Stabilizing And Strengthening The Individual Health Insurance Market

A report from the Brookings Institution examines the causes of instability in the individual market and identifies measures to help improve stability based on information obtained from 10 states.

The report can be obtained at https://www.brookings.edu/wp-content/uploads/2018/07/Stabilizing-and-Strenghtening-the-Individual-Health-Insurance-Market2.pdf.

Health Care Employment Experiences Steady Growth

A report from the Altarum Institute indicates that health care added 25,200 new jobs in June 2018, consistent with the 12-month average of 25,800 new jobs per month. Employment increased by 309,000 over the past year. Hospitals added 10,600 jobs in June, higher than the 12-month average of 7,900. Ambulatory settings such as physician offices and home health added 13,500 new jobs, lower than the 12-month average of 17,000.

The report can be obtained at https://altarum.org/sites/default/files/uploaded-related-files/SHSS-Labor-Brief_July_2018.pdf.

U.S. Senate Hearing On Reducing Health Care Costs

The Senate Health, Education, Labor and Pensions Committee today held the second in a series of hearings on how to reduce health care costs, which focused on preventing unnecessary spending and improving value. Representatives from Vanderbilt University School of Medicine, Montefiore Health System, Pacific Business Group on Health, and Stanford University School of Medicine testified.
 

Testimony can be obtained at https://www.help.senate.gov/hearings/reducing-health-care-costs-eliminating-excess-health-care-spending-and-improving-quality-and-value-for-patients.

Industry Guide For Managing High-Need, High-Cost Patients

High-need, high-cost patients make up 5% of the U.S. population, but account for roughly 50% of the country’s annual healthcare spending. The Health Care Transformation Task Force (HCTTF) and the Pacific Business Group on Health (PBGH) have created resources to help provider and payer organizations effectively contract for high-need, high-cost programs. They include: a whitepaper and a practical set of guidelines.

The white paper can be obtained at https://hcttf.org/wp-content/uploads/2018/07/Care-Management-Contracting-Report_FINAL.pdf and the guidelines at https://hcttf.org/wp-content/uploads/2018/07/Care-Management-Contracting-Guidance-Document_vF.pdf.

Characteristics Of The Remaining Uninsured

The ACA led to a significant decline in the number of uninsured individuals. A new report from the Urban Institute analyzes characteristics of the remining uninsured and how this population has changed. An array of possible approaches for increasing insurance coverage based upon the characteristics is outlined.

The report can be accessed at https://www.urban.org/sites/default/files/publication/98764/2001914-characteristics-of-the-remaining-uninsured-an-update_0.pdf.

Improving College Access

According to a report from the Center for American Progress, new federal data show that the U.S. still fails miserably at providing equitable access to learning beyond high school, particularly involving socio-economic status (SES). Students from the lowest levels of SES enroll in college at a rate that’s 60% the level of their best-off peers.

The report can be obtained at https://www.americanprogress.org/issues/education-postsecondary/news/2018/07/12/453210/new-federal-data-show-america-still-needs-improve-college-access/.

Paying For Value In Home- And Community-Based Services

As the US population ages, the demand for long-term care options has grown. Special focus has been on Medicaid programs, which pay for most long-term services and supports (LTSS). As public policy has shifted LTSS from institutional settings to home- and community-based settings, questions arise regarding how Medicaid agencies measure the quality of home- and community-based services (HCBS), how they pay for them, and how to encourage more cost-effective services. A new report from the Milbank Memorial Fund discusses these questions.

The report can be obtained at https://www.milbank.org/wp-content/uploads/2018/06/MMF-HCBS-Report-FINAL.pdf.

The Shape Of Health Reform In 2020

A report from the Commonwealth Fund describes the likely health care landscape leading up to 2020 and projects Republican and Democratic reform plans. Health care promises made on the campaign trail over the decades are relevant to the new administration's policy agenda.

The report can be obtained at https://www.commonwealthfund.org/sites/default/files/2018-06/Lambrew_getting_ready_hlt_reform_2020_presidential_0.pdf.

Hospitals Add Jobs In June

Employment at the nation's hospitals rose by 0.21% in June to a seasonally adjusted 5,175,800 workers, according to a new report from the Bureau of Labor Statistics. The figure is 10,600 more than in May and 95,300 more than a year ago. Without the seasonal adjustment, which removes the effect of fluctuations due to seasonal events, hospitals employed 5,174,300 in June – 25,900 more than in May and 95,800 more than a year ago.

The report can be obtained at https://www.bls.gov/news.release/empsit.t17.htm.

Federal Aid For Postsecondary Students

In 2017, the government financed roughly $100 billion in student loans and provided about $30 billion in grants and $30 billion in tax preferences. A report from the Congressional Budget Office (CBO) examines the impact of such aid and a number of approaches to changing it.

The report can be obtained at https://www.cbo.gov/system/files/115th-congress-2017-2018/reports/53736-postsecondarystudentaid.pdf.

Delivering Quality Health Services: A Global Imperative

Universal health coverage (UHC) aims to provide health security and universal access to essential care services without financial hardship to individuals, families and communities. A report from the Organization for Economic Co-Operation and Development (OECD) describes the current situation with regard to UHC and global quality of care, and outlines the steps governments, health services and their workers, together with citizens and patients need to urgently take.

The report can be obtained at https://read.oecd-ilibrary.org/social-issues-migration-health/delivering-quality-health-services-a-global-imperative_9789264300309-en#page11.

HRSA FY 2019 Budget Request And Funding History

The Health Resources and Services Administration (HRSA) within the Department of Health and Human Services (HHS) provides health care to individuals who are geographically isolated and economically or medically vulnerable. One of the five bureaus is the health workforce. A new fact sheet from the Congressional Research Office (CRS) focuses on the agency’s funding.

The fact sheet can be obtained at https://fas.org/sgp/crs/misc/R45245.pdf.

Trump Administration Encourages Race-Blind Admission Standards

The Trump administration will encourage the nation’s school superintendents and college presidents to adopt race-blind admissions standards, abandoning an Obama administration policy that called on universities to consider race as a factor in diversifying their campuses, Trump administration officials said. Last November, Attorney General Jeff Sessions asked the Justice Department to re-evaluate past policies that he believed pushed the department to act beyond what the law, the Constitution and the Supreme Court had required, Devin M. O’Malley, a Justice Department spokesman said. As part of that process, the Justice Department rescinded seven policy guidances from the Education Department’s civil rights division on Tuesday.

The full New York Times article may be accessed here

Designing A Medicare Benefit Covering Home And Community-Based Services

Approximately one in five Medicare beneficiaries has serious physical or cognitive limitations that require personal care services and supports, but only low-income beneficiaries eligible for Medicaid can obtain them. A Commonwealth Fund report explores important considerations in offering home- and community-based services by examining Maryland's experience with Community First Choice.

The report can be obtained at https://www.commonwealthfund.org/sites/default/files/2018-06/Davis_designing_medicare_help_home_maryland_CFC_ib_v3.pdf.

Labor-HHS Appropriations Bill Moves Forward In U.S. Senate

The Senate Appropriations Committee on June 28, 2018 voted 30-1 to approve legislation that would provide $179.3 billion in discretionary funding for the Departments of Labor, Health and Human Services, and Education in fiscal year 2019. The bill would provide $90.1 billion for HHS, with specific increases that include $2 billion more for the National Institutes of Health and $579 million more for the Substance Abuse and Mental Health Services Administration.

A video of the committee hearing can be obtained at https://www.appropriations.senate.gov/hearings/full-committee-markup-of-the-defense-and-labor-h-appropriations-bills-for-fy2019.

Actions Needed to Mitigate Medicaid Improper Payments and Program Integrity Risks

The Medicaid program helped provide health care to an estimated 73 million individuals in fiscal 2017 at a cost of about $596 billion. A report from the Government Accountability Office [GAO] focuses on the major risks to the integrity of Medicaid. Efforts needed to strengthen oversight include: expansion of a national Medicaid data system that will allow comparisons across states, a national anti-fraud strategy, and greater collaboration between state and federal auditors.

The report can be obtained at https://www.gao.gov/assets/700/692821.pdf.

Senate Hearing On Reducing Health Care Costs

The Health, Education, Labor and Pensions Committee today held the first in a series of hearings on how to reduce health care costs, which will examine administrative costs and waste, how to improve transparency, private sector solutions, and other issues. Witnesses included representatives from the Department of Health Policy at Vanderbilt University School of Medicine, Harvard Global Health Institute, Health Care Cost Institute, and Georgetown University Law Center.

Witness testimony can be obtained at https://www.help.senate.gov/hearings/how-to-reduce-health-care-costs-understanding-the-cost-of-health-care-in-america.

Gaps In Student Default

Prior research shows that default rates vary by institution sector and by race/ethnicity. Black, non-Hispanic entrants, and for-profit entrants experience default at much higher rates than other students. A new report examines whether these disparities in default rates can be explained by other factors, what happens after a default, and whether it also varies by race or institution sector. 

The report can be obtained at https://www.brookings.edu/research/what-accounts-for-gaps-in-student-loan-default-and-what-happens-after/

 

Report To Congress On Medicaid And CHIP

The Medicaid and CHIP Payment and Access Commission (MACPAC) released its June 2018 Report to Congress, which focuses on the high cost of prescription drugs, the opioid epidemic, and implications for the growing trend of delivering long-term services and supports (LTSS) through managed care.

The report can be obtained at https://www.macpac.gov/wp-content/uploads/2018/06/June-2018-Report-to-Congress-on-Medicaid-and-CHIP.pdf