HealthCare Roundtable e-News – January 16, 2024


Outlook for 2024: Public Sector Health Care Policy, Politics, & Predictions

Thank you to those who participated in our webinar – Outlook for 2024: Public Sector Health Care Policy, Politics, and Predictions.

To view a copy of the webinar presentation, please click here.

Top News

Roundtable Signs on to Stakeholder Letter Advocating to CMS for Stability and Support in Medicare Advantage

The Public Sector HealthCare Roundtable signed on to a letter from the Better Medicare Alliance (BMA), along with over 65 Medicare Advantage (MA) stakeholders, supporting a strong, sustainable MA ahead of the Centers for Medicare and Medicaid Services’ (CMS) advance rate notice announcement. The letter strongly supports MA and its high-quality care for seniors and people with disabilities, emphasizing the need for policies promoting stability and sustainability for over 31 million beneficiaries. Highlighting that MA serves 51 percent of the Medicare population and is expected to increase, the letter underscores its affordability and value, with beneficiaries saving over $2,400 annually compared to Fee-for-Service Medicare. The letter aligns with CMS’ goals for CY 2025, including advancing health equity, enhancing supplemental benefits, improving access to mental and behavioral health care, and providing marketing guidance. As programmatic changes are implemented, the letter emphasizes the importance of stability and understanding the impact on beneficiaries. The full letter can be read here.


CMS Releases Medicare Telehealth Trends Report

The Centers for Medicare and Medicaid Services (CMS) recently released their Medicare Telehealth Trends Report that analyzed Medicare beneficiaries who utilized telehealth services from January 1, 2020, to June 30, 2023. In response to the COVID-19 public health emergency, CMS expanded telehealth services to increase access to care. During the initial outbreak of COVID-19, the percentage of Medicare beneficiaries who utilized a telehealth service jumped from 7% to 47% between the first and second quarters of 2020. That same figure has declined in a consistent manner since the public health emergency, with only 13% of Medicare beneficiaries utilizing a telehealth service in June of 2023. The telehealth data was also broken down into different demographics including race, ethnicity, gender, age, and whether the beneficiary is dually enrolled, aged, disabled, and live in a rural or urban area. These comparisons were relatively congruent, aside from the comparison between rural and urban beneficiaries which showed that urban beneficiaries are maintaining their telehealth services more than their rural counterparts.


HHS Secretary Xavier Becerra Appoints Stacy Sanders to be Chief Competition Office

Stacy Sanders was named Chief Competition Officer at HHS by Secretary Becerra. Last month, the Biden-Harris Administration established the new role of Chief Competition Officer at HHS to focus on reducing health care and prescription drug prices through boosting competition. As Chief Competition Officer, Ms. Sanders will work to promote competition within health care markets through engaging with the Federal Trade Commission and Department of Justice to address concentrated markets. Acting as a Counselor to the Secretary, Ms. Sanders’ role also includes leading the Department’s implementation of the Inflation Reduction Act as well as long-term care and Medicare policies. Ms. Sanders will prioritize the health care components of the President’s 2021 Executive Order on Promoting Competition in the American Economy to lower health care and prescription drug costs. Ms. Sanders has been a part of HHS since November 2022. Her previous experiences include serving as Staff Director of the Senate Special Committee on Aging for Senator Bob Casey and as Federal Policy Director of the Medicare Rights Center.


HHS Final Rule Protects Against Conscience and Religious Discrimination by Rescinding A 2019 Trump Administration Policy

The U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) released a Final Rule, Safeguarding the Rights of Conscience as Protected by Federal Statutes, that partially rescinds a 2019 Trump Administration rule. Federal laws permit health care workers to decline services according to religious beliefs during certain situations, and the 2019 Trump Administration rule would have broadened the implications of those federal laws. The 2019 policy aimed to give medical professionals more rights to abstain from providing health care services that may go against their religious or moral principles. In 2019, three federal district courts found the Trump policy unlawful, and its execution has been blocked. This Final Rule repeals the part of the 2019 policy that would have withdrawn federal funding from health facilities that mandated health care workers perform services they opposed. This HHS 2024 Final Rule focuses on protecting Americans against conscience and religious discrimination in health care, and is the department’s most recent action supporting Executive Order 13985, Advancing Racial Equity and Support for Underserved Communities Through the Federal Government. Abortions, contraception, gender-affirming care, and sterilization are examples of services that health care workers could have refused under the Trump Administration 2019 rule. With this new Final Rule, the Department hopes to clarify and find a balance between provider conscience rights and patient health rights. The Final Rule will be effective March 11, 2024.

Administrative Action

  • The Centers for Medicare and Medicaid Services (CMS) announced the approval of an amendment to New York’s Medicaid section 1115 demonstration that aligns with the Biden-Harris Administration’s efforts to strengthen health care systems. The demonstration amendment aims to improve access to primary and behavioral health care as well as foster health equity throughout the state. The approval authorizes New York to allocate significant resources to innovative and wide-ranging Medicaid projects, allowing the state to advance initiatives focused on integrating primary care providers, community-based organizations, and behavioral health specialists with a goal to address population health and social needs. The demonstration seeks to improve hospitals addressing the needs of vulnerable populations and contains funding for a Medicaid Hospital Global Budget Initiative for safety net hospitals to shift payment to compensating value, not volume of care. The state will further develop the health care workforce and boost provider payment rates as well as Medicaid managed care payment rates in obstetric, primary care, and behavioral health fields. This approval also allows the state to focus on social needs such as care for substance use disorders (SUDs), as well as nutritional and housing support. New York State and CMS will consider how these initiatives are advancing through independent evaluations.
  • The Biden-Harris Administration recently launched a new program through the Advanced Research Projects Agency (APRA-H) aimed at addressing the country’s most pressing preventable health challenges. The Health Care Rewards to Achieve Improved Outcomes (HEROES) program intends to encourage investment in community-based preventative care resources, focusing on communities that historically have limited access to breakthroughs in medicine and health care. The announcement cites people with low incomes dying 15 years younger than Americans with high incomes and Americans in rural areas dying at higher rates than those in urban areas as the rationale for the program. HEROES will solicit proposals from potential actors called “Health Accelerators,” which can be groups like health consortiums and community health centers that will support addressing health challenges in underserved parts of the nation. Health Accelerators will be awarded agreements and then have three years to show quantifiable reductions in their tasked health challenge. The program’s incentive-based model hopes to bring in potential long-term payers to shift the United States to a system that rewards better health.

Congressional Action

Members of the bipartisan Paid Family Leave Working Group recently released their policy framework (press release) for the upcoming year. Following a year of information gathering, the group announced its framework, which consists of four pillars of legislative policy. The first pillar focuses on public-private partnerships aimed at implementing paid leave pilot programs that would resemble those trial programs already instituted by fourteen states. The next pillar would establish an “Interstate Paid Leave Action Network (I-PLAN)” that would serve to drive improvements in coordination of benefits across the growing number of states with their own paid leave programs. The third pillar deals with small employers joining association-style insurance pooling plans with the intention of lowering the cost of providing paid family leave through pooling risk for the employer. The final pillar hopes to make improvements to 45S, paid leave tax credits for small businesses and working families. Proposed revisions to the tax credit include making it permanent, increasing the tax credit for small businesses, and increasing awareness of the credit among employers.

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Roundtable’s 20th Annual Conference

November 6-8, 2024

The Mayflower Hotel, Washington, DC

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