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...

CNBC: Biden Administration Unveils First 10 Drugs Subject To Medicare Price Negotiations The drugs listed Tuesday are among the top 50 with the highest spending for Medicare Part D, which covers prescription medications that seniors fill at retail pharmacies. The 10 medicines accounted for $50.5 billion, or about 20%, of total Part D prescription drug costs from June 1, 2022, to May 31, 2023, according to the Centers for Medicare and Medicaid Services, or CMS. (Constantino, 8/29)

The New York Times: Mental Health Spending Surged In Pandemic, Study Finds Use of mental health care increased substantially during the coronavirus pandemic, as teletherapy lowered barriers to regular visits, according to a large study of insurance claims published Friday in JAMA Health Forum. From March 2020 to August 2022, mental health visits increased by 39 percent, and spending increased by 54 percent, the study found. Its examination of 1,554,895 claims for clinician visits also identified a tenfold increase in the use of telehealth. (Barry, 8/25)

Axios: Medicaid Unwinding And Fewer Outpatient Procedures Squeeze Hospitals Hospitals' financial performance worsened in July due to a summertime drop in outpatient business and ongoing Medicaid redeterminations in more than 30 states, the consultancy Kaufman Hall said in its latest industry report. While there was some improvement in operating margins compared to last year, bad debt and charity care as a percentage of hospitals' gross operating revenue rose 7% from June to July. (Bettelheim, 8/29)

For a Deeper Dive...

KFF Health News: 5 Things To Know About The New Drug Pricing Negotiations The Biden administration has picked the first 10 high-priced prescription drugs subject to federal price negotiations, taking a swipe at the powerful pharmaceutical industry. It marks a major turning point in a long-fought battle to control ever-rising drug prices for seniors and, eventually, other Americans. Under the 2022 Inflation Reduction Act, Congress gave the federal government the power to negotiate prices for certain high-cost drugs under Medicare. The list of drugs selected by the Centers for Medicare & Medicaid Services will grow over time. (Allen, Pradhan and Hilzenrath, 8/30)

Modern Healthcare: Hospital Portfolios Shrink As Systems Sell Non-Essential Businesses Hospital systems are returning to their roots as they look to cut costs and simplify operations. Over the past two decades, many health systems have acquired long-term care, rehabilitation, home health, nursing home and hospice businesses, seeking to keep patients within their system. Owning these services allowed providers to generate extra revenue while closely overseeing care transitions and quality. (Kacik, 8/28)

Politico: ‘Go After It’: GOP Strategists Say Republicans Need To Hit Biden On Drug Pricing As President Joe Biden touts the first 10 drugs subject to Medicare price talks, Republicans are searching for their own message that would resonate with voters on the downsides of his signature domestic achievement. Piggybacking on the pharmaceutical industry’s strategy, Republicans are working to persuade Americans that the Biden plan will stifle innovation and lead to price controls, several strategists say. (King, 8/29)

KFF Health News: Exclusive: CMS Study Sabotages Efforts To Bolster Nursing Home Staffing, Advocates Say The Biden administration last year promised to establish minimum staffing levels for the nation’s roughly 15,000 nursing homes. It was the centerpiece of an agenda to overhaul an industry the government said was rife with substandard care and failures to follow federal quality rules. But a research study the Centers for Medicare & Medicaid Services commissioned to identify the appropriate level of staffing made no specific recommendations and analyzed only staffing levels lower than what the previous major federal evaluation had considered best, according to a copy of the study reviewed Monday by KFF Health News. Instead, the new study said there was no single staffing level that would guarantee quality care, although the report estimated that higher staffing levels would lead to fewer hospitalizations and emergency room visits, faster care, and fewer failures to provide care. (Rau, 8/29)

The Hill: Medicaid-Eligible People Who Aren’t Enrolled Far More Likely To Delay Care Adults who are eligible for Medicaid but not enrolled in the program are more likely to delay care due to costs, according to an analysis published Tuesday by the Urban Institute. The survey found 21.4 percent of non-Medicaid enrolled individuals delay medical care due to the cost, compared to only 7.3 percent of enrollees and 9.5 percent of Medicaid-eligible individuals with private insurance. (Nazzaro, 8/29)

CNN: An ‘Obscene’ Number Of Kids Are Losing Medicaid Coverage For months, Evangelina Hernandez watched helplessly as her autistic twin sons regressed – their screaming, biting and scratching worsening. The Wichita, Kansas, resident couldn’t afford the $3,000 monthly tab for their 10 prescriptions or their doctor visits without Medicaid. The toddlers, along with three of their sisters, lost their health insurance in May, swept up in the state’s eligibility review of all its Medicaid enrollees. Hernandez said she only received the renewal packet a day before it was due and mailed it back right away. She also called KanCare, the state’s Medicaid program, and filled out another application over the phone, certain that the kids remained eligible. (Luhby, 8/26)

CIDRAP: Heart Attack Patients Had Higher Odds Of Poor Outcomes Amid COVID Surges Hospitalized US patients who had a type of heart attack called non–ST segment elevation myocardial infarction (NSTEMI) were at a 51% higher risk of death by 30 days and 32% higher risk of release to non-home settings amid COVID-19 patient surges than before, a University of Rochester–led research team reports. (Van Beusekom, 8/28)

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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