Patient-Provider Communication Disparities By Limited English Proficiency

Using the Medical Expenditure Panel Survey, investigators found that provider-patient communication became worse for individuals with limited english proficiency (LEP) between 2006 and 2010, at a time when communication improved for the population overall. After 2010, a year that marked substantial efforts to reform the U.S. healthcare system, communication for individuals with LEP were better, although linguistic disparities persist. 

More information can be obtained at https://link.springer.com/article/10.1007%2Fs11606-018-4757-3.

Impact Of Work-Limiting Health Shocks On Employment And Income

According to a report from the Urban Institute, researchers found that that each year, on average, 4.2% of adults age 18 to 62 who are in the labor force report developing a new work-limiting health condition or experiencing a new health shock.  Within two years, these workers are three times more likely to have left the labor force than workers who did not experience a health shock. 

The report can be obtained at https://www.urban.org/sites/default/files/publication/100748/how_work-limiting_health_shocks_affect_employment_and_income_0.pdf.

Long-Term Trends In Health Insurance Coverage

As the airwaves and print media provide information about health insurance proposals by candidates seeking to be elected President of the U.S., data from the National Center for Health Statistics (NCHS) describe long-term coverage trends.

Data can be obtained at https://www.cdc.gov/nchs/data/nhis/health_insurance/TrendHealthInsurance1968_2018.pdf.

Two-Year Budget Agreement Sent To President By Congress

The Senate voted 67-28 today to pass and send to the president a two-year budget agreement, the Bipartisan Budget Act of 2019 (H.R. 3877), that increases discretionary funding limits and suspends the debt limit through July 31, 2021. This legislative package is partially offset, including with a two-year extension of mandatory sequestration.

The Budget Act can be obtained at https://www.congress.gov/bill/116th-congress/house-bill/3877.

New Resources On International Education

The American Council on Education (ACE) recently published three new papers covering international perspectives on attainment and inclusion, international student funding, and Intensive English Programs (IEPs). The first is the spring 2019 edition of International Briefs for Higher Education Leaders, which can be obtained at https://www.acenet.edu/news-room/Documents/ACE%20Brief_8_final_3_27.pdf. International Student Funding: Tuition, Fees, and Financial Aid can be obtained at https://www.acenet.edu/news-room/Documents/International_Student%20_Funding.pdf.   Intensive English Programs: Questions and Considerations can be obtained at https://www.acenet.edu/news-room/Documents/IEP%20Questions%20and%20Considerations.pdf.

ASAHP Supports the POST GRAD Act

On Friday, ASAHP joined numerous other associations as part of the Federation of Associations of Schools of the Health Professions (FASHP) in a letter supporting H.R. 3418, the Protecting Our Students by Terminating Graduate Rates that Add to Debt Act or POST GRAD Act. The letter thanks Rep. Judy Chu, the bill’s sponsor, for her leadership. The legislation, which was introduced in the House last month, would make graduate and professional students eligible for subsidized direct federal Stafford Loans.

The bill may be accessed here and the letter may be accessed here.

Promoting Health Equity For Children

A new report from the National Academies of Sciences, Engineering, and Medicine outlines steps needed to move children who are at risk for negative outcomes toward positive health trajectories and reduce health disparities.  

The report can be obtained at http://nationalacademies.org/hmd/Reports/2019/vibrant-and-healthy-kids.aspx.

HHS Invites Comments On Health Literacy Definition For Healthy People 2030

The Department of Health and Human Services (HHS) invites comments on a proposed new health literacy definition for Healthy People 2030, which sets health promotion goals for the nation. The proposed new definition is “Health literacy occurs when a society provides accurate health information and services that people can easily find, understand, and use to inform their decisions and actions.” The deadline for comments is August 5, 2019. 

Instructions on how to comment can be found at: https://www.federalregister.gov/documents/2019/06/04/2019-11571/solicitation-for-written-comments-on-an-updated-health-literacy-definition-for-healthy-people-2030.

Impact Of Erosion Of Employer-Sponsored Insurance On Medicare Beneficiaries

An Issue Brief from the Commonwealth Fund examines coverage trends for Medicare beneficiaries between 2010 and 2016, looking at rates of coverage under employer-sponsored insurance, Medigap supplemental plans, and private Medicare Advantage plans. The proportion of beneficiaries with supplemental employer coverage dropped between 2010 and 2016, particularly for those with low or middle incomes. 

The Issue Brief can be obtained at https://www.commonwealthfund.org/sites/default/files/2019-07/Davis_erosion_ESI_Medicare_financial_burden_ib.pdf.

Protection From Surprise Medical Bills

The National Governors Association (NGA) issued a report on state strategies to protect consumers from surprise medical bills. Eleven states have enacted surprise billing legislation since 2017, including six this year. The report summarizes round table discussions on the issue hosted by the NGA Center for Best Practices Health Division. 

The report can be obtained at https://www.nga.org/wp-content/uploads/2019/05/NGA-Surprise-Medical-Bills-Brief-July-2019.pdf.

Summary of Two Year Budget Agreement

The FY 20 budget agreement provides a 4% increase for domestic programs than in FY 19. A four percent increase is also in marked comparison to the Administration’s budget request for a 10% overall cut to domestic programs.

However,  the Senate now needs to allot funding to each of its twelve Appropriations Subcommittees. They will probably allot less for their Labor-HHS bill than was available in the House, and then go to a House-Senate conference this fall.

Read the budget summary here.

Two Year Budget Agreement in Place

The President moments ago announced a two year budget agreement is in place — the compromise would increase fiscal 2020 spending limits for domestic programs by about 4% above current FY 19 funding levels. For fiscal 2021, which begins Oct. 1, 2020, domestic spending limits would be raised another 1%.

Conservatives had been making an eleventh hour plea circulating a letter for signature to the President urging him not to accept this deal without further concessions from the Democrats, but the President tweeted his approval of the deal and that it “was a real compromise in order to give another big victory to our Great Military and Vets!”. The agreement also contains a two year extension of the debt limit. Assuming the agreement stays in place, a vote will take place before Members depart for the August recess. More details to come.

House Votes To Repeal “Cadillac Tax”

The House of Representatives on the evening of July 18 voted 419-6 to pass legislation (H.R. 748) that would repeal the 40% excise tax on high-value employer-sponsored health plans set to begin in 2022. The tax was scheduled to take effect in 2018 under the Affordable Care Act, but Congress has delayed it several times. According to the Congressional Budget Office and Joint Committee on Taxation, repealing the so-called “Cadillac” tax would reduce federal revenues by an estimated $197 billion. 

The legislation can be obtained at https://www.congress.gov/bill/116th-congress/house-bill/748.

What Can The Private Sector Do In Health Care?

The next health care innovations may not come from large insurers or health plans, but rather from big retail chains like Walmart or even financial services firms. A posting on July 18, 2019 from the Commonwealth Fund examines private-sector efforts to improve quality and reduce costs in health care. 

The post can be obtained at

https://www.commonwealthfund.org/blog/2019/private-sector-takes-health-care.

House Committee Passes Reauthorization of Health Professions Workforce Programs

Earlier today the House Committee on Energy & Commerce passed H.R. 2781, the Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act of 2019 by voice vote. The bill, which reauthorizes the Title VII HRSA health professions workforce programs, also included language from the Allied Health Workforce Diversity Act that was adopted as an amendment at last week’s markup in the Committee’s Health Subcommittee. That language authorizes funding for a new grant program to increase educational opportunities in the professions of physical therapy, occupational therapy, audiology, and speech-language pathology. ASAHP applauds the work of the Committee in passing this legislation, particularly Committee Chairman Frank Pallone, Ranking Member Greg Walden, Reps. Janice Shakowsky and Michael Burgess for their work on Title VII reauthorization, and Reps. Bobby Rush and Cathy McMorris Rodgers for their work on the Allied Health Workforce Diversity Act. 

More information may be accessed here.

Congressional Task Force On Rural And Underserved Communities Launched

The U.S. House Ways and Means Committee today announced the creation of the “Rural and Underserved Communities Health Task Force.” A bipartisan group of four co-chairpersons will lead the new effort, which will convene members and experts to discuss the challenges of delivering health care in rural and underserved areas, and explore holistic bipartisan policy options that could improve outcomes and care in these communities. The group plans to hold its first meeting on July 25.  

More information about the task force can be obtained at https://waysandmeans.house.gov/media-center/press-releases/ways-and-means-committee-launches-rural-and-underserved-communities.

ASAHP Joins Joint Letter on the DREAM Act

ASAHP joined dozens of organizations in a letter to Senate leaders which urges passage of the Dream Act of 2019. The legislation would provide a pathway to citizenship for undocumented young people and those approved for Deferred Action for Childhood Arrivals (DACA), and would ensure that this segment of the health care workforce are able to continue their employment, education, training, and research in the health professions.

The letter may be accessed here.

Dr. Peggy Valentine Named Interim Chancellor at Fayetteville State University

On Friday it was announced that Dr. Peggy Valentine will serve as Interim Chancellor at Fayetteville State University. Dr. Valentine is the Dean at Winston-Salem State University’s School of Health Sciences. She has served on the ASAHP Board of Directors as well as its Diversity, Equity, and Inclusivity, Committee. Dr. Valentine was named an ASAHP Fellow in 2003.

An article may be accessed here.

Medicare Insolvency Projections

Since Medicare’s creation in 1966, the Part A Hospital Insurance Trust Fund always has faced a projected shortfall. The insolvency date has been postponed a number of times, primarily due to legislative changes that have had the effect of restraining growth in program spending. A new report from the Congressional Research Service (CRS) provides historical accounts of various projections and actions that were taken to deal with them. 

The report can be obtained at https://fas.org/sgp/crs/misc/RS20946.pdf.

CMS Proposes Calendar Year 2020 Home Health Update

The Centers for Medicare & Medicaid Services today released a home health prospective payment system proposed rule for calendar year 2020, which would increase payments by a net 1.3% ($250 million). The agency also proposes to allow therapist assistants, rather than only therapists, to perform maintenance therapy enabling them to practice at the top of their state licensure, give flexibility to home health providers, and improve beneficiary access to these services.

The proposed rule can be obtained at https://s3.amazonaws.com/public-inspection.federalregister.gov/2019-14913.pdf.