Trump’s $4.1 trillion budget: 9 healthcare takeaways

http://www.beckershospitalreview.com/finance/trump-s-4-1-trillion-budget-9-healthcare-takeaways.html

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President Donald Trump’s first full budget proposal will include $3.6 trillion in spending cuts to balance the budget in the next decade.

Although the full $4.1 trillion budget plan, titled “A New Foundation for American Greatness,” will be released Tuesday, Office of Management and Budget Director Mick Mulvaney briefed White House reporters Monday on the budget.

Here are nine of the key proposals related to healthcare in President Trump’s budget proposal for fiscal year 2018, which begins Oct. 1.

1. Medicaid cuts. President Trump’s budget includes $610 billion in Medicaid cuts over 10 years. The reduction is in addition to the $839 billion pulled from Medicaid under the proposed American Health Care Act, the ACA repeal and replacement bill that phases out Medicaid expansion, according to The Hill.

2. Repeal and replace the ACA. The budget assumes passage of the AHCA. The Trump administration expects to save $250 billion over 10 years by repealing and replacing the ACA. These savings are in addition to the $610 billion in proposed Medicaid cuts in the budget, according to The New York Times.

3. Medicare unscathed. The budget makes no changes to the Medicare program or to core Social Security benefits, two programs President Trump vowed during his campaign to leave alone, according to The Hill.

4. Reduction in CHIP funding. Under the budget, $5.8 billion would be cut from the Children’s Health Insurance Program over 10 years, according to a budget document posted by The Washington Post.

5. NIH funding cut. Under the budget proposal, the National Institutes of Health budget would be reduced from $31.8 billion to $26 billion, according to The Washington Post.

6. Cuts to CDC funding. Several CDC programs would be hit with cuts under the budget proposal. One of the biggest cuts is to the agency’s chronic disease prevention programs, which would have funding reduced by $222 million, according to The Washington Post.

7. Veterans Choice Program extended. The budget calls for extension of the Veterans Choice Program, which allows veterans to go outside of the Veterans Affairs system for care. Under the budget, $29 billion more would be spent on this program over 10 years, according to The New York Times.

8. Medical malpractice limits. The budget includes medical malpractice reforms, such as capping awards for noneconomic damages, that are intended to reduce the practice of defensive medicine. The Trump administration expects these changes to save Medicare $31 billion over a decade, according to The New York Times.

9. Funds substance abuse treatment. The budget would allocate $500 million to expand access to treatments, including medication-assisted treatment, for those suffering from opioid addiction. The budget also includes $1.9 billion in block grants for states to use for substance abuse treatment and $25 million for the Substance Abuse and Mental Health Services Administration for expanding access to critical interventions. SAMHSA would also receive an additional $24 million to equip first responders with overdose reversing drugs.

An Association Of Health Funders And The Changing Political Landscape

http://healthaffairs.org/blog/2017/01/19/an-association-of-health-funders-and-the-changing-political-landscape/

As the professional association for health foundations and corporate-giving programs, Grantmakers In Health (GIH) connects the hundreds of health funders who are spread across the American landscape, keeping them up-to-date on rapidly changing developments and providing opportunities for them to share what they’re learning and doing in their respective communities.

Times like now—when dramatic changes to the health care landscape are anticipated—accentuate the importance of this role. In 2017 it will be especially important that we help funders understand, and respond to, significant expected changes in public policies and programs that affect the communities they serve.

We will not simply be in crisis mode, however. Our concern for both informing and shaping the bigger picture of philanthropy’s health and health care priorities is ongoing.

As the year begins, the future of the Affordable Care Act (ACA) is naturally a high priority for us. Health funders are rightly anxious to understand the changes that are likely with a new Congress and presidential administration. Many grantmakers have invested for years at a national or state level to support the implementation of the ACA. They are keenly aware that rolling back the law will have consequences not only for people’s access to health care services, but also, more broadly, for jobs and state economies.

In an immediate response to these concerns, GIH has organized a series of webinars for its membership that offers the perspectives of a range of policy experts. Immediately post-election, these topics included strategies for adapting health reform–related grant making, the future of Medicaid, and the election’s implications for the State Children’s Health Insurance Program (CHIP) and other children’s coverage. Upcoming webinars will include bipartisan views of the new Trump administration’s health priorities and plans, the implications of a possible repeal of the ACA without implementing an immediate “replace” strategy, and the 2016 election’s possible effects on the health of immigrant communities.

Other ACA-related programming will include activities taking place at our annual conference in June, as well as meetings, calls with funders, and publications, including in-depth interviews about foundation strategies. Because changes to the ACA, Medicaid, and other programs will heighten the importance of state-level actions, our 2017 programming will pay special attention to elevating what funders are doing in states and sharing this information nationally.

In addition to this focus on policy changes that will affect access and coverage, we also want to identify health investment areas in which the new administration seems to be interested. We anticipate that addiction, delivery system reform, veterans’ health, and rural health will be on that list.

The top 5 conditions affecting communities, according to new BCBSA tool

http://www.healthcaredive.com/news/blue-cross-blue-shield-health-index/431194/

Mapping technologies and population health make a beautiful pairing. Using geographical data can assist care delivery strategies as tech tools such as GIS can track and trend health data for a community overtime.

“As the move to accountable care and value-based payments takes hold, providers and health plans are increasingly interested in applying GIS to assess risk based on geography and the populations that live there, reveal where the greatest need is, and prioritize areas for interventions,” Danny Patel, account executive for health and human services at GIS software maker Esri, told Healthcare Dive in May.

While providers can look to reduce unnecessary readmissions using such efforts, plans like Blue Cross Blue Shield Association – which recently released its new BCBS Health Index – can use local health data to understand the health of a county/population. The tool, using blinded claims data from more than 40 million commercially-insured BCBS members, identifies the health conditions with the greatest impact on the commercially insured. The tool includes information on over 200 conditions.

“What the health index gives us is the ability to work with local stakeholders…to talk about where we need to focus broader health resources,” Maureen Sullivan, chief strategy and innovation officer at Blue Cross Blue Shield Association, told Healthcare Dive. She said the tool isn’t a “healthiest place to live” navigator but rather a starting point to understand conditions affecting communities and develop peer networks.

Clinton vs. Trump: 5 critical election issues

http://managedhealthcareexecutive.modernmedicine.com/managed-healthcare-executive/news/hillary-vs-trump-5-critical-election-issues?cfcache=true&ampGUID=A13E56ED-9529-4BD1-98E9-318F5373C18F&rememberme=1&ts=25102016

While Hillary Clinton vows to forge ahead with Obamacare if she is elected president, Donald Trump would scrap it altogether. The end results would be two very different forms of healthcare, and industry leaders have much to consider.

Brill“Many different factors are weighing on managed care executives such as the costs of pharmaceuticals, diagnostics and devices; the impact of consolidation amongst hospitals, physicians, health plans; and the losses in the exchange marketplace,” says Managed Healthcare Executive editorial advisor Joel V. Brill, MD, chief medical officer, Predictive Health, LLC, which partners with stakeholders to improve coverage of value-driven care. “With each of these factors, plans can, at least at a high level, make some educated guesses about the relative risk of each factor and impact to the bottom line.”

The election results, however, are much less certain, which from a risk perspective, weighs heavily on the minds of healthcare executives, Brill says. “How can you plan for business knowing that whatever you are doing currently could be upended in the beginning of November?”

To help provide some clarity, Managed Healthcare Executive identified five of the top industry issues, reviewed the candidates’ platforms for each, and asked industry experts to weigh in.

Medicaid plans can now pay mental health institutions. Most won’t until 2017

http://www.modernhealthcare.com/article/20160705/NEWS/160639991

A policy that lifts a 50-year ban on Medicaid pay for mental health institutions kicked in Tuesday, but it may be months before many enrollees can take advantage of the new coverage

Since the creation of Medicaid in 1965, the program has excluded payment for institutions of mental disease (IMDs) for beneficiaries 21 and over. Most residential treatment facilities for mental health and substance-use disorders with more than 16 beds did not qualify for Medicaid reimbursement.

The imposing cost of a single opioid overdose

http://www.metrowestdailynews.com/article/20160521/NEWS/160528946

Framingham firefighter Joe Sylvester, left, holds a Narcan nasal spray as  firefighter Jose Funes looks on at the Loring Street station Tuesday.   (Daily News and Wicked Local Staff Photo/Ken McGagh)

A five- or six-figure bill that doesn’t even include the hospital stay.

http://www.fiercehealthfinance.com/story/imposing-cost-single-opioid-overdose/2016-05-23?utm_medium=nl&utm_source=internal&mrkid=959610&mkt_tok=eyJpIjoiWWpCalpUWXpNREJtWkRjMiIsInQiOiIxSmJGXC9ScEZZSU5icXBzQ2FpYjNER0ljaVV0VGFIRHBVd2RRaEcxNU56elwvbkw5aHkwYTZNaHppSDFlOUlDSndYS1N4dDAzN3l0N0hZbUlMWnh6ZWUyUllqRFhPTHJ1TWxRNUh0bzRCMDBrPSJ9

AJMC: Innovation to manage special populations

AJMC: Innovation to manage special populations

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