In this edition, learn about increasing COVID-19 cases, new sign-ups for ACA plans, hospitals’ compliance with the federal price transparency rule, and more.
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Kelly Devers Joins IMPAQ Health as Vice President
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Kelly Devers, Ph.D., has joined IMPAQ’s Health Division as vice president of federal market strategy. She is a widely recognized expert in health services and policy, specifically in alternative payment models and their effects on access, quality, and cost. She also has deep expertise in qualitative and mixed methods research and evaluation. Across her 25-year career, Devers has served in key roles at the Agency for Health Care Research and Quality, the White House Office on Health Reform, the Urban Institute, the Lewin Group, and most recently at NORC. In her new role, Devers will lead business development for IMPAQ Health.
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IMPAQ Health Expert Contributes to Study Examining Waitlist Variations for Kidney Transplants
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Compared with dialysis treatment, a kidney transplant can be more cost-effective and lead to improved quality of life for patients with end-stage renal failure. Dialysis facilities play a significant role in the transplantation process, serving as the major referral source for patients to receive transplants and providing patients with education about their health and the procedure itself. Taylor Melanson, an IMPAQ Health research associate, and colleagues conducted a study to examine current and historical variation in wait listing at these facilities, with a goal of informing stakeholders on how they might make changes to this process.
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Medicare, Medicaid, and the ACA
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More than two million Americans have signed up for plans provided under the ACA during the special enrollment period open through Aug. 15. Roughly 1.5 million Americans have purchased insurance through Healthcare.gov, and an additional 600,000 enrolled through the 15 state-based exchanges. Reuters (7/14)
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Democratic Sens. Raphael Warnock (Ga.), Jon Ossoff (Ga.), and Tammy Baldwin (Wis.) have introduced legislation to create a new health insurance plan in the 12 states that have not expanded Medicaid. The new insurance option would specifically target those who have incomes lower than 138 percent of the federal poverty level and are ineligible for subsidies on the ACA exchanges. While the coverage would be as close to Medicaid as possible, it is unclear if the federal government would be able to contract with the managed care networks that provide Medicaid services in multiple states. AP News (7/12)
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According to new research, collection agencies held $140 billion in unpaid medical bills in 2020, compared with an earlier study showing $81 billion in medical debt. Americans living in states that have not participated in Medicaid expansion owed an average of $375 more in medical bills than their counterparts in states that expanded the program, according to the new research. Additionally, the study found that higher medical debts were concentrated in the country’s lowest-income ZIP codes, where residents owed an average of $677 each. The New York Times (7/20)
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Democratic Senators are considering how to divide up the $3.5 trillion budget framework they agreed upon last week, such as adding new dental, vision, and hearing benefits to Medicare and allowing the federal government to negotiate drug prices for the program. Other proposals include offering incentives to compel holdout states to expand their Medicaid programs and funding expanded home health care services. Wall Street Journal (7/17)
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While hospitals are now required to post a price list for services online, a report from Patients Rights Advocate shows that nearly 94 percent of the 500 hospital websites the group surveyed do not include such lists. A week before the report was released, President Biden asked HHS to enforce the rule. Patients Rights Advocate urged the Biden administration to implement a penalty higher than the current $300 a day to encourage hospitals to comply with the rule. Washington Post (7/16)
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A new proposed rule from CMS aims to more strictly enforce price transparency. Under the proposed rule, hospitals with 30 or fewer beds would pay $300 per day for not complying, while hospitals with more beds than 30 would pay $10 per bed per day, up to a maximum of $5,500 daily. CMS (7/19)
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The Executive Order Biden signed on 7/9 aims to boost competition in the economy in a variety of industries, including health care. Initiatives to improve health care access include: lowering prescription drug prices, targeting “pay for delay” programs, making hearing aids accessible over the counter within 120 days, and monitoring the hospital price transparency rule. HHS will also seek to standardize health insurance plan options under the National Health Insurance Marketplace. White House (7/9)
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In the proposed Physician Payment Rule, CMS is proposing ways to improve health equity. Specifically, the proposed rule asks for feedback on health equity data collection efforts, suggests expanding telehealth services for behavioral and mental health care, and calls for increasing participation in the Medicare Diabetes Prevention Program. Further, the proposed rule includes several changes to strengthen the Quality Payment Program, such as introducing the Merit-based Incentive Payment System Value Pathways and allowing physician assistants to bill directly to Medicare. CMS (7/13)
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According to new data from Fair Health, telehealth claims as a percentage of all medical claims dropped for the third month in a row in April. At the same time, the data show telehealth claims associated with mental health continued to increase nationally. According to researchers, the overall decline appears to be driven by patients seeking care in person. Healthcare Dive (7/8)
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As part of the Biden administration's vaccination outreach campaign, pop star Olivia Rodrigo visited the White House and sat down with Dr. Anthony Fauci to promote vaccinations among young Americans.
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Upcoming Events, Trainings, & Webinars
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Tuesday, July 27, 2021, 1:30 PM ET – 2:45 PM ET
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The USC-Brookings Schaeffer Initiative for Health Policy will hold a webinar on July 27 in response to rising drug prices’ increasingly large burden on those who are prescribed expensive medications with high rebates. During the webinar, the issue of large rebates’ negative impact on participants of Medicare Part D will be explored and possible policy solutions will be identified. Register here.
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Colliding Crises—Connecting the Dots between Overdose Prevention and Adverse Childhood Experiences, Overdose Prevention Network, Dialogue4Health
Wednesday, July 28, 2021, 10:00 AM – 11:00 AM PT
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Join the Overdose Prevention Network on July 28 for a webinar dedicated to investigating the link between Adverse Childhood Experiences and the risk for substance abuse and other chronic health conditions. Register here.
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NOTE: The information, analyses, and opinions expressed in the articles, publications, or comments contained therein are those of the authors and should not be considered verified or endorsed by IMPAQ or any of our partners or clients.
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