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IRS issues temporary/proposed rules on premium tax credit   07/25/2014
The Internal Revenue Service yesterday issued identical temporary and proposed rules relating to the premium tax credit for health insurance purchased through an Affordable Care Act exchange. The regulations provide an indexing methodology; clarify how to reconcile tax credits with advance premium payments for certain taxpayers, such as divorced or separated individuals; address the premium deduction for self-employed individuals; and provide relief from the joint filing requirement for victims of domestic abuse and spousal abandonment. Both rules will be published in the July 28 Federal Register, with comments on the proposed rule accepted for 90 days. The temporary rule takes effect upon publication.
NJ hospitals save $113 million in gainsharing demonstration   07/25/2014
A consortium of 12 New Jersey hospitals achieved nearly $113 million in health care savings under a three-year “gainsharing” project that encouraged hospitals and physicians to work together to provide more efficient, high-quality care, the New Jersey Hospital Association reports. About 17% of the savings was shared with physicians based on their performance on quality and efficiency metrics, including performance versus peers and improvement over time. NJHA last year launched a larger demonstration of the model under the Centers for Medicare & Medicaid Services’ Bundled Payments for Care Improvement initiative. CMS requires hospitals participating in the bundled payment demonstration (Model 1) to “guarantee” a certain level of Medicare savings after the first six months. For more on the NJHA project, see the profile on the Agency for Healthcare Research and Quality’s Innovations Exchange.
Reminder: AHA webinar July 30 on patient and family engagement strategies   07/25/2014
AHA’s Hospitals in Pursuit of Excellence initiative will host a free webinar Wednesday on results from a recent survey on the state of hospital strategies to engage patients and families in their care, as well as case studies of excellence in patient and family engagement. Patient and family engagement is associated with fewer adverse events, lower health care costs, decreased use of services, better patient self-management and higher patient-satisfaction scores. The survey was conducted by AHA’s Health Research & Educational Trust and the Gordon and Betty Moore Foundation. To register for the webinar, from 2-3:15 p.m. ET, click here.
HHS announces $332 million in 2013 premium rebates under MLR   07/24/2014
About 6.8 million Americans will receive premium rebates averaging $80 per family from health insurers who did not meet medical loss ratio requirements in 2013, according to a report released today by the Department of Health and Human Services. Under the Patient Protection and Affordable Care Act, most individual and small group health plans must spend at least 80% and most large group plans at least 85% of premiums on direct medical care or quality improvement efforts or rebate the difference to policyholders annually by Aug. 1. For more on the 2013 MLRs and refunds by state and market, visit www.cms.gov.
Hospitals encouraged to complete survey on supply chain savings strategies   07/24/2014
AHA encourages hospital supply chain executives to complete a short online survey by July 31 on the value of supply chain strategies and group purchasing organizations. Responses will remain anonymous and confidential. Aggregate results from the study, conducted by Wharton School professor Lawton Robert Burns with support from the AHA and its Association for Healthcare Resource & Materials Management, will be shared with survey participants and publicized later this summer. In 2010, the Government Accountability Office reviewed the research literature on the perceived benefits of GPOs to hospitals and found only one peer-reviewed report, which was based on a prior national survey by the Wharton School. The current survey will allow the school to update those published findings and discern the trend in hospitals’ evaluation of their GPO ties. For a link to the survey, or more information, email Burns at BurnsL@wharton.upenn.edu.
Study: Uninsured rate for adults down 5.2 percentage points since October   07/24/2014
The proportion of U.S. adults without health insurance declined 5.2 percentage points since October 2013, with an estimated 10.3 million adults gaining coverage, according to a new study by researchers at the Department of Health and Human Services. Using survey data from the Gallup-Healthways Well-Being Index and HHS enrollment statistics for Medicaid and marketplace coverage, the authors estimate that the uninsured rate for adults under age 65 fell from 21% in September 2013 to 16.3% in April 2014, a 5.2 point change after adjusting for economic factors and pre-existing trends. The decline coincides with the initial open enrollment period for the Affordable Care Act’s health insurance marketplaces for uninsured adults and families. Coverage gains were concentrated among low-income adults in states expanding Medicaid under the ACA, and among individuals in the income range eligible for marketplace subsidies, the authors said. The study was published online by the New England Journal of Medicine.
Burwell names HHS senior counselor   07/23/2014
Health and Human Services Secretary Sylvia Burwell today named former Walmart executive Leslie Dach to a senior counselor position in the department. As executive vice president of corporate affairs for Walmart Stores from 2006 to 2013, Dach worked with the administration on initiatives to make food healthier and more affordable. At HHS, he will work with senior staff on key policy challenges and strategic initiatives, engagement with external partners, and the second Open Enrollment period for the Health Insurance Marketplace, the agency said.
FDA alerts health professionals to potentially contaminated drug products   07/23/2014
The Food and Drug Administration today alerted health care professionals and consumers to a voluntary recall of all non-expired drug products produced for sterile use by Unique Pharmaceuticals Ltd. of Temple, TX. Health care professionals should immediately quarantine the products, which may be contaminated, and not administer them to patients, the agency said. Two recent FDA inspections of the company’s facility revealed sterility failures in several lots of drug products intended to be sterile, recurring environmental contamination problems and poor sterile production practices, the agency said. At the request of FDA, the company is ceasing sterile compounding operations until sufficient corrections are made. The agency asks health care professionals and consumers to report adverse events or quality problems associated with use of the products to the MedWatch program.
House caucus will promote state Medicaid expansions   07/23/2014
More than 25 members of the House of Representatives have formed the State Medicaid Expansion Caucus, Reps. G.K. Butterfield (D-NC) and Hank Johnson (D-GA), co-chairs of the group, announced. They said caucus members “will highlight the need for recalcitrant states to expand Medicaid through floor speeches, op-eds, social media posts, discussions with their colleagues and constituents.” For more information, visit butterfield.house.gov.
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.”