POLICY BRIEFINGS


ACOs Reported to Save Medicare Money


Accountable Care Organizations (ACOs) created under the PPACA were reported by CMS to have saved Medicare more than $372 million via the Pioneer ACO Model and Medicare Shared Savings Program (MSSP). ACOs also qualified for shared savings payments of $445 million. In 2013 over 125,000 eligible professionals who were ACO providers or suppliers qualified for incentive payments for reporting their quality of care through the Physician Quality Reporting System (PQRS). The agency said that over 360 Medicare ACOs have been established in 47 states and cover over 5.6 million Medicare beneficiaries.


Efforts to Address Problem of Antibiotic Resistance


At a House Energy and Commerce Subcommittee on Health hearing, Chairman Joe Pitts (R-PA) said that the Antibiotic Development to Advance Patient Treatment (ADAPT) Act is but one of a series of proposals that should be considered as part of an initiative to provide more incentives for the development of antibiotic drugs and diagnostics to combat antibiotic resistance. The CDC has said that antibiotic resistance is associated with about two million infections each year resulting in 23,000 deaths and about $20 billion in treatment costs. Rep. Henry Waxman (D-CA) said that means also need to be adopted to reduce the overuse and misuse of such drugs. Janet Woodcock, the Director of the Food and Drug Administration’s (FDA) Center for Drug Evaluation and Research (CDER) also described the President’s executive order directed to help combat antibiotic resistance. The order directs that a task force be created which includes the Secretaries of HHS, DoD and the U.S. Department of Agriculture (USDA) to develop a National Strategy for combating anti-resistant drugs. The President’s Council of Advisors on Science and Technology (PCAST) also released a report containing recommendations for the task force in order to better track the use of antibiotics, improve the stewardship of existing drugs and develop incentives for new drugs. The PCAST said that federal spending should be doubled to $900 million for tracking and researching antibiotic use and should be increased by another $800 million annually for the development of new antibiotics. The executive order also established a $20 million prize from the National Institutes of Health (NIH) and the Biomedical Advanced Research and Development Authority (BARDA) to develop a test that hospitals can use to quickly identify highly resistant bacterial infections.


Members Object to CMS Letters to State Medicaid Agencies


Senators Orrin Hatch (R-UT) and Lamar Alexander (R-TN) and Rep. Fred Upton (R-MI) sent a letter to the CMS Administrator objecting to letters the agency sent to six states because of the backlogs in their Medicaid programs. The members said the challenges states are having with Medicaid applications “are problems that CMS itself directly contributed to or created.” The letters gave the states only ten days to submit their plans for reducing the backlogs.


CHIP Extension Promoted in Senate


At a hearing of the Senate Finance Subcommittee on Health Care, Sen. Jay Rockefeller (D-WV) said that the Children’s Health Insurance Program (CHIP) should not be allowed to lapse next September and should be extended through FY 2019. A witness said there is some urgency in passing an extension soon given the state budgeting season. Douglas Holtz-Eakin, former director of the Congressional Budget Office (CBO) said that the PPACA has changed the coverage landscape and that the CHIP program needs to be refined to be more efficient in covering the intended population.



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