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The Rundown | Week of 1.1.2019

The Rundown | Week of 1.1.2019
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CMS Encourages Risk in ACOs

The Centers for Medicare and Medicaid Services (CMS) have announced a revision to the Medicare Shared Savings Program (MSSP) to spur accountable care organizations’ (ACOs) shift to performance-based, downside risk. The “Pathways to Success” initiative is designed to help the 561 ACOs enrolled in the program to transition to value-based contracting by reducing the time window from six to two years before ACOs must take on risk. The change also includes amendments for “new beneficiary incentives, telehealth services, and choice of beneficiary assignment methodology” to comply with the Bipartisan Budget Act of 2018. The revised program’s deadline for applications into the new agreement is July 1.
>>Read More: Final Rule Creates Pathways to Success for the Medicare Shared Savings Program

Mediterranean Diet, Different Benefits for Men and Women

A population-based, case-controlled study that analyzed 1,721 patients and 3,667 controls noted a link between the Mediterranean diet and reduced rates of seropositive rheumatoid arthritis for men. Mediterranean diets include a high intake of plants, seafood, and nuts and a low intake of red meat and processed food. Researchers from the EIRA, Epidemiological Investigation of Rheumatoid Arthritis, controlled for “body mass index, educational level, physical activity, use of dietary supplements, energy intake, and smoking” and used a 124-item dietary questionnaire. A separate study in JAMA Network Open found that, for women, a Mediterranean diet may carry cardiovascular benefits such as a 25 percent lower risk of heart disease as indicated by reduced inflammation and changes in insulin resistance and glucose metabolism.
>> Read More: Mediterranean Diet and Risk of Rheumatoid Arthritis

340B Struck Down, Hospitals Celebrate

Rudolph Contreras, a federal judge, ruled against the Trump administration’s planned cuts to 340B payments for outpatient drugs. The decision came days before the reimbursement reductions were to take place on January 1, 2019. The Department of Health and Human Services (HHS) sought to lower reimbursements by $1.6 billion for the 2,000+ hospitals that participate in the program, which is intended to help low-income patients by providing discounted medications. Groups such as America’s Essential Hospitals and the American Hospital Association petitioned on the grounds that the cuts would harm vulnerable Medicare beneficiaries. The ruling stipulated that hospitals and the federal government have 30 days to create “supplemental briefing[s] on the appropriate remedy.”
>>Read More: Memorandum Opinion: The American Hospital Association, et al., v. Alex Azar, et al.

Asthma Underdiagnosed in Urban Teens

A study in the Journal of Public Health discovered that teens in urban environments are more likely to have asthma and chronic lung disease left undiagnosed or untreated. Researchers surveyed more than 33,000 high-school-aged students in New York City. Among these teenagers, 20 percent reported asthma symptoms yet were never diagnosed — and therefore treated for — the illness. These rates of possibly overlooked diagnoses were especially high among Asian-Americans and females.
>> Read More: Asthma Often Goes Undetected in Urban Teens, Study Finds

Study: Colleges Offering More High-Deductible Health Plans

A survey found a meteoric rise in the number of high-deductible health plans (HDHPs) offered by colleges and universities. From 2016 to 2017, HDHPs increased by five percent while preferred provider organizations’ (PPOs) offerings fell by seven percent. The number of colleges and universities with HDHPs stands at 72 percent, a 13 percent increase in only two years. Norman Jacobson, senior vice president at Sibson Consulting, remarked, “The dramatic increase in HDHPs is a direct result of institutions’ desire to engage faculty and staff in the healthcare purchasing process to promote consumer awareness of the high cost of medical services.”
>> Read More: Study: More Colleges Offer High-Deductible Health Plans

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