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This Week in Health Care Reform: February 2nd, 2018

The State of the Union offers few insights as to what could be next for health care; Medicare Advantage stakeholders brace themselves for the latest round of proposed changes to the program; Medicare looks to capitalize on telehealth’s promise; and, Medicaid expansion is shown to connect more patients to the right care at the right time.

Week in Review

SOTU: Earlier this week, the President delivered the State of the Union address, his first since taking office last year.  Heading into the speech, polling showed that a majority of voters ranked health care and the economy as “very important” issues that they wanted to hear addressed in the speech.  However, what stood out to many was how little health care was even mentioned Tuesday night.  Often serving as something of a legislative roadmap, lawmakers now face the difficult task of charting a path forward on health care priorities heading into this year’s midterm elections.

Medicare Advantage Changes: It was expected that the Centers for Medicare & Medicaid Services (CMS) would release its annual proposed changes to the Medicare Advantage program’s underlying funding structure on Wednesday.  However, that notice was delayed in order to give newly sworn-in Health & Human Services (HHS) Secretary Alex Azar a chance to review the annual proposal.  In anticipation of those proposed changes – which were ultimately released yesterday – stakeholders have marshaled their forces in support of the program, which currently serves nearly 20 million American seniors and persons with disabilities.  On a separate, but related, track, value-based care proponents point to the lessons learned through Medicare Advantage’s innovative care model as something of a blueprint for replicating those benefits throughout our larger health care system.

Medicare & Telehealth:
As telehealth continues to reshape our approach to health care delivery, it’s hardly surprising that more stakeholders have integrated its utilization into how they connect consumers and patients to their care.  Recently, that saw the Department of Veterans Affairs (VA) move forward with plans for a national telehealth network for veterans.  Now, a whole new population is being targeted to access these benefits, as senior centers across the country are deploying a wide range of digital technologies to serve as gateways to better patient engagement.  Against this backdrop, Medicare has begun to explore solutions to the barriers that have prevented the program from allowing its beneficiaries to benefit from telehealth.  Specifically, a handful of bills could potentially be signed into law this year that would remove regulatory roadblocks to telehealth’s wider application in Medicare, including outstanding issues surrounding reimbursement.

Medicaid Expansion:
A new study indicates that Medicaid expansion has improved the quality of care delivered to surgery patients, at least according to data presented in the JAMA Surgery medical journal.  Researchers set out to determine what impact the expansion of the Medicaid program under the Affordable Care Act may have had on the management of common surgical conditions.  For their analysis, they looked at five-years’ worth of data from more than 290,000 patients admitted to hospitals in 42 states for five common surgical procedures.  What they found was that Medicaid expansion led to “earlier presentation and improved probability of optimal care for common and serious surgical conditions.”  The study’s authors go on to contextualize their findings, pointing out the importance of the positive clinical effects of Medicaid expansion as federal and state lawmakers consider the program’s future.      

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