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January 15, 2024

Good Articles On Takeaways From JPM Healthcare Conference Two good articles summarizing some major trends and topics at the JPM healthcare conference.  Highlights include: Additional article here: https://www.modernhealthcare.com/finance/jpm-2024-takeaways-commonspirit-mayo-clinic-centene-cvs-cigna-teladoc (Some articles may require a subscription.) #healthplans #providers #hospitals #stars #pbms Link to Article AI Can Help Drive Social Determinant Information And Extraction Stories on the ability for generative AI to identify social determinants of health (SDOH) data in notes is a key development. The study indicates that extraction from clinical notes in tuned models show success in insights into housing, employment status, etc. Language models were able to identify about 94% of cases where SDOH barriers existed compared with 2% using diagnostic codes. We know that social determinants may be a greater predictor of health outcomes than underlying disease status.  This will be key to driving outcomes in the future. Additional article here: https://www.modernhealthcare.com/digital-health/generative-ai-social-determinants-of-health-mass-general-brigham (Some articles may require a subscription.) #sdoh

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January 12, 2024

What Would A Nikki Haley Healthcare Agenda Look Like? The Republican debates continue with Donald Trump bowing out and Ron DeSantis and Nikki Haley taking center stage.  A recent CNN debate saw the two sparring, sometimes on healthcare issues. Both Haley and DeSantis declared that they would like to replace the Affordable Care Act (ACA) with a block grant.  It is a horrible idea. With Chris Christie’s departure from the race and Haley rising in the polls, Kaiser Health News (KHN) did a feature on what a Haley administration’s healthcare agenda may look like. Additional article on Haley’s views on entitlement reform here: https://www.cnn.com/2023/12/05/politics/nikki-haley-social-security-medicare-reform/index.html #gopprimary #haley #desantis #trump #healthcare #aca #obamacare Link to Article Fight (Verbal Anyway) Breaks Out at MedPAC Meeting A verbal clash broke out at a MedPAC meeting, with one member reasonably arguing that MedPAC is not truly as non-partisan as it says it is. I generally

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January 4, 2024

Hospitals, Payers Have Better Compliance With Transparency Requirements Hospitals and payers seem to be complying more with required price transparency postings.  As well, the Centers for Medicare and Medicaid Services (CMS) has ramped up enforcement.  New rules went into effect 1/1 and Congress wants to codify the rules and enhance them. Additional article here: https://www.medpagetoday.com/special-reports/features/108126 #transparency #pricetransparency #healthplans #hospitals #cms Link to Article Physician and Hospital Groups Object To Info-Blocking Penalties In Proposed Interoperability Rule Provider and hospital groups dislike proposed penalties for info-blocking under a new proposed interoperability rule.  Penalties include a change in meaningful-use status in federal programs and reductions in payments. Additional article here: https://insidehealthpolicy.com/daily-news/stakeholders-seek-less-severe-penalties-potential-info-blocking-claims (Some articles may require a subscription.) #interoperability #infoblocking #hospitals #providers Link to Article Lawmakers Miss Medicare Advantage’s Benefits Lawmakers at a symposium on Medicare drug pricing complained that healthcare inflation is impacting Medicare provider payments and hurting access for Medicare beneficiaries. They

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January 3, 2024

Aggressive Agenda for Healthcare on Capitol Hill Good article on all the healthcare priorities for 2024.  This tracks very closely to my predictions for 2024 blog ( https://www.healthcarelabyrinth.com/channeling-nostradamus-the-healthcare-labyrinths-2024-predictions/ ). As I noted, a continuing resolution (CR) or other funding bill must pass soon to keep healthcare agencies open. As well, the article says that price transparency reporting, PBM reforms, and site-neutral payments are on the agenda. Note the reference to the long shot possibility of Medicare Advantage (MA) payment reductions. Troubled by prior authorization and overpayment headlines, Congress could take a bite out of rates for MA plans. This was also a possibility I raised in my predictions. There is also the issue of physician fee cuts in Medicare. (Article may require a subscription.) #transparency #pricetransparency #governmentshutdown # crs #siteneutral #pbms #medicareadvantage #medicare #overpayments #providers #rates Link to Article FDA Approvals Up FDA approvals of new novel drugs are up. 

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January 2, 2024

KHN Series On Rural Healthcare Crisis Good article from Kaiser Health News on the rural healthcare crisis.  It tackles how primary care doctors may be able to help with the maternal healthcare crisis.  #ruralhealthcare #healthcare Link to Article More States Cover Illegal Immigrants’ Healthcare This was surprising to me.  Eleven states and Washington, D.C.  provide full health insurance coverage to more than 1 million low-income immigrants regardless of their legal status.  Most are in California, but even Republican Utah is getting into the act. Coverage is expected to almost double by 2025. In this other article, ABC News reports that CA becomes first state to offer full health benefits to all immigrants regardless of status: https://abcnews.go.com/Health/california-1st-state-offer-health-insurance-undocumented-immigrants/story?id=105986377 #immigrants #coverage #healthcare Link to Article Drug Price Hikes Coming As happens each January, drug makers plan to raise prices in the United States on more than 500 drugs, according to data analyzed by

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