The Rundown | Week of 10.1.2018

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Happy Primary Care Provider Week! Explore the intersection of population health and primary care in a reader favorite from the archives! 

“Population Health and Primary Care”

National Breast Cancer Awareness Month

Since 1985, every October has been designated Breast Cancer Awareness Month. The goals of the international health campaign are to educate people about the benefits of early screening, promote healthy behaviors that lower cancer risk, and garner donations for more research. In October of 2016 alone, donations to the National Cancer Institute’s program totaled $520 million. According to the Centers for Disease Control and Prevention, breast cancer is the second most common cancer death among women, and in 2018 it is estimated that 266,000 women will be diagnosed with invasive breast cancer. While breast cancer is still a leading cause of death among women, there is hope; from 1975 to 2010, the rate of mortality from breast cancer declined by 34 percent.

Medicare Advantage Monthly Payments at Three-Year Low

Leading up to the 2018 open enrollment period, the Centers for Medicare and Medicaid (CMS) announced that the average monthly payment will be $28, the lowest since 2015. This 6 percent drop means that approximately 83 percent of Medicare Advantage (MA) enrollees who renew their current plan will see savings. The decline is motivated by the increase in coverage options as a high-supply market often drives competition up and cost down. There are 600 more MA plans available in 2019 to accommodate the projected all-time high enrollment of 22.6 million, 11.5 percent more than 2018. This announcement follows an allegation from the HHS’ Office of Inspector General’s allegation that MA may have denied necessary medical procedures and services to create more profit.
>>Read More: Medicare Advantage premiums expected to drop again

Nobel Prize in Medicine Awarded to Cancer Trailblazers

James P. Allison, Ph.D., and Tasuku Honjo, MD, Ph.D., shared the prestigious 2018 Nobel Prize in Physiology or Medicine. Their pioneering research into immunotherapy led to immune checkpoint inhibitor therapy, which targets key immune regulators that shield tumors from treatment. A statement from the Nobel committee stated, “Until the seminal discoveries by the two laureates, progress into clinical development was modest. Checkpoint therapy has now revolutionized cancer treatment and has fundamentally changed the way we view how cancer can be managed.” The doctors separately developed antibodies that bind to CTLA-4 proteins and PD-1 inhibitors, which then triggers the immune system to target tumors. In 2010, Dr. Allison oversaw a clinical trial used the method to achieve “remarkable results” among melanoma patients. In 2013, cancer immunology was recognized as the “breakthrough of the year” by the American Association for the Advancement of Science.
>>Read More: Nobel Prize in Medicine Goes to Cancer Immunotherapy Pioneers

Employer Health Insurance at All-Time High (As Are Premiums)

According to the Employee Benefit Research Institute (EBRI), the percentage of private-sector employers that offer health insurance benefits increased for the first time in almost a decade. Lower unemployment, self-employment, and part-time employment combined with a thriving economy were identified as the primary drivers of this increase. While the Affordable Care Act (ACA) was targeted as a reason for employers to drop coverage options, EBRI researchers discovered that the number of businesses offering health insurance has actually increased. Small businesses especially have increased their offerings, though the cost of health insurance remains the top problem for small businesses (and has since 1986). However, the increase is largely due to the rise of high-deductible health plans with narrow networks, which shift costs to employees. A study from the Kaiser Family Foundation found that employee deductibles rose 4.5 percent in 2017 alone for an average cost of $1,573. Researchers found that the average family premium has increased 55 percent since 2008, twice as fast as wages and three times the rate of inflation.
>>Read More: Employer-based health insurance offerings increase for first time in decade

Opioid Crisis Focus of Recently Passed Health Appropriations Bill

On September 28, President Trump signed into law an appropriations bill that increased funding to the National Institutes of Health’s budget for medical research, particularly the opioid crisis, by $2 billion. The bill also included $317 million to combat the decline of rural health centers ($1 million of which was earmarked for expanding telehealth capabilities), $1.5 billion in State Opioid Response Grants, $765 million to CMS to detect and correct fraud, and other measures. Further legislation to address the opioid epidemic also passed the House of Representatives the same day as the appropriations law was ratified. The proposed law seeks to halt a funding ban that prevents Medicaid beneficiaries from receiving inpatient treatment for addiction at psychiatric institutions.
>>Read More: Congress Passes Healthcare Appropriations Bill