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This Week in Health Care Reform: October 6th, 2017

Lawmakers work to find a path forward in their efforts to stabilize the individual market; meanwhile, a 5-year extension is proposed for CHIP; the VA looks to capitalize on telehealth’s reach; and, stakeholders shine a spotlight on maximizing health care value.

Week in Review

Stabilization Negotiations: As has been the pattern, the decision was made last month to authorize the latest payment for the cost-sharing reduction (CSR) subsidies that allow low-income individuals and families to better afford their premiums, co-pays, and the other out-of-pocket costs associated with their health care coverage.  However, stakeholders continue to point to the month-to-month uncertainty attending these payments as contributing to the instability undermining the individual market.  Lawmakers this week signaled their receptivity to addressing the issue, as Republicans on the Senate HELP Committee cited their willingness to fund CSRs for 2-years in their ongoing negotiations with their colleagues across the aisle as a key part of their larger stabilization package.

CHIP Extension: Despite having missed the deadline to reauthorize the Children’s Health Insurance Program (CHIP) last weekend, lawmakers continue to work towards advancing a bill that will extend financing for the program.  On Wednesday, the Senate Finance Committee approved a bill that would provide more than $100 billion over 5-years to CHIP.  But, over in the House Energy & Commerce Committee, a similar bill was met with resistance over spending offsets, before eventually passing.  Unfortunately, that partisan dissonance only added to the growing concern that quick refinancing for the popular program serving nearly 9 million children is unlikely.

VA Telehealth Proposal:
A new proposed rule from the Department of Veterans Affairs (VA) would help the VA overcome some of the traditional geographic barriers to care by allowing its providers to treat patients across state lines.  The VA, which has actively embraced telehealth, says its proposed rule is crucial if the Department is to continue expanding its telehealth services.  While it’s anticipated that issues regarding provider certification regulations will only become more problematic as telehealth’s application grows, the VA hopes that their proposal could speed up efforts to remove the regulatory barriers at both the state and federal level.

Maximizing Value:
Not to be lost amidst the discourse surrounding the future of health care in this country, is the overarching importance of managing the total cost of care.  In pursuit of enhanced consumer centricity, health care stakeholders have warmed to the need for greater transparency.  Elected officials and regulators have also glommed onto the effort reshaping our relationship to health care delivery, drawing attention to the use of real-world evidence in decision-making.  And, according to the results of a new study published in Health Affairs, practical opportunities exist to slash billions of dollars in wasteful health care spending, specifically, through reductions in low-cost, high-volume services.      

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