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This Week in Health Care Reform - February 17th, 2017

Republicans struggle to coalesce around repeal of the health care law; double digit percent increase seen in drug prices last year; telehealth makes inroads in cancer care; and, polling finds high satisfaction amongst Medicaid beneficiaries.

Week in Review

GOP Efforts: Despite the uncertainty surrounding the future of the exchanges, more than 12.2 million people signed up for coverage during the just-closed open enrollment period according to data compiled by the Associated Press.  Although slightly lower than last year’s numbers (4 percent), the number of sign-ups presents something of a challenge for Republicans in their ongoing efforts to do away with the health care law.  With Tom Price now sworn in as the new Secretary for the Department of Health & Human Services (HHS), it was thought that the GOP would finally get down to the business of dismantling the Affordable Care Act – an expectation only bolstered by reports last week that House Republicans had already been working with the nonpartisan Congressional Budget Office (CBO) on the details of their repeal bill.  However, cracks within the GOP front have begun to appear as sharp divisions over timing and the practical realities of repealing the law without a replacement at the ready have raised doubts as to whether or not Republicans can find their way forward.

Rx Price Growth: A new analysis released earlier this month reported drug prices having increased by 11 percent last year.  While the data presented something of a mixed narrative – employers’ costs having gone up a comparatively modest 2.5 percent across all prescription drugs – the trajectory of drug prices can’t be minimized, especially when compared to the consumer price index, which rose just 2.1 percent.  Further, the average list price for a brand name medication last year was nearly $308, more than triple what it was in 2008, whereas price inflation for common household items during that same period was 14 percent.
Telehealth and Cancer Care:
Telehealth has proven to be an increasingly vital diagnostic tool in patients’ continuum of care.  With that in mind, a first-of-its-kind study was recently launched to further explore just how useful it can be.  Led by the University of Virginia (UVA), the project seeks to detect bladder cancer in underserved parts of the state.  Through the use of a mobile health van, patients are screened for cancer by onsite nurse practitioners virtually connected to a UVA urologist who then makes a diagnosis.  While incidence of bladder cancer is low in the southwestern corner of Virginia, it’s believed that has more to do with how few urologists practice in that part of the state, leading to fewer people being screened.  Separately, researchers from the United Kingdom found that the majority of cancer survivors believed that the utilization of telehealth in their treatment was a positive and worthwhile experience.  Patients appreciated the flexibility and convenience offered up by telehealth for meetings and follow-up consultations.  It also helped to reduce cancer survivors’ vulnerability, allowing them to voice concerns they may not have otherwise been able to in person. 
Medicaid Polling:
As efforts surrounding the repeal of the Affordable Care Act pick up steam, there’s growing concern that the Medicaid program could soon find itself in the crosshairs.  Beyond the 70 million Americans who depend on the program, there’s growing recognition that Medicaid represents a critical mechanism through which we can build a better culture of health in this country by utilizing the program’s extensive reach to address the underlying social determinants of health.  But, back to those beneficiaries, who, overwhelmingly, say they are not only satisfied with their Medicaid plans (87 percent), but with the costs (also, 87 percent) and the benefits (83 percent), too.  Against that backdrop, it’s not hard to imagine why beneficiaries are feeling especially vulnerable as lawmakers take aim at the health care law and the expanded Medicaid coverage that came with it.      

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Looking Ahead

As previously covered, comprehensive efforts to protect Medicare Advantage from damaging cuts continue to draw support as stakeholders from all over the health care map weigh in, urging the Centers for Medicare & Medicaid Services (CMS) to ensure that the 18 million seniors and persons with disabilities enrolled in the program don’t lose access to the comprehensive and integrated care made available through Medicare Advantage.

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