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HEALTH ACTION NETWORK - ADVOCATES FOR BETTER HEALTH CARE SOLUTIONS

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This Week in Health Care Reform: April 20th, 2018

States work to stabilize the exchanges; health care prices hit their highest annual growth rate in years; Medicaid expansion heads to the ballot box; and, lawmakers work to expand telehealth under Medicare.

Week in Review

Market Stabilization: Deciding to take matters into their own hands, states are racing to piece together legislative fixes aimed at bringing much-needed stability to the insurance exchanges.  The most common approach adopted by states involves establishing reinsurance programs, which help insurers cover the highest-claim patients while also incentivizing lower premiums.  Other states are looking to expand competition on the exchanges.  A handful are also exploring the reimplementation of the requirement mandating that everyone has insurance.

Cost Growth: Health care prices rose 2.2 percent year-to-year last month in the latest report from Altarum.  That rate was the highest observed since 2012 – a trend, the report goes on to warn, that is likely to continue.  While rapid price growth was not consistent across all categories, the overall acceleration was driven primarily by the uptick in hospital pricing growth.  In fact, according to the analysis, that growth held just about steady from the previous month, which had marked the highest growth rate since 2009.

Medicaid Expansion:
Following in the footsteps of Maine – the only state to have approved Medicaid expansion by way of ballot initiative – three other states find themselves heading in the same direction.  Those states – Utah, Idaho, and Nebraska – have all secured, or are on track to do so, the necessary signatures to put the issue on their respective ballots come November.  Meanwhile, Virginia could also become the next state to approve expansion, as its House of Delegates adopted a new version of its old budget this week in a special session that had been convened to settle the legislative stalemate over expanding the state’s Medicaid program.  That measure now heads to the state Senate.

Medicare Telehealth:
GOP members on the House Ways & Means Committee are at work drafting legislation that would expand coverage of telehealth under Medicare.  While the bill has yet to come together, supporters are optimistic that the measure will focus on addressing a glaring inefficiency in the program – namely, unnecessary, expensive hospital visits.  Currently, Medicare covers relatively little when it comes to telehealth, and spends even less on technology-enabled care.  Experts point to the need for lawmakers and regulators to address this deficiency by focusing on modernizing the program and framing out a new model that would reduce unnecessary hospitalizations.  

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One forward-thinking health care leader challenges the conventional wisdom surrounding health care consumerism, offering up his organization’s approach to focusing on the kind of consumer centricity that matters to patients.
                                            
                                            

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