In This Edition:
From Kaiser Health News:
The “overall hospital quality” rating is designed to help consumers who are sometimes confused by the variety of quality measures that the government already provides. But members of Congress had asked for the delay because of concerns that the methodology for the stars was not accurate. (Jordan Rau, 4/20)
A class action lawsuit in Los Angeles and a task force in Memphis both try to counter the “adverse childhood events” that impair health and well-being. (Sarah Varney, 4/21)
Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Broken Heart'" by Dan Piraro.
Here's today's health policy haiku:
CONGRESSIONAL PRESSURE LEADS MEDICARE TO PUT RATINGS ON HOLD
When will we see stars?
Hospital ratings, that is…
Release is delayed!
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Summaries Of The News:
New research shows that many poor Americans' financial woes have been eased by the expansion of Medicaid under the Affordable Care Act, but experts are unable to show if it has made low-income people any healthier.
The Washington Post's Wonkblog: The Big Way Obamacare Helps The Poor Isn’t Really About Their Health
President Obama's health-care reform law made government health insurance available to more people living in poverty or near poverty by expanding Medicaid. The hope was to improve people's physical health, but new research shows an important effect on financial health: The law has helped many poor Americans pay off the collection agent. The analysis, conducted by a team of university researchers and members of the Federal Reserve Bank of Chicago, estimates that those who signed up for Medicaid under the law reduced their collection balances by $600 to $1,000 each. (Ehrenfreund, 4/20)
CBS News: Is Obamacare Making Americans Healthier?
State Medicaid expansions under Obamacare have improved low-income Americans' insurance coverage, increased their doctor visits and enhanced detection of chronic health conditions, which could lead to improvements in health, a new study suggests. (Pallarito, 4/20)
In other news, both sides of the case against the health law's contraception mandate submit briefs that reinforce their views on the matter —
The Wall Street Journal: Supreme Court Contraception Case Shows No Signs of Compromise
The Obama administration and religiously affiliated employers in a final round of legal briefs Wednesday moved no closer to a compromise for covering contraception in workers’ insurance plans, likely leaving it to the eight-member Supreme Court to settle the dispute. The justices in an unusual step had requested supplemental briefs from both sides on a potential solution as they sought a way to avoid a potential 4-4 split following the February death of the court’s ninth justice, Antonin Scalia. The high court is reviewing a dispute over the 2010 health-care law requirement that employers provide birth-control coverage for workers. (Radnofsky, 4/20)
The legislation now goes to the House. Opponents warn that Gov. Asa Hutchinson's controversial strategy for the bill could invoke lawsuits. Meanwhile, in Kansas, the hospitals and others are frustrated by the lack of progress for a bill to expand the program that provides health coverage to low-income residents.
The Associated Press: Arkansas Senate Approves Bid To Preserve Medicaid Plan
The Arkansas Senate approved a plan Wednesday allowing Gov. Asa Hutchinson to continue the state's hybrid Medicaid expansion despite lawmakers voting to end it, though opponents warned the tactic opens the door for lawsuits. (DeMillo, 4/20)
Arkansas News: Medicaid Funding Bill Clears Senate, Heads To House
A budget bill containing funding for the governor’s Medicaid expansion plan cleared the Senate on Wednesday, thanks to an unconventional strategy that involved asking supporters of the plan to vote to kill it in order to save it. Senate Bill 121 by the Joint Budget Committee passed in a 27-2 vote, receiving exactly the number of votes the appropriation bill needed to reach the required three-fourths majority in the 35-member Senate. The bill goes next to the House, which is expected to vote on it Thursday. (Lyon, 4/20)
Arkansas Democrat-Gazette: Arkansas Senate Approves Plan To Preserve Medicaid Funding
The Arkansas Senate has approved funding for the state’s hybrid Medicaid expansion, with an amendment that the expansion come to a stop by the end of this year. ... Considered a workaround plan, the amended legislation grants Gov. Asa Hutchinson the opportunity to veto the amendment, thus allowing for the reinstatement of the expansion. Hutchinson has said he intends to use that authority. (Riddle, 4/20)
Wichita Eagle: Inaction On Medicaid Expansion Bill Rankles Kansas Health Community
Thus far, the push for Medicaid expansion in Kansas has been fruitless. An expansion bill proposed more than two months ago has not reached the Statehouse floor. Hospitals and health groups, who have long pushed for expansion, remain frustrated by the lack of progress. “What we’re most concerned about is the future,” said Bill Voloch, CEO of Wesley Healthcare. (Dunn, 4/20)
This week's expected release of the latest star ratings by the Centers for Medicare and Medicaid Services is postponed until July following congressional and industry questions about the methodology.
Kaiser Health News: Medicare Delays Plans For New Star Ratings On Hospitals After Congressional Pressure
Bowing to pressure from the hospital industry and Congress, the Obama administration on Wednesday delayed releasing its new hospital quality rating measure just a day before its planned launch. The new “overall hospital quality” star rating aimed to combine the government’s disparate efforts to measure hospital care into one easy-to-grasp metric. The Centers for Medicare & Medicaid Services now publishes more than 100 measures of aspects of hospital care, but many of these measures are technical and confusing since hospitals often do well on some and poorly on others. The new star rating boils 62 of the measures down into a unified rating of one to five stars, with five being the best. (Rau, 4/20)
The Wall Street Journal: U.S. to Delay Release of New Hospital Ratings
“CMS is committed to quality improvement and transparency for people with Medicare,” the agency said in a notice to lawmakers Wednesday. Medicare, the federal insurance program for older Americans, is one of the biggest payers for health care in the U.S. and has long been seen by different presidential administrations as a way to influence the entire health system. CMS said it was releasing the new timeline “in response to hospital and other stakeholder feedback.” (Radnofsky and Armour, 4/20)
Modern Healthcare: CMS Delays New Hospital Quality Ratings Amid Pressure From Congress, Industry
The CMS postponed the release of new overall quality star ratings for U.S. hospitals one day before their scheduled reveal, bowing to pressure from lawmakers and industry stakeholders. (Rice, 4/20)
Rising doctors learn new skills in dealing with terminally ill patients and their families. Meanwhile, The Associated Press offers the key things to know for doctor-patient conversations on critical care options.
Modern Healthcare: Teaching Young Physicians How To Say No To Aggressive End-Of-Life Care
Nneka Sederstrom, director of the Center of Ethics at MedStar Washington Hospital Center in Washington, D.C., about seven years ago noticed that medical residents at the hospital seemed overly stressed. She set out to discover why. (Castellucci, 4/19)
The Associated Press: Medicare Aims To Foster Critical Care Talks With Doctors
Medicare wants more doctors and patients to talk about the tough care decisions that must be made if a person becomes seriously ill or incapacitated. The federal entity, which covers health care for people over age 65, has started reimbursing doctors for having face-to-face, advance care planning discussions about a patient's treatment preferences should they become unable to speak for themselves. (Murphy, 4/20)
UnitedHealth is pulling out of all but a few Obamacare markets, Cigna is heading in the opposite direction with plans to expand, and Anthem is pursing a collaborative approach to working with hospitals. The changes show a fluid marketplace as companies race to find the best way to cut costs and improve care.