POLICY BRIEFINGS


MedPAC Weighs In on ACO Program Shortcomings


The Medicare Payment Advisory Commission (MedPAC) sent CMS a letter containing several recommendations to help the PPACA’s accountable care organization (ACO) program overcome shortcomings through regulation and legislation. To improve the certainty of meeting ACO financial targets, MedPAC recommended that CMS improve beneficiary assignment and simplify quality measurements and the evaluation process. To strengthen program incentives, MedPAC said that ACOs should participate not only in shared savings but in financial risks under a two-sided payment model.


Senate Finance Seeks Comments on Health Care Data Use


Finance Committee Chairman Ron Wyden (D-OR) and Senator Chuck Grassley (R-IA) said they are seeking comments on the use of health care data that they say has great potential for use by consumers, providers and payers to improve choice and quality of care. They asked for comments on the following: what data should be made more publicly available; how the data should be presented to the public; what reforms should be undertaken to improve the accessibility and usability of data for consumers, payers and providers; and what the current obstacles preventing access to data are and what can be done to remove them. Responses are due by August 12th.


House E&C Health Subcommittee Hearing on MedPAC Recommendations


Ways and Means Health Subcommittee Chairman Kevin Brady (R-TX) said that the MedPAC report “will not just sit on a shelf” and that the various MedPAC recommendations will be considered for improvements to Medicare. The MedPAC report discussed the issue of having Medicare make the same payments for the same care across different sites of service and suggested that savings could be achieved if payments were equalized between skilled nursing facilities and inpatient rehabilitation facilities. This was disputed by a witness representing Inpatient Rehabilitation Facilities (IRFs). Members also discussed MedPAC’s previously suggested benefit redesign as an alternative to the fee-for-service payment model. Ranking Democrat Jim McDermott (D-WA) said that any change should ensure that beneficiaries are protected from having to pay a higher share of costs than they do now. In related news, the House Energy and Commerce Committee released another White Paper as part of its “21st Century Cures” initiative which asks for comments on “the development a digital health care ecosystem” and the use of human genome data to provide personalized care. Comments are due by July 22, 2014.


CMS Announces 5-Star Rating System for Hospitals


CMS announced that it will add a so-called “five star” rating system for hospitals, home health agencies and dialysis providers under the agency’s Hospital Compare, Dialysis Facility Compare and Home Health Compare websites.


HHS Stays With Orphan Drug Discount Rule


Despite a recent negative court ruling, HHS and the Health Resources and Services Administration (HRSA) issued a statement to the effect that they will continue to abide by final regulations which would allow 340B covered entities affected by the orphan drug exclusion to purchase orphan drugs at 340B prices when orphan drugs are used for indications other than treating the rare disease or condition for which the drug received an orphan designation.



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