CBO: Halting CSR payments would raise premiums 20% next year | CDC data show 65% jump in US antidepressant use over 15 years | Report: Hospitals may benefit from combining FHIR, Direct standards for HIE
August 16, 2017
AHIP Solutions SmartBrief
Top Stories
CBO: Halting CSR payments would raise premiums 20% next year
Discontinuing cost-sharing reduction payments to insurers would increase premiums for silver-tier plans, the most popular plan tier sold on Affordable Care Act exchanges, by 20% next year and by 25% by 2020, and would raise the federal deficit by $194 billion through 2026, according to an analysis by the Congressional Budget Office. The move would prompt insurers in some states to exit the market, leaving about 5% of Americans with no insurance options next year, although insurers are expected to rejoin the market in 2020.
The New York Times (free-article access for SmartBrief readers) (8/15),  The Hill (8/15) 
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CDC data show 65% jump in US antidepressant use over 15 years
Data from the CDC's National Center for Health Statistics showed antidepressant use in the US was up by almost 65% over the last 15 years, increasing to 13% in 2011-2014 from approximately 8% in 1999-2002. Researchers said antidepressant use increased with age for both genders, but women were about twice as likely as men to report using the medications in the past month.
Medscape (free registration) (8/15),  HealthDay News (8/15) 
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Providers & Suppliers
Report: Hospitals may benefit from combining FHIR, Direct standards for HIE
Hospitals and medical practices could improve the exchange of health information by using HL7's Fast Healthcare Interoperability Resources standard in combination with the Direct protocol, according to a DirectTrust report coauthored by FHIR architect Grahame Grieve of HL7, DirectTrust CEO Dr. David Kibbe and members of the DirectTrust Policy Committee. "No single standard ... can do everything that is needed by providers and patients wanting to securely share and exchange health information using various tools and technologies," Kibbe said.
Healthcare IT News (8/14) 
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Report: Almost 575,000 Medicare patients have end-of-life talks
Federal data show that in the first year that health care professionals were allowed to bill Medicare for advance care planning, almost 575,000 beneficiaries engaged in end-of-life discussions with a clinician. The number still represents just a small percentage of eligible patients, however, and AAFP Medicare coding expert Barbie Hays says some physicians do not know about the service or how to get paid for it.
Kaiser Health News (8/14) 
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Impact Retention, Insight, & Regulatory Compliance
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Medical Update
Study: Adults considered fit but fat have higher heart risks
Study: Adults considered fit but fat have higher heart risks
(Lisa Maree Williams/Getty Images)
Metabolically healthy adults who were overweight had a 26% higher risk of heart disease, compared with normal-weight adults, while those who were obese had a 28% higher risk, according to a study in the European Heart Journal. People with three or more heart risk factors had twice the likelihood of developing heart disease regardless of their weight, the study found.
HealthDay News (8/14),  CNN (8/14) 
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Study links poor medication adherence in diabetes to increased CVD risk
UK researchers found that type 2 diabetes patients with poor medication adherence had a higher risk for cardiovascular disease than those with good medication adherence. The findings in Diabetes Care, based on a meta-analysis of eight observational studies involving 318,125 adult diabetes patients, also revealed an association between good medication adherence and reduced risks for all-cause mortality and hospitalization.
Healio (free registration)/Endocrine Today (8/14) 
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Webinar: Are you ready for 350% more calls?
Open enrollment is nearly here, and with it, a significant spike in contact volumes, adding pressure at a time when customer service teams must deliver. Join a discussion with UnitedHealth as they gear up for a 350% increase call volume and learn best practices to tackle these challenges. Register now.
Emerging Trends
Survey reveals top EHR platforms used by senior living providers
Chicago-based specialty investment bank Ziegler surveyed 143 chief financial officers and financial professionals at senior living providers across the US and found that 35.4% who have implemented EMR/EHR platforms within their organizations use MatrixCareAOD/SigmaCare, while 29.9% use PointClickCare and 15.7% use Netsmart/HealthMEDX. The poll showed that almost 90% of respondents use EMR/EHR platforms.
Senior Housing News (8/14) 
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Health Insurance Plan Company News
Find the gems in your healthcare data
Much of healthcare insight remains locked away in vast amounts of raw data. Find out how a leading national TPA uses HDMS' powerful & flexible analytics platform to turn this raw data into real results: 23.7% overall plan savings, 17.4% reduction in unnecessary ED visits & more. Read more here.
Solutions Provider News
Join the conversation on LinkedIn®
Do you use social media to stay up to date and give your inbox a break? Then let's connect! Join the AHIP Education group on LinkedIn® today! Stay up-to-date on professional development opportunities, educational offerings, discounts, and more. Join the group today!
Pharma News
Drug companies struggle to fill up clinical trials
The rise of new treatment strategies, immunotherapy and personalized medicine has led to a growing list of cancer drugs to test and too few clinical trial patients to test them on, experts said. Also, some drugs are designed to treat uncommon genetic mutations, which could lead to worldwide searches for clinical trial participants that last years, and sometimes drugs are so similar they target the same patient pool.
The New York Times (free-article access for SmartBrief readers) (8/12) 
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Policy Watch
Appeals court sides with HHS in RAC case
The US Court of Appeals for the District of Columbia sided with the HHS in a Recovery Audit Contractor Program case brought by the American Hospital Association, overturning an order that a backlog of Medicare reimbursement claims be cleared off the books by the end of 2020. HHS said it could not reduce the backlog by the scheduled target date without improperly paying claims.
Becker's Hospital Review (8/14) 
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CMS urged to do more to ensure fair readmission penalties
Health care organizations want the CMS to do more to ensure hospitals are not unfairly penalized for readmissions due to the socio-demographic makeup of patients. Experts say policy in the 21st Century Cures Act that requires the CMS to consider socio-demographics in readmissions lacks specificity and details, and CMS noted in its final inpatient payment rule that the overall percentage of hospitals being penalized would not show much change.
Modern Healthcare (tiered subscription model) (8/12) 
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New approaches to the changing health care marketplace
A new speaker has been announced for AHIP's State Issues Retreat, Sept. 28 through Sept. 29 in Washington, D.C.: Michael Consedine, CEO of the National Association of Insurance Commissioners. Hear how Insurance Commissioners are approaching the changing marketplace and addressing those challenges - both for major medical issues as well as other health insurance issues. Register today. Attendance is limited.
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Wherever you're starting from, you'll go farther with a good grounding in the basics from AHIP's cornerstone course. Health Insurance 101 is a comprehensive overview of the health care industry in just nine flexible modules. Get started and enroll today.
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Learn more about a myriad of health care topics through these recently posted white papers from AHIP's Affiliate members, including NTT DATA, Surescripts, InterSystems, Convergys, and Cierant. Check them all out today.    
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