Public Policy Weekly Clips: March 22, 2016

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Every Tuesday, NCQA gives a rundown of the best national, state and private sector health care articles from the week. Here are our picks for today’s Public Policy Weekly Clips.

National:

NCQA PCMH quality and utilization benefits start small but grow over time & with shared savings.

A Health Affairs op ed says quality would rise faster if quality and efficiency incentives were separate.

58% of Medicare Part D drugs require coinsurance rather than fixed copays, up from 35% in 2014

CMS’ new Medicare Disparities tool IDs racial, ethnic & geographic spending, use & outcome disparities.

High-minority hospitals have more ED diversions that increase heart attack deaths & disparities.

Dartmouth Atlas shifted its focus from regional variation to the experience of increasingly aged patients.

Over 40% of Marketplace insurers also offer Medicaid managed care plans in the same states.

Average ACA Marketplace premiums rose 5% for 2016.

Prescription fills rose by 8.6% in 2015 for ACA enrollees, 4 times greater than in other commercial plans.

Doctors who got industry payments are 2-3 times more likely to prescribe brand-names at high rates.

Drug prices rose 5.2% overall in 2015, but brand names jumped 16.2% for a total 98.2% rise since 2011.

CDC issued guidelines on how to use, select & minimize risk of opioids for chronic pain in primary care.

CDC says 1 in 7 children under 9 have a mental, behavioral or developmental problem

22% of smokers who quit cold turkey are smoke-free at 6 months vs. 15.5% for gradual quitters.

Working 60 hours per week raises heart disease risk 35% higher risk over people working 45 hours.

High physical activity levels raise brain grey matter linked to lower Alzheimer’s cognitive impairment.

HHS announced the membership of the Health Care Industry Cybersecurity Task Force.

28% of providers will merge mobile device data into EHRs & 74% of patients say data helps to engage.

USPSTF new chair is UCSF’s Kirsten Bibbins-Domingo & U of Iowa’s Susan Curry is vice-chair.

5 large health insurers will have almost half of the market under continuing Medicaid expansion.

State:

California’s Marketplace wants to kick poor performing or high-cost hospitals out of plan networks.

California’s insurance commissioner made his emergency network adequacy rules permanent.

DC proposed telemedicine rules that require real-time auditory doctor-patient communication

Florida passed bills to explore telehealth expansion as well as increase health pricing transparency.

Massachusetts will limit prescriptions, require state database checks & take other steps to curb opioids.

Missouri’s law limiting Marketplace navigator efforts was struck down by a federal district court.

Washington’s Group Health Cooperative members agreed to join Kaiser Permanente in a $1.8B deal.

Private:

High deductible plans reduce spending significantly, but not in a smart way says Harvard & Berkeley.

Last year, 36% of U.S. workers with employer-sponsored benefits had a deductible of at least $2,000

The Health Care Cost Institute says hospital consolidation is why employer health costs keep rising.

Employers cost cutting cannot come at the expense of value, says new NBCH CEO.

Harvard & Stanford say the most effective thing to improve worker health is to reduce worker stress.

Offering consumers money to shop around for procedures reduces saves employers millions.

Paul Cotton
Paul Cotton is the Director of Federal Affairs. He works on health reform and other initiatives to improve health care quality. Previously he was an AARP Senior Legislative Representative lobbying Congress and the Administration on Medicare, Medicaid, CHIP, health reform and quality improvement issues. He has also worked at the Center for Medicare & Medicaid Services as Hearings & Policy Presentation Director in the Office of Legislation, and as a journalist for publications including the Journal of the American Medical Association.

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