Integrating Health Care And Social Services For Patients With Serious Illness

As a way of better understanding and facilitating discussions about challenges and opportunities related to integrating health care and social services for patients with serious illness, the National Academies of Sciences, Engineering, and Medicine held a full-day public workshop on July 19, 2018 in Washington, DC. A new publication summarizes presentations and discussions from the workshop. 

It can be obtained at https://www.nap.edu/read/25350/chapter/1.

The Failings Of Online For-Profit Colleges

A report from the Brookings Institution addresses the trend of for-profit colleges going exclusively online or contracting with nonprofit (mostly public) colleges to run their online programs. Using results from focus groups of for-profit student borrowers, the report explores the risks that this rapid shift entails for students already vulnerable to poor outcomes. 

The report can be obtained at https://www.brookings.edu/wp-content/uploads/2019/03/The-Failings-of-Online-For-profit-Colleges.pdf.

Senate Hearing on Dept of Education FY 20 Budget

The Senate Committee on Appropriations, Labor, Health and Human Services, Education, and Related Agencies Subcommittee held a hearing on “Review of the FY2020 budget request for the U.S. Department of Education” in which Education Secretary DeVos testified on behalf of the Department’s budget request.

Bipartisan support surrounded funding for the Special Olympics, CTE awareness for high school students and families, apprenticeships, and short-term Pell grants. Ranking Member Patty Murray (D-WA) expressed concern about the Department issuing higher education regulations for accreditation and distance learning as she and Sen. Lamar Alexander (R-TN) work on reauthorizing the Higher Education Act.

Democrats expressed frustration with the Department’s slow progress to approve borrower defense claims (especially for students defrauded by for-profit colleges), proposal to cut PSLF, and cuts to GEAR UP and TRIO. Republicans supported the Department’s proposals for teacher professional development vouchers and the Education Freedom scholarships.

Read ASAHP’s full memo here.

Possible Consequences Of A Full Repeal Of The Affordable Care Act

A brief from the Urban Institute discusses a case before the US Court of Appeals for the 5th Circuit, which if decided in favor of the plaintiffs, would eliminate the entire Affordable Care Act. State-by-state implications of full ACA repeal for insurance coverage and government funding of health care in 2019 are estimated. 

The brief can be obtained at https://www.urban.org/sites/default/files/publication/100000/repeal_of_the_aca_by_state_0.pdf.

House Education & Labor Committee Hearing on Registered Apprenticeships

The House Committee on Education and Labor, Higher Education and Workforce Investment Subcommittee held a Hearing on “Innovations in Expanding Registered Apprenticeship Programs” to discuss expansion of apprenticeships through the current registered model or through Industry Recognized Apprenticeship Programs (IRAPs).

Democrats continued to emphasize their support Registered Apprenticeship programs that they believe ensure high quality programming with portable credentials. With the current skills gap, Republicans believe more needs to be done and that the Administration’s Industry Recognized Apprenticeship programs (IRAPs) provide curriculum flexibility for employers in high demand professions without the lengthy approval process included with Registered Apprenticeship programs. Democrats raised concerns that IRAPs could take away taxpayer dollars from the Registered Apprenticeship program, which has a proven, standardized model.

Community colleges were also highlighted for their partnerships and work as intermediaries between high schools, 4-year institutions, and businesses, to create programs that meet the needs of the community.

Read ASAHP’s full memo here.

FY20 Department of Education Budget Hearing

The House Committee on Appropriations, Labor, Health and Human Services, Education, and Related Agencies Subcommittee held a hearing on “Department of Education Budget Request for FY 2020” in which Education Secretary DeVos testified on behalf of the Department’s budget request.

Among the issues that received bipartisan support were funding for CTE and the expansion of Pell grants for short-term programs. Democrats emphasized the importance of guardrails with short term Pell and DeVos supported working with Congress for this expansion of Pell.

Public charter schools were a hot button issue throughout the hearing, with Republicans supporting charter schools as a mechanism to find the best type of education for students, while Democrats were concerned about a recent report showing up to $1 billion in misuse of charter school funding and they also reiterated their belief that charter schools are largely a means to privatize education. Subcommittee Chairwoman Rosa DeLauro (D-CT) stated their focus is on the 90% of students who are in public schools, not charters.

There was bipartisan support to continue funding TRIO and GEAR UP, rejecting the Department’s proposal to eliminate these programs. Democrats continued to raise concerns about the lack of transparency and oversight of loan servicers along with concerns about potential equity issues for low-income individuals if the Department implemented an institutional risk-sharing program.  

DeLauro emphasized in her closing statement, “I look forward to working with my colleague across the aisle to reject the cuts…and we won’t be reviewing what has been proposed.”

Read ASAHP’s full memo here.

2019 Exchange Open Enrollment Period Final Report

The Centers for Medicare & Medicaid Services (CMS) today released the Health Insurance Exchanges 2019 Open Enrollment Report. It shows plan selections in Exchange plans in the 50 states and D.C. remained steady at 11.4 million, representing a minimal decline of around 300,000 plan selections from the same time last year. Also, average total premiums for plans dropped by 1.5% from the prior year, the first decline since the Exchanges began operations in 2014.  

The report can be obtained at https://www.cms.gov/newsroom/fact-sheets/health-insurance-exchanges-2019-open-enrollment-report.

Framework For Improving End-Of-Life Care

The Institute for Healthcare Improvement has published the second edition of its white paper, "Conversation Ready: A Framework for Improving End-of-Life Care." The paper presents a framework relevant to any health care professional and organization to provide respectful end-of-life care that is concordant with patients’ stated goals, values, and preferences.  

The white paper can be obtained at http://www.ihi.org/resources/Pages/IHIWhitePapers/ConversationReadyEndofLifeCare.aspx.

The Value Of A College Degree

The House Committee on Education and Labor issued a report entitled Don’t Stop Believin’: The Value of a College Degree. It states that a college degree is still well worth the cost, noting that bachelor’s degree holders earn up to $1 million more and associate’s degree holders up to $400,000 more than high school graduates during their work lives. Expanded access and increased affordability are goals highlighted in the report that may be addressed in the next reauthorization of the Higher Education Act 

The report can be obtained at https://edlabor.house.gov/imo/media/doc/FINAL%20VALUE%20OF%20COLLEGE%20REPORT.pdf.

Toolkit For Strengthening Medicaid Long-Term Services And Supports

As the population ages, one of the greatest challenges facing state officials is how to organize and pay for long-term services and supports (LTSS) for low-income elderly and disabled adults—the most complex, expensive, and fastest-growing group covered by Medicaid. To help address this challenge, a toolkit for state leaders published in December 2017 has been updated by Manatt Health Strategies and the Center for Health Care Strategies. 

The toolkit can be obtained at https://www.milbank.org/wp-content/uploads/2019/03/Strengthening-LTSS-Toolkit_032019.pdf.

Closing The Medical Research Gap Involving Women

Women have long been left out of biomedical research, even though some of the most common diseases, like cancer and heart disease, present differently in men and women. As a result, much less is known about how to prevent, diagnose, or treat these diseases in women. An article from the Commonwealth Fund examines how attitudes toward the health of women are changing and describes efforts to close the gender gap in medical research.

The article can be obtained at http://features.commonwealthfund.org/closing-the-medical-research-gap.

Medicare Payment Advisory Commission Report to Congress

The Medicare Payment Advisory Commission released its March report to Congress. It details the fee-for-service payment recommendations for 2020 approved by the commission in January, including recommendations for hospital services and post-acute care. The report also includes MedPAC’s recommendation to replace the four existing inpatient quality programs with one single program, the Hospital Value Incentive Program.  

The report can be obtained at http://medpac.gov/docs/default-source/reports/mar19_medpac_entirereport_sec.pdf?sfvrsn=0.

Applications Open for HRSA 2019 Opioid Workforce Expansion Program (OWEP) funding

The Health Resources and Services Administration (HRSA) is accepting applications for the 2019 Opioid Workforce Expansion Program (OWEP). OWEP works to enhance community-based experiential training for student behavioral health professionals focusing on Opioid Use Disorder and other Substance Abuse Disorders. Application deadline is May 7, 2019.

Click here for more info.

Health Care Analysis Tool For Health Care Spending And Use Of Services

A new health care analysis tool from the Health Care Cost Institute shows that medical spending across the U.S. has increased even though individuals used fewer health care services. An examination of data between 2012 and 2016 across 112 metro areas found that spending increased nearly 13 percent, while the use of services was down by 17 percent.  

The tool can be obtained at https://www.healthcostinstitute.org/research/hmi/hmi-interactive?utm_source=STAT+Newsletters&utm_campaign=103c773fcd-MR_COPY_01&utm_medium=email&utm_term=0_8cab1d7961-103c773fcd-149940042.

Education & Labor Committee Hearing on the Cost of College

The House Committee on Education and Labor held a hearing on “The Cost of College: Student Centered Reforms to Bring Higher Education Within Reach”. Discussions centered around barriers to postsecondary education for all students, but particularly low-income and students of color. There was bipartisan agreement that students need to learn financial literacy, so they can understand that taking out the maximum loan amount is not always necessary and also understand the process for repayment. There was also bipartisan support to expand awareness and increase resources for technical education and community colleges along with expanding Pell to short-term programs. The Public Service Loan Forgiveness faced disagreement with Republicans questioning the negative incentives to borrow more while Democrats believe eliminating PSLF will reduce the diversity of the industries eligible for PSLF.

Read ASAHP’s full memo here.

Affordability Of 2019 ACA Premiums For Members Of Middle Income Group

According to the Kaiser Family Foundation, after several years of rising ACA plan premiums, their prices are falling in many parts of the U.S. for 2019. Despite this trend, premiums for even the cheapest exchange plans remain out of reach for many middle class individuals who are not eligible for ACA subsidies, particularly those who are older or live in high-premium areas.  

More information can be obtained at https://www.kff.org/health-reform/issue-brief/how-affordable-are-2019-aca-premiums-for-middle-income-people/.

IPEC Spring Institute and April Webinar

The Early-bird registration deadline ends Friday, March 15, for the Spring 2019 Interprofessional Education Collaborative (IPEC) Institute in Washington, DC. Taking place May 22-24, 2019, the Spring Institute will be a unique gathering of health professions faculty, collaborative partners, expert presenters and staff facilitators. The next IPEC webinar, “Enabling IPE Through Health Communications & Health Technology”, takes place on Thursday, April 18, from 2-3pm ET and will feature the 2017 and 2018 USPHS IPEC honorable mention winners in the category of health communications and technology.

Links below:

Senate HELP Hearing on Simplifying FAFSA

The Senate Committee on Health, Education, Labor & Pensions Committee held a hearing on “Reauthorizing the Higher Education Act: Simplifying the FAFSA and Reducing the Burden of Verification”. There was bipartisan support for reducing the number of FAFSA questions, sharing data between the IRS and FSA, expanding Pell to short-term programs, and introducing CTE and community colleges to middle and high school students. Concern was expressed for first generation students and students of color who get selected for verification and may end up not going to college because they just stop the process, while the questions flagged for verification could be answered with data sharing between the IRS and FSA.

Read ASAHP’s Full Memo here.