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This Week in Health Care Reform - March 3rd, 2017

A new report warns of disruption to the Medicare Advantage market should recently proposed cuts to the program currently under consideration be finalized; a plurality of voters support funding for expanding Medicaid; support for the health care law reaches a new high; and, virtual visits are found to be as effective as face-to-face consults for minor ailments.

Week in Review

Medicare Advantage: As previously covered, the Centers for Medicare & Medicaid Services (CMS) released its annual proposed changes to the Medicare Advantage program early last month.  While initial analysis by CMS showed a 0.25 percent increase to plans, that estimate failed to account for the nearly 2 percent net reduction to payments owing to, amongst other items, the reinstatement of the health insurance tax for next year.  Those findings, reported last week in a new analysis from actuarial consulting firm Oliver Wyman, sought to shine a light on the impact of CMS’ latest round of proposed changes to the popular Medicare Advantage program.  When combined with other cuts exacted on the program in recent years, many worry that this year’s proposed modifications to Medicare Advantage’s underlying funding structure will only serve to further degrade the program’s ability to connect an already vulnerable patient population to the critical coordinated care upon which they depend.  As a reminder, some 18 million American seniors and persons with disabilities are enrolled in Medicare Advantage plans – nearly one-in-three Medicare beneficiaries.  With so much at stake, supporters have already mobilized, calling on policymakers to protect the program from further harm.
Medicaid Expansion: With so much uncertainty surrounding what the future holds in store for our country’s health care system, the majority of Americans seem to have found at least one aspect of that system upon which they can agree – Medicaid.  The Affordable Care Act expanded the Medicaid program in more than half the states through the aid of increased federal funding, adding coverage for some 11 million low-income Americans.  Now, as Republicans in Congress work to coalesce around repeal of the health care law, there’s growing concern over what that might mean for Medicaid going forward.  With that in mind, a handful of new polling finds general support for the program across party lines.  In fact, one such poll, from inside-the-Beltway publications Morning Consult and POLITICO, found that roughly twice the number of voters (40 percent) said they wanted to see the federal government increase spending on the program compared to those who thought fewer resources should be poured into it (21 percent).  Separate polling, this time from the nonpartisan Kaiser Family Foundation, found that 8-out-of-10 respondents want to see lawmakers preserve federal funding to Medicaid.  Against this backdrop, Republican governors find themselves having to navigate increasingly perilous waters, as they struggle to reconcile their dependency on federal funding to help administer the Medicaid program in their states with the political optics of towing the party line.  Whichever direction the legislative winds blow, experts advise lawmakers to focus their efforts on fixing the marketplace first, before turning their attention to Medicaid.
Public Opinion:
Support for the Affordable Care Act reached its highest level to date last week, at least according to the just-published results from the Pew Research Center.  Throughout its contentious history, the law has been divisive, with public sentiment generally being more negative than positive.  However, in Pew’s latest survey, 54 percent of respondents said that they approved of the law, as opposed to the 43 percent who disapproved of it.  It’s polling like this that has led some – including former Republican Speaker of the House, John Boehner (Ohio) – to say that Congress is unlikely to find a clear path forward on repeal and replace.  Nevertheless, conservatives maintain that they possess both the political will and the legislative momentum they need to accomplish something they’ve been campaigning on for years. 
Virtual Visits:
Last month, results from a new study were announced in which virtual video visits with doctors to resolve minor medical ailments were shown to be as effective as in-person, face-to-face consultations.  Conducted jointly by experts at HealthCore and LiveHealth Online, researchers discovered that follow-up visits for patients with 11 of the most common telehealth diagnoses were in line with those that saw a provider at an urgent care clinic, retail health clinic, emergency department, or doctor’s office for the same types of ailments.  Further, incidences of hospitalizations and emergency department visits were actually lower for those patients who had virtual visits.  The first study of its kind, researchers point to the results as “a great step in boosting confidence among consumers” of telehealth’s efficacy and growing importance in our evolving health care toolbox.      

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