Medicare

Traditional Medicare remains the driver of risk-based pay models, according to a report released by Premier Inc. Tuesday (Sept. 17), but a Premier official said progress is slower than the hospital group had hoped for as few providers surveyed expect their total patient percentage in these models to exceed 50% within five years.

House Speaker Nancy Pelosi (D-CA) is expected to release her long-awaited government drug price negotiation plan on Wednesday (Sept. 18).

Mental health and substance use treatment advocates are calling on Congress to reauthorize funding for mental health clinics, remove barriers to medication-assisted treatment and allow mental health counselors to bill Medicare.

Justice in Aging and the National Consumer Voice for Quality Long-Term Care are urging others to “speak out for nursing home residents” by opposing CMS’ proposed rule to ease nursing home regulations, and the groups have developed sample comments that lay out why the agency shouldn’t move forward with many of the rule’s proposals.

Lawmakers and administration officials are slowly backing away from the White House’s promise to roll out a large-scale Affordable Care Act replacement plan and are instead saying the president is focusing on smaller-scale items such as drug pricing and surprise billing, and will take another look at protecting coverage for preexisting conditions if the courts overturn the health law.

Health care issues made up a large portion of the first two Democratic debates as candidates parried over their respective visions on universal health coverage, and some Democratic strategists say the candidates in tonight’s debate need to also make clear that the Trump administration has been working to undermine the existing law, both through regulatory moves and by backing a lawsuit that aims to scrap the Affordable Care Act.

The White House on Tuesday welcomed House Speaker Nancy Pelosi’s ideas on drug pricing, hiking President Donald Trump’s pressure on Senate Republicans and the drug industry to back a less aggressive, but strongly pharma-opposed, drug-pricing bill passed by the Senate Finance Committee.

A drop-off in Medicaid enrollment was the primary driver of the nation’s uninsured rate climbing to 8.5% in 2018 -- the first year since 2009 that the rate increased, according to national census data released Tuesday (Sept. 10).

Congressional Medicare advisers are considering recommending a unified, value-based incentive program for all post-acute care settings that would score providers on three quality measures and use a 5% withhold from base payments to fund the incentive payments.