Administration, House leaders ask for 90-day extension on CSR case | Insurer sees collaboration as key to value-based care | Intervention helps reduce benzodiazepine use in older adults
May 23, 2017
AHIP Solutions SmartBrief
Top Stories
Administration, House leaders ask for 90-day extension on CSR case
The Trump administration and House Republicans filed a request Monday for another 90-day extension in a lawsuit over the Affordable Care Act's cost-sharing reduction payments while they "continue to discuss measures that would obviate the need for judicial determination of this appeal, including potential legislative action." A delay would leave the subsidies in place for most of the summer, but it fails to address concerns about the stability of insurance markets, which AHIP says will require a long-term commitment to the CSR payments to prevent premium increases and marketplace exits.
Bloomberg (5/22),  The Washington Post (tiered subscription model) (5/22),  The Hill (5/22) 
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Insurer sees collaboration as key to value-based care
Insurer sees collaboration with providers as key to value-based care
(Joe Raedle/Getty Images)
In an effort to improve health care quality while reducing costs, Independence Blue Cross has created a value-based care model that relies on what it calls Facilitated Health Networks, designed to promote collaboration between health care providers and insurers for better care. Components include innovative contracting models designed for shared accountability, real-time sharing of data to facilitate health care decision-making, and a Clinical Care Transformation team that provides support, tools and best practices to providers.
AHIP blog (5/22) 
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Optimize Healthcare Opportunities at AHIP
Join DST on June 8th for our AHIP speaking session "The Opioid Epidemic: Mastering the Complexities and Improving Outcomes" to learn about effective end-to-end strategies for identifying, managing and monitoring member abuse. Read the full session description online and visit us at Booth #1407.
Providers & Suppliers
Intervention helps reduce benzodiazepine use in older adults
A study presented at the American Geriatrics Society's annual meeting found having pharmacists fax evidence-based opinions about benzodiazepine use in older patients to physicians led to twice the number of deprescriptions, compared with patient education alone. The study was an offshoot of the randomized EMPOWER trial, designed to educate seniors about the potential risks of benzodiazepines so the patients could help facilitate deprescribing.
Medscape (free registration) (5/19) 
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Public stop-bleeding program tested by surgeons
A group of surgeons tested a 15-minute course intended to train the public in skills needed to help stop a victim's bleeding during emergencies, and 93% of tested physicians said the B-Con course was at a suitable level of difficulty for use with the general public. "Our goal is to inform and empower the public because that first line of defense can really make a difference," said Dr. Lenworth Jacobs, lead study author and director of the Hartford Hospital Trauma Institute in Connecticut.
Medscape (free registration)/Reuters (5/19) 
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Medical Update
CDC reports increasing diarrhea outbreaks from US swimming pools
The number of diarrhea outbreaks related to cryptosporidium in US swimming pools rose from 16 in 2014 to at least 32 in 2016, CDC researchers reported in the agency's Morbidity and Mortality Weekly Report. The CDC urged parents to restrict swimming for children with diarrhea and discourage swallowing of pool water, while patients with cryptosporidiosis should not swim until two weeks after being diarrhea-free.
TIME online (5/19),  Reuters (5/18) 
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Take Action with Proactive Analytics
Looking for new ways to control costs and improve member health? Learn how Meritain Health, a leading TPA, uses proactive analytics with HDMS, a leader in health care analytics, to turn health care data into actionable insights for a competitive edge. Register for the webinar here.
Emerging Trends
ONC, CDC to create national system for electronic sharing of Zika data
The Office of the National Coordinator for Health IT and the CDC are developing a system to facilitate electronic sharing of Zika virus testing data between laboratories and health care providers. The project will use a web portal for providers and Health Level Seven's Fast Healthcare Interoperability Resources standard, said Michelle Meigs of the Association of Public Health Laboratories, which is also a partner on the project.
Health Data Management (5/19) 
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Study evaluates new photoacoustic imaging for breast tumors
A breakthrough photoacoustic imaging method developed by researchers at Washington University School of Medicine in St. Louis yielded detailed imaging results for assessing breast tumors and could reduce the need for additional procedures for breast cancer patients, compared with standard staining methods that require tissue processing. The approach, described in Science Advances, provides images containing many of the same features as traditional staining, and the team is developing a system that aims to cut scanning time to 10 minutes, according to researcher Lihong Wang.
MassDevice (Boston) (5/19) 
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Health Insurance Plan Company News
Integrated Risk Assessments White Paper
Download this complimentary white paper from ZeOmega® today. It offers compelling insights on how integrated patient-centered risk assessments can accelerate value-based care initiatives by supporting more impactful care plans, increasing engagement, and improving outcomes.
Solutions Provider News
Pharma News
Cinfa reports positive result on biosimilar drug
Cinfa Biotech said its drug candidate B12019, a biosimilar to Amgen's Neulasta, or pegfilgrastim, has met the primary and secondary endpoints of an early-stage trial, in which it was compared with its reference drug. The company intends to advance the candidate to European regulators in the second half of the year.
BioCentury (5/17) 
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Policy Watch
Senate Republicans continue work on ACA replacement
Senate Republicans continue to work on legislation dismantling the Affordable Care Act despite unified Democratic opposition to repeal. Proposals include changing the law's tax credits, relaxing coverage rules and cutting funds for Medicaid expansion.
ABC News/The Associated Press (5/22) 
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Calif. single-payer health care bill would cost $400B, analysis finds
Implementing a California bill that would create a single-payer health care system in the state would cost $400 billion annually, according to a legislative analysis released by the Senate Appropriations Committee. The state would need all public funds allotted for health care, including Affordable Care Act subsidies, to cover about half of the projected costs, while the rest would require a 15% payroll tax, according to the analysis.
San Francisco Chronicle (tiered subscription model) (5/22),  The Detroit News/The Associated Press (5/22) 
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What can we learn from non-health care industries?
You'd be surprised! During AHIP's Institute & Expo, June 7-9 in Austin, Whole Foods Market Co-Founder and CEO John Mackey will discuss "The Battle for the Heart and Mind of the Health Care Consumer: Lessons Learned from Other Industries." Information that can help your organization make health care better, more affordable, and more sustainable. Register today and save.
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Must-attend webinars. Register today
June 13, 2 to 3 p.m. ET, "Demystifying Natural Language Processing: Successful Use Cases in Healthcare" highlights ways to leverage natural language processing and machine learning technologies, impacting analytics and payment. June 21, 2 to 3 p.m. ET, "Managing Consumer Data for Mitigating Compliance and Fraud Risk" shares best practices for managing identity data when contacting consumers through various communications. 
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AHIP Individual Membership -- your one-stop professional resource
Join AHIP now as an Individual Member and gain access to an impressive package of professional resources, including: discounted rates on in-person conferences and online courses, access to the AHIP Career Center, breaking news about our fast-changing industry, and more. See if you qualify for Individual Membership and join today.
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