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This Week in Health Care Reform: July 7th, 2017

Senate Republican leaders spend the holiday break working to find a way forward on their health care replacement bill; Medicaid programs feel the burden of rising drug prices; and, stakeholders continue to embrace telehealth.

Week in Review

Replacement Bill: When lawmakers headed home last week for the 4th of July break, they did so with the expectation that they would come back to Washington with a clearer picture of next steps on the health care replacement bill that has come to dominate the legislative landscape.  What that means, exactly, is less clear, as GOP leaders in the Senate continue to review changes to their bill that would secure enough votes from their rank-and-file to see it pass.  Opponents, for their part, are hoping to capitalize on the uncertainty, urging for a bipartisan approach as a means of finding a way to a compromise.  Regardless, with a sizable legislative ‘to-do list’ looming, there’s growing concern that lawmakers’ bandwidth may already be stretched thin.

Medicaid's Rx Burden: The rising price of prescription drugs continues to exact a destructive toll on our health care system.  While the pursuit of solutions to address the issue has resulted in the development of some creative, if not, unexpected, partnerships, the harsh realities of high-cost drugs and its impact on an increasingly dependent patient population, threaten to overwhelm stakeholders across the health care spectrum.  State Medicaid programs, for instance, such as Wisconsin’s, find themselves vulnerable to these out-of-control prices, particularly when it comes to spending on specialty drugs, which, in the Badger State alone, has gone up 40 percent over the past four years.  And, separately, Louisiana is now considering the radical move of asking the federal government to intervene, going so far as to override pharmaceutical manufacturers’ patent protections over their medicines.

Telehealth Inroads:
Momentum to expand Medicare’s telehealth coverage continues to build, most recently in the form of a pair of bipartisan bills offered up earlier this year.  That first one, the Telehealth Innovation and Improvement Act, introduced by Sens. Cory Gardner (R-Colorado) and Gary Peters (D-Michigan), looks to “expand access to health care in both rural and urban areas to cover additional telehealth services” beyond those currently covered under the Medicare program’s limited benefit.  The other bill, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Care Act of 2017, introduced by Sens. Brian Schatz (D-Hawai’i), Roger Wicker (R-Mississippi), Thad Cochran (R-Mississippi), Ben Cardin (D-Maryland), John Thune (R-South Dakota), and Mark Warner (D-Virginia), would also expand telehealth services in Medicare, specifically for remote patient monitoring (RPM), which studies have shown leads to better quality care and increased cost savings.  Meanwhile, providers, too, have warmed to the benefits that can accrue from their embracing telehealth.  Independent doctors, who often lack the requisite infrastructure to deploy wide-ranging telehealth programs, are growing more comfortable with how these digital technologies, in the forms of apps and other services, can allow them to see more patients by offering virtual visits.  And, large hospital systems, such as the Cleveland Clinic, are able to leverage telehealth as a means of introducing new dimensions of care.  The organization, which includes more than 51,000 caregivers, including nearly 3600 physicians, performs 7 million outpatient visits a year.  In recognizing telehealth’s ability to improve the way they deliver care to their patients, the Cleveland Clinic developed an enterprise telehealth strategy, driven largely by the organization’s desire to: 1) Increase efficiency and lower costs; 2) Stay current with patient expectations; 3) Expand access and reach at a lower cost than simply building new facilities; and, 4) Prepare to support the transition to value-based care.      

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Looking Ahead

The evolution of our health care delivery model has resulted in the rise of consumer centricity.  While the transition to a more “patient consumerism” paradigm has not been without its share of hiccups, the advent of new technologies has allowed people to take a level of ownership in their own health care that just wasn’t possible a generation ago.

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