HHS Creates Federal Healthcare Advisory Committee
The Department of Health and Human Services (HHS) announced the creation of a Federal Healthcare Advisory Committee, which will drive reforms to restore patient-centered care in the healthcare system. The committee would be a group of experts charged with delivering strategic recommendations to improve how care is financed and delivered across Medicare, Medicaid and the Children’s Health Insurance Program (CHIP), and the Health Insurance Marketplace. Further, the committee would find ways to cut waste, reduce paperwork, expand preventive care, and modernize CMS programs with real-time data and accountability. CMS is currently accepting nominations for committee members and is looking for experts in chronic disease management, financing in federal health programs, and delivery system reform. Individuals can either be nominated by an organization or submit a nomination for themselves.
The advisory committee will focus on developing:
- Actionable policy initiatives to promote chronic disease prevention and management;
- Opportunities for a regulatory framework of accountability for safety and outcomes that reduce unnecessary red tape and allow providers to focus on improving patient health;
- Levers to advance a real-time data system, enabling a new standard of excellence in care, rapid claims processing, rapid quality measurement, and rewards;
- Structural opportunities to improve quality for the most vulnerable in the Medicaid program; and
- Sustainability of the Medicare Advantage (MA) program, identifying opportunities to modernize risk adjustment and quality measures to assess and improve health outcomes.
Additional article: https://www.cms.gov/newsroom/press-releases/hhs-drives-reform-restore-patient-centered-care-announces-request-nominations-members-serve-federal
#cms #hhs #medicare #medicaid #chip #healthcarereform #coverage #interoperability #fwa #exchanges #maha
https://www.fiercehealthcare.com/regulatory/hhs-form-committee-offers-guidance-medicare-medicaid
United Creates New Board Committee
In its continuing efforts at reform, financially beleaguered and often chastised UnitedHealth Group announced it has created a new public responsibility committee. Meant to provide an additional level of governance, the committee will monitor and oversee financial, regulatory, and reputational risks. It will oversee areas where it has struggled or faced public scrutiny, including underwriting and forecasting, regulatory relationships, reputational matters, and M&A.
Additional articles: https://www.healthcaredive.com/news/unitedhealth-board-committee-reputational-regulatory-risks/758246/ and https://www.beckerspayer.com/executive-moves/unitedhealth-names-lead-independent-director-forms-new-committee/
#unitedhealthcare #governance
United, Elevance Leave Some Individual Plans In Colorado Exchanges
UnitedHealth Group Inc. and Elevance Health Inc. told Colorado regulators they will exit some individual health plans in the state.
The plan exits would mean 96,000 Coloradans would have to find new coverage next year.
Aetna said in May that it would withdraw from the Exchange markets entirely.
(Article may require a subscription.)
#aca #exchanges #co #coverage #healthplans
https://www.modernhealthcare.com/insurance/mh-unitedhealth-elevance-colorado-aca-marketplace
340B Explained
Becker’s Payer has a good article explaining 340B – what it is, the ongoing controversy, and recent efforts to challenge upfront discounts. The article notes the recent Senate report that found that some of the largest health systems were exploiting the drug discount system. It noted that 340B discounts were not being passed through and these hospitals charged patients significantly higher prices.
Senate report: https://www.help.senate.gov/imo/media/doc/final_340b_majority_staff_reportpdf.pdf
#340b #drugpricing #hospitals #branddrugmakers
https://www.beckershospitalreview.com/pharmacy/the-340b-program-explained
Medicare OOP Costs Analyzed
Healthcare policy group KFF published an analysis on the major costs Medicare beneficiaries see in the program. This is especially a problem for lower income individuals.
Out-of-pocket healthcare spending by Medicare beneficiaries accounted for 39% of Social Security income per person in 2022, on average. Medicare beneficiaries spent 11% of their total per capita income on out-of-pocket healthcare costs, on average. About 1 in 4 beneficiaries spent at least 21% and 1 in 10 beneficiaries spent 39% or more.
#medicare #kff
— Marc S. Ryan
