Trump to discontinue CSR payments | Trump signs executive order relaxing ACA rules | Hospitals to receive payment adjustments for failure to show EHR MU attestation
October 13, 2017
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Trump to discontinue CSR payments
Trump to discontinue CSR payments
(Joe Raedle/Getty Images)
The Trump administration announced Thursday that it will immediately discontinue cost-sharing reduction payments, saying it cannot lawfully continue the payments because there is no congressional appropriation, a move criticized by Democratic lawmakers and state attorneys general. A Congressional Budget Office analysis released in August found that halting CSR payments would increase premiums by about 20% and leave an additional 1 million Americans uninsured.
Reuters (10/12),  The Hill (10/12),  Lincoln Journal Star (Neb.) (tiered subscription model)/The Associated Press (10/12) 
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Trump signs executive order relaxing ACA rules
President Donald Trump on Thursday signed an executive order directing federal agencies to develop regulations that would make it easier for small businesses and other groups to partner and buy association health plans and to relax limits on short-term health plans. Health care experts and industry groups said the changes could drive healthier people to purchase leaner plans, leaving only sicker people in Affordable Care Act plans, which could force insurers to raise premiums and possibly exit markets altogether.
The Hill (10/12),  The Examiner (Washington, D.C.) (10/12),  CNBC (10/12) 
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Healthcare payer speeds processing by 72%
With OnBase workflow, provider enrollment staff at Wisconsin Physicians Service Insurance need just 17 days for the work that used to take them 62 days to complete. This payer also cut 1.4 million pages of paper, reduced/repurposed 50 FTEs and eliminated all overtime. Read the case study.
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Providers & Suppliers
Hospitals to receive payment adjustments for failure to show EHR MU attestation
The CMS warned that as of Oct. 1, eligible hospitals that are not meaningful EHR users during the fiscal year 2018 reporting period will receive Medicare payment reductions for that year. "This payment adjustment is applied as a reduction to the applicable percentage increase to the Inpatient Prospective Payment system rate, thus reducing the update to the IPPS standardized amount for these hospitals," the CMS said.
Health Data Management (10/11) 
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Are you ready for machine learning?
With the advent of big data, the amount of data and our ability to process it has increased exponentially. It's an environment perfectly suited for machine learning. So how can you make it part of your analytic infrastructure? This e-book highlights the capabilities of machine learning, and best practices you can implement to take full advantage of it. Download Here.
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Medical Update
Global cost of treating obesity to reach $1.2T per year by 2025
A study by the World Obesity Federation showed that the cost of treating obesity would reach $1.2 trillion annually by 2025 across the world, with the US poised to surpass all other nations in terms of health care costs. The US health care system spent $325 billion per year in 2014 to treat cancers associated with obesity and other obesity-related illnesses and is projected to spend $4.2 trillion between this year and 2025, researchers found.
CBS News/The Associated Press (10/11) 
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Prevalence of risk factors for stroke increases, study finds
Researchers found an increase in the prevalence of risk factors for ischemic stroke from 2004 to 2014, including diabetes, which increased from 31% to 38% among hospitalized stroke patients and rose by 2% each year. The findings in Neurology, based on 922,451 patients, revealed that 48.7% of Hispanic patients had diabetes, compared with 30.5% of white patients.
Healio (free registration)/Cardiology Today (10/11),  HealthDay News (10/11) 
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Emerging Trends
Tiny ultrasound device tracks brain activity in infants
A domino-size ultrasound scanner can detect abnormal brain activity and seizures through the anterior fontanelles in real time and could be used to monitor infants' brain function. Researchers reported in Science Translational Medicine that the probe distinguished active and quiet sleep, and, when combined with EEG, not only detected seizures in two at-risk infants but also identified where in the brain the seizures originated.
Science online (10/11) 
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Health Insurance Plan Company News
Solutions Provider News
Pharma News
Study: Higher prices, more shortages after Unapproved Drugs Initiative
The FDA's Unapproved Drugs Initiative, which requires FDA approval of unapproved drugs already on the market, appears to have led to higher drug prices and more frequent drug shortages, and the approval process did not always require that sponsors conduct new clinical trials to establish safety or efficacy. Journal of Managed Care & Specialty Pharmacy (10/17)
STAT (tiered subscription model) (10/11) 
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Mylan's Neulasta biosimilar turned down by FDA
A complete response letter was issued by the FDA to Mylan regarding its marketing application for a biosimilar of Amgen's Neulasta, or pegfilgrastim. The letter said more data on manufacturing, controls and chemistry from Mylan's research partner, Biocon, was necessary.
Seeking Alpha (free registration) (10/10) 
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Policy Watch
Report: Action needed to shore up Medicare, Social Security
The Social Security trust fund faces a financing shortfall equal to 17% of projected costs over the next 75 years, while the Medicare fund faces a shortfall of 14% of projected costs if nothing is done legislatively to close the gaps, according to a report from the Bipartisan Policy Center. The report favors both raising taxes and cutting benefits to deal with the shortfalls.
ThinkAdvisor (free registration) (10/11) 
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ACA navigators will reduce services due to Trump funding cuts
Health care navigator groups will limit their services in the wake of Trump administration funding cuts, according to a recent Kaiser Family Foundation survey. Fifty-five percent of statewide programs and 72% of regional programs said they will serve a limited territory, and 89% of all programs expect to reduce staff. Advertising and outreach activities will also be reduced, as will the number of months they provide enrollment assistance.
The Hill (10/11) 
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AHIP News
AHIP Individual Membership
If you are an agent or broker, AHIP Individual Membership is ideal for you. Throughout the year, you'll receive access to the latest news and information affecting the industry, as well as discounts on dozens of AHIP education programs, such as, "Health Insurance 101," "Long-Term Care Professional Combined Course" and many more. Learn more and join.
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Must-attend webinars. Register today.
Oct. 19, 1 to 2 p.m. ET, "NCQA Discussion: Lab Hedis Measures & Quality Improvement" explores lab-focused quality measures and strategies to improve quality outcomes! Oct. 25, 1 to 2 p.m. ET, "Reduce Cardiovascular Risk With Personalized Engagement " examines case study involving strategies for engaging members with diabetes, heart disease, and hypertension.
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Protecting Patients from Opioid Abuse
Many health plans are refining their approaches and driving the innovations needed to make a real difference in the opioid crisis. Here's a look at what two Pennsylvania health plans are doing to protect patients and curtail the misuse of prescription opioids. Read more.
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