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This Week in Health Care Reform: February 23rd, 2018

Medicare Advantage stakeholders rally around the program; value-based care continues to reshape the health care landscape; and, new estimates underscore the rising costs of the opioid epidemic.

Week in Review

Medicare Advantage: Earlier this month, the Centers for Medicare & Medicaid Services (CMS) released its annual proposal aimed at changing how the popular Medicare Advantage program is both administered and funded.  Medicare Advantage currently serves nearly 20 million Medicare beneficiaries – nearly one-third of all enrollees in the Medicare program.  While this year’s proposed changes include provisions that will support Medicare Advantage’s ability to connect seniors and persons with disabilities to the program’s enhanced level of coordinated care, there’s concern that other provisions would only serve to further unravel the comprehensive blanket of care that means so much to so many.  In advance of those proposed changes being released, hundreds of Members of Congress signaled their support of the program in letters to CMS, urging the agency to protect Medicare Advantage and its millions of beneficiaries.  As industry stakeholders continue to marshal their energies in support of Medicare Advantage, we’re looking to our Health Action Network members to also step up and add your voices to the growing chorus being raised on behalf of the program and its enrollees.  Act now!

Value-Based Care:
Even as the focus in health care delivery shifts to a more value-based design model, stakeholders find themselves having to come to grips with their own evolving role in the transition.  For instance, electronic health records (EHRs), which have long capitalized on their perceived faculty in streamlining processes and communications, now find their shortcomings exposed as the health care system looks to shift accountability to providers for the holistic quality and cost of the care that they deliver.  Specifically, experts point out that EHRs were originally developed to automate a fee-for-service environment.  Additionally, interoperability and analytics continue to be insufficient.  And, perhaps most saliently, the patient portals facilitated by EHRs don’t automatically lead to patient engagement.  Nevertheless, health care thought leaders remain optimistic, particularly when it comes to the integration of behavioral and physical health, where they argue that value-based contracting promotes the type of engagement, accessibility, availability, and partnership that makes a difference in overall health care delivery.  And, not to be discounted, these value-based care initiatives are projected to be the biggest drivers of health care technology investment this year, at least according to a recent survey.

Opioid Epidemic:
A new analysis seeks to put a pricetag on the opioid epidemic ravaging communities across the country.  Performed by health research and consulting institute Altarum, the economic cost associated with the opioid crisis is estimated to be $1 trillion from 2001 through 2017 – and, is projected to cost an additional $500 billion through 2020.  While these numbers fail to account for the incalculable toll exacted on families, they do serve to contextualize just how much has already been lost – and, how much more we stand to lose.  With that in mind, stakeholders across the industry continue to implement process improvements and integrated methodologies to combat the issue.

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Price changes in hospital and medical services have been shown to drastically outpace overall inflation.  As the conversation surrounding health care costs continues to evolve, experts offer up a handful of issues that will likely shape the policy discussion going forward.

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