Ochsner to pay tuition for future physicians, nurses who pledge to 5 years with system

https://www.beckershospitalreview.com/hospital-physician-relationships/ochsner-to-pay-tuition-for-future-physicians-nurses-who-pledge-to-5-years-with-system.html%20?utm_medium=email

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New Orleans-based Ochsner Health System created a $10 million tuition fund to grow its own workforce amid current labor market challenges, according to The Advocate, a Louisiana news outlet.

The system will begin by paying tuition for a cohort of 30 primary care physicians and psychiatrists. The physicians must commit to working in Louisiana with the health system for at least five years to receive the funding.

Ochsner has plans to offer similar scholarship opportunities for employees who want to become licensed practical nurses or registered nurses. It plans to ultimately cover tuition for about 1,000 employees, according to the report.

Read the full story here.

 

 

President Trump’s budget cuts target Medicaid, Medicare

https://www.healthcarefinancenews.com/news/president-trumps-budget-cuts-target-medicaid-medicare?mkt_tok=eyJpIjoiWVRnM01UZzNaR0V6TTJFNSIsInQiOiJ6aXpsQnNCRjhHdCs4SnN0UytlZnJVUlZUeFdreEZyQ2V6RWE0YklvYmFMOGJnbWpXT3ZHeG0rOHMwNkJPcE9rMUlGb3NzVkpId3NrZHNkZmR2VlZISXZCVGgrbU94cFV3aVlNR1NYamlhazF1R1kzaXd3RXVISm9OSGJoYmVrVCJ9

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Blueprint includes cuts for care in hospital outpatient departments, teaching hospitals and post-acute care providers, AHA says.

President Trump’s proposed $4.8 trillion budget slashes billions of dollars from Medicaid, food stamps and other safety net programs in an attempt to shrink the federal deficit.

Medicaid and the Affordable Care Act see about $1 trillion in cuts over the next decade, according to The Hill. The budget eliminates the enhanced federal match for Medicaid expansion enrollees. An additional $150 billion is expected to be shaved off of Medicaid from the implementation of work requirements, which is expected to result in people losing their healthcare coverage.

The “President’s health reform vision” to ax the Affordable Care Act takes $844 billion over 10 years from the ACA, the report said.

The decrease in federal spending on Medicare would total about $750 billion over 10 years, but that includes shifting two programs out of the budget. After accounting for those changes, the reduction is just over $500 billion, according to CNN. Much of that cut comes from reducing payments to providers.

The budget needs Congressional approval and is not expected to get past a Democratic-controlled House without changes.

House Speaker Nancy Pelosi tweeted: “The budget is a statement of values. Once again, the #TrumpBudget makes it painfully clear how little the President values the good health, financial security and well-being of America’s hard-working families.”

Ways and Means Committee Chairman Richard E. Neal, D-MA, said, “When I saw the President’s proposed budget today, I felt an immense sense of relief – relief that there is absolutely no chance of his ruthless cuts to critical programs ever becoming law. Slashing billions from Medicare and Medicaid will only make it harder for Americans to access the healthcare they need.

Cutting nutrition assistance and Social Security benefits for the disabled won’t enable people to get back on their feet financially.”

Senator Lamar Alexander, R-Tenn said, “Under the Constitution, it is Congress’ job to set spending priorities and pass appropriations bills, and as a member of the Senate Appropriations Committee, my priorities will continue to be making sure our national defense, national laboratories, the National Institutes of Health and national parks have the resources they need. I am encouraged to see the president is calling to end surprise medical billing.”

The budget adds money to the National Institutes of Health. The NIH will invest $50 million for new research on chronic diseases, using AI and related approaches, according to the White House briefing. It adds $7 billion over 10 years to fight opioid abuse and for mental health in the Medicaid program.

WHY THIS MATTERS

Cuts to Medicare and Medicaid mean uncompensated care to providers, or a reduction in the government payments.

The American Hospital Association said, “The budget request, which is not binding, proposes hundreds of billions of dollars in reductions to Medicare and Medicaid over 10 years.”

AHA President and CEO Rick Pollack said, “Every year, we adapt to a constantly changing environment, but every year, the Administration aims to gut our nation’s healthcare infrastructure. The proposals in this budget would result in hundreds of billions of dollars in cuts that sacrifice the health of seniors, the uninsured and low-income individuals. This includes the one in five Americans who depend on Medicaid, of which 43% of enrollees are children.

“In addition to the hundreds of billions in proposed reductions to Medicare, the blueprint includes cuts we strongly oppose for care in hospital outpatient departments, teaching hospitals and post-acute care providers. These cuts fail to recognize the crucial role hospitals serve for their communities, such as providing 24/7 emergency services. Post-acute cuts threaten care for patients with the most medically complex conditions.”

 

The health system “black market” for care

https://mailchi.mp/192abb940510/the-weekly-gist-february-7-2020?e=d1e747d2d8

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Recently we’ve been working with one of our member health systems to build a comprehensive plan for ambulatory access. As we were brainstorming a list of success metrics, one physician leader made an interesting comment: “I’ll know we’re successful at improving access when people stop calling me asking to get their mom or husband or friend into a specialist.”

The other leaders in the room all nodded in agreement. While we’re all happy to assist friends and family with finding the best doctor for their problem, or getting in more quickly, these leaders recognized that these informal channels represent yet another level of inequality in our healthcare system: patients and families who can tap into “insider” provider connections have access to a “black market” of enhanced access and information that can expedite treatment, assuage worry, and potentially provide better outcomes.

Thinking about eliminating the need for the healthcare black market broadened our discussion of a successful access solution. Getting a quick appointment doesn’t fully solve the problem, patients want to be assured they’re seeing the “best” doctor for their problem—meaning the system needs to have a better process for matching new patients to the most appropriate provider.

One call to tap into the “black market” can eliminate a dozen frustrating calls and dead ends; any solution must also address the many friction points in finding the right care. A tall order for sure, but one that could address one large inequity in our healthcare system: the difference between people who know someone on the inside and those who don’t.

 

 

The growth of private equity investment in physician practice

https://mailchi.mp/192abb940510/the-weekly-gist-february-7-2020?e=d1e747d2d8

Private equity (PE) investment in US healthcare has ballooned over the past decade—2018 and 2019 saw record numbers of deals, representing more than $100 billion in total value. As we show below, in 2018 just under a fifth of these transactions were in the physician practice space, with the largest number of deals in dermatology and ophthalmology.

While these two specialties remain active areas of PE investment, a growing number of recent deals have focused on women’s health, gastroenterology, and urology practices.

Across all these areas, PE firms see an opportunity to grow revenue from high-margin ancillary services, cash procedures, and retail products.

Physician groups are pursuing PE investment as an alternative to joining health systems or large payer-owned physician organizations to access capital and fund buyouts of legacy partners. Doctors’ heads are increasingly being turned by the current sky-high multiples PE firms are offering, often up to 10 or even 12 times EBITA.

Private equity roll-ups of physician practices are far from over. Recent activity suggests that the behavioral health market is heating up, as it remains very fragmented in a time of increasing consumer demand.

And we predict a rush for further investment in cardiology and orthopedic practices, as investors look to profit from the shift of lucrative joint and heart valve replacement procedures to outpatient facilities.

 

Bipartisan Ways and Means leaders unveil measure to stop surprise medical bills

https://thehill.com/policy/healthcare/481985-bipartisan-ways-and-means-leaders-unveil-measure-to-stop-surprise-medical?utm_source=&utm_medium=email&utm_campaign=27536

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The bipartisan leaders of the House Ways and Means Committee on Friday released their legislation to protect patients from getting massive, surprise medical bills as congressional action on the subject intensifies.

The legislation is backed by the panel’s chairman, Rep. Richard Neal (D-Mass.), and its top Republican, Rep. Kevin Brady (Texas). It would protect patients from getting bills for thousands of dollars when they go to the emergency room and one of their doctors happens to be outside their insurance network.

Surprise billing is seen as a rare area of possible bipartisan action this year and has support from President Trump.

But the effort has been slowed by varying approaches and intense lobbying from doctor and hospital groups.

The Ways and Means bill is a rival approach to the bipartisan bill passed out of committee last year by the House Energy and Commerce Committee.

The divide between those two committees will have to be overcome for any bill to move forward.

Neal and Brady said in a statement Friday that their approach “differs” from others because “we create a more balanced negotiation process.”

“Our priority throughout the painstaking process of crafting our legislation has been to get the policy right for patients, and we firmly believe that we have done that,” Neal and Brady said. “We look forward to working with our Democratic and Republican colleagues in Congress, as well as the Administration, to advance this measure swiftly.”

The Ways and Means Committee is planning to vote on the legislation next week.

While all sides in the surprise billing fight agree the patient should be protected, the main dispute has been how much the insurer will pay the doctor once the patient is taken out of the middle. 

Doctors and hospitals have lobbied hard against the Energy and Commerce approach, which they fear would lead to damaging cuts to their payments. That approach sets the payment based on the median rate in that geographic area, with the option of going to arbitration for some high-cost bills.

The Ways and Means approach has generally been seen as more favorable to doctors and hospitals, but industry groups have not yet responded to the details on Friday morning.

The Ways and Means bill gives the decision on how much the insurer should pay the doctor to an outside arbiter, although that arbiter will have to consider the median rate usually paid for that service in making its decision.

The House Education and Labor Committee is also planning to vote on legislation next week, and released a bill on Friday that closely reflects the Energy and Commerce and Senate Health Committee legislation, isolating Ways and Means.

Shawn Gremminger, senior director of federal relations at the liberal health care advocacy group Families USA, said it is “disappointing” that Ways and Means is using an approach that will not lower health costs as much, but he said it is good the process is moving forward.

The Energy and Commerce leaders, along with leaders of the Senate Health Committee, who also back their bill, released a conciliatory statement on Friday about the Ways and Means bill.

“Protecting innocent patients has been our top goal throughout this effort, and we appreciate that the other two House committees share this priority,” said Reps. Frank Pallone Jr. (D-N.J.) and Greg Walden (R-Ore.) and Sens. Lamar Alexnader (R-Tenn.) and Patty Murray (D-Wash.). “We look forward to working together to deliver a bill to the president’s desk that protects patients and lowers health care costs for American consumers.”