Projected Impact Of Medicaid Work Requirements On Beneficiaries And Spending

New community engagement waivers could impact approximately 1.7 million Medicaid beneficiaries in 10 states, about half of the beneficiaries in those states, according to an analysis by PwC’s Health Research Institute (HRI). Section 1115 waivers which require some beneficiaries to work or otherwise engage in some kind of defined activity for a specified number of hours per week or month, are being approved by CMS, which is encouraging states to develop and apply for them. The waivers could lead to reductions in Medicaid populations, with implications for hospitals and health systems serving high proportions of patients covered by Medicaid.

The report can be obtained at https://www.pwc.com/us/en/health-industries/health-research-institute/publications/pdf/pwc-health-research-institute-medicaid-1115-waivers-insight.pdf.

Fostering Collaboration To Support A Culture Of Health

The organization AcademyHealth and the Network for Regional Healthcare Improvement convened five multi-sector teams led by regional health improvement collaboratives (RHICs) and content experts to inform next steps in the teams’ specific community-based collaborative projects. An Issue Brief describes progress over the course of the year.

The Issue Brief can be obtained at http://www.academyhealth.org/sites/default/files/fostering_collaboration_for_culture_of_health_feb2018_0.pdf.

Economic Impact Of Medical Schools And Teaching Hospitals

According to a new report from the Association of American Medical Colleges (AAMC), U.S. medical schools and teaching hospitals represented by the AAMC generated about 3.1% of the U.S. gross domestic product and supported 6.3 million jobs. Many kinds of allied health professionals work in these teaching hospitals.

The report can be obtained at https://www.aamc.org/data/486632/economicimpactreport.html.

Racial, Ethnic, And Gender Disparities In The Health Care Advantage Program

A new report from the Centers for Medicare & Medicaid Services’ Office of Minority Health examines racial, ethnic, and gender differences on 27 clinical quality and eight patient experience measures for beneficiaries with Medicare Advantage health and drug plans in 2015-2016. The data are from the Healthcare Effectiveness Data and Information Set and the Consumer Assessment of Healthcare Providers and Systems survey. 

The report can be obtained at https://www.cms.gov/About-CMS/Agency-Information/OMH/Downloads/2018-National-Level-Results-by-Race-Ethnicity-and-Gender.pdf.

Burden Of Diseases/Injuries/Risk Factors Among U.S. States

An article that appeared in today’s issue of the Journal of the American Medical Association describes a study involving examination of 333 causes and 84 risk factors, demonstrating that health in the U.S. improved from 1990 to 2016, although the drivers of mortality and morbidity have changed in some states, with specific risk factors such as drug use disorders, high body mass index (BMI), and alcohol use disorders being associated with adverse outcomes. In five states, the probability of death between ages 20 and 55 years has increased more than 10% between 1990 and 2016.

The article is available for free from the journal.

2018 Health Insurance Exchange Enrollment Data

The Centers for Medicare & Medicaid Services (CMS) has released the Final Enrollment Report for the 2018 Health Insurance Exchanges showing approximately 11.8 million consumers selected or were automatically re-enrolled in an Exchange plan in the 50 states, plus DC. The amount includes 8.7 million consumers in the 39 states using Healthcare.gov and 3 million consumers in State-based Exchanges.

More information can be obtained at https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2018-Press-releases-items/2018-04-03.html.

Transitioning The U.S. National Vital Statistics System Into the 21st Century

The National Vital Statistics System makes it possible to track indicators of health status for the population at the national, state, and local levels, including disparities by age, sex, race and ethnicity, and detailed geography. The data are invaluable for identifying populations at risk, program planning, and developing initiatives to target health disparities. Anew report updates previous histories to reflect developments and changes over the past two decades that have been extraordinary and far-reaching.

The report can be obtained at https://www.cdc.gov/nchs/data/series/sr_01/sr01_062.pdf.

Geographic Distribution Of Student Debt

According to a report from the Urban Institute, little attention has been given to the geographic distribution of student loans and how it relates to cost of attending college in a state. The states where the largest shares of college students have student debt are in the Midwest and the Northeast. The Western region of the country has the lowest share of college students with student loans. The share of the college-going population with student loans in a state is positively associated with the average cost of attending a public four-year institution.

The report can be obtained at https://www.urban.org/sites/default/files/publication/97751/where_is_student_debt_highest_0.pdf.

Improving Population Health

To reduce health care spending overall and have a healthier population, communities have to spend smarter. They need to incentivize the health care and non-health care sectors to integrate social services and identify innovative funding and financing models to support this integration and contribute to population health improvements. Since all health is local, regional collaboratives can have important roles to play in addressing this challenge. A brief from AcademyHealth describes these potential roles.

The brief can be obtained at http://www.academyhealth.org/sites/default/files/regional_collaboratives_financing_pop_health_feb2018.pdf.

Rankings Of U.S. Healthiest Communities

The U.S. News Healthiest Communities rankings measure crucial health-related components of society with the aim of empowering citizens, health care leaders and officials to make decisions about policies and practices that can improve health outcomes for all. Guided by a pioneering framework developed by a committee appointed to advise the U.S. Department of Health and Human Services, the project scores nearly 3,000 counties on approximately 80 indicators across 10 categories that drive health outcomes. 

The rankings can be obtained at https://www.usnews.com/news/healthiest-communities/rankings.

Medicaid And CHIP Enrollment Increases 2013-2018

Approximately 16.4 million individuals enrolled in Medicaid or the Children’s Health Insurance Program between October 1, 2013 and January 31, 2018, increasing total enrollment in the programs by 29% since the start of the first open enrollment period for the Health Insurance Marketplace, according to a report that was released by the Centers for Medicare & Medicaid Services. More than 72.9 million beneficiaries were enrolled in Medicaid or CHIP in those states as of January 31, with Medicaid expansion states showing a 38% increase and non-expansion states showing a 12% increase. The Health Insurance Marketplace concluded its fifth open enrollment period in mid-December 2018.

The report can be obtained at file:///C:/Users/Owner/AppData/Local/Temp/Temp1_january-2018-enrollment-data.zip/January%202018%20Enrollment%20Report.pdf.

Who Struggles Most To Repay Student Loans?

More than 40 million Americans hold student loans. During the past decade, the amount of outstanding debt from federal student loans jumped from more than $500 billion to over $1.3 trillion, surpassing all categories of household debt other than mortgages. A panel discussion arranged by the Pew Charitable Trusts discussed which borrowers might be at risk for delinquency and default.

More information can be obtained at http://www.pewtrusts.org/en/research-and-analysis/analysis/2018/03/20/who-struggles-most-to-repay-student-loans?hd&utm_campaign=2018-03-28+PNN&utm_medium=email&utm_source=Pew.

State Higher Education Finance

For the first time in U.S. history, more than half of all states relied more heavily on tuition dollars to fund their public systems of higher education than on government appropriations, despite increased state and local support for public colleges and universities, according to the State Higher Education Finance (SHEF) FY 2017 report, a comprehensive, nonpartisan analysis of educational appropriations, tuition revenue, and enrollment trends in all 50 states, released by the State Higher Education Executive Officers Association (SHEEO).

The report can be obtained at http://www.sheeo.org/sites/default/files/SHEF_FY2017.pdf.

The Role Of Nursing In Enhancing Patient Health Literacy Skills

The American Academy of Nursing on Policy has addressed the importance of enhancing health literacy skills in health care systems and community health care settings. The overarching goal of policy statement is to influence policy in three domains—practice, systems of care, and partnerships—to minimize the gap between patient skills and abilities and the demands and complexities of health care systems.

More information about this policy can be obtained at http://www.nursingoutlook.org/article/S0029-6554(17)30628-0/pdf.

Effects Of Tuition Increases On Racial/Ethnic Diversity At Public Institutions

Results of a study suggest that tuition increases at open-access, non-selective public four-year institutions are associated negatively and significantly with the racial/ethnic diversity of enrolled students. This same negative relationship can be seen among two-year public institutions. The effects are more pronounced in full-time, first-time freshmen as compared to the overall full-time campus population.

Additional information can be obtained at https://link.springer.com/article/10.1007%2Fs11162-018-9502-6.

The National Health Service Corps

The National Health Service Corps (NHSC) is a clinician recruitment and retention program administered by the Bureau of Health Workforce in the Health Resources and Service Administration (HRSA) that aims to reduce health workforce shortages in underserved areas. Under its three components, health providers receive either scholarships or loan repayments in exchange for a service commitment at an NHSC-approved facility located in a federally designated health professional shortage area (HPSA).

A Congressional Research Service report that provides information about this program can be obtained at https://fas.org/sgp/crs/misc/R44970.pdf.

Changes In Marketplace Insurance Premiums 2017-2018

A new report from the Urban Institute delineates factors that contributed to large 2018 marketplace health insurance premium increases, provides state-by-state estimates of average premium increases in silver (70 percent actuarial value) and gold (80 percent actuarial value) plans in the marketplaces, and provides more detailed analysis of changes in select markets within 20 states.

The report can be obtained at https://www.urban.org/sites/default/files/publication/97371/changes_in_marketplace_premiums_2017_to_2018_0.pdf

House Passes FY 2018 Omnibus Appropriations Bill

The House of Representatives today voted 256-167 to approve an omnibus spending bill to fund federal discretionary programs through September. The $1.3 trillion bill, released last night after an agreement by congressional leaders and the White House, includes $88.1 billion for Department of Health and Human Services programs, a $10.1 billion increase from fiscal year 2017. The current continuing resolution (CR) funding the government expires tomorrow at midnight.

The bill can be obtained at http://docs.house.gov/billsthisweek/20180319/BILLS-115SAHR1625-RCP115-66.pdf.

Medicare Advantage And Medicaid Managed Care Financial Performance

While many health plans increasingly regard Medicare Advantage and Medicaid managed care as growth engines, a recent analysis indicates that health plan financial performance in these segments between 2011 and 2016 varied widely, with significant differences related to scale, tenure, and geography. Six key findings are described in a new report from Deloitte.

The report can be obtained at file:///C:/Users/Owner/Downloads/us-health-plan-financial-trends-2018.pdf.