HealthCare Roundtable e-News – Aug. 11, 2017

Registration Open for Nov. 1-3 Roundtable Annual Conference

Each year since 2005, the Roundtable has brought together some of the country’s leading experts on health care policy to share insights about how legislation, regulations and politics will shape the health care system – especially for the public sector – in the coming year. This year’s conference will be held Nov. 1-3 at The Alexandrian in Old Town Alexandria, Va.

This year’s session topics will include:

  • Congressional Action: Health Care Reform Efforts and the Impact on Public Purchasers
  • Containing Drug Costs: Administration, Congressional and Public Purchaser Action
  • Insurance Markets and Coverage: Stabilization, Premium Levels and Plan Options
  • Delivery Reform and Value-Based Purchasing: Updates and Forecasts from CMS
  • The Cadillac Tax: Assessing Repeal Efforts and Advocacy Strategies
  • Quality and Comparative Effectiveness Research: Tools for Public Purchasers
  • The FDA and Accelerated Innovation: Safety, Access and the 21st Century Cures Act
  • The CMS Innovation Center: What Are We Learning and How Can We Use It?
  • Successful Advocacy: High-Impact Strategies and Tactics to Influence Policy and Politics

Registration fees are $500 for Roundtable members, $750 for corporate members and $1,000 for non-members.

Rooms can be reserved at The Alexandrian for the special conference rate of $229 a night through Oct. 4.

Top of page

CBO Examines Chronic Care Proposal

A bipartisan chronic care bill would have no net impact on federal spending over the next decade, according to a Congressional Budget Office (CBO) report.

In May, the Senate Finance Committee unanimously voted to send the “Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act” (S. 870) to a vote by the full Senate. The legislation was crafted by the Senate Finance Committee Chronic Care Working Group, which includes committee Chairman Orrin Hatch, R-Utah, Ranking Member Ron Wyden, D-Ore., Sen. Johnny Isakson, R-Ga., and Sen. Mark Warner, D-Va.

The CBO concluded that, while the bill would decrease Medicare and Medicaid spending by $217 million between 2018 and 2022, there would be no net change in spending from 2018 through 2027, and the spending differences after 2027 would be negligible.

The report confirmed estimates that the CBO produced in May, but provided more details about the legislation’s individual programs.

The proposal would, among other things, expand certain telehealth and home care options; enhance options for the chronically ill within Medicare Advantage; increase payment accuracy for patients with chronic conditions; provide more flexibility to the beneficiary selection process in accountable care organizations, and allow more care coordination in ACOs. (Summary)

The senators in the working group unsuccessfully introduced the same bill during the last session of Congress.

The proposal is based in part on the 327 comments the working group received regarding a December 2015 policy options paper. The Roundtable submitted comments in January 2016 stating that the options paper “reflects work and analysis that will further the goal of improving care for the millions of vulnerable Medicare beneficiaries managing multiple chronic conditions.”

Top of page

Trump Wants to Revive Repeal-and-Replace Effort

President Donald Trump does not want to give up on repealing and replacing the Patient Protection and Affordable Care Act.

Republicans were expected to repeal the ACA with relative ease after Trump was elected president and the party held on to its majorities in both the House of Representatives and the Senate last year. However, House Republicans in the spring struggled to narrowly pass a repeal bill that Trump later described as “mean,” and Senate Republicans in July fell one vote short of passing a placeholder bill just to keep the process going.

With Congress now in recess until after Labor Day, Trump has been pushing for Senate Leader Mitch McConnell, R-Ky., to revive the repeal effort when lawmakers return to Washington.

“Mitch, get back to work and put Repeal & Replace, Tax Reform & Cuts and a great Infrastructure Bill on my desk for signing. You can do it!” Trump tweeted on Aug. 10. This came shortly after he tweeted, “Can you believe that Mitch McConnell, who has screamed Repeal & Replace for 7 years, couldn’t get it done. Must Repeal & Replace ObamaCare!”

Some Republicans suggested that Trump erred in feuding with one of the men most responsible for moving his legislative priorities through Congress.

“Attacking Mitch McConnell is the most gobsmackingly stupid thing the president has done yet,” said Michael Steel, a former spokesman for ex-Speaker of the House John Boehner, R-Ohio. “And that’s saying quite a bit.”

Trump continued the following day, saying, “What happened, in my opinion, last week is unacceptable.”

“People have been talking about repeal and replace for seven years, long before I ever decided to be doing what I’m doing,” Trump said. “Seven years, they’ve been talking repeal and replace, and it didn’t happen. And not only didn’t happen, it was a surprise, and it was a horrible surprise.”

McConnell has not publicly said anything in response to Trump’s tweets and remarks, but it was a comment by the majority leader on Aug. 9 that appears to have set off the already disappointed Trump.

“Our new president, of course, has not been in this line of work before and, I think, had excessive expectations about how quickly things happen in the democratic process,” McConnell said at a Rotary Club meeting in Kentucky.

This led to the first of Trump’s tweets calling out McConnell: “Senator Mitch McConnell said I had “excessive expectations,” but I don’t think so. After 7 years of hearing Repeal & Replace, why not done?”

Several GOP senators defended McConnell, and Senate Finance Committee Chairman Orrin Hatch, R-Utah, dismissed any talk of returning to the repeal effort.

“We’re not going back to health care,” Hatch said to Politico. “We’re in tax now. As far as I’m concerned, they shot their wad on health care and that’s the way it is. I’m sick of it.”

Top of page

Large Employers Looking to Alternative Approaches to Contain Health Costs

Large employers are looking to alternatives such as telehealth, accountable care organizations (ACOs) and value-based benefit design to contain health care costs, according to the results of a survey conducted by the National Business Group on Health.

The survey of 148 large employers found that companies, on average, expect health care expenses to increase 5 percent in 2018, bringing the total expected cost next year to $14,156 per employee. Employers plan to cover an average of 70 percent of those costs.

Employers, according to the group, are using some non-traditional approaches to manage costs. Nearly all employers – 96 percent – will make telehealth options available to their employees where allowed by law, and almost as many – 88 percent – plan to use centers of excellence with bundled payment arrangements for certain medical procedures. Just over half of large employers plan to offer onsite or nearby health centers next year, and by 2020, two-thirds expect to have them. Two out of five employers offer value-based programs that provide incentives for managing chronic conditions and utilizing more efficient care, and about one out of five plan to promote ACOs next year. Another 26 percent are considering offering ACOs.

“Employers are recognizing that traditional cost control techniques alone aren’t able to reduce costs to the point where they are no longer a drain on the bottom line,” National Business Group on Health President and CEO Brian Marcotte said. “While employers continue to address costs through health care management and plan design efforts, they are also ramping up efforts to positively affect the supply side of the health care system by pursuing health care payment and delivery reform initiatives.”

Top of page