The Rundown | Week of 10.21.2019

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CMS Asks Private Sector for AI Advice

The Centers for Medicare & Medicaid Services (CMS) sent out a request for information (RFI) “to obtain input on how the agency can better use emerging technologies. The agency was specifically interested in artificial intelligence “to ensure proper claims payment, reduce provider burden, and overall, conduct program integrity activities in a more efficient manner.” The stated goal of the RFI was to “elevate program integrity, unleash the power of modern private sector innovation, prevent rather than chase fraud waste and abuse through smart, pro-active [sic] measures, and unburden our provider/supplier partners so they can do what they do best – put patients first.”
>> Read More: Request for Information on Using Advanced Technology in Program Integrity

Bipartisan Bill to Boost Rural ACOs

Two senators have introduced a bill that would potentially increase reimbursements for rural accountable care organizations (ACOs). Senators Catherine Cortez Masto (D-Nev.) and Pat Roberts (R-Kan.) are the sponsors of the Rural ACO Improvement Act. The bill would amend “title XVIII of the Social Security Act to improve the benchmarking process for the Medicare Shared Savings Program (MSSP) to ensure that all ACOs have an equal opportunity to share in savings regardless of their geographic location,” according to a letter from the National Association of ACOs (NAACOS). Experts explained: “This legislation fixes an important flaw in the current MSSP benchmarking methodology – a flaw that systematically disadvantages ACOs in rural areas and makes it harder for them to achieve savings even when they improve quality and reduce costs on par with their counterparts in urban areas.”
>> Read More: Rural Glitch Support Letter

HealthCare.Gov Premiums Dropped 4 Percent

Premiums for insurance plans available through HealthCare.gov dropped 4 percent, though experts note that the plans are still unaffordable to many without subsidies. The benchmark plan is “the second lowest cost silver plan … for a 27 year-old.” Alex Azar, secretary of the Department of Health and Human Services (HHS), said: “Lower costs and more options for American patients are a key piece of President Trump’s healthcare vision: an affordable, patient-centric system that puts you in control, and treats you like a person, not a number.” However, “average premiums are still too high and affordability remains a substantial challenge for people who do not qualify for a tax credit and must pay the entire premium themselves.” Researchers pointed to the 2.5 million people who left the healthcare marketplace because they didn’t receive federal premium tax credits that curb costs.
>> Read More: Premiums for HealthCare.gov Plans Are Down 4 Percent but Remain Unaffordable to Non-Subsidized Consumers

Report: Burnout Affects Up to 54 Percent of Clinicians, 60 Percent of Residents

According to a recent report from the National Academy of Medicine, between “one-third and one-half of U.S. clinicians experience burnout.” Furthermore, researchers concluded that “addressing the epidemic requires systemic changes by health care organizations, educational institutions, and all levels of government.” The report also found that “45 to 60 percent of medical students and residents” also experienced burnout. Researchers identified six goals to combat the epidemic: create positive work environments; address burnout in training and at the early career stage; reduce tasks that do not improve patient care; improve usability and relevance of health IT; reduce stigma and improve burnout recovery services; and create a national research agenda on clinician well-being.
>> Read More: Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being

Study: Walking Speed Linked to Aging

Researchers discovered that the “speed of one’s gait” may “serve as an integrative measure of physical and cognitive health.” Research participants were measured beginning at age 3, and regular follow-up studies occurred for more than 40 years. The study’s authors noted that walking speed involves “an interplay of the musculoskeletal, visual, central nervous, and peripheral nervous systems, as well as aerobic capacity, cardiorespiratory fitness, and energy production and delivery.” This complex combination of functions led researchers to discover that “slow gait speed measured at age 45 years was “associated with physical and biological indicators of accelerated aging, as well as poor neurocognitive functioning.”
>> Read More: Slower Walking in Midlife May Predict Faster Aging

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