RealClearHealth Morning Scan -- 03/23/2016

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Medicare Saved $473 Billion from Cost Slowdown
Peter Sullivan, The Hill
Medicare spent $473 billion less between 2009 and 2014 than it would have if previous cost-growth trends had continued, a marker of a slowdown in healthcare spending, the Department of Health and Human Services (HHS) announced Tuesday. The announcement comes around the sixth anniversary of ObamaCare as part of the administration’s effort to highlight some of the lesser-known parts of the law, such as reforms to Medicare payments, that can help limit cost growth.

On ACA Anniversary, White House Declares Victory
Maggie Fox, NBC
Obamacare has its sixth anniversary Wednesday and the White House is declaring victory over critics who said it would fail and multiple lawsuits seeking to have it declared unconstitutional.

Americans Get Used to Popular Provisions of ACA
Muchmore, Mod. HC
On this sixth anniversary of the Affordable Care Act, the health reform law is garnering limited attention on the presidential campaign trail, but the Republican vow to “repeal and replace” is still a staple of most stump speeches. Some aspects of the law however, have been popular among the public and politicians on both sides of the aisle. Provisions like allowing children to remain on their parents' insurance until the age of 26 and requiring insurers to cover people with pre-existing conditions are almost certainly here to stay.

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Preserve Medicare Advantage to protect those with chronic conditions who need the quality, coordinated care it provides. Learn more.

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VA's Veterans Choice Program Is Broken
Quil Lawrence, NPR
Two years ago Congress created the Veterans Choice Program after scandals revealed that some veterans were waiting months to get essential medical care. The $10 billion program was designed to get veterans care quickly by letting them choose a doctor outside the VA system. Now Congress and the U.S. Department of Veterans Affairs are pushing through new legislation to fix the program.

Debate Heats Up over Who Pays for Telemedicine
Melissa Bailey, Stat
When is a video chat with a doctor equivalent to an office visit? State legislators across the US have been grappling with that question as hospitals press for insurance companies to fully cover virtual appointments — and insurers balk at those demands.

Get Comfortable With Bundled Payments
Philip Betbeze, HealthLeaders
The Centers for Medicare & Medicaid Services has mandated that hospitals in 67 markets participate in bundled payments for hip and knee replacements. It's part of an acceleration in the transition to risk-based payment arrangements, and about 800 hospitals will be subject to the new reimbursement regime. This is the first time CMS is requiring mandatory participation in any bundling; before, all such initiatives have been voluntary for hospitals.

Obama's Budget Takes on Surprise Medical Bills Debate
Ahn, et al., HA
President Obama’s final budget proposal was met with little fanfare, but a lot of political opposition. The President, however, put forth one legislative proposal that deserves attention. It is aimed at helping consumers who get stuck with surprise bills from out-of-network health care providers. Specifically, the proposal would protect patients from having to pay unexpected fees to out-of-network providers for services delivered while they are in an in-network hospital.

Employer Self-Insuring Is All the Rage
Peter Wehrwein, Managed Care
But there’s really no denying the appeal of self-insurance and its growing popularity among employers. According to last year’s Kaiser Family Foundation–Health Research & Educational Trust (HRET) survey on employer health benefits, the percentage of employers who fully or partially self-insure has increased from 44% in 1999 to 63% in 2015. Among employers with 5,000 or more workers, self-insurance has become the rule with the rare exception, according to the survey, which found that 94% of employers that size self-insure.

Electronic Records No Panacea at End of Life
Shefali Luthra, KHN
In a perfect world, patients with advance directives would be confident that their doctors and nurses — no matter where they receive care — could know in a split second their end-of-life wishes. But this ideal is still in the distance. Patients’ documents often go missing in maze-like files or are rendered unreadable by incompatible software. And this risk continues even as health systems and physician practices adopt new electronic health records. So advocates and policymakers are pushing for a fix.

Big Price Hikes for Aid in Dying Drug
April Dembosky, KQED
When California’s aid-in-dying law takes effect this June, terminally ill patients who decide to end their lives could be faced with a hefty bill for the lethal medication. It retails for more than $3,000. Valeant Pharmaceuticals, the company that makes the drug most commonly used in physician-assisted suicide, doubled the drug’s price last year, one month after California lawmakers proposed legalizing the practice.

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Millions are facing new cuts to Medicare Advantage that will undermine chronic care management for those who don’t qualify for both Medicare and Medicaid. That means fewer choices and higher costs. Proposed changes to Medicare Advantage should be delayed to find a solution that works for everyone. Learn more.

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