Category Archives: Uncategorized

Biotech billionaire in talks with Trump about a senior health care role, sources say

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Biotech billionaire in talks with Trump about a senior health care role, sources say

Dr. Patrick Soon-Shiong, an audacious biotech billionaire who has pledged to “solve health care,” has been in talks with the Trump administration about the possibility of serving in a senior role overseeing the US health care system, according to individuals familiar with the discussions.

Soon-Shiong, a trained surgeon, has met with President Trump and his advisers at least twice in recent weeks. During those discussions, he raised the possibility that he could serve as a “health care czar” with a broad portfolio in the administration as it seeks to reshape the health care system and replace the Affordable Care Act, according to two individuals, who spoke on the condition of anonymity.

Asked about the discussions, an adviser to Soon-Shiong told STAT that the word “czar” had not been used but did not dispute that the biotech mogul has discussed the possibility of taking on a senior role overseeing health care in the Trump administration.

Trump revives policy eliminating funding for foreign groups that provide abortion services

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Trump revives policy eliminating funding for foreign groups that provide abortion services

President Trump on Monday reinstated a US policy preventing foreign nonprofit groups that receive federal funds from administering abortions or providing abortion counseling or referrals.

Originally enacted by President Ronald Reagan in 1984, the “Mexico City Policy” was rescinded by Bill Clinton and Barack Obama — and reinstated by George W. Bush and now Donald Trump — in the first days of each new administration.

Known as the “global gag rule” by pro-abortion rights groups, the Mexico City Policy goes a step further than existing legislation, which prevents federal dollars from being used for abortions. Instead, it prevents organizations that receive any federal funds from paying for their own abortion programs.

Existing legislation known as the Helms Amendment already prevents federal funding of foreign abortions “as a method of family planning,” a restriction abortion rights advocates say has led to excessive interpretation. George W. Bush’s administration clarified that the amendment exempted abortions performed in cases of rape, incest, or when the mother’s life would be endangered by the pregnancy.

Trump’s move forces nonprofit groups to choose between cutting abortion services altogether or looking to fill a major budget gap left by the withholding of federal dollars.

The executive order comes as part of a broader salvo on federally funded abortion and contraceptive coverage.

Separately, a bill under consideration by the House rules committee aims to change the Hyde Amendment, a provision in annual appropriations bills that prohibits federally funded abortions, into permanent law. The proposal would also make employers with insurance plans that cover abortion ineligible for tax credits under the Affordable Care Act.

Trump also issued an executive order on Friday that, depending on how the Department of Health and Human Services interprets it, could eliminate the ACA requirement that private insurers include contraception in their coverage.

Trump’s Vow to Repeal Health Law Revives Talk of High-Risk Pools

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Image result for high risk pools

About 27 percent of people under 65 are thought to have some sort of pre-existing condition that will most likely leave them without individual insurance if the law is repealed, according to a recent study. The guarantee of coverage has already become a rallying cry for people who want to keep the law.

The issue “is the third rail” for the Republicans, said Michael Turpin, a longtime health industry executive.

Before the law, a fairly typical life event — like a divorce or the loss of a job — and a relatively minor medical condition could upend a person’s health coverage options. Stories of sick people unable to get coverage when they needed it most were legion.

Mr. Trump insists he wants to keep the pre-existing requirement for insurers, and other top Republicans say people who want coverage should not be turned away. Details about how they will cover people with existing medical conditions have not yet emerged, but many lawmakers have started pushing an idea — known as high-risk pools — that left many people uncovered or with strict limits to their coverage in the past.

The challenge for lawmakers is this: How do you get insurers to cover people who will definitely need costly medical care — and do so without making insurance too expensive for everyone?

Trump’s Health Plan Would Convert Medicaid to Block Grants, Aide Says

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President Trump’s plan to replace the Affordable Care Act will propose giving each state a fixed amount of federal money in the form of a block grant to provide health care to low-income people on Medicaid, a top adviser to Mr. Trump said in an interview broadcast on Sunday.

The adviser, Kellyanne Conway, who is Mr. Trump’s White House counselor, said that converting Medicaid to a block grant would ensure that “those who are closest to the people in need will be administering” the program.

A block grant would be a radical change. Since its creation in 1965, Medicaid has been an open-ended entitlement. If more people become eligible because of a recession, or if costs go up because of the use of expensive new medicines, states receive more federal money.

If Congress decides to create block grants for Medicaid, lawmakers will face thorny questions with huge political and financial implications: How much money will each state receive? How will the initial allotments be adjusted — for population changes, for general inflation, for increases in medical prices, for the discovery of new drugs and treatments? Will the federal government require states to cover certain populations and services? Will states receive extra money if they have not expanded Medicaid eligibility under the Affordable Care Act, but decide to do so in the future?

 

 

THE HEROISM OF INCREMENTAL CARE

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http://www.newyorker.com/magazine/2017/01/23/the-heroism-of-incremental-care

We devote vast resources to surgeons and the like, while starving the physicians whose steady, intimate care helps many more.

We devote vast resources to intensive, one-off procedures, while starving the kind of steady, intimate care that often helps people more.

Medicare ACO explosion: CMS boasts 570 participants for 2017

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http://www.fiercehealthcare.com/healthcare/cms-more-than-570-new-returning-participants-enroll-medicare-acos-for-2017

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More than 570 Medicare accountable care organizations will participate this year in Centers for Medicare & Medicaid Service models, including the Shared Savings Program, Next Generation ACO Model and The Comprehensive ESRD Care Model, with 131 in a risk-bearing track.

MSSP added 99 new participants and 79 ACOs renewed their commitment to the program, bringing the total number of MSSP ACOs to 480 across all U.S. states, the District of Columbia and Puerto Rico, according to a CMS announcement. Medicare officials have also revealed a new track under MSSP to begin in 2018, the Medicare ACO Track 1+ Model, that offers lower risk to encourage smaller practices and rural hospitals to participate.

After three high-profile members left the Next Generation ACO program last year, many questions emerged about the future of the model. However, the agency said that 28 new participants have joined the Next Generation program for 2017, bringing the total to 45 and more than doubling the number in the program.

Atrius Health is among the new participants in the program for 2017, and in an announcement officials at the Boston-region health system said its previous experience in the Pioneer ACO program have prepared it to take on the higher financial risks associated with the Next Generation model.

“Our experience as a Pioneer ACO has enabled us to build upon our strengths in providing high-quality, coordinated care for our patients across the continuum,” CEO Steven Strongwater, M.D., said in the announcement. “CMS has been an excellent partner in this work, and we look forward to further collaboration and innovation with them in the years to come.”

Joe Damore, vice president for population health, Premier, said the growing number of participants is a “clear signal” that the shift to value-based care will continue.

In an emailed statement, Cliff Gaus, CEO and president of The National Association of ACOs, agreed. “We, along with the ACO community, are feeling confident about the future of the program and we’re looking forwarding to seeing the ACO program grow and stabilize in the coming years,” he said.