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AHA advertorial: Hospitals going for the 'Triple Aim'   07/22/2014
Hospitals are improving the individual care experience and health of populations while reducing per capita cost, a “Triple Aim" that holds great promise for the future of health care, writes AHA President and CEO Rich Umbdenstock in an advertorial today in The Wall Street Journal. He notes, “Growth in both health care spending and hospital prices has slowed. Hospitals are using new information technologies to track their own performance, avoid duplication in services and identify ways to improve the overall health of the populations and communities they serve. They are also taking important steps to better engage patients and their families, physicians and the community. Hospitals recognize that keeping their doors open every hour of every day, even in disasters, means keeping their minds open too. Every day, they are employing new and better ways to deliver care that achieve better outcomes for patients. And every day they are making progress in making communities healthier and bending the cost curve.”
Appeals courts issue opposing opinions on ACA subsidies   07/22/2014
A federal appeals court in Virginia today upheld premium subsidies for health coverage purchased through federally facilitated exchanges, while its counterpart in Washington, D.C., rejected such subsidies in a separate case. In both cases, the district courts had upheld an Internal Revenue Service rule providing premium tax credits to help low- and middle-income individuals afford insurance purchased through exchanges, whether state-run or federally-facilitated. In a unanimous decision, the Virginia appeals court sided with the government in upholding the IRS rule under the Affordable Care Act, while the D.C. appeals court reversed the district court in a 2-1 decision. The Virginia panel found the applicable statutory language “ambiguous and subject to multiple interpretations,” but deferred to the IRS determination “as a permissible exercise of the agency’s discretion.” The opinion states, “What we must decide is whether the statute permits the IRS to decide whether the tax credits would be available on federal Exchanges. In answering this question in the affirmative we are primarily persuaded by the IRS Rule’s advancement of the broad policy goals of the Act.” In the D.C. case, the 2-1 majority concluded that the ACA “unambiguously” restricts the subsidy to insurance purchased on exchanges “established by the state.” They write, “Applying the statute’s plain meaning, we find that [the statute] unambiguously forecloses the interpretation embodied in the IRS Rule and instead limits the availability of premium tax credits to state-established Exchanges.” Final resolution in the courts is likely to take a year or more and subsidies will continue during that period. The AHA submitted friend-of-the-court briefs supporting the government in both cases (Halbig v. Burwell and King v. Burwell). “The American Hospital Association strongly supports subsidies that help patients purchase coverage on the federal exchanges,” said AHA President and CEO Rich Umbdenstock. “We support the 4th Circuit decision upholding federal subsidies and will continue to be active in this case as it appears headed to the Supreme Court over the next year or two to ensure individuals have access to the coverage they need.”
Reminder: Friday deadline for quarterly AHA RACTrac survey   07/22/2014
AHA recently extended to July 25 the deadline for hospitals to submit data to its quarterly RACTrac survey. Hospitals are asked to complete the survey even if they did not experience recovery audit contractor activity during the second quarter of this year. The free web-based survey helps AHA gauge the impact of Medicare's RAC program on hospitals and advocate for needed changes. To register for the survey or for technical assistance, contact RACTrac support at (888) 722-8712 or ractracsupport@providercs.com. For more on the survey, including the latest results, visit www.aha.org/ractrac.
AHA SmartMarket connects health care professionals, vendors   07/21/2014
A new AHA social platform where health care professionals can search products and services, rate and review product performance, and collaborate with peers and experts debuted yesterday at the AHA-Health Forum Leadership Summit in San Diego. Called AHA SmartMarket, the service is free for health care professionals working in hospitals and other settings. “Health care is a team sport,” said AHA President and CEO Rich Umbdenstock. “And no one knows more about the products and services used by health care professionals than other health care professionals.”  AHA built the “crowd-sourcing platform” to help the field discuss emerging issues, network with peers, and share experiences with product and service providers, said Anthony Burke, AHA senior vice president and AHA SmartMarket president and CEO. “Ultimately, we want to strengthen the alignment and collaboration between health care providers and the vendor partners that support them,” he said. For more information, visit www.AHASmartMarket.com.
AHA announces chair-elect designate   07/21/2014
The AHA Board of Trustees has elected as its chair-elect designate Jim Skogsbergh, president and CEO of Advocate Health Care in Downers Grove, IL. He will assume the chairmanship in 2016. Affiliated with the Evangelical Lutheran Church in America and the United Church of Christ, Advocate includes 12 acute-care hospitals, an integrated children’s system, a large employed medical group and home health company, and the nation’s largest accountable care organization. Before joining Advocate in 2001, Skogsbergh served as executive vice president of the Iowa Health System in Des Moines, as well as president and CEO of Iowa Methodist, Iowa Lutheran and Blank Children’s hospitals. He is a member of the AHA Board of Trustees and Executive Committee, chair of the Coalition to Protect America’s Health Care, and member of the AHA SmartMarket board, among other activities. “It is an exciting time to be a health care leader as we work to improve the care we provide patients, and I look forward to working with the AHA and its members in support of the AHA mission to advance the health of individuals and communities,” Skogsbergh said.
HHS/HRSA issue 'interpretive rule' on 340B orphan drug discounts   07/21/2014
The Department of Health and Human Services and its Health Resources and Services Administration today issued an interpretive rule that continues to allow hospitals subject to the orphan drug exclusion to purchase “orphan drugs” through the 340B Drug Pricing Program when the drugs are not used to treat the rare conditions for which the orphan drug designation was given. The agencies said the interpretive rule intends to provide clarity in the marketplace; maintain the 340B Program savings for newly-eligible entities; and protect the financial incentives for manufacturing orphan drugs designated for a rare disease or condition, as indicated in the Affordable Care Act. “The AHA supports HHS and HRSA’s interpretive rule and believes it reflects the intent of Congress to improve access to 340B discounted drugs for rural and cancer hospitals and the patients and communities they serve,” said Jeffrey Goldman, AHA vice president for coverage policy. In May, a federal court ruled in favor of the Pharmaceutical Research and Manufacturers of America and vacated HHS’s adoption of a regulation to implement the orphan drug exclusion policy; however, it did not invalidate HRSA’s interpretation of the statute or preclude HRSA from issuing guidance in the form of an interpretive rule to implement its interpretation. PhRMA continues to challenge HRSA’s interpretation in the courts. The orphan drug exclusion policy applies to critical access hospitals, sole community providers, rural referral centers and free-standing cancer hospitals.
HIV diagnoses rates decrease overall, increase among young males   07/21/2014
The annual HIV diagnosis rate in the U.S. decreased 33% between 2002 and 2011, to 16.1 per 100,000 people, according to a study published Saturday in the Journal of the American Medical Association, a theme issue on HIV/AIDS. The largest declines were observed in people of multiple races (57%), aged 35-44 (50%) and women (49%). More than 493,000 U.S. cases were diagnosed over the 10-year period, including a 133% increase in diagnoses among males aged 13-24 attributed to male-to-male sexual contact. The findings are based on data from the Centers for Disease Control and Prevention’s National HIV Surveillance System. “Accurate HIV diagnosis data recently became available for all states, allowing for the first time an examination of long-term national trends,” the authors said. “These data can be used to monitor awareness of serostatus among persons living with HIV, primary prevention efforts and testing initiatives.”
CMS awards 14 additional contracts under QIO program restructuring   07/18/2014
The Centers for Medicare & Medicaid Services today awarded 14 Quality Improvement Organizations five-year contracts to work with health care providers on strategic quality initiatives and provide technical assistance to participants in CMS value-based purchasing programs. Each of the recipients, known as Quality Innovation Network-QIOs, will work with providers in specific states. They are: Great Plains Quality Innovation Network (Kansas, North Dakota, Nebraska and South Dakota); TMF (Arkansas, Missouri, Oklahoma and Texas); Lake Superior/Stratis (Minnesota, Wisconsin and Michigan); Telligen (Colorado, Iowa and Illinois); HealthInsight (New Mexico, Nevada, Oregon and Utah); Georgia Medical Care Foundation (Georgia and North Carolina); Qsource (Alabama, Kentucky, Mississippi and Tennessee); Mountain Pacific Quality Health Foundation (Alaska, Hawaii, Montana and Wyoming); IPRO (District of Columbia, New York and South Carolina); WVMI Quality Insights (Delaware, Louisiana, New Jersey, Pennsylvania and West Virginia); VHQC (Maryland and Virginia); Qualis (Idaho and Washington); Health Services Advisory Group (Arizona, California, Florida and Ohio); and HealthCentric Advisors (Connecticut, Massachusetts, Maine, New Hampshire, Rhode Island and Vermont). The Indiana, Puerto Rico and Virgin Islands awards have not yet been determined. In May, CMS awarded two QIOs five-year contracts to support case review and monitoring activities. The contracts are part of a restructuring of the QIO program under a new statement of work effective Aug. 1.
CMS issues revised guidance on Part D drug payment for hospice patients   07/18/2014
The Centers for Medicare & Medicaid Services today issued revised guidance on Medicare Part D payment of drugs for beneficiaries enrolled in hospice care. The agency said the document supersedes portions of its March 10 guidance to address operational and beneficiary access concerns raised by the field. “Our goal for the policy we set forth in March was to ensure that the hospice and Part D programs correctly pay for prescription drugs covered under each respective Medicare benefit while ensuring timely access to needed prescription medications,” the new guidance states. “While this remains CMS’s objective, we recognize that the operational challenges associated with prior authorizing all drugs for beneficiaries who have elected hospice to determine whether the drug is coverable under Part D have created difficulties for Part D sponsors and hospice providers, and in some cases, barriers to access for beneficiaries.”
First U.S.-acquired Chikungunya case reported in Florida   07/18/2014
The first U.S.-acquired case of chikungunya, a virus carried by mosquitoes, has been reported in Florida, the Centers for Disease Control and Prevention announced yesterday. Previous cases have been reported in travelers returning from countries where the virus is common. Typical symptoms include fever and joint pain. Patients typically recover in about a week, although long-term joint pain occurs in some people. CDC said it will monitor for additional U.S.-acquired cases of the virus, which can be transmitted by mosquito species found in the southeastern U.S. and parts of the Southwest, East Coast and lower Midwest. “None of the more than 200 imported chikungunya cases between 2006 and 2013 have triggered a local outbreak,” the agency said. “However, more chikungunya-infected travelers coming into the United States increases the likelihood that local chikungunya transmission will occur.”