ACA birth control coverage rule lands in Supreme Court | Transparency rule services account for a fraction of Medicare spending | EHR, claims data alone, combined useful for predicting hospitalization
January 21, 2020
AHIP Solutions SmartBrief
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ACA birth control coverage rule lands in Supreme Court
ACA birth control coverage rule lands in Supreme Court
(Mark Wilson/Getty Images)
The Supreme Court will hear a petition from the Trump administration asking it to allow implementation of a 2018 rule scaling back the Affordable Care Act's birth control mandate. The rule permits employers to stop covering contraceptives on moral or religious grounds, but it was blocked after Pennsylvania and New Jersey challenged the policy.
Reuters (1/17) 
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Transparency rule services account for a fraction of Medicare spending
An analysis from the Health Care Cost Institute found that spending for 70 "shoppable" health care services targeted in a Trump administration rule mandating disclosure of insurer-negotiated rates for certain care by 2021 only accounted for 12% of Medicare's medical spending and 16% of out-of-pocket spending in 2017. The findings suggest that consumer-focused transparency efforts "alone are not likely to substantially alter the trajectory of healthcare spending," said Katie Martin, a senior fellow with the HCCI.
FierceHealthcare (1/17) 
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Teladoc Health 2020 Predictions
Explore our five predictions about the future of virtual care—from its impact on private and public healthcare partnerships to the barriers it can break for mental health, and the important role it will play as individuals around the world face more chronic and complex health conditions. Download now.
Providers & Suppliers
EHR, claims data alone, combined useful for predicting hospitalization
Analytic tools that use EHR data, claims data or both had similar power in predicting hospitalizations over a six-month period, researchers reported in the American Journal of Managed Care. "Although our results suggest some utility to combining EHR and claims data to inform predictive model creation, we find that even in scenarios in which only EHR or claims data are available, strong performance can be achieved provided that a diverse collection of variable types is represented," researchers wrote.
EHR Intelligence (1/16) 
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Medical Update
CDC issues scaled-back e-cigarette warnings
The CDC warned against the use of e-cigarettes containing tetrahydrocannabinol in an update of last year's broader recommendations advising against all use of e-cigarettes, but the agency still discourages use of any type of e-cigarette by youths, pregnant women and nonsmokers. The agency said 82% of sickened patients for whom data is available reported use of products containing THC.
WTOL-TV (Toledo, Ohio) (1/19),  The Wall Street Journal (tiered subscription model) (1/17) 
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3 US airports to screen travelers from China for emerging coronavirus
Three US airports -- San Francisco International Airport, New York's John F. Kennedy International Airport and Los Angeles International Airport -- will begin screening travelers arriving from central China for a new coronavirus causing a pneumonia outbreak in China. The CDC is sending health workers to assist with screening for the virus, which is genetically similar to Middle East respiratory syndrome and severe acute respiratory syndrome.
HealthDay News (1/17) 
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Mass. Addressing Bad Directory Data
It's highly likely that your provider directory is peppered with inaccuracies. Members, providers and state regulators are taking notice and becoming increasingly vocal about addressing this issue. Join the discussion about advances Massachusetts is making in directory data accuracy while highlighting what you can do today to make an impact in your data quality.
Emerging Trends: Social Determinants of Health
Kaiser, Blue Shield to contribute $45M to Calif. homeless fund
An executive order signed last week by California Gov. Gavin Newsom will create a $750 million state fund to combat rising homelessness in the state. Blue Shield of California pledged $20 million while Kaiser Permanente will contribute $25 million to the fund, which will be used to pay rents, subsidize housing or assist board and care homes.
The Associated Press (1/17) 
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Study links food insecurity to increased risk of premature death
A study in the Canadian Medical Association Journal found adults with food insecurity had 10% to 37% increased odds of dying prematurely from any cause except cancer, compared with their peers who had adequate access to food. The findings, based on data from over 510,000 adults in Canada from 2005 to 2017, showed rates of premature death due to suicide, unintentional injury and infectious-parasitic disease were more than doubled among adults experiencing severe food insecurity.
HealthDay News (1/20) 
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Study looks at factors tied to pediatric health care use
Children, including those with special health care needs, with elevated family resilience and neighborhood cohesion had a reduced likelihood of having unmet health needs, researchers reported in Pediatrics. The findings, based on 2016 CDC data involving 11,543 youths whose family incomes were lower than 200% of the poverty level, also correlated material hardship with increased emergency department visit risk for those with and without special health care needs, with neighborhood cohesion mediating the link between material hardship and ED visits among those with special health care needs.
2 Minute Medicine (1/16) 
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Health Insurance Provider Company News
Solutions Provider News
Two health care conferences. Countless insights.
Engage with the experts who can help you get a better picture of what health care will look like moving forward and your organization's role. Register now for AHIP's National Health Policy Conference and the National Conference on the Individual and Small Group Markets in D.C.
Pharma News
Expanded indication approved for Novo Nordisk's Ozempic
Novo Nordisk announced that the FDA has approved its application for the expanded indication of its drug Ozempic, or semaglutide, to diminish the risk for major adverse cardiovascular events in adult patients with type 2 diabetes who have been previously diagnosed with heart disease. The approval was based on data from its SUSTAIN 6 trial.
Seeking Alpha (1/16) 
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Policy Watch
HHS proposal would lift referral requirement for religious providers
HHS has proposed ending a policy requiring religious providers of social services to refer patients elsewhere for any services they don't offer on the basis of religion. The proposal would also lift the requirement that faith-based organizations provide notification of the mandate.
HealthLeaders Media (1/17) 
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FTC to closely scrutinize hospital mergers in 2020
Federal Trade Commission member Christine Wilson told a Council for Affordable Health Coverage event that horizontal hospital mergers will be under scrutiny in 2020, and some mergers could get an after-the-fact review to see whether they achieved cost and quality goals. Wilson said the FTC will continue to focus on competition, including seeking the repeal of state certificate-of-need laws and flexibility in scope-of-practice laws.
Healthcare Dive (1/17) 
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Better health care begins with ah-ha moments
2020 will be another tumultuous year in health care. The election cycle will be an ongoing platform to debate Medicare for All versus building upon and strengthening our current system. Institute & Expo is your opportunity to think clearly about the future of health care and see how health insurance providers are leading the way toward more accessible, safe and affordable care.
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Listen: The Next Big Thing in Health
Tune in to AHIP's "The Next Big Thing in Health" podcast, where health care leaders take a deep dive into the big ideas and new solutions to improve care. The podcast features insights, trends, and perspectives to make care more affordable, more available, and more effective. Catch up on Season 1 episodes.
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Featured resources: AO recent white papers
White papers and case studies submitted by our Affiliate Organizations (AOs) bring you the latest thinking on current topics in health care. This month's features include white papers from Change Healthcare on payment accuracy, the transition to value-based care, and claims pre-submission notification; MCG Health on trends in neonatal and pediatric hospitalization; and Mark Farrah Associates on Medicare markets.
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