Gregg's Top Three Health Policy Articles

Health policy impacts everyone, but it can be hard to know what is important.  If you can only read three things about health policy this week, I suggest...

The Top Three...

Modern Healthcare: Healthcare Spending Hit $4.3T In 2021 But Growth Slowed U.S. healthcare spending totaled $4.3 trillion in 2021, an increase of just 2.7% from a year earlier as COVID-19 relief funding waned, the Centers for Medicare and Medicaid said Wednesday. Healthcare spending jumped 10.3% in 2020—the largest growth rate since 1984—when the federal government distributed $193.1 billion designed to offset providers’ losses related to the pandemic. (Kacik, 12/14)

Axios: Patients' Health Care Spending Spiked In 2021 Americans' out-of-pocket health spending rose 10.4% in 2021, a growth rate not seen since 1985 that was driven in part by demand for dental services, eyeglasses and medical supplies, according to Centers for Medicare and Medicaid Services' annual National Health Expenditures report. (Owens, 12/15)

The New York Times: Congress Clears Military Bill Repealing Vaccine Mandate For Troops The Senate on Thursday gave final approval to an $858 billion military policy bill that would rescind the Pentagon’s mandate that troops receive the coronavirus vaccine, defying President Biden’s objections and sending to his desk a bill that paved the way for a massive increase in spending on the military. The vote was 83 to 11, an overwhelmingly bipartisan margin that reflected support in both parties for boosting the Pentagon’s budget by $45 billion over Mr. Biden’s request, as lawmakers in both parties argued that the protracted war in Ukraine and an emboldened China had changed the nation’s security posture. (Edmondson, 12/15)

For a Deeper Dive...

Fierce Healthcare: CMS Tackles Medicare Advantage Prior Authorization, Marketing The Biden administration released a proposal to streamline Medicare Advantage (MA) and Part D plan prior authorization and add health equity requirements to star ratings. The Centers for Medicare & Medicaid Services (CMS) released a proposed rule Wednesday outlining policies for MA and Part D plans for the 2024 coverage year and implementing drug price provisions in the Inflation Reduction Act. It is the latest move by the Biden administration to address prior authorization, a key source of administrative burden for doctors, and to address misleading marketing. (King, 12/14)

CNN: More Than 7 Million Incorrect Diagnoses Made In US Emergency Rooms Every Year, Government Report Finds A new study finds that nearly 6% of the estimated 130 million people who go to US emergency rooms every year are misdiagnosed, which translates to about 1 in 18 patients getting the wrong diagnosis. ... Stroke was missed 17% of the time, often because people reported symptoms of dizziness and vertigo. When they entered the ER, 40% of patients who had those two symptoms had their stroke missed initially. (Kounang, 12/15)

Modern Healthcare: 3 Hospital CEOs Reveal Their Regulatory, Policy Wish Lists An increasing number of health systems are seeking to shift care delivery to home and outpatient care. But regulatory and policy changes are necessary to help enable those changes—and to address ongoing challenges facing the industry, including reimbursement and surprise billing. (Hudson and Kacik, 12/12)

The Washington Post: Surprise Bills From Ground Ambulances Is Next Up In The Move Toward Reform The Biden administration is set to kick off the work of a key advisory committee designed to help stop patients from getting hit with pricey surprise medical bills from ground ambulances, The Health 202 has learned. It took roughly two years for the new committee to get its start. But the panel’s meetings are now set to begin in the new year, with the first scheduled for Jan. 17-18. A critical report will be due 180 days later on how to prevent patients from owing hundreds of dollars for receiving out-of-network ambulance rides through no fault of their own. (Roubein and Beard, 12/13)

KHN: How Medicare Advantage Plans Dodged Auditors And Overcharged Taxpayers By Millions In April 2016, government auditors asked a Blue Cross Medicare Advantage health plan in Minnesota to turn over medical records of patients treated by a podiatry practice whose owner had been indicted for fraud. Medicare had paid the Blue Cross plan more than $20,000 to cover the care of 11 patients seen by Aggeus Healthcare, a chain of podiatry clinics, in 2011. (Schulte and Hacker, 12/13)

Reuters: Catholic Healthcare Providers Can't Be Forced To Do Gender Surgeries: U.S. Court The Biden administration cannot force a group of Catholic healthcare providers and professionals to perform gender transition surgeries under an Obama-era regulation barring sex discrimination in healthcare, a U.S. appeals court ruled on Friday. (Wiessner, 12/9)

Axios: MedPAC Wants Pay Boost For Docs And Hospitals MedPAC wants Congress to increase hospitals and clinicians' 2024 Medicare payment rates. If Congress opts not to follow the recommendations, CMS has to make payment updates according to current law — setting up another year of providers running to lawmakers for relief from Medicare cuts after the fact. (Goldman, 12/12)

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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?

-Gregg S. Margolis, PhD