Tavenner on the ACA: What's working and what's needed | Private insurance linked to better cancer outcomes | CMS: Hospital readmission rates drop average of 8%
September 19, 2016
AHIP Solutions SmartBrief
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Tavenner on the ACA: What's working and what's needed
Tavenner on the ACA: What's working and what's needed.
Tavenner. (Mark Wilson/Getty Images)
The insurance industry has made important strides for consumers in the past few years, says AHIP President and CEO Marilyn Tavenner, but she says government and Congress must act to continue the momentum. Better oversight of special enrollment periods is needed to balance risk, and measures are needed to allow plans to design benefits that will appeal to young, healthy adults, Tavenner says.
The Business Journals (tiered subscription model)/Portland, Ore. (9/15) 
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Private insurance linked to better cancer outcomes
Private health coverage is associated with earlier diagnosis and better survival among adults diagnosed with glioblastoma multiforme or testicular cancer, according to separate studies in the journal Cancer. Privately insured patients with testicular cancer have 88% lower mortality risk than uninsured patients, while privately insured patients with glioblastoma multiforme tend to live longer than those without insurance and those covered by Medicaid.
Kaiser Health News (9/16) 
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Your Security Strategy Should Revolve Around Customers, Not Technology
The best technology won't stop a data breach, but a customer-obsessed security program will preserve trust when it happens. Download the report and learn how from Forrester Research.
Providers & Suppliers
CMS: Hospital readmission rates drop average of 8%
The CMS reported an average 8% decrease in hospital readmission rates from 2010 to 2015. Agency officials credited much of the improvement to the Hospital Readmissions Reduction Program that cuts Medicare reimbursements for hospitals with 30-day readmission rates that are higher than expected for acute myocardial infarction, heart failure and pneumonia.
Medscape (free registration) (9/15) 
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Study: Incentive program has little effect on preventive care
Data showed similar racial disparities in preventive care before and after the CMS Quality Bonus Payment Demonstration in Medicare Advantage, which was introduced in 2012, researchers reported in the journal Preventing Chronic Disease. Researchers studied whether program incentives affected preventive care in the areas of improving bladder control, reducing risks of falls, and physical activity monitoring.
Healio (free registration) (9/14) 
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Webinar: Prove the Value of Engagement Initiatives with Interaction Analytics
Engaged members mean better health and financial outcomes. Measuring engagement remains elusive, however. Join us to learn about the data management and communication technologies for making the most of every member touch point. Hear about the latest techniques for optimizing critical interactions, which can drive better results and member satisfaction. Click here to register.
Medical Update
CDC reports brain cancer as top cause of pediatric cancer deaths
A report from the CDC's Center for National Health Statistics found that brain cancer was the leading cause of pediatric cancer deaths after deaths rose from 516 in 1999 to 534 in 2014, while leukemia deaths declined from 645 to 445. The findings also showed that overall cancer mortality among youths declined by 20% over the same period.
Reuters (9/16),  The Washington Post (tiered subscription model) (9/16) 
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CDC examines physical activity among older US adults
Thirty-one million US adults ages 50 and older don't engage in any physical activity, including almost 26% of men and more than 29% of women, which increases their risk for diabetes, cancer and heart disease, according to the CDC's Morbidity and Mortality Weekly Report. Researchers evaluated the results of a 2014 national health survey and found that adults become more physically inactive as they age.
HealthDay News (9/15) 
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White paper: Create effective enterprise training programs
The top two learning priorities for companies are product training and compliance. Are your teams — your internal workforce and your external partners— prepared to do this? If not, how much money is this costing you?
Read the whitepaper now
Emerging Trends
2 Texas cities have the highest uninsured rates in the US
2 Texas cities have the highest uninsured rates in the US.
(Joe Raedle/Getty Images)
Houston and Dallas are ranked first and second among major metropolitan areas in the US with the highest rate of uninsured residents, while San Antonio ranks fourth in the list, according to data from the US Census Bureau. Coverage rates in Texas, which did not expand Medicaid eligibility, are low among low-income residents, and Texas also has seen higher-than-average maternal mortality rates.
Vice News (9/15) 
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Study uses EHR data to predict future suicidal behavior in patients
Researchers with Boston Children's Hospital Informatics Program created a model based on EHR data from 1998 to 2012 and found that the model was able to predict a patient's future suicidal behavior at an average of three to four years in advance, showing an up to 95% specificity or true negative rate and up to 45% sensitivity or true positive rate. The findings in The American Journal of Psychiatry suggest that EHR data "present a largely untapped opportunity for improving medical screening and diagnosis," researchers note.
BeckersHospitalReview.com (9/14) 
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How Benefits Might Change in 2017
As the election season marches on and the nominees have been selected, now is a good time to take a look at the changes you might expect for health benefits in 2017. It is hard to know what will simply be election fodder and what will actually come to fruition, but it is important to keep abreast of all the moving pieces and where each candidate stands. Learn more
Health Insurance Plan Company News
Count your credentialing cycle in days, not months.
Read this fact sheet to learn how you can eliminate redundant and costly outreach to providers, remove credentialing backlogs, easily meet all compliance requirements, and improve provider directory quality in less than 30 days. Get the fact sheet >>
Hot Topics
Pharma News
Aralez's Yosprala wins FDA nod
Aralez Pharmaceuticals' Yosprala, or aspirin and omeprazole, has been approved by the FDA for patients who take daily aspirin to prevent secondary cardiovascular events and are at risk for gastric ulcers caused by aspirin. Two clinical trials showed patients who received the drug had fewer endoscopic gastric ulcers compared with those who received enteric-coated aspirin.
Reuters (9/15),  MedPage Today (free registration) (9/15) 
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Policy Watch
Calif. seeks health care innovation waiver for undocumented residents
California officials are seeking permission from HHS and the Treasury Department to allow undocumented immigrants to enroll in health coverage through the state's Affordable Care Act marketplace.
The New York Times (free-article access for SmartBrief readers) (9/15) 
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Educational tracks at Consumer Experience & Digital Health Forum
Best practices, how-tos and case studies are the foundation of concurrent sessions and breakfast briefings at AHIP’s Consumer Experience & Digital Health Forum, Dec. 6-8 in Chicago. Educational tracks include: Reengineering marketing to drive consumer engagement; next-generation consumer and patient experience; infrastructure and business operations transformation, leveraging data analytics and insight; and technologies and tools for connected and collaborative care. Register today.
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Complimentary Webinar: Mapping out your diabetes prevention program
Map out the right path for your diabetes prevention program. Discover lessons learned from health plans participating in the CDC’s National, such as how to acquire measureable data, act on the information, and partner with the right organizations. Register today for this complimentary webinar, Sept. 20 from 1 to 2 p.m., ET.
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Complimentary webinar: Defeating fraud, waste, and abuse
Master a new approach for tackling Fraud, Waste, and Abuse (FWA) issues. Join us on Sept. 21 from 2:00 p.m. to 3:00 p.m. ET, as Franklin M. Din, DMD, MA, CMIO of FraudLens, Inc., discusses a new FWA strategy to produce a pre-pay behavioral change rather than post-pay enforcement and recovery. Register for this complimentary webinar today.
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