Report Finds Lack of Quality Measures for Serious Diseases

There aren’t enough quality measures for serious conditions like lung cancer, prostate cancer, and endometrial cancer according to a new study from Avalere Health. While there are more than 20 quality measures for less serious diseases like diabetes and renal disease, there is a dearth of measures for more high-impact conditions. As payments shift toward value based reimbursement, the National Quality Forum (NQF) is attempting to prioritize quality measures for these conditions, but Avalere finds that the development and adoption of metrics is still considerably imbalanced.

IPAB Repeal Passes the House

The House voted last week to repeal the Affordable Care Act’s (ACA) Independent Payment Advisory Board (IPAB). The 2010 health care law charges IPAB with reducing Medicare spending should costs exceed a target growth rate. H.R. 1190, the Protecting Seniors’ Access to Medicare Act of 2015, passed by a vote of 244-154, with 11 Democrats joining House Republicans who unanimously supported the measure. The $7.1 billion legislation is paid for with money from the Public Health and Prevention Fund, also established by the ACA. This offset was opposed by many Democrats who may have otherwise supported the legislation, including Rep. Linda T. Sánchez (D-Calif.), who introduced the repeal bill with Rep. Phil Roe (R-Tenn.) earlier this year. The cuts to the prevention fund were added to the original bill through an amendment offered by House Energy and Commerce Health Subcommittee Chairman Joe Pitts (R-Pa.). The President has already threatened to veto the legislation should it reach his desk.

Study Finds Narrowing of Physician Networks

The number of providers available in many health care plans is shrinking, according to a new report from the Robert Wood Johnson Foundation. The study finds that four in 10 plans sold through an Affordable Care Act (ACA) exchange have networks characterized as “small” or “extra small.” A small network is defined as covering fewer than 25 percent of doctors in the region, while extra small encompasses those plans with fewer than 10 percent of doctors in the region. The report concludes that reducing the size of a network is one of the only remaining cost containment tools for insurers.

Health Legislation Recently Introduced

S. 1641 (VA), to improve the use by the Department of Veterans Affairs of opioids in treating veterans, to improve patient advocacy by the Department, and to expand availability of complementary and integrative health, and for other purposes; BALDWIN; to the Committee on Veterans’ Affairs; June 22

H.R. 2846 (CANCER CARE PLANNING), to amend title XVIII of the Social Security Act to provide for coverage of cancer care planning and coordination under the Medicare program; CAPPS; jointly, to the committees on Energy and Commerce and Ways and Means; June 23

H.R. 2850 (OVERDOSES), to prevent deaths occurring from drug overdoses; EDWARDS; to the Committee on Energy and Commerce; June 23

H.R. 2866 (PREGNANCY), to amend title XXVII of the Public Health Service Act to provide for a special enrollment period for pregnant women, and for other purposes; COLEMAN; jointly, to the committees on Energy and Commerce, Ways and Means, and Oversight and Government Reform; June 23

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