CMS unveils proposed standards for 2020 ACA health plans | CDC: Opioid Rx rates tied to higher incidence of abdominal birth defect | Diabetes risk test shows promise for screening babies
January 18, 2019
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CMS unveils proposed standards for 2020 ACA health plans
The CMS unveiled its proposed notice of benefit and payment standards for Affordable Care Act plans for the 2020 coverage year and it includes proposals to lower ACA user fees, allow insurers to adopt midyear prescription formulary changes and increase the annual cost-sharing limit to $8,200 for self-only coverage and $16,400 for family coverage. The agency also asked for comments on how it might address the practice of silver-loading -- concentration of premium increases in silver plans -- and indicated support for a legislative fix enabling cost-sharing reduction payments to resume.
Modern Healthcare (tiered subscription model) (1/17) 
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CDC: Opioid Rx rates tied to higher incidence of abdominal birth defect
Counties with high and medium opioid prescribing rates had 1.6 times and 1.4 times higher prevalence of babies with gastroschisis, respectively, compared with counties with low opioid prescribing rates, CDC researchers reported in the agency's Morbidity and Mortality Weekly Report. The findings, based on data from 2006 to 2015 across 20 states, also showed a 30% increase in infant gastroschisis rates from 2006 to 2012, and while babies born to mothers younger than 20 remained most likely to develop gastroschisis, the greatest gain in prevalence was found among those born to older mothers.
CNN (1/17),  HealthDay News (1/17) 
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Providers & Suppliers
Diabetes risk test shows promise for screening babies
A new genetic risk score known as T1DGRS2 appears twice as efficient in predicting risk of developing type 1 diabetes compared with current methods, according to a study in Diabetes Care, and it could be used to predict risk in babies. Researchers analyzed gene interactions and genetic variation in more than 6,500 patients with type 1 diabetes and found that the new test was more accurate and was able to help distinguish between type 1 and type 2 diabetes.
United Press International (1/17) 
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Inappropriate antibiotics in ED prevalent in pediatric bronchiolitis
Researchers found that 69.9% of children younger than 2 who were given antibiotics in emergency departments for bronchiolitis didn't have any documented concomitant bacterial infection, with penicillins and macrolides being the most commonly prescribed antibiotics. The findings in the Journal of the Pediatric Infectious Diseases Society should prompt the implementation of quality improvement interventions, especially in nonpediatric and nonteaching hospitals, researchers wrote.
Physician's Briefing/HealthDay News (1/17) 
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Medical Update
Swapping 30 minutes of sitting with physical activity cuts death risk
Swapping 30 minutes of sitting with physical activity cuts death risk
(Peter Parks/AFP/Getty Images)
Replacing 30 minutes of sitting per day with physical activity lowers the risk of premature death by up to 35% in older adults, according to a study in the American Journal of Epidemiology. Moderate to vigorous activity was most effective, but even light-intensity activity was associated with a 17% lower risk of premature mortality.
CNN (1/14),  Bustle (1/16) 
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Study finds sharp rise in number of Americans mixing opioids, sedatives
An analysis of data from the US National Health and Nutrition Examination Survey from 1999 to 2014 found a sharp increase in the number of Americans using a combination of opioids and sedatives, which researchers say poses serious health risks, including death. The study, published in the journal Sleep, showed combination use of opioids and sedatives known as benzodiazepines, climbed by 250%, while combination use of benzodiazepines and a similar class of medications called Z-drugs increased by 850% during the period.
HealthDay News (1/17) 
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Emerging Trends
FDA opens investigation into paclitaxel devices for PAD
The FDA has issued a letter to health care providers alerting them of an investigation into paclitaxel-coated and paclitaxel-eluting devices designed for treating peripheral artery disease in the legs after a review in the Journal of the American Heart Association linked use of these devices with increased all-cause mortality risk. Spokespeople for Boston Scientific and Medtronic both noted that the meta-analysis did not consider patient-level data and maintained that the companies' devices were safe.
Star Tribune (Minneapolis-St. Paul, Minn.) (tiered subscription model) (1/17) 
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Health Insurance Provider Company News
Solutions Provider News
Pharma News
Sandoz announces availability of Symjepi injection
Sandoz has launched its Symjepi, or epinephrine, injection for treating individuals with emergency allergic reactions who weigh at least 30 kg. The Symjepi syringe contains 0.3 mg epinephrine and can be administered either subcutaneously or intramuscularly.
eMPR (1/17) 
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Policy Watch
MedPAC calls for consolidation of Medicare's value-based programs
The Medicare Payment Advisory Commission voted unanimously to recommend the consolidation of hospital quality initiatives into a single program linking Medicare payments to the quality of care, arguing the move would prevent confusion and overlapping requirements. The commission outlined recommendations for a program called the Hospital Value Incentive Program and said it should start in 2020 and increase the payment rate for acute care hospitals by 2% over this year.
Modern Healthcare (tiered subscription model) (1/17) 
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AHIP News
Confronting the growing health impact of loneliness
There is growing consensus that America is facing a loneliness epidemic -- a looming public health threat. About 1 in 11 Americans age 50 and older lacks a spouse, partner, or living child. And research shows people who are lonely and isolated are more likely to have health problems, including heart disease, stroke, and immune system problems. Learn how AHIP members are addressing loneliness.
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Leads, sales, success. Sponsorships that deliver.
As the health care industry continues to evolve, it's more important than ever for health insurance providers to focus on solutions that deliver value-based care and put the consumer at the center of care. Share your solution through an AHIP sponsorship. From webinars to conferences and white papers, get in front of decision makers. Contact BusinessDevelopment@ahip.org.
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Pairing health plans with growth-focused financial partners
HSA Direct members are potential financial partners that can help health plans expand and enhance their HSA products. Fidelity's goal is to make financial expertise broadly accessible to help people live the lives they want. With more than 12 years in HSA administration, they have proven experience helping employees plan, manage, and invest for their present and future.
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I liked being half-educated; you were so much more surprised at everything when you were ignorant.
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