In Inaugural Speech, Trump Silent on Health Care

https://morningconsult.com/2017/01/20/in-inaugural-speech-trump-administration-silent-on-health-care/

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President Donald Trump did not mention health care in his inaugural address Friday, and the new administration’s website did not have any immediate details on its health policy.

Trump has said he would put forth his own health care plan once his nominee to lead the Department of Health and Human Services, Rep. Tom Price (R-Ga.), is confirmed and in office.

Overhauling the Affordable Care Act has been cited as the top priority for both congressional Republicans and Trump, making its absence from Friday’s speech noteworthy. House Minority Leader Nancy Pelosi wore a lapel pin that read “#ProtectOurCare” at the inauguration, an ode to the Democratic Party’s efforts to defend former President Barack Obama’s signature health care law.

It’s still not clear when Price could be confirmed as HHS secretary. He’s scheduled to testify before the Senate Finance Committee, which will vote on his nomination, Tuesday.

Trump is expected to sign executive orders related to health care in the first days of his presidency.

The Problems With ‘Repeal And Delay’

http://healthaffairs.org/blog/2017/01/03/the-problems-with-repeal-and-delay/

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Republican leaders in Congress and the incoming Trump administration have said that they plan to move quickly to repeal the Affordable Care Act (ACA) in the early weeks of 2017, with a delay in the date of when key aspects of the repeal would become effective until perhaps 2019 or 2020. This is the so-called “repeal and delay” option. They have also pledged to replace the law in separate legislation, or a series of bills, that would come later, although it is not clear what the replacement would look like or when it would pass.

We do not support this approach to repealing and replacing the ACA because it carries too much risk of unnecessary disruption to the existing insurance arrangements upon which many people are now relying to finance their health services, and because it is unlikely to produce a coherent reform of health care in the United States. The most likely end result of “repeal and delay” would be less secure insurance for many Americans, procrastination by political leaders who will delay taking any proactive steps as long as possible, and ultimately no discernible movement toward a real marketplace for either insurance or medical services.

Congress should instead roll back elements of the ACA in the same legislation that moves U.S. health care more deliberately toward a functioning marketplace that is less dependent on federal coercion and control. This approach provides the best chance of constructing a replacement plan that moves decisively in a better direction without unnecessarily creating chaos during the transition.

Universal Access And Delegation To States: Examining Two Currents In ACA Replacement Plans

http://healthaffairs.org/blog/2017/01/20/universal-access-and-delegation-to-states-examining-two-currents-in-aca-replacement-plans/

As we draw nearer to the time when the Trump administration may unveil its proposals for reforming the Affordable Care Act and the Republicans in Congress may coalesce around a single repeal and replace proposal, two ideas are surfacing that should be addressed and explored—setting a goal of “universal access” rather than “universal coverage” and shifting responsibility for ACA replacement to the states. This post looks at the challenges involved in operationalizing these concepts.

Precision Medicine Has Bipartisan Support, Proponents Assure Amid Trump Administration Transition

https://360dx.com/cancer/precision-medicine-has-bipartisan-support-proponents-assure-amid-trump-administration?utm_source=TrendMD&utm_medium=TrendMD&utm_campaign=1

Precision Medicine2

At a cocktail reception in Boston last week ahead of an annual meeting on personalized medicine, attendees milled around not talking about the latest advances in genomics or the challenges of companion diagnostics development. They were too preoccupied with the impact of the Presidential elections the week before.

Will the new administration value genomics research and personalized medicine projects going on around the country that depend on government funding? How will a change in administration and priorities impact projects such as the Precision Medicine Initiative (PMI) and the Cancer Moonshot? Who will head up the US Department of Health and Human Services, the National Institutes of Health, and the US Food and Drug Administration? And will these new government officials continue efforts of the last administration to advance data sharing, privacy protections, and integrated systems critical for the implementation of personalized medicine?

 

Oncology, rare diseases and too little genomic diversity: 3 themes from #JPM17

Oncology, rare diseases and too little genomic diversity: 3 themes from #JPM17

Meet Overhead view of two business persons in the lobby

As always, the J.P. Morgan Healthcare Conference played host to wider debates about the health and direction of the life sciences in 2017.

Drug pricing was part of the discussion (Trump made his splash mid-week). Gender diversity came to the fore in 2016 and made headways at this year’s event.

Beyond the conference agenda and the breaking news, however, three underground themes were playing out at Bioweek.

Geisinger Health System CEO launches population health initiative

Geisinger Health System CEO launches population health initiative

From left: Steve Krein (moderator) Esther Dyson, Dr. David Feinberg, Dr. Richard Zane

Geisinger Health System CEO Dr. David Feinberg used the StartUp Health Festival to launch its population health initiative, Springboard Health during the J.P. Morgan Healthcare Conference in San Francisco this week.

Starting with Springboard Healthy Scranton, the program will work with Scranton, Pennsylvania residents on helping them to manage diabetes, obesity and behavioral health needs. It will also help individuals gain access to healthy food by leveraging food banks.

The program launch was part of a wider panel discussion on building innovation hubs with the panelists reaching a similar conclusion — that hospitals and health systems need to work with their communities to transform themselves or risk being disrupted in ways they can’t control.

In an interview with MedCity News, when asked what Feinberg has learned from hospital public health initiatives, for better or worse, Feinberg said he wanted to avoid the kind of piecemeal initiatives that Geisinger, admittedly, has done as well.

“A lot of times health systems do a community needs assessment because it’s a requirement and when it comes back, obesity is an issue, transportation is an issue, access to care is an issue, mental health is an issue. But then, no one does anything with that data but put it on the shelf until you do the report the next year. Then they’ll have a health fair, do some health screenings and we are guilty of all that too. So it is sort of piecemeal, not consistent and never really brings everybody into the community together and says, ‘We will do this together’.”

Feinberg noted that Springboard Healthy Scranton would include elements such as a fresh food pharmacy — an initiative that “prescribes” a food program for diabetic, food-insecure patients. The initiative will also pull together data, genomics, and double down on community involvement in an interesting combination of population health and personalized medicine.

Geisinger will do DNA sequencing for Scranton area program participants so they can receive information about serious genetic conditions they may be at risk for yet unaware of. The idea is to do early testing and get a diagnosis earlier to improve the long-term outlook for those individuals.

“It is about how we can engage with our community and benefit from our community,” Feinberg said.

Oregon policy center says health industry should fill budget gap

http://www.bizjournals.com/portland/news/2017/01/19/oregon-policy-center-says-health-industry-should.html

Hospitals should pay more to help fill a budget gap in the Oregon Health Plan, the Oregon Center for Public Policy argues.

Since the Oregon health care industry has benefited from the Affordable Care Act, it should chip in more to fill a looming hole in the Medicaid budget, a new report from the Oregon Center for Public Policy concludes.

The report by policy analyst Janet Bauer says Medicaid is a “great deal” for Oregon. It triggers a multi-billion dollar investment by the federal government into the state’s economy. Federal funds cover 75 percent of the Oregon Health Plan in the 2017-19 biennium.

But the health plan is facing an $882 million budget shortfall starting later this year, as the federal government contribution to the Medicaid expansion population dwindles.

The Center for Public Policy is calling on the state to increase the existing tax on hospital revenue, reinstate a tax on managed care organizations and consider new taxes on other types of health care providers.

“The Affordable Care Act, and the Medicaid expansion in particular, have proved to be a boon for much of the health care industry,” Bauer said in the report. “Net patient revenues at Oregon hospitals have increased sharply since the time major federal reforms came into effect. Meanwhile, hospitals’ charity care — a justification for their nonprofit status — has plummeted because many more Oregonians are able to pay for hospital care through newly-acquired insurance.”

Gov. Kate Brown’s proposed budget includes a hike in the hospital tax and reinstatement of a tax on health insurers.

Andy Davidson, president and CEO of the Oregon Association of Hospitals and Health Systems, said hospitals have a history of helping Medicaid fill budget gaps, back to the inception of the original hospital tax program in 2003.