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...

Reuters: U.S. Healthcare Spending Rises To $4.5 Trillion In 2022 The estimated healthcare spending per person in the United States stood at about $13,493 in 2022. Personal healthcare spending on hospital care, dental, clinical and physician services slowed down in the year, while non-personal expenses accelerated, driven by a turnaround in the net cost of insurance. Medicaid spending surged 9.6%, reaching $805.7 billion, and private health insurance spending grew 5.9%, totaling $1.3 trillion. Medicare spending rose 5.9% to $944.3 billion. (12/13)

The Wall Street Journal: Cigna Calls Off Humana Pursuit, Plans Big Stock Buyback Cigna Group abandoned its pursuit of a tie-up with Humana after shareholders balked at a deal that would have created a roughly $140 billion giant in the health-insurance industry. The companies couldn’t come to agreement on price and other financial terms, according to people familiar with the matter. In the near term, Cigna is turning its focus toward smaller, so-called bolt-on, acquisitions. (Thomas, 12/10)

Fierce Healthcare: TEFCA Goes Live In 'Big Bang' For Nationwide Health Data Sharing Seven years in the making, a nationwide network to exchange patient data called the Trusted Exchange Framework and Common Agreement is now operational, marking a critical step in establishing universal connectivity across providers. The interoperability framework, called TEFCA, was mandated by the 21st Century Cures Act back in 2016 and was designed to create an infrastructure to enable data sharing between health information networks. (Landi, 12/12)

For a Deeper Dive...

Fierce Healthcare: House Price Transparency Legislation Passes With Bipartisan Support In addition to mandating providers and PBMs publicly list prices before they charge patients, hospitals will be required to publish charges through machine-readable files. The bill also calls for the elimination of $16 billion in disproportionate share hospital (DSH) program cuts through 2025, $7 billion in funds for the Medicaid Improvement Fund while allocating $15 billion in funds toward community health centers and programs to address physician shortages in underserved communities. Leading House members argue the bill will help patients and employers get the­ best deal possible for patients and employers by codifying price transparency protections, allowing consumers to compare health insurers’ rates and prices hospitals charge. This means insurers will have to disclose all billing codes and modifiers. (Tong, 12/11)

Fierce Healthcare: A Closer Look At Healthcare Spending In 2022
Notably, the number of uninsured individuals has declined for three straight years with the insured population rate reaching 92%, or 26.6 million individuals uninsured. (Tong, 12/13)

Modern Healthcare: HHS Rule Sets AI, Predictive Algorithm Transparency Requirements Developers that want to certify their AI-enabled health IT products through ONC are required to describe how their algorithm was designed, developed and trained. They also must inform ONC whether patient demographic, social determinants of health or other equity-related data was used in training the AI model. Developers must provide information for clinical users about how to assess them for fairness, appropriateness, validity, effectiveness and safety, ONC said in the release. (DeSilva, 12/13)

Stat: MedPAC Advises Minor Medicare Pay Raise For Doctors In 2025 On Thursday, the Medicare Payment Advisory Commission reviewed Medicare performance data and concluded that despite doctors’ protests that their pay hasn’t kept up with inflation over the last 20 years, doctors shouldn’t get more than a minor raise for 2025. On the other hand, the committee admitted hospitals could use a larger increase in payment rates. (Trang, 12/8)

Reuters: Healthcare Providers To Join US Plan To Manage AI Risks - White House Twenty-eight healthcare companies, including CVS Health, are signing U.S. President Joe Biden's voluntary commitments aimed at ensuring the safe development of artificial intelligence (AI), a White House official said on Thursday. The commitments by healthcare providers and payers follow those of 15 leading AI companies, including Google, OpenAI and OpenAI partner Microsoft to develop AI models responsibly. (Shalal, 12/14)

USA Today: Biden Touts Prescription Drug Savings For Older Americans Medicare enrollees next year could save on dozens of medications under a federal law that penalizes pharmaceutical companies if they raise prices faster than the rate of inflation, the Biden administration announced Thursday. Officials with Medicare, the federal health program for adults 65 and older, issued a list of 48 drugs including blood thinners, antibiotics and cancer medications administered at a doctor's office, clinic or hospital, saying that potential savings on these "Part B" medications would range from $1 to $2,786 per dose, beginning Jan. 1, depending on an individual's coverage. (Alltucker, 12/14)

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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? and Tradeoffs.

-Gregg S. Margolis, PhD