CMS: US health care spending to hit $5.7T by 2026; insured rate to drop | More payers adding social determinants of health to plan coverage | MSSP results show ACO model can work
February 15, 2018
AHIP Solutions SmartBrief
Top Stories
CMS: US health care spending to hit $5.7T by 2026; insured rate to drop
CMS: US health care spending to hit $5.7T by 2026; insured rate to drop
The CMS Office of the Actuary expects US health care spending to grow an average of 5.5% annually from 2017 to 2026, reaching $5.7 trillion, driven by rising prices for health care goods and services and the aging population. Prescription drug spending will see the fastest average growth at 6.3% annually as prices and use of specialty drugs increase, while the insured rate is predicted to decline to 89.3% from 2016's 91.1% following the repeal of the Affordable Care Act penalty for Americans who don't purchase health insurance.
Reuters (2/14),  Becker's Hospital Review (2/14),  The Hill (2/14) 
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More payers adding social determinants of health to plan coverage
More payers adding social determinants of health to plan coverage
(Tobias Schwarz/AFP/Getty Images)
More than 80% of health care payers are supporting value-based care by adding social determinants of health to plan components, a survey of more than 2,000 health care industry leaders revealed. The survey, conducted by Change Healthcare and the HealthCare Executive Group, also found that security and privacy concerns are barriers to using digital health tools.
Healthcare Informatics online (2/12) 
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Post-Acute Care: Savings for Medicare Advantage Plans
One of the best ways to manage high costs associated with post-acute care is through an integrated method that is patient-focused and home-centric. Learn how closely managed care coordination of the post-acute healing journey can deliver untapped savings for your health plan. Download the study.
Providers & Suppliers
MSSP results show ACO model can work
MSSP results show ACO model can work
(Franck Fife/AFP/Getty Images)
Accountable care organizations participating in the Medicare Shared Savings Program in its first four years served older, sicker populations than typical health care providers do but still managed to improve quality while reducing postacute care expenditures. The results suggest that the ACO model "might work in other settings and populations and could shift to more advanced risk and payment models (eg, population-based prospective payment)," the study authors write.
The American Journal of Managed Care online/The American Journal of Accountable Care (2/13) 
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Medical Update
CDC: More than 8% of US adults have depression
A CDC report showed more than 8% of adults over age 20 have depression, and the rate for women was almost double that for men. The research, published in the NCHS Data Brief, found about 80% of adults with depression also reported problems with performing daily tasks.
HealthDay News (2/13),  KLKN-TV (Lincoln, Neb.) (2/13) 
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Shift workers at increased risk of type 2 diabetes, study finds
A study in Diabetes Care showed that regardless of genetic predisposition, adults who frequently do shift work, especially at night, were at an increased risk of developing type 2 diabetes, compared with those who do not have shift work. Researchers evaluated data from the UK Biobank database involving 270,000 people and found that those who worked rotating or irregular shifts had a 44% higher diabetes risk.
Diabetes (UK) (2/13) 
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Emerging Trends
Banyan Biomarkers' concussion assay gains FDA approval
Banyan Biomarkers' Brain Trauma Indicator is the first blood test to receive FDA approval to screen for a certain type of brain damage that is usually only detectable with CT scans. The test assesses levels of two proteins, UCH-L1 and GFAP, and it could reduce the need for unnecessary neuroimaging tests and radiation exposure.
STAT (tiered subscription model) (2/14) 
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Well-being scores decrease in almost half of US states
The Gallup-Sharecare Well-Being Index found scores in almost half of US states decreased and no state had a significant improvement in well-being from 2016 to 2017. At the top and bottom of the list were South Dakota and West Virginia, respectively, but overall people said they worried more, were less interested in doing things, had less positive energy from family and friends, and were depressed.
USA Today (2/14),  CNBC (2/13) 
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Health Insurance Plan Company News
Turning Point: The Fate of Standalone Dental
Ninety-six percent of insurance executives believe the embedding of dental benefits into medical plans is imminent. Yet, there is no consensus on how it will happen. Our newest research finds a gap between market realities and leadership action. Click here for the full report.
Pharma News
White House budget would boost FDA's ability to respond to opioid crisis
The White House's budget request for fiscal 2019 would increase FDA discretionary funding by $473 million, with much of the additional funding intended to advance the availability of innovative drugs and medical devices and to develop regulatory science tools for reducing opioid-drug misuse and abuse. The funding boost is "a recognition that the agency is doing its job well and making a critical public health difference," said Alliance for a Stronger FDA Executive Director Ladd Wiley.
BioWorld (free content) (2/12) 
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Policy Watch
HHS priorities are value in Medicare, Rx prices and telehealth, Azar says
HHS priorities are value in Medicare, Rx prices and telehealth, Azar says
Azar (Getty Images)
HHS Secretary Alex Azar told lawmakers during a House committee hearing that HHS remains committed to ensuring affordable access to health care and keeping Medicare solvent by driving out fraud, waste and abuse. Azar said his priorities include shifting Medicare toward a more value-based, outcome-based program; reducing prescription drug costs; and expanding telehealth services.
HealthLeaders Media (2/14) 
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House GOP lawmakers in talks to repeal ACA employer mandate
House Ways and Means Committee Chairman Kevin Brady, R-Texas, said he has talked with members of his committee and HHS Secretary Alex Azar about the prospect of retroactively eliminating or delaying the Affordable Care Act requirement that employers with 50 or more workers offer health insurance to employees.
The Hill (2/13) 
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Live longer, better with a healthy heart
Cardiovascular disease is the leading cause of death in the United States, accounting for one in every four deaths each year. Health insurance providers are doing their part to fight heart disease by educating people in their communities and encouraging preventive measures. Learn more.
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One powerful professional resource
AHIP offers a powerful professional resource for networking, career development, and news about the health insurance industry. Did you know that an Individual Membership can be a smart investment? Health insurance agents and brokers, as well as health care industry consultants and attorneys, may be eligible to apply for membership. Preview the benefits, check your eligibility status, and join today.
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Pair health plans with growth-focused financial partners
HSA Direct members are potential financial partners that can help health insurance providers expand and enhance their HSA products. For example, UMB Healthcare Services, an HSA Direct member, delivers HSA custodial services and white-label multipurpose debit cards to insurance carriers, third-party administrators, software companies and financial institutions.
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