Gregg's Top Three Health Policy Articles

If you can only read three things about health policy this week, I suggest...

The Top Three...

Modern Healthcare: Older Americans Act Reauthorization Passes Senate Committee The Senate Health, Education, Labor and Pensions Committee took the next step Wednesday in reauthorizing the expiring Older Americans Act, sending the $15 billion measure to the full Senate. The bill would increase funding for investigating abuse and poor services at long-term care facilities and includes enhanced measures for caregivers, alongside money for items such as senior centers and the Meals On Wheels program. (McAuliff, 7/31)

NBC News: After Private Equity Takes Over Hospitals, They Are Less Able To Care For Patients, Say Top Medical Researchers After private-equity firms acquire hospitals, the facilities’ assets and resources diminish significantly, leaving the facilities less equipped to care for patients, according to a new study by physician researchers at the University of California at San Francisco, Harvard Medical School and the City University of New York’s Hunter College. Published Tuesday in the Journal of the American Medical Association, the research highlights a pattern of asset stripping at health care facilities purchased by private-equity firms, its researchers said, and is the first study to analyze the activity nationwide. (Morgenson, 7/31)

Healthcare Dive: Medicare finalizes higher 2.9% inpatient payment rate for 2025 The Biden administration has finalized a 2.9% payment hike for inpatient hospitals in Medicare next year, an increase over the 2.6% that regulators initially proposed. It’s on the higher end of historical rate increases, and should result in $2.9 billion in additional funds going to hospitals in 2025 compared to this year. Hospital lobbies still decried the rate as insufficient, while taking issue with other policies in the regulation finalized Thursday that would cut payments to hospitals serving more vulnerable and long-stay patients. (Pifer, 8/2)

For a Deeper Dive...

USA Today: Nearly Half Of Insured Americans Get Surprise Expenses In Medical Bills, Survey Finds. Nearly half of Americans with health insurance said they received a recent medical bill or a charge that "should have been free or covered by their insurance," according to a survey released Thursday. The survey, from the Commonwealth Fund in New York City, found 45% of working-age consumers last year were erroneously billed, however, fewer than half of those patients challenged their health insurance company or a medical provider about the unexpected charges. (Alltucker, 8/1)

CBS News: Nearly A Third Of Adolescents Getting Mental Health Treatment, Federal Survey Finds Close to 1 in 3 adolescents in the U.S. received mental health treatment in 2023, the Substance Abuse and Mental Health Services Administration reported Tuesday, which works out to around 8.3 million young people between the ages of 12 and 17 getting counseling, medication or another treatment. The result is among the findings now released from SAMHSA's National Survey on Drug Use and Health for 2023. The federal agency's sweeping annual poll is closely tracked by mental health and addiction experts. (Tin, 7/30)

Modern Healthcare: Drug Costs To Increase 3.81% In 2025: Vizient Drug prices are expected to increase 3.81% next year, propelled by expensive cell and gene therapies and glucagon-like peptide agonists. The estimate from Vizient, a group purchasing organization, tops the company's 2024 drug cost growth projection of 3.42%. Vizient uses recent provider purchasing data to forecast what hospitals and health systems might pay for drugs after discounts and rebates. (Kacik, 7/30)

Healthcare Dive: Humana Expects To Lose ‘Few Hundred Thousand’ Medicare Advantage Members Next Year Medicare Advantage giant Humana expects to lose a “few hundred thousand” members in its marquee business next year, after seriously shrinking its benefits and exiting markets for 2025 in a bid to boost profits, the insurer disclosed Wednesday. It’s the first time Humana has estimated membership losses from culling its plans, and squares with past guesses from market watchers. (Pifer, 7/31)

Stat: Predicting The Key Players In Shaping Health Policy Under Trump A second Trump administration would bring a new wave of health policy officials into power in Washington. But many of those faces may be familiar. (Owermohle and Zhang, 7/31)

Modern Healthcare: Hospice To See Medicare Pay Increase In 2025 Medicare reimbursements for hospice providers will increase 2.9% in fiscal 2025 under a final rule the Centers for Medicare and Medicaid Services issued Tuesday. That's higher than the 2.6% payment update CMS proposed in March and comprises a 3.4% increase in the market basket minus a 0.5 percentage point productivity adjustment. Hospice providers that do not report quality data will receive a 1.1% reimbursement cut. (Young, 7/30)

Modern Healthcare: Nursing Homes To Receive 4.2% Medicare Pay Bump In 2025 Medicare rates for skilled nursing facilities will increase 4.2% in fiscal 2025 under a final rule the Centers for Medicare and Medicaid Services published Wednesday. That's higher than the 4.1% reimbursement increase CMS proposed in March. Payments for the fiscal year that begins Oct. 1 are based on a 3% increase in the skilled nursing facility market basket minus a 0.5 percentage point productivity adjustment and plus a 1.7 percentage point boost to correct previous forecasts. (Eastabrook, 7/31)

Modern Healthcare: Health Rules 2024: What’s Next For Medicare, Prior Authorization President Joe Biden has some unfinished business on health policy, and the final months of his term in office will feature a flurry of regulations touching areas from Medicare payments to prior authorizations to cybersecurity. ... While Harris likely would continue along a similar trajectory as Biden, she would put her own stamp on policy from the White House as president, while Trump's record and agenda indicate he would take health policy in a very different direction. (Early, 7/30)

Forbes: What Is Project 2025? Trump’s Potential Policy Agenda Explained As Its Director Steps Down While Project 2025 doesn’t explicitly call for an abortion ban, it would take many steps to restrict the procedure, including directing the Food and Drug Administration to revoke its approval of abortion drug mifepristone, using the Comstock Act to block any abortion equipment or medication from being mailed—which abortion rights advocates have said would be a “backdoor” way to ban abortion—barring federal funds being used to provide healthcare coverage for abortion and requiring states to report all abortions that take place there to the federal government. (Durkee, 7/30)

Crain's New York Business: New York's $7.5B Medicaid Experiment To Begin This Month Cash will finally start to flow this month from a federal program that enables the state to use Medicaid to pay for housing, nutrition and transportation. The $7.5 billion pilot program, called the 1115 waiver, unlocks federal money to revamp the Medicaid program, allowing New York state to use Medicaid in ways it’s never been used before. The state will offer Medicaid benefits for rent payments, cooking tools and non-medical transportation, for example, to attempt to improve health among enrollees and address disparities. (D'Ambrosio, 8/1)

KFF Health News: Since Fall Of 'Roe,' Self-Managed Abortions Have Increased The percentage of people who say they’ve tried to end a pregnancy without medical assistance increased after the Supreme Court overturned Roe v. Wade. That’s according to a study published Tuesday in the online journal JAMA Network Open. Tia Freeman, a reproductive health organizer, leads workshops for Tennesseans on how to safely take medication abortion pills outside of medical settings. Abortion is almost entirely illegal in Tennessee. (Varney, 8/2)

Stat: Kamala Harris Potential VP Picks On Health Care With less than 100 days until the presidential election, Democratic candidate Kamala Harris is expected to name her pick for vice president as early as this week. The pool of potential VP picks share some traits: They are largely white men from battleground or conservative-leaning states who can boast working across the aisle and bridging gaps with moderate voters. (Owermohle, 8/1)

For the Visual Among Us...

A few years ago I started a weekly e-mail for friends and colleagues who want to keep up on major federal health policy developments but did not have time to plod through all the minutiae--they were busy doing important things like running organizations and taking care of patients! Much to my surprise, it became pretty popular. I have now converted to a weekly newsletter format so you can manage your own subscription preferences and forward to others that might be interested.

These summaries represent my judgement on health policy issues that may not on the front pages, but are relevant to clinicians, administrators, and educators. I monitor many news sources and clipping services to identify content for this newsletter and I try hard to be as factual, balanced, and non-partisan as possible. While the articles are written by others (with credit attributed), the choice of what to include is entirely mine. If you are interested in receiving a daily summary of health policy news, you might consider signing up for the KHN Morning Briefing. If you enjoy podcasts, I suggest What the Health? and Tradeoffs.

-Gregg S. Margolis, PhD