Monthly Archives: March 2017

6 things keeping supply chain leaders up at night

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http://www.beckershospitalreview.com/supply-chain/6-things-keeping-supply-chain-leaders-up-at-night.html

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East Lansing-based Michigan State University partnered with the APICS Supply Chain Council to identify critical issues on the minds of supply chain leaders.

To compile the report, the groups interviewed leaders from more than 50 firms across the globe and asked them: “What keeps you awake at night?”

Here are the six most common issues on supply chain leaders’ minds, as identified in the report.

1. Capacity or resource availability. Many companies expecting market growth cited managing capacity issues as a main priority. They often wanted to avoid outsourcing and identified challenges to maximize their facilities’ capacity by replacing old equipment, among other activities.

“We’ve implemented a supply chain for a point in time,” one leader said, according to the report. “However, a supply chain is a living, breathing thing, and one needs to think about it as dynamic and impermanent. Is there a point where the supply chain becomes inappropriate for where we’re going, and we need to build a different kind of supply chain?”

2. Talent. Participating companies also described the struggle to find and keep good supply chain talent.

“The competition for talent is much higher [than it’s ever been],” said another participant in the report. “You go out to the market, and it’s one of those ironies. Right now, you put a job description out there, and you hear about 8 percent unemployment. However, I can’t find an industrial engineer worth his salt — you know, someone who can really think about strategy and think about [profit and loss statements] and drive change.”

3. Complexity. Some firms faced issues with their products becoming more complex and found it difficult to manage the increasing amount of stock keeping units.

“We’ve started building different types of products, completely new types of products. Whether it’s low or high volume, it creates another level of complexity,” said one leader in an interview.

4. Threats or challenges. A lot of supply chain leaders are worried about managing supply chain risk, and many mentioned the importance of continuity planning.

“I worry about supply risks in general, whether it’s from natural disasters or things like … a troubled supplier or a variety of issues with the whole supply chain risk piece,” one participant told researchers. “Partly that’s because that stuff is hard to control. You can try to proactively mitigate the downsides, but that’s just hard to control.”

5. Compliance. Participants cited numerous compliance issues like product regulation, trade controls and continually changing regulations, according to the report. Many leaders said they were struggling to keep up with both the high volume of regulations and how much they constantly changed.

“[The changes] are really causing us to spend a lot of money and a lot of our time. It is sucking up a huge amount of our information technology dollars and resources to be able to be compliant with those regulations,” said one study participant.

6. Cost or purchasing issues. While pressure to rein in costs is a focus for companies in every industry, it’s a top priority for healthcare and drug companies amid the shift toward value-based care, according to the report.

“Everything in healthcare is submitted through insurance for reimbursement,” one leader said. “The government won’t pay you any more to treat your patients, so you better get [the payout from] your suppliers. Well, we’re the supplier they’re coming after.”

To view the complete report, click here.

Antitrust Not Always Available in Competitor Disputes in the Healthcare Sector

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Antitrust Not Always Available in Competitor Disputes in the Healthcare Sector

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The antitrust injury and antitrust standing defenses/doctrines are alive and well in healthcare.  A recent case, SCPH Legacy Corp. et al. v. Palmetto Health et al., shows that a competitor is not always the most legally appropriate plaintiff to bring an antitrust case, especially when the competitor’s alleged harm stems from increased competition.  This article explains the court’s reasoning and makes some predictions for similar arguments in the future.

On February 24, 2017, Judge Joseph F. Anderson of the District of South Carolina, granted a motion to dismiss all federal antitrust claims brought by a small hospital chain against its larger competitor for lack of antitrust injury and antitrust standing.  The court held that poaching a group of doctors is not the type of injury that the antitrust laws are designed to protect when the suit is brought by a competitor, and that more direct plaintiffs exist.

Providence Hospitals, which operates a small hospital system in the midlands of South Carolina, alleged that Palmetto Health was a monopoly that secretly recruited employees of Providence’s orthopedic services business—the only competitive advantage that Providence had over Palmetto.  Palmetto allegedly orchestrated for 300 orthopedic physicians, executives and staff to simultaneously quit Providence and move to Palmetto in mid-2015.

 

California Employer Health Benefits: Prices Up, Coverage Down

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http://www.chcf.org/publications/2017/03/employer-health-benefits

Since 2000, the percentage of employers offering health benefits has declined in California and nationwide, although coverage rates among offering firms have remained stable. Only 55% of firms reported providing health insurance to employees in 2016, down from 69% in 2000. These findings underscore the important role that Medi-Cal and Covered California play in providing insurance to working Californians — coverage that could be negatively impacted by the Republicans’ repeal and replacement of the Affordable Care Act.

Nineteen percent of California firms reported that they increased cost sharing in the past year, and 27% of firms reported that they were very or somewhat likely to increase employees’ premium contribution in the next year. The prevalence of plans with large deductibles also continues to increase.

California Employer Health Benefits: Prices Up, Coverage Down presents data compiled from the 2016 California Employer Health Benefits Survey.

Other key findings include:

  • Health insurance premiums for family coverage grew by 5.6%. Family coverage premiums have seen a cumulative 234% increase since 2002, compared to a 40% increase in the overall inflation rate.
  • The average monthly health insurance premium, including the employer contribution, was $597 for single coverage and $1,634 for family coverage in California, and was significantly higher than the national average.
  • 41% of workers in small firms faced an annual deductible of at least $1,000 for single coverage, compared to 17% of workers in larger firms. The prevalence of these higher deductibles in small firms has increased substantially in the past five years.
  • Only one in four firms with many low-wage workers (those earning $23,000 or less) offered health coverage to employees in 2016.
  • In the past year, 24% of large firms extended eligibility for health benefits to workers not previously eligible.

The complete Almanac report, as well as past editions, is available under Document Downloads.

Americans Not Sold On Cost And Coverage Claims In GOP’s Health Bill

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http://khn.org/news/americans-not-sold-on-cost-and-coverage-claims-in-gops-health-bill/?utm_campaign=KHN%3A%20Daily%20Health%20Policy%20Report&utm_source=hs_email&utm_medium=email&utm_content=45675040&_hsenc=p2ANqtz-9_Q1KCdQHt-zQNqv48Mzr3r6MeZ9BFTStOZfC60tlVOVfayLTGpHxt7-0dYsx3c_OE2xIZHj2p4RvHcr5qETIsWtJHlw&_hsmi=45675040

A majority of the public is skeptical the Republican health plan would be an improvement over the Affordable Care Act, with widespread concerns that insurance costs would increase while people lost coverage, according to a poll released Wednesday.

The dour public assessment, from interviews with 1,206 adults conducted March 6-12, came before the Congressional Budget Office released its projections on Monday. The nonpartisan budget analysts predicted that the GOP’s American Health Care Act would leave 24 million people without insurance as it retracted Medicaid coverage for the poor and made premiums too high for many older people to afford.

The Kaiser Family Foundation poll found that 48 percent of the public thought the GOP plan would decrease the number of people who have health insurance. Another 30 percent expected the insured rate would stay the same, and 18 percent thought the number of covered people would increase. (Kaiser Health News is an editorially independent program of the foundation.)

The public doubted pledges from President Donald Trump and Republicans that the proposal would lower the costs of coverage for people who buy their own insurance. Forty-eight percent thought policies would become more expensive, while 23 percent thought they would drop. The rest thought insurance costs would stay the same.

People were also dubious that deductibles would get smaller: Only a quarter of people thought so. Respondents also were doubtful the GOP plan would be a boon even for the wealthy. About the same number of people expected the plan would increase costs for high-income people as those expecting a decrease.

For all the suspicion about the GOP approach, the public remained ambivalent about the ACA, with 49 supportive and 44 percent opposed. The public was also split about whether the ACA should be repealed.

Republicans, not surprisingly, were more optimistic than Democrats that the GOP plan would have positive effects. But it was not unanimous: 1 in 5 thought their party’s plan would lead to fewer people with insurance. A fifth of Republicans also said they expected insurance costs to rise under the plan.

Provisions of the GOP plan that would change women’s health care have strong opposition, including its ban on federal funds for Planned Parenthood to help it provide birth control and other non-abortion care to lower-income people. Three-quarters of the public thought Medicaid should continue to fund Planned Parenthood’s non-abortion services. The law already prohibits Medicaid spending for abortion, but the pollsters found that only a third of the public is aware of that.

The poll reported that 4 of 5 Americans strongly support provisions in the ACA that prohibit private insurers from denying coverage to pregnant women and from charging women more than men for policies, as well as those that require mammograms and cervical cancer screenings be provided with no out-of-pocket costs. Nine of 10 Americans support the ACA’s requirement that insurers pay for maternity care.

The poll’s margin of error was +/- 3 percent.

 

Americans divided over GOP health care bill, Kaiser poll finds

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http://www.cnn.com/2017/03/15/health/kaiser-poll-gop-health-care-bill/index.html?utm_campaign=KHN%3A%20Daily%20Health%20Policy%20Report&utm_source=hs_email&utm_medium=email&utm_content=45675040&_hsenc=p2ANqtz-_0cTjkau-NUcu2d_hfJVjIqxoefeluIt0pq_GSPzAUxDJXcCT3cxoL6Oy_5XyhcLmYmjcsCCZImWBmz09xIYJb0wXaaA&_hsmi=45675040

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A new poll finds that many Americans are not optimistic about what the GOP health care bill will do to their coverage.

Although President Donald Trump and Republicans in Congress promise that their plan will cover more people and cost less, nearly half of Americans don’t believe it, according to a Kaiser Family Foundation poll released Wednesday.
And while many Republicans are confident that defunding Planned Parenthood is the right move, the greater majority oppose that idea, it says.
This is the latest poll on the legislation from the nonpartisan Kaiser Family Foundation.
The organization polled Americans from March 6-12, before the nonpartisan Congressional Budget Office released an estimate Monday predicting that — unlike Obamacare, which brought the uninsured rate to an all-time low — the GOP bill will send the country’s uninsured rate higher than before the Affordable Care Act.
That change could be immediate for 14 million Americans who could become uninsured next year, according to the report.
Of the more than 1,200 nationally representative random Americans polled, Kaiser found that 48% think the GOP plan will cover fewer people, compared with the one in five who said the bill would increase coverage.

The CBO report raises five serious questions

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https://www.washingtonpost.com/blogs/right-turn/wp/2017/03/14/the-cbo-report-raises-five-serious-questions/?_hsenc=p2ANqtz-8z9Sylks_wibB_-6SdY9AQGBM3g03O-yrykjFdnlayePaRf6KdLp5erCdoZM5RZvXTKhGTRTUJKrOfKMio5kAnhglcYQ&_hsmi=45675040&utm_campaign=KHN%3A%20Daily%20Health%20Policy%20Report&utm_content=45675040&utm_medium=email&utm_source=hs_email&utm_term=.86ffca0b81b7

The Congressional Budget Office report on the American Health Care Act — showing that as many as 24 million people could lose health insurance, Medicaid would be drastically cut and older, poorer Americans would suffer the most — leaves us with a number of questions:

Why did House Speaker Paul Ryan (R-Wis.) force votes in two committees and then spring the disturbing CBO score, revealing that members voted rashly (not knowing the effects) or don’t care about loss of coverage and regressive consequences? Perhaps he is so convinced that his members will vote for anything that he made no effort to spare them from votes they one day (Election Day 2018, for example, and especially in districts Hillary Clinton carried) will regret. It is far from clear what he thought he was going to “get away with.” Unlike President Trump, he cannot merely dismiss inconvenient facts and plunge forward. Well, he can, but he puts his members’ seats and his own speakership at risk.

What’s the point of passing something so obviously unacceptable to the Senate? Sen. Susan Collins (R-Maine) blasted the effort: “The CBO estimate that millions of Americans could lose their health insurance coverage if the House bill were to become law is cause for alarm. It should prompt the House to slow down and reconsider certain provisions of the bill.” Her colleague and Trump supporter Sen. David Perdue (R-Ga.) echoed Sen. Tom Cotton’s advice on Sunday to “get this right.” Sen. Lindsey Graham (R-S.C.) argued, “[L]et’s say the CBO is half-right. That should be cause for concern. So, rather than attacking the CBO as the exclusive way of moving forward, I would think the prudent thing for the party to do is to look at the CBO report and see if we can address some of the concerns raised.” Sen. Bill Cassidy (R-La.) scoffedat the notion the bill would really save money. “Society is going to pay for health care whether it’s through insurance or not,” he remarked.

 

Medicaid Is About Grandma

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http://www.huffingtonpost.com/entry/medicaid-is-about-grandma_us_58c823d8e4b022817b29178d?utm_campaign=KHN%3A%20Daily%20Health%20Policy%20Report&utm_source=hs_email&utm_medium=email&utm_content=45675040&_hsenc=p2ANqtz-8LGIyTmn6nhDk89cZo6cUrufFATTTJ0UEOLkEAL40dVGaTTKG-_3pnWLxOkvp2OhsqJnaKQT0UF6ciBSrrzUF_dRYROg&_hsmi=45675040

Image result for medicaid grandma in nursing home

Why don’t Democrats more often make the point Sen. Chuck Schumer made this week about the consequences of GOP efforts to scuttle Medicaid:

Medicaid is for poor people, but also 60 percent goes to people in nursing homes. And that affects not only them, but their kids. You’re a kid 45 or 50, your Mom or Dad is in a nursing home. They could be kicked out after this bill passes. What would you do? You have to take them at home, stop working to take care of them. Or you have to shell out thousands of dollars out of your pocket. — Schumer press conference (3/13)

Bill Clinton routinely made this point when Medicaid was debated during his presidency. Inexplicably he is among a surprisingly few Democrats who stress the program’s service to elder Americans in dire need of long term care. But the GOP continues to get away with feeding the illusion that it mostly serves malingerers who’d rather take a federal handout than get a job.

Baby boomers everywhere are facing the painful needs of parents who need nursing home care. Many are finding that Medicaid is their only choice. That’s the political pitch that can save Medicaid.