Study emphasizes importance of Medicare, Medicaid business to health plans | Cancer survival disparities persist | Verma announces CMS efforts to ease quality reporting
December 6, 2017
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Study emphasizes importance of Medicare, Medicaid business to health plans
A study published in Health Affairs found that Medicare and Medicaid accounted for 59% of business at the country's five biggest commercial health plans last year. The top five collectively cover 43% of the nation's insured population, and their membership climbed by 23 million overall from 2010 to 2016.
Healthcare Finance News (12/5),  HealthLeaders Media (12/4) 
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Cancer survival disparities persist
Cancer survival disparities persist
(Chris Hondros/Getty Images)
Three studies published in the journal Cancer found that racial disparities in cancer survival persist for colon, ovarian and breast cancer. "This suggests that access to and/or use of screening and treatment services varies by race and location," said CDC researcher Dr. Arica White, an author on the study that looked at colon cancer.
Reuters (12/5) 
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Healthcare Matters: Industry Trends Tailored to You
Get the autumn edition of Healthcare Matters with top-of-mind market trends and insights for payers. We tackle the industry shift toward value-based outcomes, how healthcare IT is improving administrative efficiency and look at the next frontier of business process outsourcing. Get your copy.
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Providers & Suppliers
Verma announces CMS efforts to ease quality reporting
The CMS launched Patients Over Paperwork, an initiative designed to streamline regulatory oversight of physicians, and the Meaningful Measures initiative, which aims to ensure that clinical quality measures evaluate only core issues, CMS Administrator Seema Verma announced. Verma also said the agency is working on an easier quality measure reporting process for providers, and she stressed that improving EHR interoperability and usability will require collaboration between health IT developers and providers.
EHR Intelligence (12/4) 
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Webinar: How One Blue Plan Increased Provider EFT/ERA
Learn how a large regional health plan dramatically expanded provider enrollment in EFT and ERA to 90%, without using a payment vendor. Find out how your plan can use those lessons to cut check payments, increase payment data accuracy and reduce provider abrasion.
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Medical Update
Study: Cardioprotective effects of exercise are immediate, enduring
One or a handful of exercise sessions train the heart and coronary arteries to endure brief periods of ischemia, minimizing infarct size and ventricular arrhythmia, researchers reported in JAMA Cardiology. The findings suggest that having able patients undergo a few sessions of exercise before a planned cardiac intervention might reduce in-hospital mortality and morbidity.
MedPage Today (free registration) (11/30) 
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Heart disease risk tied to high-sugar diet, researchers say
Researchers analyzed data from old and new studies and found that diets containing more than 25% of calories from added sugars were associated with a threefold increased risk for cardiovascular mortality, compared with diets containing less than 10% of calories from added sugars. The findings, published in Open Heart, showed that added sugars may lead to the development of chronic heart disease and other CV complications via insulin resistance.
Diabetes (UK) (12/4) 
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Emerging Trends
NIH to use EHR data for All of Us research program
The NIH is creating a national network of health care provider organizations across the country to gather health data, medical records and biospecimens of participants in the Precision Medicine Initiative cohort as part of the All of Us research program. Participants will consent to have their EHR data sent by their providers to a Data and Research Support Center, and All of Us will use the common data model of the Observational Medical Outcomes Partnership to facilitate EHR sharing.
Health Data Management (free registration) (12/4) 
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HOS & CAHPS: Last Measure to Impact Stars
It's not too late to impact 2019 Star scores! Watch this 5-minute video to learn how Eliza quickly deployed a HOS & CAHPS program in December to improve key measures by 1-2 Stars and increased the plan's overall score from 3.5 to 4 Stars! Watch Video →
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Health Insurance Plan Company News
How Data Drives Clinical Insights
In this on-demand webinar, learn how Inovalon's certification as a CMS Qualified Entity (QE) can help healthcare organizations drive strategic business decisions and meaningful improvements in clinical and financial performance. Access webinar.
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Solutions Provider News
Share your solutions with health plans
As health plans make health care work better, they're looking for your solutions. Share your products and services focused on value-based care, affordability and making the consumer the center of health care. Contact BusinessDevelopment@ahip.org.
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Pharma News
Heart, stroke risk protection claims of Amgen's Repatha OK'd by FDA
The FDA granted approval to Amgen to change the prescribing label of its cholesterol drug Repatha to add that the drug can reduce the risk of heart attack and stroke. The drug reduced heart attack risk by 27% and stroke risk by 21% in a study of more than 27,500 patients released in March.
Reuters (12/1) 
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Analysis finds out-of-hospital naloxone use safe, effective
An analysis of 13 studies on the administration and dosing of naloxone in out-of-hospital settings showed higher-concentration intranasal naloxone and intramuscular naloxone had similar rates of efficacy in reversing overdose symptoms and showed no difference in adverse events. Researchers reported in the Annals of Internal Medicine that there was no serious harm associated with not visiting the hospital after using naloxone to reverse an overdose.
AAFP News (12/4) 
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Policy Watch
Mandate repeal may clear House, but bipartisan bill's fate is uncertain
House Ways and Means Committee Chairman Kevin Brady, R-Texas, expects most Republican House members to back elimination of the Affordable Care Act's individual mandate as Republican senators did last week. It's less certain that a bipartisan push to stabilize the ACA will clear the House, although the plan has been key to Senate negotiations on tax legislation.
The Hill (12/5),  The Hill (12/5) 
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Collins doubles funding request for ACA stabilization to $10B
Sen. Susan Collins, R-Maine, has introduced a bill that requests $10 billion -- more than twice her initial request -- to stabilize the Affordable Care Act in exchange for her vote on tax legislation. The bill, which Collins said has received "commitments" toward passage, would help states fund the establishment of high-risk pools or reinsurance programs to lower premiums.
The Hill (12/4) 
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AHIP News
Expert insights into operational changes
During AHIP's National Conference on the Individual and Small-Group Markets, March 8-9 in Washington, D.C., you'll come away with expert guidance from policymakers, thought leaders, and industry stakeholders on the key policy and operational changes that will affect products and planning for 2019. Sign up today to take advantage of early registration discounts.
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Work toward your FAHM designation
Sign up for AHIP's Governance, Legal Issues, Medicaid and Medicaid (AHM510) course and work toward your Fellow, Academy for Healthcare Management (FAHM) designation. Dive deep into the overall purpose and direction of health care management, the impact of fraud and abuse, and the role of public policy with this online course. Sign up today.
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AHIP Select: Leading solutions providers
AHIP member companies rely on AHIP Select members to provide the products and services that help health plans transform our health care industry. Become a Select member for direct access to health plan decision makers. Contact our Business Affairs Team at BusinessDevelopment@ahip.org for details.
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