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CMS confirmed Tuesday it will cancel two mandatory bundled payment programs and scale back another—and not all hospitals are happy about it.

A rule title posted to the Federal Register on Aug. 10 indicates CMS will cancel two mandatory bundled payment programs, the Advancing Care Coordination through Episode Payment Models (EPMs) and Cardiac Rehabilitation Incentive (CRI) Payment Models, while changing a separate payment program on joint replacements.

Following up on recommendations by his own White House commission, President Donald Trump said he will declare a national public health emergency on the opioid addiction epidemic, which would have an impact on healthcare providers.

In an analysis of what Affordable Care Act (ACA) exchange insurers are requesting to charge customers in 21 major cities in 2018, the Kaiser Family Foundation found the cost for the second-lowest silver-level plan will range from $244 to $631 per month, with most enrollees cushioned from the price hikes by federal subsidies.

The U.S. Senate unanimously passed a bill on Aug. 3 which would allow terminally ill patients the “right to try” experimental treatments that haven’t yet been approved by the Food and Drug Administration (FDA), but critics say it gives patients false hope without allowing for federal oversight.

 

Recent Headlines

Cutting off ACA insurer subsidies would raise—not lower—federal healthcare spending

If the Trump administration’s goal is to lower federal healthcare spending, discontinuing cost-sharing reduction subsidies, or CSRs, to insurers under the Affordable Care Act (ACA) could backfire, according to an analysis from the Kaiser Family Foundation.

Waiving ACA provisions brings mixed signals on whether repeal vote is coming

Republicans in Congress are under pressure from President Donald Trump to quickly push forward on a bill to repeal and replace the Affordable Care Act (ACA), according to multiple news sources, but for each comment saying the majority party is close to an agreement, there seems to be another denying it.

Hospitals give mixed reaction to IPPS proposed rule despite $3.1B boost

CMS released the 2018 Medicare Inpatient Prospective Payment System (IPPS) proposed rule on April 14, promising “transparency, flexibility, program simplification and innovation to transform the Medicare program” in the first IPPS rule under a new CMS and HHS administration.

5 things to know about the final ACA marketplace rule for 2018

CMS has issued its final rule aimed at stabilizing the Affordable Care Act (ACA) health insurance exchanges, checking many items off insurers’ wish lists while leaving the most pressing issue—whether cost-sharing reduction subsidies will be funded—unsettled as insurers decided whether to participate in the individual market next year.

ACA critic, Minnesota health economist Stephen Parente appointed to leadership post at HHS

Stephen Parente, PhD, MPH, MS, brings a long resume as a health economist and policy expert. He’s spent the last 17 years at the University of Minnesota, currently holding the title of Minnesota Insurance Industry Chair of Health Finance in the Carlson School of Management and director of the school’s Medical Industry Leadership Institute.

Florida hospitals asked to detail executive pay info to lawmakers

The Florida House of Representatives is asking the state’s hospitals for “extensive financial data,” according to the Tampa Bay Times, as the chamber considers a state budget with nearly $600 million in cuts affecting those facilities. 

Without subsidies, insurers would need 19% premium hike for ACA plans

The average monthly premium for a benchmark silver-level plan on the Affordable Care Act (ACA) insurance marketplace would need to be increased by 19 percent to compensate for lost cost-sharing subsides if the program isn’t funded by the Republican-controlled Congress for 2018.

Hospitals’ policy priorities beyond ACA repeal

While the debate over repealing, replacing or repairing the Affordable Care Act (ACA) is dominating discussion of healthcare policy in Washington these days, the American Hospital Association (AHA) has several other items on its advocacy agenda for 2017. 

Poll: Trump should ‘do what he can’ to make ACA work

A new Kaiser Family Foundation poll found the majority of Americans—including a slim majority of Republicans—feel that after the failure of the American Health Care Act (AHCA), the administration of President Donald Trump should do what it can to make the Affordable Care Act (ACA) work.

ACA subsidies could go to off-exchange insurers under Republican legislation

If a county finds itself with no participating insurers in the Affordable Care Act (ACA) exchanges in 2018, customers would be allowed to use federal subsidies on insurance outside that marketplace under a bill introduced by Tennessee’s two Republican Senators. 

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