Last December, the Trump Administration redesigned and set a new direction for the Shared Savings Program, which is Medicare’s main program for Accountable Care Organizations (ACOs) under “Pathways to Success.” Data on ACO performance in the program the first six performance years showed that, over time, those ACOs taking accountability for cost increases, or “risk,” performed better than those that did not. In fact, ACOs that did not take accountability for cost increases and only shared in savings nominally increased Medicare spending relative to their cost targets. The agency also found that ACOs led by physicians (which tend to be “low revenue” ACOs since they provide mostly outpatient services) performed better than ACOs led by hospital systems (which tend to be “high revenue” ACOs since they provide inpatient and outpatient services).
Hospitals would have to disclose the discounted prices they negotiate with insurance companies under a Trump administration rule that could upend the $1 trillion hospital industry by revealing rates long guarded as trade secrets. Hospitals that fail to share the discounted prices in an online form could be fined up to $300 a day, according to the proposal. The price-disclosure requirements would cover all the more than 6,000 hospitals that accept Medicare, as well as some others, and is likely to face fierce industry opposition.
Millions of Americans in high-deductible health plans associated with HSAs may find it easier to access insulin, inhalers and other treatments for chronic health problems under guidance released last week by the Trump administration. Currently, people in high-deductible plans with pretax health-savings accounts have to pay down their deductible before their insurance covers treatment for chronic diseases such as diabetes or high blood pressure. The rule change will allow insurers to begin providing coverage for those treatments, such as glucose or blood-pressure monitors, before the deductible is paid.
President Trump on Wednesday announced an executive order on a topic rather far afield from his usual concerns: improving care for patients with kidney disease.
That might seem like an obscure topic, but it’s a crucial one. A shortage of kidneys for transplant kills about 43,000 people every year.
A federal judge on Monday dealt a blow to the Trump administration by striking down a new rule that would have forced pharmaceutical companies to include the wholesale prices of their drugs in television advertising.
U.S. District Judge Amit Mehta in Washington sided with drugmakers Merck & Co Inc, Eli Lilly and Co and Amgen Inc by halting the U.S. Department of Health and Human Services (HHS) rule from taking effect on Tuesday as planned.
President Trump said Friday he was preparing an executive order that would lower drug prices so that the federal government would pay no more than the costs paid by other countries.
He said the action would focus on a “favored-nations clause,” which is generally a contract under which a seller gives buyers the same best terms it offers to others.
Rising out-of-pocket costs for drugs are a major concern of Americans, and for good reason. Recently, some members of Congress and officials at the Department of Health and Human Services have championed a particular strategy to address this problem: pegging U.S. drug prices to what other countries pay for the same medicines.
By the left’s account you’d think the Trump Administration’s only ambition on health care is to rip insurance from the poor and sick. So note that a Health and Human Services rule finalized last month represents a dramatic expansion in health-care choices for those who may have limited insurance options.
The Trump Administration finished regulations expanding health reimbursement arrangements, often known as HRAs. The arrangements will allow an employer to give a worker tax-exempt dollars to buy a health-insurance plan in the individual market. Such arrangements have existed in some form since the early 2000s, but the Obama Administration used the Affordable Care Act to limit them.
President Trump wants you to see upfront prices for health care. That’s why a few months ago, the Department of Health and Human Services (HHS) recently published a request for comments about whether and how to end secret prices in health care. The deadline for comments was last week, and the submissions from the industries most threatened by consumers knowing and comparing prices — hospitals and insurance companies — are an exercise in Swamp-o-nomics.
John Desser, Senior Vice President of Public Policy and Government Affairs at eHealth Inc. and former HHS official, said, “Any effort to bring more visibility and data to the consumer on health care costs is a step in the right direction. Health care is just far too opaque, and so anything we can do to address that is a step in the right direction — but there will be some controversy. There will be entrenched interests that will try to oppose it.”