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Wednesday, October 4, 2017                                                                                                                              

Well before Hurricane Marie knocked out much of Puerto Rico’s infrastructure, the territory was facing a Medicaid funding crisis. Nearly half of Puerto Rico’s 3.4 million residents participate in Medicaid, but as a territory, it only receives about 15 to 20 percent of its costs from federal coffers (because Puerto Ricans don’t pay federal income tax). U.S. states receive 57 percent of Medicaid funding from the federal program. Obamacare and Congress tided the program over until now with billions in additional funding, but the island was already running out of funds for the programs before the storm hit. (The Hill; Washington Post)

With much of the administration’s efforts focused on repeal and/or replacement of the Affordable Care Act this year, state governments are expressing frustration with the lack of federal action around the Children’s Health Insurance Program, Medicaid and state marketplace waivers. It doesn’t help that many job slots at the Department of Health and Human Services remain vacant. Oklahoma, which proposed a plan to lower prices on its health insurance exchange earlier this year, couldn’t get action on it until the waiver deadline passed. And states are still waiting to see what happens next, as funding for CHIP expired Sept. 30 without renewal. (Los Angeles Times)

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The newly-minted Institute for Accountable Care will collect data and evidence to build the case for accountable care models and measure their impact. Announced this week by the National Association of ACOs, the not-for-profit institute will partner with academic and philanthropic organizations for its research. Two former administrators for the Centers for Medicare & Medicaid Services, Don Berwick and Mark McClellan, serve on the institute’s board. (HealthDataManagement)

Survey: As ACOs mature, they take on more risk
Nearly half (47 percent) of accountable care organizations are planning for shared savings and/or shared risk, according to a new survey of 240 Medicare, commercial and Medicaid ACOs. Although ACOs are spending on health IT, they’re investing nearly twice as much on care management, indicating infrastructure costs are established and they’re able to devote more to clinical services. Use of care coordinators is a strategy employed by 95 percent of those surveyed, and nearly 90 percent said care coordinators are very important or extremely important to success. Another common theme: The greatest challenge shared by respondents is the ability to reduce spending. (HealthAffairs Blog)

A new survey finds four out of five payers and 72 percent of providers are investing in consumer engagement tools to enhance value-based care and as a hedge against the competition, according to a new survey. But the same proportion (72 percent) of consumers said their experience with providers and health plans isn’t any better, or it’s worse than it was two years ago. Consumers want a more tailored, personal experience, and investment in health IT like patient portals doesn’t equate to better engagement—especially for older patients who aren’t getting the attention they need. (Healthcare Informatics)

Retiring baby boomers will more than double the cost of Medicare and Medicaid by 2020, with more than 10,000 turning 65 every day. As health care costs continue to rise faster than the economy grows, it’s estimated the Medicare trust fund will be bankrupt by 2033. Commentator Joel Landau says better coordination and collaboration among providers that pre-empt the need for expensive treatments may be the best way to lower costs. (CNBC)

First two Telehealth Centers of Excellence named: Medical University of South Carolina and the University of Mississippi Medical Center were named the nation’s first two Telehealth Centers of Excellence by the Health Resources and Services Administration. Both medical universities received $600,000 grants to help build research infrastructure and develop national leadership in telehealth. (The Clarion Ledger; mHealth Intelligence)

Lip-syncing during surgery is a no-no: Confronted with a recent barrage of poor-taste social media postings, writers in a plastic surgery journal felt obligated to propose new guidelines for plastic surgeons tempted to sing, dance, make inappropriate comments or otherwise cross the ethical line. The study’s senior author said plastic surgeons may be particularly susceptible to posting attention-grabbing videos on social media to market their services. Patients, who give permission to be recorded without understanding how video will be used, have the most at risk when doctors are more interested in the optics than the surgery. (Chicago Tribune)

Great clinical outcomes and satisfied patients are the top two success measures for accountable care organizations. An infographic showing results of a 2017 ACO survey illustrates more integrated delivery systems are managing ACOs than physician groups or other entities, among other findings. (Healthcare Intelligence Network)

MarketVoices...quotes worth reading

“If you're distracted by actually taking time away from the surgery to do a song and dance or make inappropriate comments, then you are not performing surgery in the most efficient way possible, that's respectful of the patient." – Clark Schierle, plastic surgeon, quoted in the Chicago Tribune about his study on plastic surgeons and their use of social media.


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