtained at https://www.commonwealthfund.org/sites/default/files/2019-07/Davis_erosion_ESI_Medicare_financial_burden_ib.pdf.

Protection From Surprise Medical Bills

The National Governors Association (NGA) issued a report on state strategies to protect consumers from surprise medical bills. Eleven states have enacted surprise billing legislation since 2017, including six this year. The report summarizes round table discussions on the issue hosted by the NGA Center for Best Practices Health Division. 

The report can be obtained at https://www.nga.org/wp-content/uploads/2019/05/NGA-Surprise-Medical-Bills-Brief-July-2019.pdf.

Summary of Two Year Budget Agreement

The FY 20 budget agreement provides a 4% increase for domestic programs than in FY 19. A four percent increase is also in marked comparison to the Administration’s budget request for a 10% overall cut to domestic programs.

However,  the Senate now needs to allot funding to each of its twelve Appropriations Subcommittees. They will probably allot less for their Labor-HHS bill than was available in the House, and then go to a House-Senate conference this fall.

Read the budget summary here.

Two Year Budget Agreement in Place

The President moments ago announced a two year budget agreement is in place — the compromise would increase fiscal 2020 spending limits for domestic programs by about 4% above current FY 19 funding levels. For fiscal 2021, which begins Oct. 1, 2020, domestic spending limits would be raised another 1%.

Conservatives had been making an eleventh hour plea circulating a letter for signature to the President urging him not to accept this deal without further concessions from the Democrats, but the President tweeted his approval of the deal and that it “was a real compromise in order to give another big victory to our Great Military and Vets!”. The agreement also contains a two year extension of the debt limit. Assuming the agreement stays in place, a vote will take place before Members depart for the August recess. More details to come.