Gregg's Top Three Health Policy Articles

For the week of Jan 13-20, 2023

Author

Gregg S. Margolis, PhD
January 20, 2023

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...

(Please note, there will be no "Gregg's Top 3" next week.)

The Top Three...

KHN: As US Bumps Against Debt Ceiling, Medicare Becomes A Bargaining Chip While repealing the Affordable Care Act seems to have fallen off congressional Republicans’ to-do list for 2023, plans to cut Medicare and Medicaid are back. The GOP wants Democrats to agree to cut spending on both programs in exchange for a vote to prevent the government from defaulting on its debts. Meanwhile, the nation’s health care workers — from nurses to doctors to pharmacists — are feeling the strain of caring not just for the rising number of insured patients seeking care, but also more seriously ill patients who are difficult and sometimes even violent. (1/19)

CNBC: U.S. Uninsured Rate Fell During Covid Pandemic, Medicaid, Obamacare Coverage Grew The number of people in the U.S. without health insurance declined during the Covid-19 pandemic even as millions of people lost coverage through their employers due to layoffs. The uninsured rate in the U.S. for people under age 65 dropped from 11% in 2019 to 10.5% in 2021, according to a report released Friday by the Health and Human Services Department. (Kimball, 1/13)

Axios: GOP Introduces Bill To End Public Health Emergency Rep. Brett Guthrie (R-Ky.) launched a House Republican effort Tuesday to officially declare an end to the COVID-19 public health emergency. The measure could set up a symbolic vote similar to the one the Senate took last year that President Joe Biden would likely veto. (Reed, 1/18)

For a Deeper Dive...

Becker's Hospital Review: 'Tripledemic' Has Peaked, CDC Data Suggests The weekly rate of emergency department visits and hospitalizations for flu, COVID-19 and respiratory syncytial virus peaked in early December, new CDC data shows. The CDC unveiled two data dashboards Jan. 17 that track emergency department visits and hospitalizations for COVID-19, flu and RSV. (Bean, 1/18)

Fierce Healthcare: CMS Data: Medicare Advantage Tops 30M Enrollment in Medicare Advantage (MA) has topped 30 million, according to new data from the Centers for Medicare & Medicaid Services. This represents coverage across 776 contracts, according to the data, as of Jan. 1 payments, which reflect enrollments accepted through Dec. 2. Enrollment in standalone prescription drug plans was also about 22.7 million, bringing total enrollment across all types of private Medicare plans to nearly 50.3 million. (Minemyer, 1/17)

Roll Call: NIH Missing Top Leadership At Start Of A Divided Congress The departure of two key public health leaders at the National Institutes of Health has created vacancies some worry could present a hurdle to NIH’s agenda in the new Congress. The Biden administration has yet to nominate a permanent replacement for former NIH Director Francis Collins, who stepped down from the post in December 2021. And efforts to replace the longtime director of the National Institute of Allergy and Infectious Diseases, Anthony Fauci, who left in December of last year, are underway. (Cohen, 1/18)

Bloomberg Law: Doctors In Congress Look For Permanent Fix To Medicare Pay Woes The doctors in the House want to revamp how Medicare pays physicians, potentially giving health-care providers a boost in pay in coming years. Lawmakers with medical backgrounds say the time is right and they’re in key positions this Congress to end what’s become an annual frustration of averting billions of dollars in cuts to Medicare pay to doctors and hospitals. The annual cuts to the public health insurance program for the elderly and disabled are a side effect of the current pay structure and rules Congress set up to curb federal spending. But, those efforts will face headwinds by some Republicans more focused on cutting spending. (1/19)

Healthcare Finance News: CMS Releases Three Initiatives To Grow Medicare ACO Participation To advance its goal of having 100% of people in traditional Medicare in an accountable care relationship in seven years, the Centers for Medicare and Medicaid Services has announced three initiatives in the Medicare Shared Savings Program and the ACO REACH and Kidney Care Choices models. More than 700,000 healthcare providers and organizations will participate in at least one of the three initiatives this year, CMS said. These programs are expected to grow and provide care to more than 13.2 million people with Medicare. (Morse, 1/18)

Fierce Healthcare: Healthcare Ranked Lowest For Employee Satisfaction, Survey Finds Healthcare ranked last for employee satisfaction compared to 27 other industries, according to the 2023 Healthcare Experience Trends Report from Qualtrics. The survey of 3,000 healthcare employees across 27 countries paints a grim picture, reporting that only half of healthcare employees believe they are paid fairly, 38% report they are at risk of burnout and 39% are considering leaving their organizations. Qualtrics also surveyed 9,000 consumers, finding that hospitals ranked among the lowest across industries for satisfaction. (Burky, 1/19)

The Washington Post: Why Nurses Are Striking And Quitting In Droves This flu season, Benny Matthew — a nurse at the Montefiore Medical Center emergency room in the Bronx — has often been responsible for 15 to 20 patients at a time. By 3 p.m. most days, the emergency room is often exploding with patients, Matthew said. Hospital gurneys stand inches apart. When beds run out, patients squeeze into tightly packed chairs. When the chairs run out, patients must stand. Wait times to see a doctor can be up to six hours. At the same time, the hospital is advertising more than 700 nursing positions. (Gurley, 1/14)

Modern Healthcare: NEJM Study: 22.7% Of Hospital Patients Experience Adverse Event Almost one quarter of hospital patients in the U.S. experience an adverse event such as medication-related harm, a pressure injury or infection during their care, according to a new study. The research, which looked at a random sample of 2,809 admissions from 11 Massachusetts hospitals in 2018, found that out of the adverse events, 22.7% were deemed preventable, and 32.3% were classified as serious, life-threatening, or fatal. The study was published Wednesday in the New England Journal of Medicine. (Devereaux, 1/13)

NPR: More People Than Ever Buy Insurance On Healthcare.Gov The Affordable Care Act health insurance marketplaces just hit a record: Nearly 16 million people signed up for the insurance also known as Obamacare. That is about a million more people than signed up for ACA health insurance last year, and enrollment was still open on Healthcare.gov and in most state marketplaces through this past Sunday. (Simmons-Duffin, 1/13)

The Boston Globe: Harvard Medical School Withdraws From U.S. News & World Report Rankings Harvard Medical School will no longer submit data to U.S. News & World Report to be used in the “best medical schools” survey and rankings, the school said Tuesday. In a letter announcing the medical school would withdraw from the survey, George Q. Daley, dean of the Faculty of Medicine, said rankings “cannot meaningfully reflect the high aspirations for educational excellence, graduate preparedness, and compassionate and equitable patient care that we strive to foster in our medical education programs.”(Mogg, 1/17)

Modern Healthcare: Gallup: More Patients Delayed Healthcare Over Costs In 2022 A record number of patients delayed medical care because of high costs last year, according to survey results Gallup published Tuesday. Gallup found that 38% of respondents or a family member delayed treatment over costs in 2022, a 12 percentage point increase compared to 2020 and 2021. The upswing coincided with economywide inflation reaching a 40-year high. (Berryman, 1/17)

The Hill: More Than 1,300 Nursing Homes Had COVID Infection Rates Of At Least 75 Percent In 2020: HHS More than 1,300 nursing homes in the U.S., most of them for-profit facilities, experienced extremely high COVID-19 infection rates in 2020, according to a new report from the Office of the Inspector General (OIG) for the Department of Health and Human Services. For the OIG’s study, the agency took Medicare claims data to find nursing homes with beneficiaries who tested positive for COVID-19. The study looked at 15,086 nursing homes across the country. (Choi, 1/19)

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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?

-Gregg S. Margolis, PhD