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- Alan Mittermaier on MA and Part D Proposed Rule Increases Plan Flexibility, Reduces Regulatory Burden
- Sharon Willliams on A New Source of Capital for Star Ratings and Clinical Innovations
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Topic: Policy & Health Reform
Estimates say that last year, 3.6 million people in the U.S. missed healthcare appointments.
Lyft and Uber are both getting into that space, partnering with healthcare providers to get their patients to appointments. Now, a doctor or hospital can arrange transportation for them with a few easy clicks.
The Wall Street Journal reported last night (Cigna Nears Deal to Buy Express Scripts) that Cigna is in final talks to acquire Pharmacy Benefit Manager (PBM) Express Scripts (ESRX) for a whopping $67 billion. ESRX was the last truly independent major PBM, and the deal signals the end of an era…and ushers in a new one, further blurring the lines between insurers, providers, and their primary vendor. The combined entity will reach over 250 million people and will have a ripple effect on many of their competitors.
The draft 2019 Call Letter for Medicare Advantage (MA) included new flexibility for plans around supplemental benefits. It was codified in the recent budget resolution to keep the government open and represents the biggest news for the industry in years. It offers a whole new toolbox for plans to address social determinants of health.
House Passes Spending Bill That Includes Many Medicare Advantage Policies; Senate Announces Two-Year Budget Deal
On Tuesday, the House passed a bill that would fund the government through March 23, 2018. Meanwhile, the Senate leaders announced Wednesday afternoon they have reached an agreement on a two-year spending deal. The Senate budget deal includes another four years of Children’s Health Insurance Program (CHIP) funding, added to the previously authorized six-year extension. The bill also contains two years of funding for community health centers, and adds $6 billion for the opioid epidemic. The deal will also terminate the Independent Payment Advisory Board. Though it is still uncertain whether the Senate deal has enough support to make it through the House, with both Democrats and budget hawks on the fence, it is reported that the Senate is planning to attach this budget deal to the previously passed House spending bill, and send it back to the House for a vote.
On February 1, 2018, the Centers for Medicare & Medicaid Services (CMS) released its 2019 Advance Rate Notice (Part II) and Draft Call Letter. CMS estimates an expected increase of 1.84% to payments in 2019. CMS says its estimates do not reflect underlying coding trend, which it expects to increase risk scores by 3.1% in 2019.
Though he was largely expected to step away from remarks on healthcare in his State of the Union address on Tuesday, President Trump made several remarks regarding his administration’s plans in 2018, which give us some insight into potential actions the administration may take this year.