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This Week in Health Care Reform: October 20th, 2017

Lawmakers reach a bipartisan agreement to stabilize the individual market; digital technologies continue to reshape health care delivery; and, social determinants of health gain traction in our evolving understanding of holistic health needs.

Week in Review

Bipartisan Efforts: Despite the shifting policy dynamics surrounding their health care reform efforts, Senate HELP Committee leaders remained focused this week on finding their way to a legislative stabilization package that could earn bipartisan support.  And, on Tuesday, those efforts paid off as Senate HELP Committee Chairman Lamar Alexander (R-Tennessee) and Ranking Member Patty Murray (D-Washington) unveiled the outlines of a bipartisan agreement that they believe would stabilize the individual market by, amongst other things, extending payment for the cost-sharing reduction (CSR) subsidies for two years.  That provision comes on the heels of the announcement made last week by the Administration that they would no longer be funding CSRs.  That announcement, in turn, was met by an emergency motion filed by eighteen states and the District of Columbia to force the Administration to continue to make CSR payments.  A decision in that case is expected next week.  Meanwhile, the legislative package from Sens. Alexander and Murray would also provide states additional flexibility in navigating the rules laid out by the Affordable Care Act.  As attention now turns to the specifics of that proposal, there’s growing concern as to whether or not enough support can be drummed up to see these efforts through, with overtures from the White House and Congress casting a shadow of doubt over the proceedings.

Digital Health:
As consumers’ comfort level with technology continues to grow, so, too, do their expectations of the role that digital advances will play in how they interact with their health care, both now and in the future.  This, understandably, has led to expectations of further growth in the telehealth market.  Clinically, the increased utilization of electronic health records has led to enhanced care coordination.  And, at a more practical level, telehealth has found its way into more schools, while rural communities have also benefitted from greater connectivity to specialty care.

Social determinants of health (SDoH) have slowly gained traction in our widening approach to holistic health care.  At its most basic, SDoH are our system’s recognition that health outcomes are affected as much by what goes on outside of a care setting as they are on what goes on inside of one.  While the conditions in which people are born, grow, live, work, and age impact their overall health, these circumstances themselves are also shaped by demographics and socio-economics at a micro- and macro-level.  Further, SDoH also play a role in determining access and quality of health care.  Against that backdrop, stakeholders have begun to operationalize the integration of SDoH into their approach to meeting the varied health care needs of patient populations.  With estimates ranging in the billions of dollars overspent on medical costs attributed to SDoH, it’s hardly surprising that many, such as insurers, are embracing collaborative approaches to benefit design in an effort to ensure that the right programs are targeted to the right people in the right way.      

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