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This Week in Health Care Reform: December 1st, 2017

States grapple with uncertainty as CHIP funding negotiations advance; lawmakers take a step forward in confirming the new head of HHS; telehealth continues its march towards widespread adoption; and, health care waste drives up costs for consumers.

Week in Review

CHIP Uncertainty: As lawmakers get closer to advancing a tax reform bill, there’s growing optimism that they’re also making progress towards a bipartisan deal to reauthorize funding for the Children’s Health Insurance Program (CHIP).  With staff from the relevant committees from both parties and from both chambers of Congress meeting over the holiday break, sources say they’re as close as they’ve been to an agreement.  In the meantime, states, who have been grappling with uncertainty since CHIP funding authorization expired at the end of September, are having to prepare to make some tough decisions should federal officials fail to reauthorize funding for the program, which serves nearly 9 million low-income children.

HHS Confirmation: On Wednesday, the Senate HELP Committee held a confirmation hearing considering the nomination of Alex Azar to serve as Secretary of the Department of Health & Human Services (HHS).  The proceedings played out against an increasingly politicized backdrop, with members on both sides of the dais alternately casting the former biopharmaceutical executive, who also spent six years serving at HHS under a previous Administration, as either too close or perfectly positioned to objectively serve in the position.  While the topic of prescription drug prices dominated much of the hearing, Mr. Azar also pointed to additional priorities that would be a focus of his tenure, including: Making health care more affordable and available; shifting Medicare towards value and away from volume; and, combatting the opioid epidemic.

Telehealth Adoption:
Telehealth has enabled stakeholders to help patients, consumers, and employees overcome one of the most persistent barriers to these individuals and families seeking the care they need when they need it – namely, that of access.  One of the trends helping to usher in this change is the growing prevalence of high-touch tools, such as digital technologies and integrated benefit design.  These tools, which allow for enhanced care management and delivery, have resulted in not only improved health outcomes, but lower costs and fewer burdens, as well.  That’s why it should come as no surprise to find that an increasing majority of health care organizations now offer or plan to offer telehealth services, according to a new survey.  In fact, of those organizations who track return on investment, nearly a third reported telehealth-related savings of 20% or more.  Additionally, more than 80% said that integrating telehealth into their operations was fueling expansion of other digital health services.  However, not all is rosy, as problems, such as third-party reimbursement, state licensing requirements, and physician resistance, were all cited as ongoing challenges.

The Cost of Waste:
Of all the forces driving up costs across our health care system, waste seems to be the most pervasive.  The latest example, brought to light this week in an alarming piece of reporting, details the experience of one father who took his daughter in for a routine outpatient procedure only to find himself saddled with nearly $2,000 in additional “operating room services” stemming from the surgeon’s pre-operative offer of piercing his daughter’s ears while she was under.  While an extreme case, his experience draws attention to the underlying issue of health care waste known as overuse.  In fact, experts estimate that our health care system wastes as much as $765 billion annually – nearly one-quarter of all that’s spent.  Further, $210 billion of that spending goes to unnecessary or needlessly expensive care, according to a 2012 report from the National Academy of Medicine.      

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