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This Week in Health Care Reform - April 14th, 2017

Stakeholders urge lawmakers to continue in their efforts to stabilize the individual market; research shows that expanding Medicaid doesn’t harm states’ bottom lines; and, a new survey finds most health care organizations are planning future investment in the telehealth space.

Week in Review

Stabilizing Markets: Despite their earlier setbacks, lawmakers remain undeterred in their ongoing efforts to find a way forward on overhauling the health care law.  Recess notwithstanding, GOP leaders in the House of Representatives spent the week negotiating behind closed doors, seeking to piece together a bill that would not only repeal the Affordable Care Act, but drive down premiums, as well.  On a separate track, moderates have offered up their own approach, countering that the best way to get something accomplished would be to work from the center out.  Bipartisanship, they argue, would allow moderate Republicans and conservative Democrats to come to agreement on legislation that both parties could support.  Meanwhile, stakeholders from across the health care spectrum continue to press lawmakers, urging them to inject much-needed stability into the teetering individual market, specifically through funding the cost-sharing reduction (CSR) payments that currently connect roughly 6.4 million low-income Americans with health coverage.  While the Administration weighs next steps on CSRs, experts warn that premiums could spike, should those subsidies be eliminated.
Medicaid Expansion:
A new study looks to address arguments put forth by opponents that the Affordable Care Act’s Medicaid expansion provision only adds to the nation’s budget deficit, while further worsening states’ financial situations.  Released earlier this week by Health Affairs, researchers analyzed fiscal data from the National Association of State Budget Offices between 2010 and 2015 to assess the impact of the expansion’s first two years.  Their findings discovered that, while the states that expanded their Medicaid programs did in fact see larger health care expenditures, those costs were duly covered by federal funding.  Further, and perhaps crucially, those expansion states didn’t have to cut other policy priorities – such as housing or other public health initiatives – in order to make ends meet.  That states didn’t encounter unforeseen budget problems upon expanding their Medicaid programs comes at a salient moment in the developing conversation surrounding next steps for our health care system, particularly as a handful of those states that didn’t initially expand their programs now explore doing just that. 
Telehealth Investment:
Telehealth continues to assert itself as an integral component of our evolving health care delivery toolbox.  And, according to a new survey, health care organizations are paying close attention, as the vast majority say that they’re looking to up their investment in new technologies to keep up with growing patient comfort and demand for these services.  Performed by the American Telemedicine Association, researchers found that 83 percent of the 171 health care executives polled said that they were likely or very likely to invest in telehealth this year, compared to the just 1 percent who said the opposite.  In explaining their reasoning, the overwhelming response cited was that of competitive advantage (98 percent) and expanded market reach (84 percent).  About half of respondents (48 percent) also said increasing consumer demand would drive telehealth programs in the near term.  When asked to rank the common barriers that continue to impede successful integration of these new technologies, 71 percent cited reimbursement as being their chief concern, followed by licensure at 53 percent.      

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Looking Ahead

Researchers at Yale University discovered that a high degree of misunderstanding exists amongst patients when it comes to low-value care, a concept that’s slowly gaining traction, with its emphasis on reducing the use of unnecessary care.

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