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- Bill DeMarco on What Trump Could Actually Do to ObamaCare, Day One, Without Congress
- Bill Barcellona on The New “80/20 Rule” in Government Health Programs
- David Sayen on The New “80/20 Rule” in Government Health Programs
- world health day on Hot Takes on Medicare Advantage and Part D in 2017
- Nancy on Making Order from Chaos
This week, Representative Tom Price was named the nominee for the new Department of Health & Human Services (HHS) Secretary. This widely expected pick provides us some foresight into what type of agenda to predict from the Trump Administration. Tom Price is one of the strongest opponents of Obamacare, from the very passage of the Affordable Care Act (ACA). Putting such a firm critic of the law as the head of HHS immediately sends the message we will see “below the waterline changes” and chips away at Obamacare before any repeal is even voted on. Price will soon have control of the constant flurry of subregulations and guidance put out by the Centers for Medicare & Medicaid Services (CMS) on a daily basis. Need an example? CMS released its early preview of CY2018 Medicare Advantage rate book growth rates this week. While the 2018 preliminary baseline rate increase is 2.31%, the actual rate will be finalized in April 2017 by the new Administration.
In a shocking victory, Donald Trump is our new President-elect, and Republicans held on to control of the House and Senate. The sweep gives Republicans wide control to pass significant legislation and reshape the federal government, including the entire federal civil service and the Supreme Court, in the next four years.
Some people are list makers and wholeheartedly embrace the value of checklists. They utilize lists to manage tasks, stay focused, and ensure high-quality results. A publication by the Institute of Health’s Committee on Quality of Health Care in America, titled “To Err is Human: Building a Safer Health System,” lays out the value of checklists in improving patient safety. We should view the Centers for Medicare & Medicaid Services (CMS) Readiness Checklist in that same view: it is a tool to allow health plans to improve the quality and compliance of their health plan and safety of their members.
As 2016 comes to a close, planning for next year should be well underway. Bids are in, and budgets for the current year are being evaluated against reality before next year’s strategies are finalized. As the ACA continues to evolve, CMS has been busy with new programs and more oversight. A plan or provider has to be vigilant about identifying any weaknesses that could mean high costs or low expectations relative to budget. Parent companies have to be aware of line of business similarities and differences as Exchange and Medicaid business become more like Medicare Advantage in terms of programs and benchmarks. A recent article from Kaiser on retention makes great points about the line of business impact on retention and how it is a simple metric that encompasses many operational issues.
“The Theory of Evolution has two main points,” said Brian Richmond, curator of human origins at the American Museum of Natural History in New York City. “All life on Earth is connected and related to each other,” and this diversity of life is a product of “modifications of populations by natural selection, where some traits were favored in an environment over others,” he said.