What the Senate health care bill means for insurers | Read the legislation | How the Senate bill differs from, mirrors the House approach
June 23, 2017
AHIP Solutions SmartBrief
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What the Senate health care bill means for insurers
The Senate's Better Care Reconciliation Act includes some provisions sought by health plans, which could be enough to prevent some companies from leaving public exchanges next year, but some are worried that steep cuts to Medicaid funding could force them to reduce services for the 75 million Americans covered under the program and cut reimbursement rates. The bill would continue cost-sharing reduction payments to insurers through 2019 and cut an annual fee paid by insurers, but it also would eliminate the individual mandate, which requires all Americans to buy health insurance or pay a financial penalty.
Modern Healthcare (tiered subscription model) (6/22),  Vox (6/22) 
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How the Senate bill differs from, mirrors the House approach
How the Senate bill differs from, mirrors the House approach
(Andreas Rentz/Getty Images)
Newly released Senate legislation would provide a longer timeline than the House bill for phasing out the Affordable Care Act's Medicaid expansion; would not penalize consumers for having a break in coverage; and would link premium support to income, age and geography, rather than just age and tie that assistance to "bronze" plans. Similarities between the bills include the approach to premiums for older adults, pathways for states to seek waivers from essential health benefits and repeal of coverage mandates.
Ledger-Enquirer (Columbus, Ga.)/The Associated Press (6/23) 
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Providers & Suppliers
20% of patients return to hospital after observational stay
About 20% of Medicare patients who had an observational stay at a hospital ended up returning within 30 days, and 49.7% of those who returned were admitted for inpatient care, researchers reported in The BMJ. The study analyzed 363,037 initial observation stays from 2006 to 2011 that resulted in discharge.
Connecticut Post (Fairfield County-Bridgeport) (6/20) 
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EBOOK | Care Collaboration Success
Insurers, providers and community resources all have their own relationships with members, patients and consumers, but rarely do the three collaborate with a unifying mission. Download this eBook for real-world examples of care collaboration success that had a positive impact on outcomes.
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Medical Update
Opioid-related hospitalizations increase for men, women
A US Agency for Healthcare Research and Quality report found hospitalizations related to opioids or heroin increased 75% among women and 55% among men between 2005 and 2014. The lowest 2014 hospitalization rates for both genders were seen in Iowa and Nebraska, while the highest rates for women were in West Virginia, Maryland and Massachusetts, and for men in the District of Columbia, New York and Maryland.
HealthDay News (6/21) 
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More adults take excess dosage of vitamin D, study says
National survey data from 2013-2014 showed 3.2% of US adults took more than 4,000 international units of vitamin D each day, which is above the maximum safe dosage, compared with 0.2% in 2007-2008, according to a study in the Journal of the American Medical Association. Registered dietitian Samantha Heller commented that vitamin D deficiency is common and research has linked appropriate levels to a lower risk of disease and improved heart health and immune system regulation.
HealthDay News (6/20) 
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Cancer, CVD are top causes of mortality among cancer survivors
Thirty-three percent of cancer survivors died from cardiovascular disease, while 51% died from cancer, according to 2012 National Health and Nutrition Examination Surveys data presented by Dr. Ronald Schwartz of the University of Rochester Medical Center at an imaging meeting. The findings should prompt inclusion of patient-centered cardio-oncology using nuclear cardiology and radionuclide studies as well as PET/CT in comprehensive cancer care, experts said.
DOTMed (6/20) 
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Emerging Trends
FDA warns against use of secondhand diabetes test strips
Diabetes patients should not use unused secondhand test strips to save money because they can provide inaccurate blood glucose readings and may be unsafe to use with glucose meters, according to the FDA. The agency recommends purchasing new and unopened test strip vials that are specifically designed for the patient's glucose meter and talking to a health care provider about any concerns over which strips to buy or affording the strips.
HealthDay News (6/20) 
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Health Insurance Plan Company News
Better Quality Post-Acute Care at a Lower Cost
Post-acute care (PAC) accounts for an estimated 45 percent of total health plan spending, and of this, hospital readmissions account for more than half. A better model to build efficiency and improve outcomes is desperately needed. Learn how data and technology can help identify the best path for each patient's care, resulting in better care with lower costs. Read more.
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Solutions Provider News
Pharma News
CDC panel continues to recommend against intranasal LAIV
Draft recommendations from the CDC's Advisory Committee on Immunization Practices continue to advise against the use of live-attenuated influenza vaccine during the 2017-2018 flu season. Vaccination rates among US youths ages 6 months to 17 years remained similar between the 2015-2016 and 2016-2017 flu seasons despite the ACIP's reversal on LAIV use last season, said Lisa Grohskopf of the CDC's Influenza Division.
Healio (free registration)/Infectious Disease News (6/21) 
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Policy Watch
4 conservatives oppose current version of Senate health care bill
Sens. Rand Paul, R-Ky., Mike Lee, R-Utah, Ted Cruz, R-Texas, and Ron Johnson, R-Wis., said in a joint statement that they do not support the current version of the Senate health care bill, arguing that it does not do enough to unravel the structure of the Affordable Care Act, but they expressed willingness to negotiate. Republican leaders can only afford two defections from their party to pass the bill.
CNN (6/23),  The Hill (6/22) 
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CMS adds more flexibility to HIT mandates under proposed 2018 MACRA rule
Doctors who choose to continue using their legacy EHR systems are now allowed to do so until next year and those who will use 2015-certified EHR editions would receive a 10% payment bonus from the CMS, according to the proposed 2018 Medicare Access and CHIP Reauthorization Act rule. The new rule "helps credit clinicians for using health IT within a care improvement context," which is considered to be "a more outcomes-focused approach to measuring health IT use," said Doug Fridsma, CEO of the American Medical Informatics Association.
Healthcare IT News (6/21) 
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AHIP News
Successful searches start here
AHIP's Career Center is a better environment for your job postings. Hosted by one of our industry's most respected voices, it's destination for experienced candidates who know the power of the AHIP brand. So you'll collect better resumes, faster. You'll also benefit from a searchable resume database, activity tracking, and opportunities for enhanced exposure via AHIP partners. Start recruiting now!
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Five courses. One respected health care credential
Take your career to the next level. Earn your designation as a Fellow, Academy for Healthcare Management (FAHM). The program's five courses provide big picture understanding -- and working knowledge -- of healthcare management, finance, regulations, and risk management. The kind of training that gets noticed and builds careers. Learn more about AHIP's Academy for Healthcare Management (AHM) designations and courses.
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Reaching out to at-risk groups to prevent diabetes
Health plans are utilizing physician practices to deliver the National Diabetes Prevention Program to individuals at risk for diabetes. AHIP and health plans, working under a CDC cooperative agreement, are reaching culturally diverse, low-income, and low-literacy populations to prevent the onset of diabetes. Learn more today.
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