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Health Care Edge

With Greater Transparency Comes Lower Health Spending? - Health Care Edge

With Greater Transparency Comes Lower Health Spending? 

By Sophie Novack

PUSH FOR DATA AND INNOVATION: Democratic Sen. Ron Wyden wants more data, more transparency, and more innovation, and says this will lower health care spending--if we can just get rid of the policy barriers in the way.

 

"This whole sector now known as 'big data' can knock down those health care silos, connecting providers across these various settings and states," Wyden said at an AARP and Business Roundtable event on health transparency yesterday afternoon. "It can empower consumers and patients--in effect putting them in control of their own care--and it can help physicians identify patterns in real time to get them better care...But right now the status quo sort of ties our hands--it limits providers, patients, consumers to a world that in effect is tethered to dial up, rather than high speed internet. So, rule number one with respect to the future: let's throw out the floppy disc. Let's get in line with the times."

The new Senate Finance Committee Chairman, together with Republican Sen. Chuck Grassley, sent a letter to health care stakeholders yesterday asking for their input on how health data can be better shared and utilized. The two senators previously introduced the Medicare Data Access for Transparency and Accountability Act, and have led the charge to pressure CMS to release Medicare data. The agency released hospital pricing information in 2013, and physician payment information just this year. "Our job is to keep knocking down the barriers blocking data from the public, and identify data that is not available, but should be," Wyden said, noting that this must be done while maintaining full privacy protections.

Top Health Care News

SENATE FLOOR VOTE ON HEALTH SPENDING BILL UNLIKELY: The $158 billion Labor, Health and Human Services bill--which includes some funding for Obamacare in 2015--was supposed to be marked up in the full Appropriations Committee Thursday, but Democratic Sen. Tom Harkin, the bill's author, says it is now unlikely to be considered separately on the floor and will end up in an omnibus package. (Erik Wasson, The Hill)

  • Democratic Appropriations Committee Chairwoman Barbara Mikulski cancelled a vote on the bill after Republicans indicated they would force a series of politically painful votes on vulnerable committee Democrats. Harkin denied this is why the vote was delayed. (Andrew Taylor, Associated Press)
  • Republican Sen. Lamar Alexander accused Democrats of avoiding "tough" votes: "Our markup was indefinitely postponed...because some senators don't want to vote on difficult or tough amendments. That's what we do," Alexander said on the floor Thursday. "The Democratic gag rule on important amendments has moved from the Senate floor to committees. This is a new level of obstruction.I hope to have the opportunity to offer these amendments at a markup." (Ramsey Cox, The Hill)

STUDY: AMERICAN TEENS DRINKING AND SMOKING LESS: About 35 percent of high school students said they had had alcohol in the previous month, down from 39 percent in 2011, according to 2013 results from the Centers for Disease Control and Prevention's National Youth Risk Behavior Survey, released Thursday. Meanwhile 15.7 percent report smoking, beating the goal of reducing cigarette smoking among American adolescents to 16 percent or less by 2020. (Mike Stobbe, Associated Press)

  • The bad news includings findings that a lot of teens are still texting while driving. (Abby Phillip, Washington Post)

Insurance

HOW THE WHITE HOUSE SOLD OBAMACARE: "The success of Obamacare's first enrollment period—as told in interviews with Obama administration officials, advocacy groups, health care experts, and Obamacare shoppers—was not just about fixing a broken website. Healthcare.gov's disastrous rollout and ultimate repair mattered, but they didn't explain why people decided to buy insurance. Behind the scenes, convincing Americans that they could afford insurance was the White House's biggest challenge in making Obamacare work." (Sarah Kliff, Vox Media)

GROWING NUMBER OF INSURERS PARTICIPATING IN ACA EXCHANGES NEXT YEAR: The number of insurers in the New Hampshire exchange will increase from one to five in 2015; from 13 to 18 in Michigan, and from six to 10 in Illinois. (Ferdous Al-Faruque, The Hill)

  • A chart of insurers joining the exchanges in year two, from @ddiamond.

WASHINGTON INSURANCE MARKET GROWS 30 PERCENT IN LAST YEAR: "Today's individual market total includes 171,286 people enrolled outside the Washington Health Benefit Exchange, Wahealthplanfinder, and 156,155 people enrolled inside the Exchange as of June 1, 2014, [according to new information reported by insurers to the Office of the Insurance Commissioner]...No information is available on how many of the 327,000 newly enrolled people had coverage before or how many had to find coverage because their old plan was discontinued."

LOWER-THAN-EXPECTED PREMIUM INCREASES FOR ANTHEM IN CALIFORNIA: The largest for-profit health insurer in California and the biggest by enrollment in the state exchange will increase ACA premiums by less than 10 percent in 2015, reflecting a successful first enrollment period for the company, which had initially predicted double-digit rate increases. (Chad Terhune, Los Angeles Times)

OBAMACARE HILL SUBSIDY LAWSUIT GOES TO COURT NEXT MONTH: Republican Sen. Ron Johnson's lawsuit against the ACA policy allowing the federal government to pay for part of the exchange plans for lawmakers and hill staffers will be heard by a Wisconsin district court judge July 7. (Jennifer Haberkorn, Politico)

White House

ADMINISTRATION FIGHTS BACK TO KEEP EXPANDED DRUG DISCOUNT PROGRAM: "HHS said in a court filing Thursday that the agency plans to appeal a District Court ruling that struck down its regulations on the federal 340B drug discount program—or issue guidance that would replace the rule and compel drugmakers to provide the discounts. The Pharmaceutical Research and Manufacturers of America, a trade group for the drug industry, argued in a lawsuit last year that HHS misinterpreted the law and overstepped its rulemaking authority. (Jaimy Lee, Modern Healthcare)

FIRST LADY PLEDGES TO FIGHT CHANGES TO NEW SCHOOL LUNCH STANDARDS: "Michelle Obama on Thursday turned her annual garden harvest into a showcase for healthier school lunch standards and pledged to "fight until the bitter end" to keep them in place. The House is soon to vote on a bill that would allow some schools to opt out of new federal requirements that school lunches include more whole grains, fruits and vegetables. The White House has threatened to veto the measure." (Darlene Superville, Associated Press)

Medicare

NEW JERSEY AMBULANCE COMPANIES BILL MEDICARE HUGE NUMBERS: For each one-way ride, Medicare pays ambulance companies nearly $200, plus $6 a mile. The program only covers ambulance rides if a doctor certifies that other modes of transportation would endanger a patient's health. That happens rarely in most parts of the country. But not here. Dozens of New Jersey ambulance companies...billed Medicare for unusually large numbers of non-emergency ambulance rides in 2012, a ProPublica analysis of recently released Medicare payment data found. Some 37 operators claimed an average of 50 trips or more per patient, collecting more than $46.5 million from Medicare that year. By comparison, in 33 other states, not a single ambulance company billed Medicare for that many rides per patient, the analysis showed." (Charles Ornstein, ProPublica)

ANALYSIS: SOME EXPENSIVE HOSPITAL COMPLICATIONS NOT TRACKED BY MEDICARE: Dozens of potentially avoidable conditions are not being tracked by the government, even though some occur often and are costly to treat, according to an analysis released Thursday from Premier, Inc. consulting group. (Jordan Rau, Kaiser Health News, Washington Post)

Providers

PHYSICIAN WAIT TIMES ARE NOT JUST A VA PROBLEM: "Need routine primary care? The average wait to see a family physician for the first time ranged from 66 days in Boston to just five days in Dallas, according to a survey in 15 large cities by health care consulting firm Merritt Hawkins. And doctors are bracing for new demand from millions of people newly insured through the federal health care law." (Lauran Neergaard, Associated Press)

Abortion

LOUISIANA GOV. SIGNS ANTIABORTION BILL: Republican Gov. Bobby Jindal signed legislation into law Thursday that requires doctors performing abortions to have admitting privileges at a nearby hospital. The bill is expected to close four of the five abortion clinics in the state, unless they are granted admitting privileges. (Irin Carmon, MSNBC)

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