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Health Care Current Library

Health care current: Weekly insights to keep you informed and ahead

This weekly series explores breaking news and developments in the U.S. health care industry, examines key issues facing life sciences and health care companies and provides updates and insights on policy, regulatory and legislative changes.

Each edition includes:

My Take: Insights from Deloitte leaders on the current state of the industry, where it could be headed and possible implications for key stakeholder groups.

Implementation & Adoption: Updates on ACA implementation and other significant health care policies and regulatory changes.

On the Hill & In the Courts: Recent, current and pending health care-related legislation, major rules/guidance and court rulings of importance to industry stakeholders.

Around the Country: State-level health care issues, policies and programs.

Breaking Boundaries: Breakthroughs and new technologies that are driving momentum and change.

Join Deloitte’s leaders as they share updates, insights and implications that help industry executives stay informed and ahead of changes in the health care system.

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Current: July 15, 2014

  • My Take: Taking the patient experience to new heights
    • Poll question:In your opinion, which of the following is the largest barrier to greater patient engagement in health care?
  • Implementation & Adoption
    • UnitedHealthcare: cancer costs cut by changing physician incentives
    • Study: health IT buying behavior varies by hospital tax status
    • Study: hospital use of EHRs not leading to an increase of Medicare billing
    • Survey: life sciences and health care consolidation expected to increase this year
    • Health Affairs highlights VA’s analytics and big data initiatives
  • On the Hill & In the Courts
    • CMS proposes updates to PFS, PQRS, Open Payments and more
  • Around the Country
    • Colorado estimates 24 percent of marketplace enrollees will drop insurance policies
    • Study: potential consequences of states’ decisions to expand or not expand Medicaid
  • Breaking Boundaries
    • ONC announces EHR challenge for blood pressure control
    • U.K. cardiovascular health group launches heart age app

Current: July 8, 2014

  • My Take: From formation to reform: Three major shifts in the U.S. health care system
    • Poll question: In your opinion, which of the following could have the most influence on the future of the U.S. health care system?

Current: July 1, 2014

  • My Take: Welcome to the age of biosensing wearables
    • Poll question: What do you think will be the future of wearables in the next decade?
  • Implementation & Adoption
    • CMS could penalize 760 hospitals for poor performance
    • Poll: 5 percent of Americans have gained health insurance coverage in 2014
    • Report: Trends in job creation and entrepreneurship in the life sciences sector
    • Study: Provider outlook from health care reform less positive than other sectors
  • On the Hill & In the Courts
    • SCOTUS rules for religious employers in Burwell v. Hobby Lobby
    • Senate Finance and House Ways & Means committees propose post-acute care bill
    • AHA urges CMS and ONC to finalize new timeline quickly for Stage 2 Meaningful Use
    • House E&C Committee hearing assesses Medicare fraud and abuse
    • Draft guidance indicates that FDA will not provide regulatory oversight of medical device data systems
    • CMS issues proposed guidance on reenrollment to reduce burden and costs
  • Around the Country
    • California approves expansion of Medi-Cal while maintaining provider payment reductions
    • Oregon’s health system transformation project sees advances and areas for improvement
  • Breaking Boundaries
    • Alabama’s Medicaid agency uses data visualization to aid in health care decision making
    • Three-dimensional heart image technology could help detect and treat heart disease

Current: June 24, 2014

  • My Take: In health care compliance, the devil is often in the details
    • Poll question: In your opinion, which of the following could have the greatest effect on decreasing fraud and abuse in the health care system?
  • Implementation & Adoption
    • Two organizations offer lessons learned from the first open enrollment period
    • Report from The Commonwealth Fund finds U.S. health care lagging behind other countries
    • Vitality Institute recommends greater investment in health promotion and prevention
    • Survey: Physicians, PAs and pharmacists concerned with FDA’s generic drug labeling rule
  • On the Hill & In the Courts
    • PhRMA requests CMS extension of Open Payment website due to technical concerns
    • Physician organizations ask Congress to extend Medicaid primary care payment policy
    • FDA releases draft guidance related to industry use of social media
  • Around the Country
    • Colorado approves health insurer market assessment
    • Illinois governor signs bill to restore and transform the Medicaid program
  • Breaking Boundaries
    • New personalized medicine vaccine technique attacks cancer cells using patient’s immune system
    • University of Maryland receives a grant to support a personalized medicine approach to monogenic diabetes

Current: June 17, 2014

  • My Take: How can acute care hospitals ward off commoditization?
    • Poll question: In your opinion, what effect might commoditization of the acute care sector have?
  • Implementation & Adoption
    • Study: On average, off-marketplace plans are 40 percent more expensive than those offered on new marketplaces
    • Report: Value-based insurance design for specialty drugs may reduce cost-sharing and improve access
    • AHIP proposes solutions to improve customer experience in new marketplaces
  • On the Hill & In the Courts
    • CMS approves employee choice delay in 18 federally-facilitated SHOP marketplaces
    • Industry groups send Secretary Burwell letters requesting removal of barriers to telehealth reimbursement
  • Around the Country
    • Report: Minnesota’s uninsured population has declined by 40.6 percent since open enrollment
    • Massachusetts health insurance coverage increases by 3.9 percent, nearing universal coverage
  • Breaking Boundaries
    • Harvard hospitals pilot Google Glass app that share physician’s point of view
    • New device can identify aggressive cancer cells that lead to metastasis

Current: June 10, 2014

  • My Take: All health care is local – or is it?
    • Poll question: In your opinion, which country’s health care system has more to learn from the other—India or the U.S.?
  • Implementation & Adoption
    • Survey: At least half of ACOs identify as physician-led
    • CBO, JCT: 2 million fewer expected to pay mandate penalty than originally projected
    • CMS: 89 percent of claims accepted during ICD-10 testing
    • Study: Variation in silver plans leads to variation in cost-sharing
  • On the Hill & In the Courts
    • CMS releases another set of payment data and information on provider utilization
    • Medicare to cover Hepatitis C screening
    • House E&C Committee sends letter to ONC requesting clarification on role
  • Around the Country
    • Burwell confirmed as new HHS Secretary
    • Study: Expansion states saw an increase in Medicaid hospital charge volumes
    • New York to spend $55 million to connect 10 regional health systems into a statewide HIE
  • Breaking Boundaries
    • Kaiser Permanente receives $7 million grant to enhance patient-centered database
    • ONC announces winners of the Code-a-Palooza and Digital Privacy Notice Challenge

Current: June 3, 2014

  • My Take: The next leg of health care’s run toward the Triple Crown
    • Poll question: When thinking about the future of the health care system, which of the following do you believe to be true?
  • Implementation & Adoption
    • CMS alters Meaningful Use deadlines
    • FTC urges lawmakers to require greater transparency among data brokers
    • National Coalition on Health Care launches Rx pricing campaign
    • Report predicts uninsured rate to rise after 2016
  • On the Hill & In the Courts
    • CMS announces Round 2 of State Innovation Model Initiative grants
    • IRS: employers seeking to shift employees to HIX may face additional penalties
    • Court overrules expansion of 340B pricing for non-orphan use
  • Around the Country
    • Connecticut unveils smartphone app for HIX enrollment
    • CMS approves Texas’s dual eligible demonstration
  • Breaking Boundaries
    • Study: telehealth services for chronically-ill improve both patient and physician satisfaction
    • NIH announces new initiative to harness biomedical research techniques from big data

Current: May 20, 2014

  • My Take: Young and looking for more: Is the health care industry hitting the mark with young adults?
    • Poll question: In your opinion, what could be most effective in getting more young adults to sign up for health insurance?
  • Implementation & Adoption
    • HCCI partners with three health insurers to provide price and quality information
    • Study: Health insurance coverage expansion leads to higher wages for young adults
    • Report: What states can learn from CHIP outreach, enrollment, retention
    • Report: Medicaid expansion and its potential risks to health insurers’ profitability
    • Study: MLR rebates to consumers for 2012 half those of 2011
  • On the Hill & In the Courts
    • HHS releases final rule on insurance exchange standards for 2015 and beyond
    • CMS releases MA and Part D final rule
    • FDA draft guidance released to establish drug trial process to demonstrate biosimilarity
    • MPHA requests guidance from CMS on health insurance providers tax
  • Around the Country
    • Virginia, Washington, and Indiana release health insurance rate filings for 2015 plan year
    • New Jersey hospitals avoided at least $100 million in costs through Partnership for Patients
    • Report: Hispanic residents in Texas more likely find ACA beneficial than White residents
  • Breaking Boundaries
    • Smartphone transformed into eye care medical device PEEK
    • Heart disease on a chip technology could be another step toward personalized medicine

Current: May 13, 2014

  • My Take: States’ roles in the value-based care revolution
    • Poll question: In your opinion, how could states best work with private payers to get the most leverage for value-based care?
  • Implementation & Adoption
    • Gallup survey: uninsured rate drops to 13.4 percent, the lowest recorded
    • HIMSS survey: 85 percent of RECs plan to remain open after federal funds expire
    • MU update: few hospitals and providers have attested to Stage 2
    • Study: vertical integration and its effect on hospital prices
    • Study: targeted oncology therapy sales grew to 46 percent of global sales
    • KFF: Medicare Advantage enrollment at an all-time high of 16 million
  • On the Hill & In the Courts
    • Insurance industry submits comments on CMS proposal to make risk corridor program budget neutral
    • Proposed rule would require employers to inform laid-off employees about HIX coverage options
  • Around the Country
    • Study: growth in personal health spending on children surpasses older adult spending
    • BCBSA: consumer interest in multi-state plan program is “significant”
  • Breaking Boundaries
    • Mayo Clinic launches mHealth app to provide consumers with concierge medicine
    • NIH offers grant awards for mHealth development

Current: May 6, 2014

  • My Take: Updating the M&A playbook: Deepening the bench for a “value game”
    • Poll question: In your opinion, where might the recent M&A examples have the most impact for consumers?
  • Implementation & Adoption
    • HIX enrollment for first open enrollment season totaled 8 million; 28 percent young adults
    • Administration releases updated spending report; attributes sharp growth in health care spend to increased health insurance coverage
    • Federation of State Medical Boards adopts new guidelines for appropriate use of telemedicine
    • Study: top 10 conditions contribute to most readmissions and related hospital costs regardless of payer
  • On the Hill & In the Courts
    • CMS issues a collection of proposed payment rules
    • ICD-10 deadline set for October 1, 2015
  • Around the Country
    • Kentucky, South Dakota extend non-compliant health insurance plans
    • RWJF report advocates for patient safety and quality policy to prevent diagnosis error
    • Washington issues provider network adequacy standards for insurers in the state
  • Breaking Boundaries
    • CDC program targets DNA sequencing to identify deadly bacteria and virus outbreaks
    • Boston Children’s Hospital uses predictive modeling system to assess patient risk in the ICU

Current: April 29, 2014

  • My Take: The new wallet biopsy
    • Poll question: In your opinion, what is the biggest barrier consumers face in making value-based decisions in their health care?
  • Implementation & Adoption
    • ACO spotlight: study reveals new patterns; CMS highlights efforts
    • JASON, AHRQ offer vision for future of the health IT ecosystem
    • Report: many U.S. hospitals lack patient-centered websites
    • Reports: policy options for FDA to improve internal performance and drug review process
  • On the Hill & In the Courts
    • CMS guidance offers clarification on budget neutrality of the risk corridor program
    • FDA announces collaborative program to expedite approval process for medical devices
    • Legislator sends comment to FTC asking for more regulation of consolidation
  • Around the Country
    • Arkansas releases demographic profile of approved applicants for alternative Medicaid expansion
    • Maryland passes hospital readmission reduction incentive program
    • Arizona passes bill to regulate insurance navigators
  • Breaking Boundaries
    • Home health care workers use tablets to provide coordinated care to 100,000 patients
    • Mississippi creates state-wide telehealth program for diabetes monitoring

Current: April 22, 2014

  • My Take: On the road to value-based care, are the physician reimbursement data a gold mine?
    • Poll question: In your opinion, was the CMS decision to release physician reimbursement data a good idea?
  • Implementation & Adoption
    • 8 million enrolled through HIXs; California reaches nearly 1.4 million enrollees
    • Survey: 59 percent of health care professionals report an expected loss of momentum due to ICD-10 delay
    • Study: U.S. medication spending increased last year
    • Non-physician provider use is up; challenges remain
    • Study: Medicare Advantage payment rates to drop by 13.3 percent on average under the ACA
  • On the Hill & In the Courts
    • CBO estimates $104 billion less in spending for insurance coverage provisions of ACA
    • CBO updates budget projections for 2014-2024
    • OIG report: 11 out of 56 state Medicaid agencies allow outsourcing of administrative functions
  • Around the Country
    • New report details the successes of the New Hampshire’s price transparency efforts
    • Study: diabetes rate increases three-fold but complications decline over 20 year period
  • Breaking Boundaries
    • 3-D mapping of the brain gives insight to the brain’s developmental disorders
    • Scientists testing a new process for clinical trials; no randomization involved

Current: April 15, 2014

  • My Take: Quality rating scores in exchanges are important, even if consumers don’t use them
    • Poll question: When considering the move to a more quality-based health care system, with which of the following would you most agree?
  • Implementation & Adoption
    • CMS releases reimbursement data on 880,000 Medicare physicians, invites “public scrutiny” of dataset
    • Prescription claims from the first two months of HIX enrollment suggest higher specialty drug spending by enrollees
    • Report: more health care providers participating in quality reporting and e-prescribing programs
    • Study: hospitalization, ED visits more likely among community-dwelling patients with Alzheimer’s disease
  • On the Hill & In the Courts
    • HHS Secretary Kathleen Sebelius resigns; Sylvia Mathews Burwell to be replacement
    • CMS issues final call letter for Medicare Advantage, Part D
    • GAO: competitive bidding for durable medical equipment doesn’t adversely affect Medicare beneficiaries
  • Around the Country
    • Avalere: 10 states account for 80 percent of new Medicaid enrollees under ACA
    • New York state allows certain nurse practitioners to practice without a physician-written practice agreement
    • Study: one-in-five Americans had trouble paying medical bills; “near poor” faced more difficulties than poor
  • Breaking Boundaries
    • Study: cardiac rehabilitation mobile app could reduce ED readmissions by 40 percent
    • ONC app helps small- to medium-sized health care practices assess HIPAA compliance

Current: April 8, 2014

  • My Take: No time to slow down: looking forward to 2015 open enrollment
    • Poll question: In your opinion, what is the biggest looming question after the end of the 2014 open enrollment season?
  • Implementation & Adoption
    • Open enrollment figures begin rolling in
    • Reactions: SGR patched and ICD-10 delayed
    • Report: 10 recommendations for the 2015 HIX open enrollment period
    • Health care spending growth rose to 5.6 percent in the last quarter of 2013
    • Insurers unveil new efforts to expand value-based care coordination and quality improvement
  • On the Hill & In the Courts
    • CMS releases data on Medicare payments to physicians in 2012
    • Proposed FDASIA risk-based framework for health IT released
  • Around the Country
    • CMS approves dual eligible demonstration project in Michigan
    • CMS awards Tennessee $80 million for essential access hospitals in Medicaid
    • Report: high- and low-rated hospitals vary significantly on patient safety
  • Breaking Boundaries
    • Study: simple blood test could accurately rule out heart attacks in the ER
    • PCORI launches mHealth app challenge to boost research partnerships

Current: April 1, 2014

  • My Take: ICD-10: Dealing with uncertainty when the stakes are high
    • Poll question: How would you describe your organization’s readiness to meet the prior ICD-10 October 1, 2014, deadline?
  • Implementation & Adoption
    • SGR patch passed: one-year ICD-10 and two-midnight rule delays included
    • Administration announces special enrollment period after March 31
    • Report: state of the state-based SHOP exchanges
    • Study: drug utilization management controls stronger in HIX-based plans than in employer-sponsored plans
    • Report: gaps in health rankings across U.S. counties exist, but positive trends noted in specific measures
  • On the Hill & In the Courts
    • ACA policies in court last week
    • FDA proposes rule to re-classify medical devices
  • Around the Country
    • New Hampshire passes Medicaid expansion
    • Report card on consumer access to state’s health care prices shows poor transparency
  • Breaking Boundaries
    • New smartphone app reads colorimetric tests instantly for multiple health conditions
    • Health departments expected to see an increase in notifiable disease reporting volumes due to Meaningful Use program

Current: March 25, 2014

  • My Take: Fixing an unsatisfactory equilibrium in health care: riding the new wave of social entrepreneurship
    • Poll question: In your opinion, which of the following unsatisfactory equilibriums in the U.S. health care system could be best solved using social entrepreneurship?
  • Implementation & Adoption
    • Survey: 66 percent of Americans are satisfied with U.S. health care system
    • Study: 18-34 year-olds may not be enrolling in HIXs on account of narrow subsidy eligibility
    • Study: current or planned ACO participation depends on practice size
    • Ponemon: survey reveals new, expanded threats to security and privacy of patient information
    • Study: surgical site infection quality measures do not offer much distinction between hospitals
  • On the Hill & In the Courts
    • FDA report: medical device recalls increased by 97 percent between 2003 and 2012
    • CMS now releasing doctors’ Medicare payment data
    • CMS moves forward with Medicare Care Choices Model pilot; testing begins on alternative palliative care and hospice benefits
    • Lawmakers request more transparency around FDA regulation of medical mobile applications, medical software
    • BIO submits alternative options for FDA proposed generic labeling rule
  • Around the Country
    • Maryland, Nevada to allow enrollment in HIX for special cases after March 31 deadline
    • California’s HIX, Covered California, makes up one-fifth of total U.S. enrollment
  • Breaking Boundaries
    • NY hospital hosts hackathon, resulting in innovative mobile health apps for patient engagement
    • Stanford laboratory creates the Foldscope, a paper microscope that costs less than $1

Current: March 18, 2014

  • My Take: Is compliance enough? Five steps for managing cyber threats in an ever-evolving risk landscape
    • Poll question: When thinking about your cyber risk strategy, what is the most difficult challenge you face?
  • Implementation & Adoption
    • HIX enrollment reaches 5 million as of March 17; Avalere predicts 5.4 million total enrollees
    • CMS issues proposed changes to HIX, insurance market standards
    • Survey: U.S. uninsured rate declines to 15.9 percent
    • Survey: data breaches present the greatest barrier to mHealth adoption
    • Report: EHR program incentive payments to eligible hospitals and physicians increase, but many dropped out after the first year
    • NCQA previews 2014 PCMH standards required to receive recognition
    • Hospital employment drops while overall health care jobs increase in February
  • On the Hill & In the Courts
    • CMS releases Meaningful Use hardship exemption guidelines for Stage 2
    • CBO budget review: growth in Medicare spending per person will slow compared to prior years
  • Around the Country
    • CCIIO releases blueprint for states seeking new HIX approval
    • Study: churning to vary substantially from state-to-state
  • Breaking Boundaries
    • Study: engaged use of telemedicine reduces nursing home hospitalizations, generates savings
    • Study: robotic-assisted prostate surgery yields better results than traditional surgery

Current: March 11, 2014

  • My Take: Innovation to what end? Taking care of the “jobs to be done” for health care consumers
    • Poll question: In your opinion, which of the following do you believe to be true regarding health care innovation?
  • Implementation & Adoption
    • Administration releases FY2015 budget proposal
    • RAND finds modest effects from value-based purchasing, offers recommendations for national strategy
    • Report: approximately 2.4-3.5 million enrolled in Medicaid from October 2013-January 2014
    • Study: state participation in health care reform initiatives has little effect on insurer competition in HIXs plans
  • On the Hill & In the Courts
    • CMS puts some of proposed Part D changes on hold
    • Administration further extends health insurance policy cancellations
    • CBO: ACA coverage provisions net $9 billion lower than originally projected
    • CMS releases final rule for the basic health program
    • AHIP voices concerns to CMS about changing requirements for QHPs
  • Around the Country
    • Arkansas alternative Medicaid expansion plan passes
    • New Hampshire Senate passes Medicaid expansion bill; House vote pending
  • Breaking Boundaries
    • WEDI & ENHAC collaborate to create a third-party review process for PMS
    • A new test saves time in identifying bone marrow and stem cell donor compatibility

Current: March 4, 2014

  • My Take: Achieving interoperability: it’s not about how much you own; it’s about how much you share
    • Poll question: Of the following, which do you believe will be the most challenging as the health care industry works to achieve interoperability?
  • Implementation & Adoption
    • HIX enrollment reaches 4 million; Medicaid, CHIP eligibility determinations reach 8.9 million
    • Report: 65 percent of small employers likely to see higher premiums due to ACA
    • Poll: consumer preferences split between more affordable, narrow network plans and costlier, more inclusive networks
    • Study: early patient-centered medical home shows few improvements in cost, utilization, quality of care
  • On the Hill & In the Courts
    • Progress toward Meaningful Use: survey finds positive sentiment among provider groups; national organizations request extension of timelines
    • HHS: $4.3 billion recovered from fraud and abuse investigations during FY2013
    • CBO: SGR bill would cost more than $138 billion over 11 years
  • Around the Country
    • Report: obesity rate in young children drops significantly, but overall obesity rates remain high
    • NASHCO highlights state CO-OP updates
  • Breaking Boundaries
    • U.S. launches Global Health Security Agenda to guard against security and health threats from infectious diseases
    • NIH to make patient genetic and medical data accessible to researchers

Current: February 25, 2014

  • My Take: Thinking big, starting small, moving quickly: the power of health care analytics
    • Poll question: In my opinion, the biggest challenge facing widespread adoption of analytics capabilities in health care is:
  • Implementation & Adoption
    • Health care organizations send letter to CMS opposing Medicare Part D changes
    • CMS to conduct end-to-end testing on ICD-10 codes
    • AdvaMed: medical device tax costing the industry 33,000 jobs
  • On the Hill & In the Courts
    • Virginia district court: subsidies for federally-facilitated HIX are lawful
    • Comments to Senate Finance Committee: U.S. mental health system in need of reform
  • Around the Country
    • Pennsylvania submits revised alternative Medicaid expansion request
    • Virginia Senate committee passes alternative Medicaid expansion plan
    • Kentucky considers “bridge plans” for coverage continuity
    • Arkansas House votes against alternative Medicaid expansion plan
  • Breaking Boundaries
    • Ricoh & InterSystems create partnership to develop health IT interoperability solutions

Current: February 18, 2014

  • My Take: Fighting fraud and abuse in health care: creating a culture of compliance
    • Poll question: In your opinion, who has the greatest responsibility to prevent and investigate fraud and abuse in the health care system?
  • Implementation & Adoption
    • ACA employer mandate delayed an additional year for mid-size employers
    • HHS: more than one million people enroll in HIXs in January, bringing total to 3.3 million
    • CMS releases guidelines on switching health plans in the initial open enrollment period
    • Drug, device companies begin reporting provider relationships to CMS via Sunshine Act
  • On the Hill & In the Courts
    • Congress urges OMB to release final rule on electronic drug labeling
    • Debt limit bill signed, military pension funds reinstated using Medicare sequestration cuts
    • GAO report: new drug shortages decrease, long-term shortages continue to rise
  • Around the Country
    • More states enroll long-term care residents in managed care
    • HHS approves New York’s waiver to use $8 billion for Medicaid program
  • Breaking Boundaries
    • NASA licenses medical device patents for pain and tissue regeneration
    • An examined life: the first pilot for quantified self-preventative care

Current: February 11, 2014

  • My Take: “All we want are the facts, ma’am”: Product messaging in a value-based marketplace
    • Poll question: Which of the following do you believe could prove to be most valuable to the health care industry when considering the move to value-based care?
  • Implementation & Adoption
    • CBO: 1 million fewer people expected to enroll in HIX
    • CMS updates guidance to QHPs on federally facilitated HIXs
    • PCORI awards $1 billion in funding for comparative effectiveness studies
    • HHS updates HIPAA laws to grant patients direct access to lab results
  • On the Hill & In the Courts
    • Congress agrees to bipartisan SGR replacement bill
    • FDA’s draft guidance agenda includes social media, biosimilars and quality control
    • Congress challenges validity of ACA risk-corridor payments
  • Around the Country
    • Washington state considers health care price transparency regulations
    • New York state sees early success with new prescription drug monitoring program
  • Breaking Boundaries
    • NIH and pharmaceutical companies team to create a new drug development model
    • Public-private partnership to combat bioterror, treat antibiotic-resistant infections

Current: February 4, 2014

  • My Take: There's more than one way to cook an egg: Medicaid and its possible recipes for expansion
    • Poll question: In your opinion, which of the following is likely to have the most positive impact on state Medicaid programs’ cost and quality?
  • Implementation & Adoption
    • CMS delays 'two-midnight' rule until after Sept. 30
    • CMS: ACOs generate millions in savings during first year of operation
    • DOJ: Medicare fraud taskforce recovers $3.8 billion in 2013
    • HIX successfully transferring Medicaid applications to half of state Medicaid agencies
    • Report: PCORI urged to amplify CER funding
    • Study: HIXs may offer better deals to those with cancelled health plans
  • On the Hill & In the Courts
    • CBO estimates that SGR replacement bill will cost $121 billion
    • Supreme Court allows nuns temporary relief from contraceptive coverage during lawsuit
  • Around the Country
    • Medicaid expansion could save Virginia $1 billion through 2022
    • Final negotiation talks needed to expedite approval of NY’s $10 billion Medicaid waiver
  • Breaking Boundaries
    • New technology delivers vaccine through patch needle injection
    • Researchers discover alternative method for producing stem cells

Current: January 28, 2014

  • My Take: Seeing past the blind spot: is transparency in health care enough?
    • Poll question: In my opinion, the removal of this blind spot in the health care system is…
  • Implementation & Adoption
    • IRS: consumers with limited coverage won’t pay individual mandate penalties
    • RAND: consumers keeping non-compliant health plans in 2014 not likely to impact HIXs
    • Reports: health care spending continues slow growth; price growth remains slow; and health care jobs decline
    • Gallup: rate of uninsured has dropped
    • CMS awards new HIX grants
  • On the Hill & In the Courts
    • Lawmakers express concern over FDA’s generic drug labeling proposals
    • District judge blocks navigator restriction law
  • Around the Country
    • Virginia governor plans to expand Medicaid
    • Tennessee seeks additional $80 million to help struggling hospitals in absence of DSH funding
    • Report: Wisconsin hospitals saved $45 million by reducing readmissions and surgical infections
  • Breaking Boundaries
    • DNA ‘barcoding’ provides faster analysis of cancer-related proteins
    • Genetic platform developed at UC San Diego used to produce new antibiotic

Current: January 21, 2014

  • My Take: Government policy influencing health care change in the world’s two largest economies – can regulation act as a catalyst to improvement?
    • Poll question: Is the U.S. health care public policy governance construct adequate for continued development of our health care eco-system?
  • Implementation & Adoption
    • HHS report: 24 percent of 2.2 million HIX enrollees are young adults
    • HHS to release Medicare physician reimbursement data
    • PCIP enrollees again granted additional time for coverage: HHS extends deadline to March
    • FDA: drug manufacturers not responsible for independent social media posts
    • Report: uncompensated care provided by U.S. hospitals increases to $45.9 billion
    • Health care fraud cases multiply steadily
  • On the Hill & In the Courts
    • Spending bill increases funding for some health care services; no new funds for ACA
    • D.C. federal judge rules federal tax credits to HIX lawful
  • Around the Country
    • Final rule encourages states to develop Medicaid home and community-based services programs
    • Maryland announces change in hospital service and payment delivery model
  • Breaking Boundaries
    • UK patient records to be shared in vast database with researchers and pharmaceuticals
    • Home device for receipt and transmission of patient data receives FDA clearance
    • PCMH model reduces cost of care and hospital visits while improving population health

Current: January 14, 2014

  • My Take: Understanding the balance between fostering innovation and driving competition in biopharma
    • Poll question: In your opinion, which of the following uncertainties surrounding the biopharmaceutical industry will pose the greatest challenge for innovation?
  • Implementation & Adoption
    • Survey finds one in four eligible Americans visited HIX
    • CMS creates office for HIX and Medicare complaints
    • 123 new ACOs created to coordinate care for Medicare beneficiaries
    • HHS requires insurers to provide preventive breast cancer drugs at no cost
  • On the Hill & In the Courts
    • CMS proposes rule changes to Medicare Part D and Medicare Advantage Programs designed to save $1.3 billion
    • Telemedicine coverage expands for military members
    • CMS proposes rule allowing all pharmacies to participate in preferred cost-sharing
  • Around the Country
    • Wisconsin receives CMS approval for Medicaid plan
    • Millions expected to shift between HIXs and Medicaid
    • CMS creates workarounds for sending eligible Medicaid applicants to states
    • Massachusetts launches next phase of its HIE
    • Report identifies strategies for states to cut health care costs and improve quality
  • Breaking Boundaries
    • Study: telestroke services are cost-effective for rural providers
    • ECRI report lists 10 health care technologies and systems that offer best returns

Current: January 7, 2014

  • My Take: No more “business as usual” in 2014: setting attainable New Year’s resolutions
    • Poll question: In your opinion, which industry stakeholder is most likely to achieve its resolution?
  • Implementation & Adoption
    • More than 2.1 million enroll in insurance through HIX in 2013
    • Some pharmacies pledge continuity of prescription coverage for 30 days
    • HHS and CMS amend protection for EHR donations
    • ACO participation on the rise
    • USPSTF recommends CT scans for high-risk smokers
  • On the Hill & In the Courts
    • President signs Bipartisan Budget Act
    • House introduces telehealth bill
  • Around the Country
    • CMS approves Medicaid expansion in Michigan
  • Breaking Boundaries
    • PCORI awards $93.5 million to develop national patient-centered clinical research network
    • New screening method can detect Alzheimer’s disease with 90 percent accuracy
    • Healthcare informatics field gets its first class of board-certified physicians

Current: December 17, 2013

  • My Take: Pharma innovation: it’s the science, stupid!
    • Poll question: In your opinion, what is the biggest threat for the life sciences and health care industry in the next five years?
  • Implementation & Adoption
    • HHS extends pre-existing condition program through the end of January
    • HHS Secretary instructs assessment of events leading to HealthCare.gov launch failure
    • HHS makes recommendations on how to make EHRs safer
    • HHS releases November HIX enrollment figures: 4 percent increase in those selecting plans
  • On the Hill & In the Courts
    • Congress reaches budget deal: three-month SGR fix included
  • Around the Country
    • CMS partially approves Iowa’s Medicaid expansion proposal
    • States rated poorly on making physician quality information accessible
    • NYDOH gives consumers access to online hospital pricing data
    • Arizona’s Medicaid expansion expected to cost almost $1 billion over the next 10 years
  • Breaking Boundaries
    • Inhaler could revolutionize vaccination technology
    • Soldier controls prosthetic arm using thought

Current: December 10, 2013

  • My Take: Doctor, please help—big data is making me phat!
    • Poll question: If we had smarter health care data, what would you use it for?
  • Implementation & Adoption
    • CMS delays Meaningful Use Stage 3 by one year
    • Hospital groups seek to end DSH payment cuts
    • Brokers urge Administration to fix technical obstacles on Healthcare.gov
    • Gallup poll: one in four uninsured individuals may elect to pay individual mandate penalty
    • CMS: Medicaid applications increase in October
  • On the Hill & In the Courts
    • Committees unveil updated SGR-repeal draft, short-term fix expected
    • FDA urges providers to only use compounded drugs from registered facilities
  • Around the Country
    • Louisiana sets rule to deter steering patients into managed-care plans
    • Chicago area hospitals join together to make one of the largest HIEs in the country
    • Pennsylvania releases alternate Medicaid expansion plan
  • Breaking Boundaries
    • Digital database tracks infectious diseases for the past 125 years
    • Pen developed for bone marrow repair unveiled in Australia
    • CNS symposium unveils breakthrough neurological technologies

Current: December 3, 2013

  • My Take: Global health care: Shared challenges leading to shared solutions
    • Poll question: In your opinion, does the changing environment in the U.S. health care system relate to a larger trend on the global stage?
  • Implementation & Adoption
    • Administration delays SHOP online enrollment one year
    • CMS releases 2014 physician fee schedule and payment policy updates
    • HHS and CMS release rule for reinsurance and risk corridors
    • Home health services to see smaller pay cuts than originally proposed in 2014
  • On the Hill & In the Courts
    • U.S. Supreme Court to review two ACA employer contraceptive coverage cases
    • House members express concern over CMS Sunshine Act interpretation
  • Around the Country
    • D.C. and Pennsylvania announce decisions on the extension of individual health policies
    • Washington receives CMS approval for capitated dual-eligible demonstration
  • Breaking Boundaries
    • Mobile app helps gastroenterology patients measure ostomy bags
    • Study uses EMRs to link DNA variations to skin disease

Current: November 26, 2013

  • My Take: From scrape to hospital stay: the case for health care at home
    • Poll question: If you had the option to be treated at home for a condition usually cared for in a hospital, would you take it?
  • Implementation & Adoption
    • ACA 2015 open enrollment may be delayed by 1 month
    • CCIIO issues guidance to insurers on the extension of non-compliant individual and small group health plans
    • Value-Based Purchasing program sees more low-performing hospitals in FY2014
    • AHIP pushes for changes in ACA premium stabilization programs
    • IMS Health: pharmaceutical sales projected to increase at the lowest growth rate in four years
  • On the Hill & In the Courts
    • Seniors in Medicare Advantage required to verify mail-order prescriptions before delivery
    • AMA votes to partially support current SGR draft
  • Around the Country
    • States divided on Administration’s policy to give insurers a year to make individual health plans ACA compliant
    • Indiana requests HHS to approve Medicaid alternative
  • Breaking Boundaries
    • Smart glasses technology enables medical personnel to see veins underneath the skin
    • NIH grants fund genomic testing for infants

Current: November 19, 2013

  • My Take: Translating between finance and benefits: becoming an employer of choice
    • Poll question: Which of the following do you believe will have the greatest impact on improving the overall performance of the U.S. health care system?
  • Implementation & Adoption
    • Administration announces plan to delay health insurance policy cancellations
    • HHS gives first updates on HIX enrollment data
    • Study identifies highlights in health care trends over the past three decades
    • The Administration announces final rule on mental health/substance abuse parity
  • On the Hill & In the Courts
    • CBO suggests five policy changes to reduce health care spending
    • MedPAC looking into payment per Medicare patient to reimburse primary care
    • FDA announces proposed generic drug parity rule
  • Around the Country
    • Maryland SHOP launch delayed again
    • California union files two ballot initiatives designed to regulate not-for-profit hospitals
    • Michigan to share patient information with federal agencies and six states through national HIE network
  • Breaking Boundaries
    • CMS announces new research tool
    • Time Warner Cable Business Class starting first “Virtual Visit” telemedicine trial
    • Physicians improve lesion detection skills after taking online training course

Current: November 12, 2013

  • My Take: The art of becoming big: the dilemma of mergers & acquisitions in health care
    • Poll question: There are many factors driving consolidation in health care, but I believe the greatest is...
  • Implementation & Adoption
    • HHS: HIX plans will not be considered federal health programs
    • MA plan performance outcomes differ for dual-eligibles, study questions star ratings
    • Kaiser: 17 million people will qualify for tax credits on HIX
    • Gallup poll: most uninsured adults aware of individual mandate, but not HIXs
  • On the Hill & In the Courts
    • OMB confirms FDA user fees cannot be used due to the sequester
    • Supreme Court will review ACA contraceptive cases
  • Around the Country
    • HHS adds $150 million funding for new community health centers
    • GME payments unequal throughout the nation
    • AAMC: GME funding can mitigate national physician shortage
    • CMS approves South Carolina dual-eligible program
  • Breaking Boundaries
    • Study: NPs practicing independently in retail clinics could save millions in health care costs
    • Study: 12 percent of health care projected to be delivered using telemedicine tools

Current: November 5, 2013

  • My Take: Exponential times call for innovative minds
    • Poll question: When considering my organization’s approach to innovation, I believe we are:
  • Implementation & Adoption
    • HHS issues guidance on enrollment dates and penalties
    • Medicare premiums will remain the same or slightly decrease in 2014
    • CMS re-opens ACO applications for kidney care
    • 2014 PCORI budget increases to $650 million
    • Nearly half of all ‘young invincibles’ may be eligible for coverage for under $50 after subsidies
  • On the Hill & In the Courts
    • Senate may vote on drug compounding bill this week
    • Lawmakers drafting bill to delay ACA insurance premium tax
    • Physicians concerned with implications of CMS’ interpretation of the Sunshine Act
    • Bipartisan SGR draft freezes pay and establishes physician bonuses for quality
  • Around the Country
    • Medicaid directors concerned about duplicate applications via Healthcare.gov
    • Study examines increase in prison health care expenditures
    • Michigan HIEs partner to share patient data
  • Breaking Boundaries
    • WebMD adds patient engagement portal capabilities
    • FDA gives first “breakthrough’ drug approval

Current: October 29, 2013

  • My Take: Health plans: are you ready to retail?
    • Poll question: In your opinion, what has been the greatest driver of the retail megatrend in health insurance?
  • Implementation & Adoption
    • CMS finalizes QHP calculations in HIX rule
    • Study shows increase in insurance coverage results in increased outpatient visits
    • New legislation intended to repeal SGR garners limited support
    • States receive more grants for HIX
  • On the Hill & In the Courts
    • Judge allows ACA lawsuit on subsidies to proceed but denies injunction
    • HHS Secretary to testify next week on HIX glitches
    • New FDA agreement between opioid patients and physicians gets mixed reaction from safety advocates
    • FDA finalizes mobile medical app guidance
  • Around the Country
    • Illinois hospitals reduce adverse events and infections
    • Ohio decision of Medicaid expansion now pending
    • Oregon hospital pilots a program that coordinates psychologists and primary care visits
  • Breaking Boundaries
    • Illinois and Michigan collaborate to create a cloud-based Medicaid Management Information System
    • NSF awards multi-year grants to health care robot projects

Current: October 22, 2013

  • My Take: Overprescribed: health care and the challenge of drug diversion
    • Poll question: In your opinion, what holds the greatest potential to break the cycle of drug diversion in the U.S.?
  • Implementation & Adoption
    • Over 5 million people remain uninsured in states not expanding Medicaid
    • Prescriptions for Medicare patients differ by area of residence
    • Medicare expenditures and utilization to decrease under ACA
  • On the Hill & In the Courts
    • CR signed to end government shutdown, HHS to report on ACA income verification
    • Groups urge FDA to use risk-based approach to REMS
    • NAMD urges policy makers to revise mental health policies
    • OIG provider self-disclosure protocol: updates and implications
  • Around the Country
    • CA Governor vetoes biosimilar bill
    • Technology associated with compensation of hospital CEOs
  • Breaking Boundaries
    • Cleveland Clinic releases top 10 medical innovations for 2014
    • Launch of virtual personal assistant for healthcare
    • HIE services save over $1 million in South Carolina

Current: October 15, 2013

  • My Take: Health care and the global tax landscape: remaining flexible amid uncertainty
    • Poll question: In your opinion, which of the following transformations in the global tax landscape will be the most impactful for the health care industry in the future?
  • Implementation & Adoption
    • Medicaid enrollment projected to grow in all states
    • Health care sector added nearly 33,000 jobs in August
    • Medicare Part D premiums projected to increase 5 percent in 2014
    • ACOs found more in areas of increased provider integration
  • On the Hill & In the Courts
    • House passes stop-gap spending measure for FDA
    • Federal government shutdown uniquely affects DC’s Medicaid payments
  • Around the Country
    • Maine residents gain legal access to mail-order drugs
    • New Hampshire Commission votes to expand Medicaid
  • Breaking Boundaries
    • Radio frequency identification may improve hospital supply chain, despite costs
    • Study projects health and economic returns from delaying aging

Current: October 8, 2013

  • My Take: Defining moments and the evolution of Medicaid managed care
    • Poll question: In your opinion, which of the following will have the most impact on Medicaid managed care cost and quality?
  • Implementation & Adoption
    • ACA not causing employers to shift from full-time to part-time workers
  • On the Hill & In the Courts
    • CMS amends DSH rule to accommodate hospitals
  • Around the Country
    • IA moves forward on alternate Medicaid expansion before HHS approval
    • Arkansas Medicaid expansion will not include drug rebates
    • CMS approves Mississippi SHOP Marketplace
    • California dental program faces challenges due to inconsistent funding
    • WI fund created to help low-income residents buy health insurance on HIX
    • NH House Republican requests tax bill remove non-profit exemption
  • Breaking Boundaries
    • FDA approves first early stage breast cancer drug
    • RWJF awards innovative tools to address hospital price transparency

Current: October 1, 2013

  • My Take: Health insurance exchanges: now taking orders…
    • Poll question: What industry innovations are likely to be realized first in HIX 2.0?
  • Implementation & Adoption
    • HHS report says health insurance exchange plan options to be plentiful
    • Administration announces delay in SHOP online enrollment
    • CMS proposes rule for alternative health plan
    • Avalere Health analysis shows a reduction in MA options
  • On the Hill & In the Courts
    • Federal government begins shutdown, most ACA activities continue
    • FDA releases guidance for medical mobile apps
    • House members urge delay of “two-midnight” rule, CMS allows grace period
    • Lawmakers agree on legislation to regulate compounding pharmacies
  • Around the Country
    • Attorneys general urge regulation of e-cigarettes to youth
    • NAMD: states still working to have Medicaid programs ready by October 1
    • Florida proposes expansion to LIP program
    • Arkansas releases HIX premium rates
  • Breaking Boundaries
    • mHealth Evidence tool provides state-of-the-art insights
    • Mathematical model aims to reduce reactions to implanted devices

Current: September 24, 2013

  • My Take: The medtech industry: four key areas critical for future success
    • Poll question: Which of the four areas described above do you believe has the greatest potential impact on the medtech industry?
  • Implementation & Adoption
    • CBO projects federal debt increase for 2038
    • Administration denies tax subsidy request by union groups
    • Health care spending projected to rise in 2014
  • On the Hill & In the Courts
    • FDA releases new requirements for surveillance of medical devices
    • House bill raises concerns from biotech industry
    • CBO determines bill to fix SGR will cost more than a pay freeze
  • Around the Country
    • PA submits Medicaid proposal to HHS
    • MI Governor signs Medicaid expansion into law
    • MD commissioner approves 13 carriers for SHOP
    • NJ and PA health care systems join forces
  • Breaking Boundaries
    • Sensors in health care are positioned to enable interventions and predictive capabilities
    • Handheld device opens up possibilities for global health and HIV monitoring

Current: September 17, 2013

  • My Take: Health IT: Adding lasting value to the “fly-by” appointments
    • Poll question: As a health care consumer, I would most benefit from:
  • Implementation & Adoption
    • Rite Aid to provide ACA and HIX enrollment education
    • Patient-centered outcomes research will soon get $114 million in funding thanks to PCORI
    • Healthcare.gov cloud software system to cost $35 million
    • CMS delays DME requirement
  • On the Hill & In the Courts
    • House approves bill on income verification for HIX subsidies
    • OIG: CMS should create Medicare Part B drug rebate program to save money
    • FDA requires new labels for opioids and more research to reduce abuse and misuse
  • Around the Country
    • Keeping track of state-level activity: useful resources
    • HIX navigators face criticism
    • CA’s legislative body passes biosimilar bill, among others, for Governor to sign
  • Breaking Boundaries
    • Cleveland Clinic will expand services by contracting with orthopedic practices
    • Mayo Clinic uses remote fitness monitors to show association between post-surgical care setting and length of stay on recovery time
    • Employers use reference price benefit designs to decrease patient volume at high-priced facilities

Current: September 10, 2013

  • My Take: Innovation through convergence - the lesson of color TVs and the Wizard of Oz
    • Poll question: When thinking about convergence in the health care industry, I believe the most promising outcome is likely to be…
  • Implementation & Adoption
    • CMS may update rules on preferred pharmacy networks on Part D plans
    • IRS releases guidance on ACA employer mandate requirements
    • Final rule issued on ACA program integrity provisions
    • Expect to see final rule on state Medicaid DSH payment reductions released soon
    • Study renews debate on 'rate shock' fears
  • On the Hill & In the Courts
    • Stakeholders urge FDA to include rare diseases in expedited drug approval process
  • Around the Country
    • Keeping track of state-level activity: useful resources
    • Medicaid shared savings guidance: CMS will only partner with states that can improve patient outcomes and reduce costs
    • NY and CMS join together for a demonstration project to cut dual eligible costs
    • Indiana’s HIP granted one year extension
    • Medicaid expansion becomes reality in Michigan
    • Minnesota releases HIX individual market rates—may be as low as $90.59 per month for some
    • Looking to 2016: Arkansas may consider a state-based exchange
  • Breaking Boundaries
    • NYC innovates with use of EHRs in public health surveillance
    • Hand washing among nurses jumps from 2.97 to 6.6 times per hour due to electronic monitoring system
    • NIH to award $25 million for newborn genomic sequencing

Memo: September 3, 2013

  • My take: Health Reform 2.0 will likely be more challenging than the current chapter

Memo: August 26, 2013

  • My take: the U.S. health care system: a mosaic of businesses and organizations
  • Implementation update
    • IRS releases proposed rules for small business exchange tax credits
    • Rand: impact of employer mandate delay
    • Gallup: opinions mixed about ACA
    • HHS promotes coverage for young invincibles
    • IRS launches ACA tax website
    • Update: PCORI to award $300 million for research
    • House committee seeks IRS background files on employer mandate delay
    • 80 GOP House, 14 GOP Senators pledge vote against funding of the ACA
  • Legislative update
    • FDA considers ban on online sales of electronic cigarettes
  • State update
    • Voter registration during HIX enrollment focus of debate
    • CMS signs agreement to manage, protect data flow between states and federal agencies
    • USA Today analysis: disciplinary actions by state medical boards against physicians fall short
    • HIX update
    • Medicaid expansion update
    • State round-up
  • Industry update
    • Moody's outlook for hospital reimbursement problematic
    • Survey: employers concerned about cost, interest in wellness and private exchanges significant
    • MGMA, HIMSS caution against unfair penalties in Stage 2 meaningful use implementation
    • Critical access hospitals get support from senators
    • Nursing Homes concerned about value-based purchasing, bundled payments
    • Private exchange enrollment update
    • Device reporting changes increase burden on manufacturers
    • Co-pays for home health increase costs: trade group
  • Quotable
  • Fact file

Memo: August 19, 2013

  • My take: health system transformation is a long journey
  • Implementation update
    • $67 million awarded to HIX navigators
    • Study: average federal tax credit to purchase individual coverage through exchanges $2,672
    • Oklahoma challenge to ACA proceeds in court
    • HIX eligibility update: HHS initiates data sharing with VA, IRS
  • Legislative update
    • Meaningful use workgroup releases stage 3 recommendations for comment
    • AHRQ report: health IT alone won't improve quality in primary care settings
    • OIG report: majority of critical-access hospitals do not qualify for cost-plus Medicare reimbursement
    • CMS miscalculated inpatient rehab compliance, House committee looking at reduction in post-acute costs
  • State update
    • HIX update
    • Medicaid expansion update
    • State round-up
  • Industry update
    • Hospital consolidation gets attention
    • Hospitals at odds with Medicare Advantage plans about 2% sequestration cuts
    • Hospitals ask CMS to require exchange plans to pay claims during ACA grace period
    • Health insurers advertising for expanded coverage in 2014
    • Technology price index: average price paid for PET/CT systems dropped 21% in last year
    • Pioneer ACO results update
    • American Medical News to shut down
    • CMS physician fee schedule proposal criticized by AMA
    • Study: behavior changes prompted by lab results problematic for older adults
  • Research snapshot
    • Studies conclude that limiting residents' work hours does not hurt patient safety, but results in less time with patients
  • Quotable
  • Fact file

Memo: August 12, 2013

  • My take: latest findings from survey of U.S. health care consumers
  • Implementation update
    • OIG operational assessment: HIX federal hub comes up short
    • E-brokers for federal HIXs signed to date
    • Guidance about Congressional staff enrollment in HIX released
    • CMS issues HIX income verification FAQs
    • U.S. Department of Labor turns down request to changes in out-of-pocket limits
    • Stark self-reporting update
    • HHS launches HealthCare.gov app, video to support enrollment
  • Legislative update
    • FY14 final payment adjustments for health care providers
    • Report: smaller and rural hospitals struggle with electronic health record implementation
    • ONC head steps down
    • Military hospital cuts part of sequester
    • Medicare transparency: access to physician payment data advancing
  • State update
    • HIX update
    • Medicaid expansion update
    • State round-up
  • Quotable
  • Fact file

Memo: August 5, 2013

  • My take: a threat and an opportunity: shifting health care costs to consumers
  • Implementation update
    • Tavenner tells House Committee ACA implementation on track
    • HHS announces deal with eHealth to handle enrollment, subsidy verification in exchanges
    • Insurers ask HHS for one-year delay to comply with technical interface requirements of HIXs
    • Committee testimony: ACA employer impact most significant for mid-size companies
    • House passes bill to ban the IRS from enforcing the ACA, 40th bill passed in House to repeal ACA
    • CRS: ACA funding not affected by a government shutdown
    • CBO estimates $12 billion increase in cost to Feds due to employer mandate delay
    • Poll finds voters less likely to support members of Congress who attempt to defund the ACA
    • HHS: ACA drug benefit saves Medicare beneficiaries $1,061 each
  • Legislative update
    • House Energy and Commerce Committee passes SGR repeal legislation
    • FDA plans to increase enforcement of dietary supplement claims
    • Democrats in Senate request cost-savings target for ACA
    • Republican Senators request information about federal agency involvement in ACA implementation
  • State update
    • CAP identifies 200 counties with highest uninsured, least access
    • HIX update
    • Medicaid expansion update
    • State round-up
  • Industry news
    • Big deals announced last week
    • Wyeth fined for off-label use
    • CT scans recommended for smokers
    • Meaningful use update: providers have received $15.5B in EHR incentive payments
    • Kaiser funds $1.8 million partnership to help safety net providers expand coverage under the ACA
  • Research snapshots
    • Physician self-referral volume increase correlated to financial incentives: GAO analysis
    • Study: physician entry in EHRs accurate
  • Quotable
  • Fact file

Memo: July 29, 2013

  • My take: comparing the dual aims of reform: “reducing costs” and “covering everyone”
  • Implementation update
    • GAO: individual premiums vary widely
    • Home health industry wants employer mandate exemption
    • Poll: public opinion about the ACA mixed: changes in system desirable, but complete repeal not favored
    • Report: 90% of CO-OPs are on track to reach their goals
    • Treasury officials, Tavenner testify on ACA implementation this week
    • Congressional leaders request insurance premium information for federally facilitated HIXs
  • Legislative update
    • Update on SGR repeal
    • Legislative attention to “pay-for-delay” agreements
    • FDA to tighten restrictions on menthol cigarettes
    • IOM challenges regional variability premise
  • State update
    • HIX update
    • Medicaid expansion update
    • State round-up
  • Industry news
    • Truven report identifies drivers of employer health costs
    • Georgia not-for-profit hospitals pool resources to create population health management alliance
    • AMA, AHA request delay of Stage 2 meaningful use for one year
    • Physician disciplinary report suspended for public release
    • Debates continue over employer access to genetic test results
  • Research snapshots
    • Physicians are concerned about costs, but blame others
    • Parents with insurance and a pediatric physician relationship use retail clinics for convenience
  • Fact file

Memo: July 22, 2013

  • My take: Three reasons why accountable care organizations are not likely to go away
  • Implementation update
    • Pioneer ACO update: mixed results in 2012
    • White House promotes lower insurance premiums in exchanges, MLR rebates
    • Hobby Lobby wins exemption from contraception coverage requirement
    • HHS awards $12 million to increase primary care training
    • CMS releases mobile apps to stimulate transparency in financial relationships between drug and device manufacturers and providers
  • Legislative update
    • SGR fix update: bipartisan bill proposes 5-year phasing from FFS to performance based payments to doctors
    • House passes bills to delay employer mandate, individual mandate
    • House Ways and Means releases Medicare reform draft
    • Bipartisan bill exempts FDA user fees from sequester
    • OMB: 340B drug discount program final rule after two years
  • State update
    • Report: managed care programs for dual eligibles vary in approach
    • HIX update
    • Medicaid expansion update
    • State round-up
  • Industry news
    • CMS update: use of EHRs by clinicians
    • Survey: health information exchanges struggling for sustainability
    • KLAS ACO report
    • Survey: ACOs using remote monitoring
    • FDA examining clinical lab testing oversight
    • AMA, JCAHO target overuse of treatments to reduce costs
    • Hospital transparency: readmission data for PCI added to CMS Hospital Compare
  • Research snapshots
    • PCPs accept new Medicaid enrollees but wide variation by state: what’s the future for primary care?
    • Managing high-cost Medicare enrollee utilization represents modest opportunity for savings unless accompanied by other market innovations
  • Quotable
  • Fact file

Memo: July 15, 2013

  • My take: Employers—a catalyst for health reform
  • Implementation update
    • Employer mandate news coverage focused in four areas
    • CMS final rule on navigators released
    • Final rule on eligibility in Medicaid, CHIP and exchange coverage released
    • Public opinion about ACA are mixed
    • HHS awards $150 million to health centers for enrollment assistance
    • Court challenge dismissed
  • Legislative update
    • White House projects higher health care spending for Medicaid, lower overall deficit due to improving economy
    • CMS releases updates to payment rules for hospital outpatient and physician services
    • Senate appropriations subcommittee approves spending bill fully funding ACA implementation, rejects cuts to HIX, IPAB in full committee votes
    • SGR update: Energy and Commerce latest proposal
  • State update
    • HIX update
    • Medicaid expansion update
    • State round-up
  • Industry news
    • Hospitals, Blues call for no more ICD-10 delays
    • Health care M&A strong in second quarter
    • CMS analysis: Part D preferred networks offer lower drug prices for two-thirds of usage
    • Study: “Managed Medicaid” widely variable
    • Fraud: 70% rule in heart-stent cases
    • Transparency: drug companies required to disclose doctor payments
    • Study: Hospital employment of physicians tied to increased costs, site neutral payments likely to change acquisitions valuations
    • Employee financial security linked to health care needs
    • RWJF Report: Four Key Findings on EHR Adoption
    • CMS reported meaningful use attrition by doctors
    • New branding for ONC Certified EHRs
  • Research snapshots
    • Utilization rates in Medicare Advantage somewhat lower than in fee-for-service but wide variance between markets
    • Variation in bundled payments must consider local market costs and practice patterns
  • Quotable
  • Fact file

Memo: July 8, 2013

  • In observance of the July 4th holiday, there will not be a memo for the week of July 8. Normal production will resume on July 15.

Special edition memo: July 3, 2013

  • My take: health reform breaking news: ACA’s employer mandate will not take effect until 2015

Memo: July 1, 2013

  • My take: Connecting the dots: costs and value to consumers
  • Implementation update
    • Poll: 43% of uninsured population unaware of ACA’s individual mandate
    • Federal hub readiness focus of committee request
    • HHS: 120 issuers apply for FFEs
    • CMS: $290 million cut to home health agencies in 2014
    • Final rule on preventive health services requirements for religious employers released
    • HHS goal for HIX coverage: 7 million by March 2014
    • HHS finalizes HIX rule
    • CMS delays face-to-face requirement for DME
    • CMS launches a redesign of the Physician Compare website
    • ACOs considering moving from the Pioneer Program to Medicare Shared Savings Program
  • Legislative update
    • FDA tackles tobacco products, food safety, counterfeit drug websites
      • Tobacco product oversight
      • Federal court gives FDA timeline to finalize food safety laws
      • FDA shuts down counterfeit websites
    • SGR repeal update: House introduces draft legislation
    • Retailers push for ACA employer mandate delay, change in definition of “full-time worker”
    • Immigration legislation passes in the Senate
    • Health care legislation introduced last week
  • State update
    • State round-up: Medicaid
    • State round-up: HIX
    • State round-up
  • Industry news
    • Supreme Court ruling on Mutual Pharmaceutical v. Bartlett significant
    • Provider consolidation: two deals announced last week
    • Plan to pay primary care for care coordination
    • Clinical trial subject recruitment challenging
    • Resident training rollout starts; “July effect” focus
    • Drugstore chain announces retail clinic deal
    • New delivery system research journal launched
  • Quotable
  • Fact file

Memo: June 24, 2013

  • My take: the new health care normal: increased transparency and public scrutiny
  • Implementation update
    • HIX enrollment push starts
    • GAO: HIXs might not be ready
    • Senators introduce bill to raise full-time employment threshold
    • HHS: consumers saved $3.9 billion on insurance premiums in 2012
    • Oversight committee subpoenas HHS over CO-OP documents
    • Hospitals want DSH cuts delayed
    • CMS extends Pioneer deadline (again)
  • Legislative update
    • Supreme Court rules “pay-to-delay” case can proceed
    • Committee seeks information about IRS access, handling of personal health information
    • Immigration legislation would increase health spending $100 billion
    • Compounding pharmacy legislation introduced in the House
    • MACPAC report to Congress
    • HHS proposal: including medical records in gun background checks faces opposition from physicians
    • SGR fix update: Congressional committees look to offsets in post-acute care sectors
    • Transparency of Medicare payments sought in bill
    • @Regulatory update: CMS Medicare Advantage Annual Notice and RADV Audit Notification
  • State update
    • State round-up: Medicaid
    • State round-up: HIX
    • Deloitte Center for Health Solutions analysis: number of health insurance carriers per state: HIX individual market
    • State round-up
  • Industry news
    • Meeting highlights: AMA House of Delegates in Chicago last week
    • Pfizer, Takeda case signals alert for at-risk generic launches
    • MGMA survey: 55% of medical practices not ready for ICD-10 rollout
    • Moody’s: hospitals seeing volume declines, increased focus on value
    • NCQA updates medical home certification requirements
    • Study: $105 billion potential savings from medical adherence improvement
    • Public hospital association gets new name
  • Research snapshots
  • Quotable
  • Fact file

Memo: June 17, 2013

  • My take
  • Implementation update
    • IRS releases final rule on excise tanning tax: fitness facilities not assessed tax
    • Chairman and vice-chairman appointed to the Long-Term Care Commission
    • Report: MA enrollment increases
    • CMS issues proposed rule on HIX, SHOP, premium stabilization and consumer protections
  • Legislative update
    • MedPAC recommends changes in Medicare payment policies
    • FDA concerns about food safety
    • CO-OP loan program gets attention from House committee; 5 of 24 considered at risk of non-performance
    • Senators urge vote on compounding pharmacy bill
    • Congress asks CMS to delay the Competitive Bidding Program for DMEPOS
    • FDA issues cybersecurity warnings for medical devices
    • Lawmakers call for an integrated EHR for Defense and Veterans Affairs by October 2016
    • Senators question HHS on HIX navigators
    • Medical, dental, nursing schools warned against hepatitis B discrimination
  • State update
    • Small-business exchanges not attracting plans
    • State round-up: Medicaid
    • State round-up: HIX
    • State round-up
  • Industry news
    • Supreme Court: genes cannot be patented
    • MGMA study: docs not prepared for ICD-10
    • Physician compensation up in 2012; gap between specialist and primary care income significant
    • Hospital ownership status linked to performance
  • Research snapshots
  • Quotable
  • Fact file

Memo: June 10, 2013

  • My take
  • Implementation update
    • HIX enrollment support through navigators and health centers: update
    • House committee hearing about solicitation of funding for ACA enrollment
    • Employers challenged to provide pregnancy benefits
    • HHS launches call center to promote public awareness of ACA
    • Senator Hatch seeks information about funding request for premium subsidies
  • Legislative update
    • White House hosts mental health conference
    • Report: nearly 30% of uninsured adults eligible for Medicaid expansion in 2014 have a mental illness
    • SGR repeal update: issues remain about funding, replacement for physician payments
    • House passes track and trace bill
    • CMS, ONC releases data promoting transparency
  • State update
    • State round-up: Medicaid expansion
    • State round-up: HIX
    • State round-up
  • Industry news
    • Report: premiums reduced as result of ACA
    • Health care employment continued to trend up May: Bureau of Labor Statistics
    • ACO risk sharing with commercial insurers, Medicare
    • Medical spas: medical treatments and beauty treatments?
    • Medical oncologist survey: Cancer drug shortage
    • Immunotherapy strategy gets attention at national meeting
  • Research snapshots
  • Quotable
  • Fact file

Memo: June 3, 2013

  • My take
    • Major elements of ACA wherein “evidence-based medicine” is a central feature
  • Implementation update
    • Final rule released on employer worksite wellness programs
    • Small business coverage final rule released
    • HIX update
  • Legislative update
    • Trustee report: Medicare trust fund solvent through 2026, Social Security through 2033
    • This week: Congress in session, White House hosts mental health conference
    • GOP Senators seek clarity around HHS fundraising for enrollment campaign
    • CMS to make provider, consumer fraud data available for analytics by health plans
    • SGR repeal framework to be discussed this week
    • Hospital readmission rate drops
    • Immigrants made 14.7% of Medicare contributions and account for 7.9% of its expenditures
  • State update
    • State round-up: Medicaid
    • State round-up: HIX
    • State round-up
  • Industry news
    • Physician data to be released after 33-year protection
    • FDA official challenges drug class safety
    • HIT spending
  • Research snapshots
  • Quotable
  • Fact file

Memo: May 28, 2013

  • My take
  • Implementation update
    • CMS: states to receive additional funding for Medicaid expansion
    • States drop ACA duals program
    • Hobby Lobby challenge to ACA heard in federal court
  • Legislative update
    • HHS: 50 percent of eligible physicians, 80 percent of hospitals have adopted EHRs
    • Think tanks propose Medicare enrollees share in savings
    • State fraud units can use federal funds for Medicaid data mining
    • SGR status
    • Lawmakers propose alternative for calculating medical practice cost differences
    • Legislation to allow FDA to access user fees explored
    • Compounding pharmacy, track and trace legislation advance in Senate
    • Senator proposes blocking ICD-10 implementation
    • Health care-related legislation introduced last week
  • State update
    • State round-up: HIX
    • Medicaid expansion update
    • State round-up
  • Industry news
    • Insurers announce exchange participation on state-by-state basis
    • @Regulatory update: The cloud in life sciences—a regulatory perspective
    • New coalition promoting medication adherence
    • HIT oversight challenging to medical device manufacturers
    • American Benefits Council seeks clarity on ACA employer reporting requirement
    • Certified medical home experts recognized by NCQA
    • Psychiatric manual controversial
    • Actavis to acquire Warner Chilcott in $8.5 billion transaction
  • Quotable
  • Fact file

Memo: May 20, 2013

  • My take
  • Implementation update
    • CBO updates ACA impact on coverage, costs
    • CMS seeks Bundled Payments applicants
    • New funds for innovation available
    • 4th Circuit hears ACA challenge
    • PCIP guidance released as program winds down
    • CMS proposed rule would separate DSH payments from Medicaid expansion temporarily
    • IRS, HHS release MLR guidance for certain organizations, Medicare Part C and Part D plans
  • Legislative update
    • Physician ban on hospital ownership challenged
    • Tavenner confirmed
    • House passes legislation to repeal ACA for 37th time
    • Report: increases in premium prices due to ACA
    • Track and trace legislation advances in Congress with bipartisan support
    • Health care related legislation introduced last week
  • State update
    • State round-up: HIX
    • Medicaid expansion update
    • State round-up
  • Industry news
    • AMA membership up, revenues down
    • Stem cell cloning promising as Oregon researchers
    • SEC investigating political intelligence activity
    • Jolie preventive mastectomy puts spotlight on genetic testing for cancer risk
    • IOM: salt intake precautions not warranted; American Heart Association disagrees
    • Immunotherapy market might be $20 billion annually
  • Research snapshots
    • Recent health spending trend might persist to produce longer-term savings
  • Quotable
  • Fact file

Memo: May 13, 2013

  • My take
  • Implementation update
    • Three stages for the adoption of MU over five years
    • Clinical effectiveness researchers receive $86.6 million in federal funding
    • HHS releases funding to support health insurance enrollment in 2014
    • GOP rejects IPAB
    • FDA proposes reclassification of tanning beds
  • Legislative update
    • Medicare hospital pricing data released
    • Mobile device legislation proposed; increased scrutiny of regulators
    • Acting Director of CMS likely to be confirmed this week
    • Appropriations bills expected in the House among controversy over spending caps
    • Senate to hold hearing on NIH FY2014 budget request
    • Capitol Hill briefing: patient centered medical home effectiveness not yet known
    • GOP senators working to reinforce restrictions to accessing federal health programs for immigrants
    • Recently introduced health care legislation
    • Report: combining Medicare hospital, physician and prescription drug programs proposed
    • Report: federal government could generate $264 billion by capping employer tax exemption
  • State update
    • State round-up: HIX
    • Medicaid expansion update
    • State round-up
  • Industry news
    • Study: gap between MU adopters, non adopters widening
    • Study: slowdown in health costs might be long term trend
    • Drug spending down 3.5 percent last year
    • Home care industry rebasing harmful to sector
    • HHS to partner with Archimedes in open source clinical analytics partnership
    • Restaurant, retail trade groups challenge auto enrollment requirement
    • Prostate diagnostic test promising
    • Mesothelioma lawsuits gets media attention
  • Research file
    • ROI for EHR use is primarily driven by increased physician income, reduction in transcription costs
  • Quotable
  • Fact file

Memo: May 6, 2013

  • My take
  • Implementation update
    • Upcoming implementation deadlines
    • IRS releases rule on minimum value requirement in employer coverage, tax credits
    • Roles of agents and brokers in HIX outlined by CMS
    • Briefings with states implementing federally-run or federal partnership exchanges underway
    • HHS releases shorter HIX enrollment application form, takes 7 minutes to enroll
    • USPSTF adds HIV screening to preventive health guidelines
    • States ask for more time before caps on state run high risk pools implemented
  • Legislative update
    • Medicare spending slowed in 2013; IPAB trigger not likely
    • Hospices will see increase in payments in FY2014
  • State update
    • State round-up: HIX
    • Medicaid expansion update
  • Industry news
    • Physician income up; steady decline in overall satisfaction
  • Research file
    • The Search for a Meaningful ROI for Patient Centered Medical Homes Continues
  • Quotable

Memo: April 29, 2013

  • My take
  • Implementation update
    • CMS announces outreach timeline for HIXs
    • Democratic Senators voice concerns about ACA implementation
    • Insurers indicate interest in federal exchange participation
    • Biologics and biosimilars in the ACA
    • PCORI plans national CER network
    • CMS will use real-time data to evaluate ACO program
    • New Part D, DSH regulations expected
    • Additional 2,000 IRS employees needed for ACA implementation
    • CMS releases measures and evaluation process for acute and LTCHs
    • Senator questions Massachusetts waiver for insurance rating requirements
    • Vote on bill to fund PCIP postponed
  • Legislative update
    • Security and privacy audit results reported; many problems unknown to organizations who are unaware of regulations
    • Medicare DME competitive bidding program gets attention
    • CMS proposes bigger rewards for Medicare fraud tips, denial of providers for violations
    • FDA sequester cuts compromise food safety
    • Fake medicine focus of FDA effort
    • National drug strategy: continue pain pill addiction efforts, refocus on heroin
    • Health care-related legislation introduced last week
  • State update
    • State round-up: HIX
    • Medicaid expansion update
    • State round-up
  • Industry news
    • Supreme Court hears oral arguments on patenting genes
    • Myriad Genetics court ruling puts spotlight on patents
    • Biotech manufacturers cautious about biosimilar drug market entry
    • Naming for biosimilars point of tension
    • Study: declines in U.S. biomedical and health R&D funding threaten global competition
    • Autism risk diagnostic test
  • Quotable
  • Fact file: spotlight on drugs

Memo: April 22, 2013

  • My take
  • Implementation update
    • Study: 25.7 million eligible for Affordable Care Act insurance subsidies
    • ACA Prevention and Public Health Fund targeted to support HIX enrollment
    • Analysis: 3.1 million newly covered under ACA adult-dependent mandate, 0.2 percent cost increase for employers
    • CMS issued a notice on Early Retiree Reinsurance Program
    • Major ACA provisions impacting acute hospitals
  • Legislative update
    • Senators propose national drug tracking program
    • BPC proposes plan for $560 billion health spending cost-containment
    • Final mental health parity regulations to be released in 2013
    • GOP senators challenge health IT implementation efforts
    • Health IT workgroup to recommend innovation and regulatory efficiency improvements
    • Highlights: new health care legislation introduced last week
  • State update
    • State round-up: HIX
    • Medicaid expansion update
  • Industry news
    • Diagnostics and therapeutics
    • Health plans and coverage
    • Delivery system (hospitals, post-acute, physicians, ancillaries, retail health)
    • Public health and disease surveillance
  • Research file
    • Costs or profitability of hospital complications vary by payer
    • Outcomes improve when physicians understand patient perspective
    • Tests ordered in hospitals less when costs known to clinician
  • Quotable
  • Fact file

Memo: April 15, 2013

  • My take
  • Implementation update
    • Final guidance for health insurance plans offering coverage through federal and federal partnership HIX
    • Out-of-pocket expenses for health care may exceed $6,250 annually for some consumers
    • Most (90 percent) consumers are unaware of the start date for HIX open enrollment
    • Navigator program gets funding from CMS
    • House Health Subcommittee recommends amendments to ACA
  • Legislative update
    • White House releases budget for FY2014
    • HHS to extend safe harbors for EHR donations
    • Tavenner testifies before Senate Finance Committee
  • State update
    • State round-up: HIX
    • Medicaid expansion update
    • State round-up
  • Industry news
    • Employer sponsored insurance decreased 10.1 percent between 1999 and 2011
    • ACA implementation: 90 percent of employers have “moved beyond wait-and-see mode” but understanding is low
    • Big data: insurer and health system team up to analyze implantable devices
    • Employers challenge unhealthy employees’ health with sticks and carrots
    • Survey: small business execs expect higher health costs, but most will keep coverage rather than pay a penalty
    • Survey: industry preparedness for ICD-10 lagging
    • Moody’s: sequestration impact on not-for-profit hospitals
    • Study: sedentary lifestyle costly to employers
    • Physicians urged to be cautious in using social media
  • Quotable
  • Fact file

Memo: April 8, 2013

  • My take
  • Implementation update
    • Key ACA provisions impacting the medical device and biopharma industries
    • Report: number of self-insured plans decreased but participant enrollment increased
    • OIG report: information about health insurance plans for consumers on Healthcare.gov website inadequate
    • HHS proposes new guidelines for HIX Navigator Program, does not allow insurance companies to provide Navigator services
  • Legislative update
    • President to release budget Wednesday
    • SGR fix proposed in House committee
    • Senate Finance Committee schedules hearing on Tavenner
    • Meaningful use update: bill to exempt solo practices and physicians nearing retirement; request for safe harbor guidance
    • District court rules in favor of emergency contraception coverage without age restriction
  • State update
    • State HIX update
    • Medicaid expansion update
    • State round-up
  • Industry news
    • Cuts to Medicare Advantage plans set aside; Part D rates announced
    • Medical testing labs see growth but margin erosion; Medicare cost-sharing accelerates sector pressure
    • Small business survey: ACA the major concern
    • Generic drug makers challenge abuse deterrent requirements as anti-competitive
    • IOM analysis: Medicare spending variation influenced largely by long-term care utilization
    • India Supreme Court strikes down cancer drug patent
    • Study: dementia costs $215 billion
  • Research snapshots
    • Mortality rates for Medicare beneficiaries in critical access hospitals higher than in non CAH settings
    • Coverage expansion for children and impact on pediatrician workload
  • Quotable
  • Fact file

Memo: April 1, 2013

  • My take
  • Implementation update
    • Medicare milestones
    • Key ACA programs related to Medicare
    • Deadline for Pioneer ACO participation extended
  • Legislative update
    • Congress on recess
    • White House to release budget next week
    • GOP wants HHS to restrict HIX implementation grants
  • State update
    • BHP Program guidance expected this year for states
    • CMS issues final rule on Medicaid FMAP methodology
    • CMS issues guidance about expansion using private plans, exchanges
    • Medicaid expansion update
    • HIX update
    • State round-up
  • Industry news
    • MA FY 2014 payment adjustment expected today
    • Report: incentives for value-based performance by providers missing in most health plans
    • Commonwealth study: 84 percent of premiums to medical care, 1 percent of premiums for quality improvement
    • FDA drug approvals: breakthrough designation for cancer drug, third drug for MS
    • “Pay-to-delay” oral arguments in Supreme Court—ruling expected in June 2013
    • Independent drug stores pursue challenge to PBM transparency
    • EHR meaningful use dominated by big players
    • Appeals court reverses decision regarding DSH payments for duals
    • IOM: payment reform should target decision makers, not geographic variation
  • Research snapshots
    • ACA will cause medical claims costs to increase 32 percent for insurers; non-group individual market to grow 115 percent
  • Quotable
  • Fact file

Memo: March 25, 2013

    • My take
    • Implementation update
      • Pioneer ACOs push for changes
      • Survey: 78 percent unfamiliar with Medicaid expansion; 48 percent unaware of HIX
      • HHS to direct insurance reforms in four states
      • ACA elements directly impacting physicians and health professionals
    • Legislative update
      • Congress approves continuing resolution to fund federal operations through September
      • Medical device tax repeal gets Senate approval; will not apply to smartphones
      • Dental care added to Medicaid
    • State update
      • States focus on medical liability reform
      • Health plan enrollees interested in HIXs if given choice to participate
      • Report: 17 percent of uninsured are illegal or recently arrived immigrants not eligible for Medicaid expansion
      • Moody’s: DSH cuts complicate Medicaid expansion decisions in states
      • Report: transparency on hospital prices inadequate in states
      • Medicaid expansion update
      • Health exchange update
    • Industry news
      • Xeijanz case raises question of ROI for basic research funded by taxpayers
      • @Regulatory update: compliance with Euro pharmacovigilance guidance
      • Drug costs down 1 percent in 2012
      • Pre-existing condition provision funded by $63 fee on privately insured
      • FDA pre-emption doctrine in spotlight: Mutual Pharmaceuticals vs. Bartlett arguments heard in U.S. Supreme Court case
      • QUEST quality improvement project projects $9 billion savings
      • Gene therapy promising in cancer treatment
      • FDA changes approval threshold for Alzheimer’s disease drugs
      • Study: preventable hospital admission rates linked to community health status
      • Lawsuit filed against IRS for HIPAA violation
    • Research snapshots
      • Physicians concerned about the future of the professionMemo: 

March 18, 2013

    • My take
    • Implementation update
      • Status of implementation: ACA
      • White House Economic Report: ACA slowing health care spending growth
      • Expatriate health plans don’t have to comply with ACA until 2016
      • White House, Democratic leaders make appointments to Commission on Long-Term Care
    • Legislative update
      • Congressional leaders introduce FY 2014 budget proposals: vast differences
      • Senate introduces legislation to avoid government shutdown
      • CMS amends Medicare Part B billing policies to allow hospitals to recover funds denied by RAC audits for inpatient services
      • MedPAC submits biannual report to Congress
    • State update
      • Study: states that don’t expand Medicaid may increase employer health costs
      • Medicaid expansion update
      • State round-up: HIX
      • State round-up
    • Industry news
      • Physicians not satisfied with EHRs
      • Study: 80 percent of physicians would prescribe cheaper drugs if they had access to patients’ formularies and co-pay information
      • Report: U.S. drug manufacturers shift patents to lower tax rate countries
      • Report: medical student debt climbs to $170,000
      • AHA: provider payment cuts will not curb health care spending
      • CDC: “Nightmare bacteria” increasing in hospitals
      • Tele-ICU: new guidelines from AACN
      • Brand and generic drug manufacturers challenge FTC pay to delay position
    • Research snapshots
      • ROI for EHR use is primarily driven by increased physician income, reduction in transcription costs
  • Memo: March 11, 2013

    • My take
    • Implementation update
      • Transparency in key ACA provisions
      • Tavenner: enrollment push this summer
      • CMS issues guidance on health plan certification requirements for HIXs
    • Legislative update
      • CMS releases 2013 HIT goals
      • GAO report: MA plans received $3.2-$5.1 billion in overpayments
      • FDA issues new plan to analyze risks and benefits of new drugs
      • Report: VA transmitted sensitive personal data on unsecured networks
      • House Republicans pass bill to avoid government shutdown
      • Senators request report on prescription drug abuse prevention
      • Congress asks FDA for mobile medical device apps guidance
      • Medical disaster bill pending signature by President
      • Dental therapists to address shortage of dental care
      • Think tank proposes option for extending eligibility age for Medicare
      • New health care bills introduced last week
    • State update
      • State round-up: HIX
      • Medicaid expansion update
      • State round-up
    • Industry news
      • Recap: HIMSS13 in New Orleans
      • Study: MA cuts could result in 11 percent decrease in enrollment
      • Chamber of Commerce encourages members to oppose tax on insurance plans
      • AHIP study: Medicaid managed care plans provides higher quality care, better value for taxpayers
      • Coalition proposes tax on sugary drinks
      • Study: hospitals feel brunt of state Medicaid cost containment efforts
      • FDA rejects hot flash medications
      • Pfizer gets extension of patent for Celebrex
      • FDA initiates surprise inspections of compounding pharmacies
      • Physician payment reform recommendations released
    • Research snapshots
      • Study shows price transparency an issue for hospitals
      • EHR alerts to physicians often overlooked, information overload cited

           Memo: March 4, 2013

    • My take
    • Implementation update
      • HHS issues proposed rule on enrollment for small businesses purchasing coverage through HIXs; significant for plans selling health insurance
      • HHS issues final rule for benefit and payment parameters
      • OPM issues final rule on multi-state plan HIXs
      • IRS issues notice on annual fees to be imposed on health insurers per ACA
      • CCIIO releases HIX implementation timeline
      • HHS report: rate increase requests from insurance plans slowing
    • Legislative update
      • GAO analysis: health care costs will grow faster than overall economy for 75 years; ACA cost containment provisions helpful but not enough to reduce shortfall
    • State update
      • OIG survey: one in four states says it’s not likely to be ready to confirm eligibility and enroll individuals and small businesses in exchanges
      • State round-up: HIX
      • Medicaid expansion update
      • State round-up
    • Industry news
      • AHIP: proposed cuts by CMS will increase Medicare Part C premiums for seniors by $50-90 per month  
      • AMA and McKesson announce collaboration to track molecular diagnostic tests
      • Excise tax on medical devices
      • Biotech manufacturers cautious about biosimilar drug market entry
      • Study: mental health service utilization, costs increasing
    • Research snapshots
      • Nurse practitioners role in reducing primary care shortage
      • Psychiatric disorders linked genetically

    Memo: February 25, 2013

    • My take
    • Implementation update
      • Health plans in exchanges get final rules on essential health benefits, actuarial value and accreditation
      • CMS issues final rule on insurance market rate review
      • Mandatory participation in individual and small group market opposed by industry groups
    • Legislative update
      • Poll: public not well informed about sequestration update
      • Simpson-Bowles 2.0
      • New health care bills introduced
      • GAO: Potential for fraud in Medicare, Medicaid, FDA high
    • State update
      • HHS announces grants to test new models of care delivery
      • State round-up: HIX
      • Medicaid expansion update
      • State round-up
    • Industry news
      • HIMSS preview
      • Hospital community benefits unrelated to profitability
      • Consortium promotes limitations on unnecessary care in “Choosing Wisely” campaign
      • FDA designates “breakthrough” status to novel cancer treatment
      • Administration announces Brain Activity Map
      • Video games to treat schizophrenia
      • Global markets: Sanofi India Ltd. focuses on OTC products
      • Analytics acquisitions
      • GPOs to focus on technology
    • Research snapshots
      • Hysterectomies: robotic technology increases costs but does not improve outcomes
      • Medicare costs for breast cancer screening above $1 billion, high regional variation

    Memo: February 18, 2013

    • My take
    • Implementation update
      • HIX readiness focus of Congressional hearing
      • Final rule on EHBs actuarial calculations expected soon
      • CMS issues guidance on MA, Part D MLR requirements
      • Website launched to connect government databases
      • Part D drug benefit guidance provided
      • SOTU: President supportive of “modest reforms” to Medicare
      • DOD: health care benefits not extended to same sex partners
      • Fraud pursuits net 8 to 1 return: DOJ, HHS
    • Legislative/regulatory update
      • Sequester approaching: HHS, Senate scramble to come up with alternatives
      • E&C Committee asks for clarification on HIPAA rules, mental health
      • GOP congressional leaders seek details on 340B audits, recertification process
      • Health legislation introduced last week
    • State update
      • Poll: majority favor Medicaid expansion
      • State round up: HIX
      • Medicaid expansion update
      • State round-up
    • Industry update
      • Study: 1 in 3 health plans will fail ACA standards
      • Report: few health IT security breaches, providers should prepare for new challenges
      • BPC offers framework for health IT patient safety
      • National nurses union partners with teacher union
    • Research snapshots
      • Bundled pricing transparency problematic for hospitals, consumers
      • HIE lack standard quality and return on investment metrics
      • CDC: hospitals report fewer health care-associated infections

    Memo: February 11, 2013

    • My take
    • Implementation update
      • CBO budget and economic outlook—new health care projections: spending, coverage assumptions and cost of ACA
      • Report: IRS did not receive adequate funding to implement ACA
      • Commission on long-term care appointed
      • Costs of ACA calculated
      • Basic health plan implementation delayed to 2015
      • Rate review rule in final review at OMB
    • Legislative/regulatory update
      • Permanent SGR fix proposed
      • CMS proposes rule to reduce regulatory burdens for providers
      • Tavenner nominated to top CMS post
      • CMMI announces bundled payment program for kidney dialysis
    • State update
      • CMS guidance to states: Medicaid cost sharing for newly eligible
      • State round-up: HIX
      • Medicaid expansion update
      • State round-up
    • Industry update
      • Survey: ACA’s major impact on how larger employers handle part-time employees
      • Three updates on information-driven health care
        •  VA and DOD will not use a single EHR system
        • AHRQ, CMS launch EHR for pediatrics
        • Survey: implementation deadlines, infrastructure major challenges for CIOs
      • FDA releases guidance on Alzheimer’s trial designs
    • Research snapshots
      • Alzheimer’s projected to triple in U.S. by 2050
      • Death rates in acute care decreasing

    Memo: February 4, 2013

    • My take
    • Implementation update
      • CMS releases final rule on physician payments: increased restrictions, transparency required
      • HHS, IRS issue proposed rules for minimum essential coverage, individual mandate exemptions  
      • HHS proposes expansion of contraception exemption for religious organizations
      • IRS clarifies eligibility for HIX subsidies for those whose employer-sponsored coverage is not affordable
      • GAO: ACA provides less generous tax credits for certain unemployed workers
      • CMS announces bundled payment participants
    • Legislative update
      • Immigration reform takes center stage
      • Debt ceiling suspended until May
      • Senate Finance Committee compiles recommendations to reduce waste, fraud and abuse
      • House Democrats seek protections against employer discrimination in wellness program due to pre-existing conditions
    • State update
      • Survey: most states need to take legislative action to comply with ACA health insurance market reforms
      • Health exchange update
      • Medicaid expansion update
      • State round-up
    • Industry news
      • HHS launches new web site for employers
      • AMGA membership increases
      • CMS: meaningful use payments $10.7 billion
      • Applications for multi-state HIX plans being accepted
      • Career Builder: health care to hire more but skilled talent a challenge
      • Compounding oversight records sought  
    • Research snapshots
      • Unlocking value in health plan M&A Sometimes the deals don’t deliver
      • Comparing ACA and state level reporting requirements for charitable hospitals
      • Cost-conscious behavior may not result in a larger savings for HSAs and HRAs

    Memo: January 28, 2013

    • My take
    • Implementation update
      • Deadline for notification of employees about HIX options extended
      • NAIC wants states to maintain primary oversight role in HIXs
    • Legislative update
      • House passes debt ceiling suspension
      • FDA panel votes to recommend painkillers move to more restrictive classification
      • Fiscal cliff concession for kidney dialysis drugs revisited
      • Hatch proposes changes to sustain Medicare
      • DEA: marijuana a dangerous drug
      • Study: VA overpayments for veterans’ disabilities
      • Medicare overpayments
      • Comparative effectiveness limitations sought in bill
    • State update
      • State priority poll: HIX, health insurance costs top list of public concerns
      • HIX update
      • Medicaid expansion update
      • State round-up
    • Industry news
      • MedPAC: reinsurance premium increases examined
      • Moody’s: outlook remains negative for not-for-profit hospitals
      • Deals and consolidation
    • Research snapshots (NEW!)
      • Physician likelihood to prescribe brand-name drugs at consumer request
      • Usefulness of electronic health records in quality measurement
      • IPOs result in lower impact of innovation due to brain drain 

    Memo: January 22, 2013

    • My take
    • Implementation update
      • Medicaid, HIX and essential benefits coordination: HHS seeks to streamline and simplify
      • CMS: quality measures for Medicaid medical homes announced
      • MACPAC likely to propose 12-month continuous eligibility for CHIP and Medicaid beneficiaries to reduce churning
      • CO-OPs ask for funds to be restored
    • Legislative update
      • Security and privacy rule increases penalties, risk for providers and their business associates; new rule take effect September 21, 2013
      • Sequester means 6.4 percent cut to NIH funding
      • Gun control executive orders issued by the White House
      • FDA: bare metal hip implants devices face increased regulatory scrutiny
      • House Dems propose public option through HIXs
      • Meaningful use for critical access hospitals and physicians
    • State update
      • Update: health insurance exchanges
      • Update: Medicaid expansion
      • State round-up
    • Industry news
      • Hospitals seek elimination of Section 3141 of the ACA
      • Industry groups reactions to Stage 3 meaningful use guidance
      • Study: Mobile apps in skin cancer detection have high degree of error due to image resolution

    Memo: January 14, 2013

    • My take
    • Implementation update
      • 106 new ACOs, CMS announces
      • Update: leadership changes important to ACA implementation
    • Legislative update
      • Senators challenge Medicare Part C (MA) and D (prescription drug discount) fraud prevention efforts
      • DEA seeks tighter control over pain medications
      • FDA issues draft guidance on tamper resistant drugs
      • MedPAC: Congress should increase hospital payments
      • CMS management of meaningful use funding gets attention
      • CDC: flu reaches epidemic levels in some states
      • SCOTUS will not hear case disputing federal funding for stem cell research
      • FCC: $400 million for rural health tele medicine
      • Health legislation introduced as the 113th Congress convenes
    • State update
      • NGA: Medicaid spending up 10 percent last year; health care states’ number one cost problem
      • EHB plans in states
      • State round-up: Medicaid expansion
      • State round-up
    • Industry news
      • U.S. health care spending increased 3.9 percent in 2011 – third consecutive year in 2011
      • Report: U.S. fares worse than peer countries in health outcome
      • NY hospitals to link physicians pay to performance
      • Study: spending on alternative health increased 6 percent
      • RAND commentary: health IT results disappointing
      • Study: GME redistribution fails to increase primary and rural health care providers
      • Report: malpractice system inefficient—physician spend years with open, unresolved claims
      • Hospital staffing up 1.1 percent in 2011
      • UK: private sector contracting with National Health Service draws attention
      • Nurse unions announce formal affiliation
      • Myriad Genetics court ruling puts spotlight on patents

    Memo: January 7, 2013

    •  My take
    • Implementation update
      • ONC seeks public comment on HIT Patient Safety Plan
      • CCIIO: guidance on state-partnership exchange model, new deadline for declaration of intent to transition from partnership to state-based model
      • IRS provides guidance on employer shared responsibility
      • Update: court challenges—Hobby Lobby will not cover contraception services
      • Key agencies with ACA implementation responsibility in 2013
      • CMS: cancer, kidney specialists might run their own ACOs
    • Legislative update
      • Congress passes American Taxpayer Relief Act to avoid fiscal cliff: sequestration, debt ceiling ahead
      • Medicare in the spotlight in 113th Congress
      • Congress responds to Newtown, final rule on MHPAEA requested
      • Study: Medicare, Medicaid should incorporate physician payment incentives used by private plans
    • State update
      • CMS releases guidance on conversion to MAGI calculations for Medicaid expansion eligibility
      • Abortion legislation
      • Study: states spend 2 percent of tobacco settlement funds on smoking cessation
      • State round-up: health insurance exchanges
      • State round-up: Medicaid expansion
    • Industry news
      • Value-based purchasing: year one results for hospitals
      • Meaningful use update: majority of hospitals, one-third of medical practices registered
      • HHS: first HIPAA breach involving fewer than 500 records
      • Study: MA use rates lower than FFS
      • Study: hospice operator survey
      • Study: pill coloring linked to medication non-adherence
      • Study: access to psychiatric patient records in hospitals

    Memo: December 24, 2012

    • My take
    • Implementation update
      • ACA implementation calendar: 2013
      • Contraceptive coverage rule legal challenges: update
      • PCORI releases funds for CER research
      • School-based health centers receive $80 million in federal funding
      • Patient advocacy groups encourage broader drug coverage in EHBs
      • ACA premium tax credits challenged; Congressmen believe they can only be accessed through state-based health exchanges
    • Legislative update
      • Update: fiscal cliff negotiations
      • House GOP introduces Spending Reduction Act of 2012; White House vows veto
      • Social security cuts on table using “chained CPI”
      • Specialists seek permanent fix for SGR as part of deficit reduction, fiscal cliff negotiation
      • FDA seeks to coordinate oversight of compounding pharmacies with states
      • Defense bill expands abortion coverage for military women
      • GAO report: CMS and CMS Innovation Center services overlap
    • State update
      • Twenty-three states receive CHIPRA bonuses
      • Medicaid 24 percent of average state budget; ten states in the red
      • State round-up
      • Health exchange update
      • Medicaid update
    • Industry news
      • Hospital systems starting their own insurance plans
      • Study: repeat testing common among Medicare beneficiaries
      • Study: length of stay drop in VA hospitals
      • Study: ‘never events’ frequent
      • Study: obesity, stress and exercise top employer concerns
      • Study: employer premiums increases passed through to employees

    Memo: December 17, 2012

    • My take
    • Implementation update
      • 18 states and DC to run state-based exchanges
      • Private and public exchanges
      • Recent guidance to states
    • Legislative update
      • Fiscal cliff update: economists estimate impact of fiscal cliff to Joint Economic Committee
      • Think tanks issue fiscal cliff recommendations
    • State update
      • Fiscal health of states improving but lag pre-recession revenues: NGA
      • State legislative make-up: blue or red, not purple in most
      • Medicaid expansion update
      • HHS gives HIX conditional approvals
    • Industry news
      • Study: ACA insurance requirements increase premiums 1.9-2.3 percent
      • Study: insurance costs 20 percent or more of household income for 80 percent of population
      • Study: access barriers to primary care increase ER visits
      • Information-driven healthcare: BPC report spotlights adoption gap, HHS cautions about mHealth privacy and security
      • CRS: federal funding for health-related R&D 21.5 percent of total R&D budget
      • Nurse practitioner groups merge
      • GAO report: payments for dialysis care in 2011 higher than necessary due to drug costs
      • Meaningful use update

    Memo: December 10, 2012

    • My take
    • Implementation update
      • IRS releases final rule on medical device tax, PCORI funding; proposed rule on Medicare tax for higher income individuals and employers
      • HHS: donut hole savings $677 per beneficiary in 2012
      • CMS CIO: ACA data requires major expansion of storage capacity, consolidation of data centers
      • DOL reports to Congress on self-insured plans
      • CMS releases interim final rule on EHR incentive program
    • Legislative update
      • Fiscal cliff negotiations, grand bargain center stage in DC; opening proposals reflect spending cuts in health programs
      • Related: upcoming deadlines in budget negotiations
      • Medical groups oppose cuts to primary care to pay for one year SGR fix
      • Compounding pharmacy law introduced
    • State update
      • State round-up: health insurance exchanges
      • State round-up: Medicaid expansion
      • State round-up
    • Industry news
      • Study: high deductible insurance users delay care due to out of pocket costs
      • Supreme Court to hear case on “pay for delay”
      • Survey: employers pursue wellness strategies
      • Mental-disorder diagnosis criteria updated
      • Survey: nearly 40 percent of physicians using EHRs
      • OIG files lawsuit against SNF for overbilling
      • MedPaC recommends 1 percent payment increase for hospitals
      • FDA labeling requirement for tobacco manufacturers deemed a first amendment violation in appeals court
      • Study: administrative costs (overhead) in individual insurance market down; up slightly in group market
      • Study: consumer protections in Medicare Advantage dual-eligible programs vary widely across states
      • Mobile health used widely by clinicians

    Memo: December 3, 2012

    • My take
    •  Implementation update
      • CMS requests input on quality measurements for health plans in health exchanges
      • New proposed rules released for multistate plans, ACA benefit and payment parameters, effective 2014
      • CBO analysis: increased access to medications via Part D reduces utilization and costs
      • Update: court challenges to religious freedom arguments against ACA
    • Legislative update
      • ONC sets sights on stage 3 meaningful use
      • Related: e-prescribing accelerating
      • Related: CMS announces EHR meaningful use extension for hospitals hit by Hurricane Sandy
      • Upton appoints clinicians to leadership roles in key health oversight committee
      • GOP physicians pursue repeal of ACA
    • State update
      • Report: Medicaid expansion costs to states
      • State round-up: health exchanges
      • State round-up: Medicaid expansion
    • Industry news
      • AMA study: health plans control anticompetitive markets
      • Study: 70,000 cases of breast cancer over diagnosed in 2008, 1.3 million over 30 years
      • USPSTF updates recommendations for Hepatitis C screening
      • Extending prescription drug expiration dates as a cost-saving strategy
      • Leapfrog analysis: hospital safety improving gradually
      • Report: 25 to 31 million receiving care through accountable care arrangements
      • Study: health insurance plans smoking cessation efforts challenging
      • Study: medical homes ROI inconclusive
      • District court ruling: tobacco companies ordered to admit deception
      • Energy drinks: FDA takes closer look
      • Compounding pharmacy update

    Memo: November 26, 2012

    • My take
    • Implementation update
      • HHS provides guidance on EHB, premium pricing and wellness programs
      • PCORI board adopts methodology strategy for CER
      • Court challenge to contraception requirement denied
    • Legislative update
      • HHS priorities in 2013
      • Senate committee requests information from state pharmacy boards
      • HIV screening recommended for all Americans
      • SGR temporary fix to cost $25.2 billion, $7 billion above prior estimate
    • State update
      • Survey: state health departments modernizing IT systems
    • Industry news
      • Hospital EHR deadline this Friday
      • Meaningful use loans available
      • Medicare claims data released
      • Study: use of allied health professionals in primary care increases efficiency, panel size
      • Study: e-visits associated with fewer diagnostic tests, more prescriptions
      • Study: portal use associated with higher utilization of services

    Memo: November 19, 2012

    • My take
    • Implementation update
      • HHS extends health insurance exchange deadline
      • Forthcoming federal guidance on the ACA
      • Bible-publishing company legal challenge to contraceptive requirement to be heard
      • PQRI: physicians face quality reporting penalty
    • Legislative update
      • GAO report: CMS fraud prevention system behind schedule, key to replacing “pay and chase” strategy
      • CMS updates Medicare payment rules
      • House GOP leaders introduce plan to streamline House oversight of health care legislation
      • Health IT safety for consumers focus of attention
      • Congressional hearings on meningitis outbreak, intensified attention to compounding center regulatory oversight
    • State update
      • State round-up
    • Industry news
      • Channel choking strategy extends to shippers
      • Study: pay for performance linked to reduced mortality
      • Medical device industry pushes for excise tax repeal
      • AARP asks Congress to override scheduled SGR cuts while replacing the SGR
      • OIG: upcoding prevalent in skilled nursing
      • Report: primary care physician workforce needs 2010-2025
      • WellStar acquires Center for Health Transformation
      •  Drug distribution group urges Congress to pass track and trace legislation
      • Report: deficit reduction plans should protect seniors
      • Organ donation regulators want hospitals to do more to protect kidney donors
      • HHS announces first external innovation fellows
      • Gene discovered that predicts Alzheimer’s
      • FDA publishes data about energy drink risks
      • Life after Lipitor: research focuses on protein

    Memo: November 12, 2012

    • My take
    • Implementation update
      • Health insurance exchange deadline extended
      • DOJ defends the ACA in DC District Court
    • Legislative update
      • Fiscal cliff negotiations begin
      • Lame duck session agenda
      • Sequestration and the ACA: what might change?
      • Report: CBO outlines health related deficit reduction opportunities
      • Tax changes scheduled January 1, 2013
      • IT incentive funds through Medicare, Medicaid top $7 billion
    • State update
      • Key ballot initiatives last week
      • Opinion: CMS will allow flexibility on Medicaid expansion
      • State round-up
    • Industry news
      • Study: less experienced physicians account for higher health cost
      • Study: non-licensed caregivers provide complex chronic care management; role needs
      • Smaller primary care practices face resistance to change necessary to participate in medical home pilots
      • Some employers opt for part time workers in lieu of full time to avoid ACA mandate
      • Report: providers seek increased capabilities from information technology vendors
      • Hearing on compounding pharmacies scheduled
      • Study: multivitamins do not cut heart attack risk
      • Humana acquires provider, analytics capabilities to expand in Medicare, Medicaid markets

    Memo: Special edition - November 7, 2012

    • My take

    Memo: November 5, 2012

    • My take
    • Implementation update
      • Department of Justice will not contest Supreme Court decision to hear Liberty University challenge
      • FTC: success of ACOs, anti-trust oversight focus of agency efforts to cut health costs
    • Legislative update
      • HHS issues rules on Medicare, Medicaid physician pay, outpatient payments
      • Public health emergency declared in New York
      • GAO: Medicare Part D discount program does not increase drug prices
      • AHA pursues lawsuit against HHS for denied reimbursements
      • Legislation introduced to allow veterans to access FEHBP for dental and vision
      • Massachusetts lawmaker introduces compounding pharmacies regulation
      • HHS backs flat-rate payment arrangement
    • State update
      • State round-up
    • Industry news
      • Beaumont-Henry Ford merger
      • Walmart announces carve out strategy
      • BMJ: published studies must provide access to scientific documentation
      • FDA examines equivalence of generics
      • Gene mapping project accelerates personalized medicine opportunities
      • Deloitte acquires data analytics firm Recombinant
      • Report: significant geographic variation in teaching hospitals
      • AHIP releases application for health care spend
      • Ameridose recalls all products 'out of an abundance of caution'
      • GAO: providers self-refer imaging services hurting Medicare
      • AHA urges MEDPAC to reconsider “site neutral” physician payments
      • Groups urge pricing transparency in health care

    Memo: October 29, 2012

    • My take
    • Implementation update
      • Study: premium rate review
      • CMS: 2.3 million Medicare beneficiaries saved an average of $657 on prescription drugs
      • Physicians hesitant to participate in Medicare with looming SGR fix
      • Study: safety net hospitals hurt by cuts in DSH payments, lower Medicaid enrollment
    • Legislative update
      • Class action lawsuit settled, Medicare enrollees with long-term medical problems entitled to coverage
      • Study: Medicaid block grants could cut $1.7 trillion in Medicaid
      • Compounding update: compounding pharmacy license revoked, CDC finds facility contaminated
      • House GOP claims HHS improperly using tax dollars in promoting ACA
      • Senate HELP Committee seeks feedback on track and trace system policy change
    • State update
      • State employee health costs
      • Massachusetts health department officials issued warnings to compounding center
      • State round-up
    • Industry news
      • Report: decline in the number of employers offering retiree health benefits
      • Updated recommendations for cervical cancer screening and hormone therapy
      • Report: medical devices spending up almost 1 percent
      • Study: declines in U.S. biomedical and health R&D funding threaten global competition

    Memo: October 22, 2012

    • My take
    • Implementation update
      • Study: premium support could raise premiums for most Medicare enrollees
      • Study: Medicare Advantage payments will be 102 percent of traditional Medicare FFS
      • Study: notable increase in Medicare Advantage, Part D ratings
      • CMS update: concerns over dual eligible demonstration projects
      • Employers challenging contraception requirement in courts
    • Legislative update
      • Deficit Reduction Commission leaders launch education effort
      • Senators urge HHS to require autism treatment in health plans, create national standard in essential health benefits coverage
      • Senate Finance Committee requests documentation of fraud efforts using CMS new predictive analytics program
      • Senators request meeting with CMS and ONC staff to discuss Stage 2 Meaningful Use
      • Physicians urge Senators to replace SGR using industry principles
      • Legislation to reform RAC program introduced in the House
    • State update
      • State round-up
    • Industry news
      • Walgreens announces medication management program to reduce hospital readmissions
      • Trinity Health, Catholic Health East explore consolidation
      • Pediatricians encourage removal of guns at home
      • Fungal meningitis outbreak prompts further investigation

    Memo: October 15, 2012

    • My take
    • Implementation update
      • Study: ACO savings limited
      • Health insurers show little interest in providing coverage across state lines
      • Comparative effectiveness research doesn’t always translate to better outcomes for patients
      • Health reform polling roundup: public spilt on changes to Medicare
    • Legislative update
      • OIG: CMS not protecting Medicare enrollee personal health information optimally
      • Fungal meningitis outbreak prompts legislative action toward compounding pharmacies
      • MedPAC: 25 percent of Medicare admissions preventable
      • GAO: Medicare, Medicaid, CHIP fraud efforts
    • State update
      • State round-up
    • Industry news
      • GOP House members seek halt to meaningful use; HIMSS opposes
      • Study: ACA impact on employer sponsored coverage, costs in 2012 negligible
      • PBM trade groups offers recommendations for reducing Medicare drug costs

    Memo: October 8, 2012

    • My take
    • Implementation update
      • Avoidable readmission program starts
      • DOJ announces arrests for Medicare fraud
      • Supreme Court may hear more cases challenging the ACA
      • GAO report: DOD and VA ineffective in collaboration on health care
      • Commonwealth Fund analysis of health care coverage
    • Legislative update
      • ICD-10 corrections released
      • GOP lawmakers challenge use of funding for meaningful use
    • State update
      • Study: state formularies vary widely
      • Study: Medicaid expansion associated with reduced mortality and improved health status
      • State round-up
    • Industry news
      • Solicitor General’s Office asks U.S. Supreme Court to rule on pay-to-delay
      • BPC survey: electronic health information sharing issues—interoperability, cost big issues, privacy or security not significant
      • Report: Medicaid managed care entities are hiring ineligible providers
      • Census report: use rates for doctors, nurses down
      • FDA reminds generic drug facilities of requirement to self-identify
      • Study: cost at end of life
      • AMGA defines high-performing health system; six attributes
      • Online pharmacies target of FDA global closure effort
      • Compounding pharmacies get scrutiny as result of steroid injections

    Memo: October 1, 2012

    • My take
    • Implementation update
      • HHS provides funding for mental health workforce expansion targeting at-risk populations
      • CMS: new initiative to study avoidable hospitalizations for nursing home residents
      • Health insurance exchange update: guidance for multi-state plans
      • Report: safety net providers critical for ACA’s insurance coverage provisions
      • Hospitals submit comments on IRS charitable hospital rule
    • Legislative update
      • House bill proposes CBO expand projections for prevention and wellness programs
      • FDA receives approval from Congress to collect funding from the generic drug industry
    • State update
      • Health insurance exchange update
      • State round-up
    • Industry news
      • mHealth task force releases recommendations for expanded use of mobile health
      • HHS, DOJ warn about fraud in hospitals
      • Military leaders say junk food is a threat to national preparedness

    Memo: September 24, 2012

    • My take
    • Implementation update
      • Sequestration and the Affordable Care Act: looking ahead
      • Study: unexpected cost-sharing under ACA’s prevention benefit
      • PCORI: $96 million for clinical effectiveness research projects
      • Senate Special Committee on Aging examines Medicare fraud in use of motorized wheelchairs
    • Legislative update
      • Bipartisan Policy Center: health care cost drivers
      • Congress passes Continuing Resolution for FY2013
      • Congressional activity on health bills in the final week before recess
      • DOL grants $500 million for HIT workforce training
      • HHS hiring, compensation constraints sought in House legislation
      • Senators searching for middle ground on deficit reduction
    • State update
      • Health insurance exchange update
      • Medicaid expansion update
      • State round-up
    • Industry news
      • CMS: Medicare Advantage enrollment, premiums in 2013
      • Wal-Mart and HumanaVitality partner for healthy eating initiative
      • Study: upcoding costs Medicare $11 billion
      • Hospitals oppose changes to non-emergency coding payment caps
      • UnitedHealth joins the Dow; health care prominent
      • Study: health information exchanges struggle to prove ROI

    Memo: September 17, 2012

    • My take
    • Implementation update
      • White House releases sequestration report, specifies cuts
      • HHS: rate review and MLR provisions in the ACA save $2.1 billion for consumers
      • CMS to states: October 2012 essential health benefits expectation
      • AHRQ: improving medication adherence can lower health care cost
      • Study: ACO savings in dual eligible population
      • Hospital readmission formula being reconsidered to account for patient risk factors
    • Legislative update
      • MedPAC suggests standardization of premium support programs in Medicare
      • House Energy and Commerce Subcommittee on Health legislative approvals
      • House Ways and Means Oversight Subcommittee hearing: administrative burden of ACA
      • House passes six month stop-gap measure for FY2013
    • State update
      • State round-up
    • Industry update
      • U.S. Census Bureau report on insurance in 2011: commercial coverage stable, household income down
      • Health insurance premiums increase 4 percent in 2012
      • IOM: major drivers of waste
      • Trade groups: sequestration will hurt FDA effectiveness, increase industry fees
      • Regulatory focus on weight loss products

    Memo: September 10, 2012

    • My take
    • Special feature
    • Implementation update
      • IRS provides guidance to employers on shared responsibility requirement
      • Guidance on 90-day waiting period limitation for employee health coverage issued
      • ACA civil rights protections apply to individuals who are transgender
    • Legislative update
      • Expanded mental health services for veterans and service members authorized by Executive Order
    • State update
      • HHS collaborating with states in education about health exchanges
      • State round-up
    • Industry update
      • Study: hospital-acquired urinary tract infection data inaccurate
      • FDA approves new orphan drug for cancer patients
      • Study: silent heart attacks common, may predict risk of death
      • Study: consumer satisfaction slightly higher among enrollees with traditional plans compared to high deductible plans
      • Study: wide variation across markets in quality, costs
      • IOM: better use of technology needed to reduce cost

    Memo: September 4, 2012

    • My take
    • Implementation update
      • GAO studies impact of ACA on employer-sponsored insurance
      • Illegal immigrants are ineligible for HIX subsidies or PCIP program
    • Legislative update
      • Report: U.S. could reduce drug costs if reference pricing, comparative effectiveness implemented
      • CDC, HRSA fund improvements in public health programs
    • State update
      • GAO study: Medicaid long-term care validation highly variable in states
      • Study: Medicaid match cuts might expose states to higher Medicaid obligations
      • State round-up
    • Industry update
      • Feds notify hospitals of fraud liability for wrongly implanted heart devices
      • Merck files petition for Supreme Court to rule on pay-to-delay agreements
      • FDA approves HIV combination therapy, novel treatment for cancer in children
      • WellPoint seeks new CEO

     

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