Learning From Health Care Setbacks To Achieve Success

Failure is essential to innovation, but few health care organizations see setbacks as learning opportunities that can help achieve goals of improving health and reducing cost. A Commonwealth Fund report shares lessons from innovators who overcame obstacles to implementing new ways of delivering care.

The report can be obtained at https://www.commonwealthfund.org/sites/default/files/2019-09/Klein_course_corrections_hlt_innovators.pdf.

Health Care Employment Data

Employment at the nation's hospitals increased in August 2019 to a seasonally adjusted 5,253,200 employees, according to a Bureau of Labor Statistics report. That figure is 8,800 more than in July and 97,400 more than a year ago. Overall, the health sector increased in August to a seasonally adjusted 16,436,700 employees, representing an increase of 23,900 more than in July and 367,000 more than one year ago.

The report can be obtained at https://www.bls.gov/news.release/empsit.t17.htm.

Changes In Enrollment In The Individual Health Insurance Market Through Early 2019

Following the implementation of the ACA, the individual health insurance market grew rapidly. A new analysis measures changes in enrollment in the individual market before and after the ACA’s coverage expansions and market rules went into effect in 2014 through the first quarter of 2019.

The analysis can be obtained at https://www.kff.org/private-insurance/issue-brief/data-note-changes-in-enrollment-in-the-individual-health-insurance-market-through-early-2019/.

Hospital Mergers Enhance Patient Quality And Cost Reduction

Hospital Merger Benefits: Views from Hospital Leaders and Econometric Analysis – An Update, is a report from Charles River Associates that updates a 2017 report. The latest findings both reinforce and strengthen the previous report’s conclusions that hospital mergers can generate significant value for patients and their communities in the form of better care and reduced costs.

 The report can be obtained at https://www.aha.org/2019-09-04-charles-river-associates-report-hospital-merger-benefits.

Role Of Three Federal Departments In Influencing Health

While the U.S. Department of Health and Human Services has a substantial responsibility in advancing the health of the nation, other federal departments and agencies also can have a significant impact on disease prevention and health promotion. Health in All Policies (HiAP) is a strategy that considers the factors that influence health across all levels of policymaking to improve health outcomes. A report from the Bipartisan Policy Center explores how the U.S. Department of Education (ED), U.S. Department of Treasury (Treasury), and U.S. Department of Labor (DOL) currently implement a HiAP approach and how these departments can build on these efforts. 

The report can be obtained at https://bipartisanpolicy.org/wp-content/uploads/2019/08/Health-in-All-Policies.pdf.

Confidence In Higher Education Declining

As students return to campus, the Pew Research Center reports that new survey results show that only half of Americans think colleges and universities are having a positive effect on the way things are going in the U.S. these days, and 61% indicate that the higher education system is moving in the wrong direction. 

The report can be obtained at https://www.pewsocialtrends.org/essay/the-growing-partisan-divide-in-views-of-higher-education/?utm_campaign=2019-08-28+Rundown&utm_medium=email&utm_source=Pew.

International Perspective On The Paradoxes Of U.S. Health Care

Premium Contributions And Cost-Sharing For Families With Large Employer Coverage

According to a brief from the Peterson-Kaiser Health System Tracker, as health costs rise, enrollees in large employer plans face higher health spending both through rising premium contributions and increased cost-sharing when they use services. On average, health spending by families with large employer health plans has increased two times faster than workers’ wages over the last decade. This increase has been driven in part by rising deductibles. 

The brief can be obtained at https://www.healthsystemtracker.org/brief/tracking-the-rise-in-premium-contributions-and-cost-sharing-for-families-with-large-employer-coverage/.

ACA’s Individual Health Insurance Market’s Resemblance To The Group Market

A posting from the Commonwealth Fund discusses the alignment between the Affordable Care Act’s individual market and the small- and large-group markets.  

The posting can be obtained at https://www.commonwealthfund.org/blog/2019/individual-health-insurance-market-looking-more-group-market-under-affordable-care-act.

CMS To Require Five-Star Quality Rating System For Plans On Health Insurance Exchanges

For the first time, the Centers for Medicare & Medicaid Services (CMS) will require the display of the five-star Quality Rating System available nationwide for health plans offered on the Health Insurance Exchanges beginning with the 2020 Open Enrollment Period November 1, 2019 to December 15, 2019. Star ratings are based on a number of important factors, including how other enrollees rate physicians in the plan’s network and the care they receive, how well the plan’s network providers coordinate with enrollees and other physicians to give members healthcare that achieves the best results, and overall administration of the plan including customer service and availability of information. 

Additional information can be obtained at https://www.cms.gov/newsroom/fact-sheets/health-insurance-exchange-quality-ratings-system-101.

Final “Public Charge” Rule Involving Immigration

Earlier this week, the Trump administration revealed its long-anticipated final “public charge” rule, a policy change that effectively would punish legal immigrants who use their Medicaid coverage to help pay for nonemergency medical care. A posting on the website of the Commonwealth Fund comments on the rule. 

The posting can be obtained at https://www.commonwealthfund.org/blog/2019/new-public-charge-rule-affecting-immigrants-has-major-implications-medicaid-and-entire?redirect_source=/blog/2018/new-public-charge-rule-affecting-immigrants-has-major-implications-medicaid.

IPEC Fall 2019 Faculty Institute Early Bird Pricing Ends Thursday

The Fall 2019 IPEC Institute, Strengthening Partnerships for IPE and Collaborative Practice, will provide health professions educators, administrators, practitioners, and other interprofessional partners the opportunity to advance their existing institutional interprofessional education for collaborative practice (IPECP) programs.

Space is limited, so register as soon as possible. Interested teams and individual learners are strongly encouraged to apply today for early bird pricing! Register before August 15 to save $100 off the regular rate. For more details or to enroll, visit the Fall 2019 IPEC institute website or contact IPEC Associate Director Shelley McKearney at smckearney@aacnnursing.org

CMS Reports On Declining Enrollment For The Unsubsidized Population

The Centers for Medicare & Medicaid Services (CMS) released two reports, the “Early 2019 Effectuated Enrollment Report” and “Trends in Subsidized and Unsubsidized Enrollment Report.” They provide information on the stability of the individual health insurance market during the 2018 plan year as well as offering preliminary insights into the market for 2019.  

The Early 2019 Effectuated Enrollment Report can be obtained at  https://www.cms.gov/newsroom/fact-sheets/early-2019-effectuated-enrollment-snapshot and the Trends in Subsidized and Unsubsidized Report can be obtained at  visit: https://www.cms.gov/CCIIO/Resources/Forms-Reports-and-Other-Resources/Downloads/Trends-Subsidized-Unsubsidized-Enrollment-BY17-18.pdf.

Projected Impact Of Increasing Hospital Prices

A new brief from UnitedHealth Group finds that hospital prices increasing at current rates could end up costing $250 billion over the next decade. The report indicates that prices set by hospitals for services, and not physician salaries or how much hospital services are used, are what’s driving up patients’ spending.  

The brief can be obtained at https://www.unitedhealthgroup.com/content/dam/UHG/PDF/2019/Hospital-Prices-Drive-Inpatient-Spending.pdf.

Explaining Support Or Opposition To Medicare For All

A new brief from the Urban Institute assesses public support for Medicare for All proposals and some incremental reforms for expanding health insurance coverage. The examination focuses on individuals with different characteristics as well as important factors to adults who support, oppose, or are ambivalent. 

The brief can be obtained at https://www.urban.org/sites/default/files/publication/100752/what_explains_support_or_opposition_to_medicare_for_all_final_v2.pdf.

Negative Impact Of A Medicare Public Option On Rural Hospitals

A government insurance program reimbursing at Medicare rates as a public option on the health insurance exchanges would have the potential to place as many as 55% of rural hospitals across 46 states at high risk of closure, according to a report by Navigant Consulting Inc.  

More information about the report can be obtained at https://www.navigant.com/insights/healthcare/2019/the-potential-impact-of-a-medicare-public-option.

Next Steps In Chronic Care

A new analysis released by the Bipartisan Policy Center demonstrates that providing non-medical benefits, such as home-delivered meals tailored to a targeted group of individuals with chronic conditions in Medicare fee-for-service, could help avert hospital readmissions. It also shows a possible savings of $1.57 per patient for every dollar spent on the meals program.  

The report can be obtained at https://bipartisanpolicy.org/wp-content/uploads/2019/07/Next-Steps-in-Chronic-Care.pdf.