<?xml version="1.0" encoding="UTF-8"?><rss version="2.0" xmlns:content="http://purl.org/rss/1.0/modules/content/" xmlns:wfw="http://wellformedweb.org/CommentAPI/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:atom="http://www.w3.org/2005/Atom" xmlns:sy="http://purl.org/rss/1.0/modules/syndication/" xmlns:slash="http://purl.org/rss/1.0/modules/slash/" > <channel> <title>Healthcare Reform – Policy & Medicine</title> <atom:link href="https://www.policymed.com/category/healthcare-reform/feed" rel="self" type="application/rss+xml" /> <link>https://www.policymed.com</link> <description>Legal, Regulatory, and Compliance Issues</description> <lastBuildDate>Mon, 13 Jan 2025 23:11:37 +0000</lastBuildDate> <language>en-US</language> <sy:updatePeriod> hourly </sy:updatePeriod> <sy:updateFrequency> 1 </sy:updateFrequency> <image> <url>https://www.policymed.com/wp-content/uploads/2018/05/cropped-favicon-32x32.png</url> <title>Healthcare Reform – Policy & Medicine</title> <link>https://www.policymed.com</link> <width>32</width> <height>32</height> </image> <item> <title>Transforming U.S. Healthcare: A Look at President Trump’s Leadership Appointments</title> <link>https://www.policymed.com/2025/01/transforming-u-s-healthcare-an-in-depth-look-at-president-trumps-leadership-appointments.html</link> <comments>https://www.policymed.com/2025/01/transforming-u-s-healthcare-an-in-depth-look-at-president-trumps-leadership-appointments.html#respond</comments> <dc:creator><![CDATA[Thomas Sullivan]]></dc:creator> <pubDate>Tue, 14 Jan 2025 09:04:24 +0000</pubDate> <category><![CDATA[Executive Branch]]></category> <category><![CDATA[Healthcare Reform]]></category> <category><![CDATA[HHS]]></category> <category><![CDATA[CDC Commissioner]]></category> <category><![CDATA[chronic disease focus]]></category> <category><![CDATA[CMS Administrator]]></category> <category><![CDATA[Deputy Secretary of HHS]]></category> <category><![CDATA[disease surveillance]]></category> <category><![CDATA[Dr. Janet Nesheiwat]]></category> <category><![CDATA[Dr. Jay Bhattacharya]]></category> <category><![CDATA[Dr. Marty Makary]]></category> <category><![CDATA[Dr. Mehmet Oz]]></category> <category><![CDATA[environmental attorney]]></category> <category><![CDATA[environmental health expert]]></category> <category><![CDATA[FDA Commissioner]]></category> <category><![CDATA[Former Rep. David Weldon]]></category> <category><![CDATA[free-market principles]]></category> <category><![CDATA[government efficiency]]></category> <category><![CDATA[healthcare innovator]]></category> <category><![CDATA[healthcare policy]]></category> <category><![CDATA[healthcare preparedness]]></category> <category><![CDATA[healthcare technology investor]]></category> <category><![CDATA[healthcare transparency]]></category> <category><![CDATA[HHS Secretary]]></category> <category><![CDATA[Jim O'Neill]]></category> <category><![CDATA[legislative experience.]]></category> <category><![CDATA[Medicare Advantage advocate]]></category> <category><![CDATA[mental health reform]]></category> <category><![CDATA[NIH Director]]></category> <category><![CDATA[pandemic policy reformer]]></category> <category><![CDATA[patient safety advocate]]></category> <category><![CDATA[Physician]]></category> <category><![CDATA[preventive medicine advocate]]></category> <category><![CDATA[public health critic]]></category> <category><![CDATA[public health educator]]></category> <category><![CDATA[public health legislation]]></category> <category><![CDATA[public health professor]]></category> <category><![CDATA[public health reform]]></category> <category><![CDATA[regulatory reform]]></category> <category><![CDATA[regulatory reform advocate]]></category> <category><![CDATA[Rep. Doug Collins]]></category> <category><![CDATA[research innovation]]></category> <category><![CDATA[Robert F. Kennedy Jr.]]></category> <category><![CDATA[Surgeon General]]></category> <category><![CDATA[TV personality]]></category> <category><![CDATA[VA Secretary]]></category> <category><![CDATA[veterans' advocate]]></category> <guid isPermaLink="false">https://www.policymed.com/?p=17535</guid> <description><![CDATA[<div style="margin-bottom:20px;"><img width="388" height="258" src="https://www.policymed.com/wp-content/uploads/2025/01/Trump-Health-Picks-2025.jpg" class="attachment-post-thumbnail size-post-thumbnail wp-post-image" alt="" decoding="async" fetchpriority="high" srcset="https://www.policymed.com/wp-content/uploads/2025/01/Trump-Health-Picks-2025.jpg 388w, https://www.policymed.com/wp-content/uploads/2025/01/Trump-Health-Picks-2025-300x199.jpg 300w" sizes="(max-width: 388px) 100vw, 388px" /></div>President Donald Trump’s lineup of nominees for top healthcare positions is set to introduce significant reforms aimed at enhancing efficiency, patient choice, and reducing bureaucratic red tape in the U.S. healthcare system. Each nominee brings a unique perspective that aligns with the administration’s vision of a more market-driven, patient-centered approach to healthcare to “Make America […]]]></description> <content:encoded><![CDATA[<div style="margin-bottom:20px;"><img width="388" height="258" src="https://www.policymed.com/wp-content/uploads/2025/01/Trump-Health-Picks-2025.jpg" class="attachment-post-thumbnail size-post-thumbnail wp-post-image" alt="" decoding="async" srcset="https://www.policymed.com/wp-content/uploads/2025/01/Trump-Health-Picks-2025.jpg 388w, https://www.policymed.com/wp-content/uploads/2025/01/Trump-Health-Picks-2025-300x199.jpg 300w" sizes="(max-width: 388px) 100vw, 388px" /></div><p>President Donald Trump’s lineup of nominees for top healthcare positions is set to introduce significant reforms aimed at enhancing efficiency, patient choice, and reducing bureaucratic red tape in the U.S. healthcare system. Each nominee brings a unique perspective that aligns with the administration’s vision of a more market-driven, patient-centered approach to healthcare to “Make America Healthy Again.” We will find out more in the coming days as hearings are held the next two weeks for senate confirmations.</p> <p><strong>Robert F. Kennedy Jr.: Nominee for HHS Secretary</strong></p> <p>Robert F. Kennedy Jr. is a notable environmental attorney and activist who has become a prominent voice in public health debates, particularly concerning vaccine safety and environmental health issues.</p> <p><strong>Professional Background</strong></p> <p>Kennedy began his career as an environmental lawyer, using his legal expertise to fight against pollution and protect natural resources. Over time, his focus shifted towards the impact of environmental factors on human health, leading to his involvement in public health advocacy.</p> <p><strong>Health Policy Stances </strong></p> <p>Kennedy’s health policy positions are deeply intertwined with his environmental activism. In his proposed role as HHS Secretary, Kennedy aims to implement a broad agenda focused on increasing transparency within federal health agencies, reducing corporate influence in public health, and promoting policies that address what he sees as the root causes of health issues—environmental toxins and poor nutrition. He has been vocal about revising vaccine policies, advocating for more rigorous safety studies and greater public disclosure of potential risks.</p> <p><strong>Vision for HHS</strong></p> <p>Kennedy’s vision for HHS involves overhauling the agency to better serve public health needs by focusing on prevention, transparency, and accountability. He proposes to shift the focus of health policy towards preventing chronic diseases through better environmental and nutritional policies, reflecting his belief that a healthier environment leads to healthier individuals. His approach includes challenging the status quo within HHS’s various agencies, including the FDA and CDC, to ensure they operate without undue influence from industries they are supposed to regulate.</p> <p><strong>Jim O’Neill: Nominee for Deputy Secretary of HHS</strong></p> <p>Jim O’Neill, known for his libertarian views and focus on innovation, is expected to support sweeping reforms within HHS. “My goal is to ensure that HHS operates with enhanced efficiency and responsiveness, free from unnecessary regulatory constraints,” O’Neill mentioned regarding his nomination. His leadership could catalyze the implementation of market-based solutions across the healthcare spectrum.</p> <p><strong>Dr. Mehmet Oz: Nominee for CMS Administrator</strong></p> <p>Dr. Mehmet Oz, nominated as CMS Administrator, is poised to leverage his vast media experience and medical knowledge to promote innovative health solutions. “Dr. Oz will bring a new perspective to CMS, particularly in promoting Medicare Advantage and expanding access to alternative medicine, reflecting our administration’s commitment to healthcare innovation,” stated President Trump. Dr. Oz’s vision includes streamlining services and expanding patient choices, particularly for seniors.</p> <p><strong>Dr. Marty Makary: Nominee for FDA Commissioner</strong></p> <p>As the nominee for FDA Commissioner, Dr. Marty Makary is known for his data-driven approach to healthcare reform. Dr. Makary advocates for “a system where innovation is fostered and public health is prioritized,” aiming to reduce the regulatory burdens that currently slow down the drug approval process. His goals include enhancing the transparency of the FDA to build public trust and expedite the introduction of safe medical products to the market.</p> <p><strong>Dr. Jay Bhattacharya: Nominee for NIH Director</strong></p> <p>Dr. Jay Bhattacharya, set to direct the NIH, has been an outspoken critic of conventional pandemic responses and is a proponent of more focused protection measures. “The NIH under my direction will prioritize innovative research and direct its efforts towards the greatest health challenges of our age, including chronic diseases,” Dr. Bhattacharya noted. His appointment signals a shift in research priorities, potentially influencing future public health strategies.</p> <p><strong>Former Rep. David Weldon: Nominee for CDC Commissioner</strong></p> <p>Former Rep. David Weldon, nominee for CDC Commissioner, is likely to focus on strengthening the agency’s capacity to manage public health emergencies. Weldon’s experience as a physician and legislator provides him with the insights needed to ensure the CDC can effectively respond to future health crises with science and clarity at the forefront.</p> <p><strong>Dr. Janet Nesheiwat: Nominee for Surgeon General</strong></p> <p>Dr. Janet Nesheiwat, appointed as Surgeon General, is expected to play a pivotal role in guiding public health education and preventive health measures. “We will enhance our focus on preventive healthcare and ensure that our medical guidelines are based on solid evidence to improve national health outcomes,” said Dr. Nesheiwat. Her background in environmental health and preventive medicine will be crucial in addressing long-term health challenges, such as chronic diseases and environmental health impacts.</p> <p><strong>Rep. Doug Collins: Nominee for Secretary of Veterans Affairs</strong></p> <p>Rep. Doug Collins, a former U.S. Representative from Georgia, has been nominated as the Secretary of Veterans Affairs. Collins, a former Air Force chaplain and a member of the House Veterans’ Affairs .</p> <p>Collins has consistently advocated for better access to healthcare services for veterans, pushing for reforms that enhance the efficiency and responsiveness of the VA. “We owe our veterans the highest level of care and support. My mission at the VA will be to ensure we live up to that promise through reform and steadfast accountability,” Collins stated upon his nomination. His current role involves legal and consulting work, where he continues to focus on veterans’ issues and public service initiatives, reflecting his ongoing commitment to the veteran community.</p> <p>As Secretary of Veterans Affairs, Collins aims to leverage his legislative experience and personal commitment to veterans to transform the VA into a more efficient, transparent, and accountable organization that effectively serves the needs of America’s veterans and their families. His focus will likely be on expanding access to mental health services, improving the VA’s healthcare system, and ensuring that veterans receive the benefits they deserve in a timely manner.</p> <p><strong>Summary </strong></p> <p>These appointments underscore President Trump’s commitment to reshaping the American healthcare landscape through strategic leadership, aiming to reduce government intervention while improving outcomes and efficiencies within the healthcare system. As these leaders take charge, their collaborative efforts with industry and their innovative approaches are anticipated to lead to substantial improvements in healthcare delivery and policy.</p> ]]></content:encoded> <wfw:commentRss>https://www.policymed.com/2025/01/transforming-u-s-healthcare-an-in-depth-look-at-president-trumps-leadership-appointments.html/feed</wfw:commentRss> <slash:comments>0</slash:comments> </item> <item> <title>Reforming the Agency for Healthcare Research and Quality (AHRQ): A Strategic Focus on Dissemination and Advancing the “Make America Healthy Again” Agenda</title> <link>https://www.policymed.com/2024/11/reforming-the-agency-for-healthcare-research-and-quality-ahrq-a-strategic-focus-on-dissemination-and-advancing-the-make-america-healthy-again-agenda.html</link> <comments>https://www.policymed.com/2024/11/reforming-the-agency-for-healthcare-research-and-quality-ahrq-a-strategic-focus-on-dissemination-and-advancing-the-make-america-healthy-again-agenda.html#respond</comments> <dc:creator><![CDATA[Thomas Sullivan]]></dc:creator> <pubDate>Wed, 27 Nov 2024 09:06:17 +0000</pubDate> <category><![CDATA[ACCME]]></category> <category><![CDATA[CME]]></category> <category><![CDATA[Executive Branch]]></category> <category><![CDATA[Global]]></category> <category><![CDATA[Healthcare Reform]]></category> <category><![CDATA[HHS]]></category> <category><![CDATA[MATE Act]]></category> <category><![CDATA[oncology]]></category> <category><![CDATA[Substance Use Disorders]]></category> <category><![CDATA[Accredited CME Programs]]></category> <category><![CDATA[Accredited Continuing Education]]></category> <category><![CDATA[AHRQ Reform]]></category> <category><![CDATA[CE]]></category> <category><![CDATA[continuing medical education CME]]></category> <category><![CDATA[Digital Health Tools]]></category> <category><![CDATA[Evidence-Based Practices]]></category> <category><![CDATA[Federal Healthcare Agencies]]></category> <category><![CDATA[Health Equity]]></category> <category><![CDATA[Health Systems Improvement]]></category> <category><![CDATA[Healthcare Cost Reduction]]></category> <category><![CDATA[Healthcare Dissemination]]></category> <category><![CDATA[Healthcare Policy Reform]]></category> <category><![CDATA[Healthcare Research Funding]]></category> <category><![CDATA[Maintenance of Certification (MOC)]]></category> <category><![CDATA[Make America Healthy Again]]></category> <category><![CDATA[Medical Education Innovation]]></category> <category><![CDATA[NEW]]></category> <category><![CDATA[Patient safety]]></category> <category><![CDATA[Public-Private Partnerships]]></category> <category><![CDATA[Regional Health Disparities]]></category> <category><![CDATA[rural healthcare access]]></category> <category><![CDATA[Value-Based Care]]></category> <guid isPermaLink="false">https://www.policymed.com/?p=17367</guid> <description><![CDATA[<div style="margin-bottom:20px;"><img width="1639" height="837" src="https://www.policymed.com/wp-content/uploads/2024/11/AHRQ-State-Funding.jpg" class="attachment-post-thumbnail size-post-thumbnail wp-post-image" alt="" decoding="async" srcset="https://www.policymed.com/wp-content/uploads/2024/11/AHRQ-State-Funding.jpg 1639w, https://www.policymed.com/wp-content/uploads/2024/11/AHRQ-State-Funding-300x153.jpg 300w, https://www.policymed.com/wp-content/uploads/2024/11/AHRQ-State-Funding-1024x523.jpg 1024w, https://www.policymed.com/wp-content/uploads/2024/11/AHRQ-State-Funding-768x392.jpg 768w, https://www.policymed.com/wp-content/uploads/2024/11/AHRQ-State-Funding-1536x784.jpg 1536w" sizes="(max-width: 1639px) 100vw, 1639px" /></div>The Agency for Healthcare Research and Quality (AHRQ) has long been a cornerstone of the U.S. healthcare landscape, driving research to improve healthcare safety, quality, and delivery. Yet, as the healthcare system faces new challenges, AHRQ must evolve to ensure its research translates into real-world improvements. By reforming its operations to focus more on dissemination, […]]]></description> <content:encoded><![CDATA[<div style="margin-bottom:20px;"><img width="1639" height="837" src="https://www.policymed.com/wp-content/uploads/2024/11/AHRQ-State-Funding.jpg" class="attachment-post-thumbnail size-post-thumbnail wp-post-image" alt="" decoding="async" loading="lazy" srcset="https://www.policymed.com/wp-content/uploads/2024/11/AHRQ-State-Funding.jpg 1639w, https://www.policymed.com/wp-content/uploads/2024/11/AHRQ-State-Funding-300x153.jpg 300w, https://www.policymed.com/wp-content/uploads/2024/11/AHRQ-State-Funding-1024x523.jpg 1024w, https://www.policymed.com/wp-content/uploads/2024/11/AHRQ-State-Funding-768x392.jpg 768w, https://www.policymed.com/wp-content/uploads/2024/11/AHRQ-State-Funding-1536x784.jpg 1536w" sizes="auto, (max-width: 1639px) 100vw, 1639px" /></div><p>The <a href="https://www.ahrq.gov/">Agency for Healthcare Research and Quality (AHRQ)</a> has long been a cornerstone of the U.S. healthcare landscape, driving research to improve healthcare safety, quality, and delivery. Yet, as the healthcare system faces new challenges, AHRQ must evolve to ensure its research translates into real-world improvements. By reforming its operations to focus more on dissemination, including accredited continuing education (CE), and aligning with the “Make America Healthy Again” agenda, AHRQ can maximize its impact on public health and healthcare delivery.</p> <p><strong>The Need for Reform</strong></p> <p>AHRQ’s funding and operational strategies have faced criticism for several reasons:</p> <ol> <li><strong>Funding Disparities</strong>: Analysis of <a href="https://www.ahrq.gov/funding/grant-mgmt/grants-by-state.html">AHRQ grants</a> shows significant disparities, with some states like Mississippi, Vermont, and Nevada receiving little or no funding. Meanwhile, elite academic institutions in states like California, Massachusetts, and New York dominate funding allocations.</li> <li><strong>Underutilization of CE</strong>: Government funding accounts for less than <a href="https://accme.org/wp-content/uploads/2024/08/2023-ACCME-Annual-Data-Report-1045_20240815.pdf">2% of the total funding</a> for CE/CME, despite its proven role in motivating healthcare professionals to adopt evidence-based practices.</li> <li><strong>Complex Funding Processes</strong>: AHRQ’s grant application and reporting requirements are complex, favoring large academic institutions and sidelining smaller healthcare providers and community organizations.</li> <li><strong>Insufficient Dissemination</strong>: AHRQ has not fully leveraged modern dissemination tools to ensure its research reaches healthcare professionals in practical, actionable formats.</li> </ol> <p><strong>AHRQ’s Role in the “Make America Healthy Again” Agenda</strong></p> <p>The “Make America Healthy Again” agenda prioritizes chronic conditions and prevention making healthcare accessible, affordable, and effective for all Americans. AHRQ is uniquely positioned to support this mission through its core strengths:</p> <ul> <li><strong>Expanding Primary Care Access</strong>: By funding additional research on team-based and patient-centered care models.</li> <li><strong>Reducing Costs</strong>: Providing data-driven policy insights to address inefficiencies and promote value-based care.</li> <li><strong>Enhancing Health for At Risk Communities</strong>: Targeting health gaps and funding research in underserved regions.</li> <li><strong>Improving Patient Safety</strong>: Advancing tools and frameworks to reduce medical errors and improve care transitions.</li> </ul> <p>However, AHRQ’s potential to influence these priorities remains underutilized without a greater focus on dissemination.</p> <p><strong>Proposed Reforms for AHRQ</strong></p> <p>To better serve its mission and align with national health priorities, AHRQ should reform its approach in several key areas:</p> <ol> <li><strong> Increase Funding for Dissemination and Continuing Education </strong></li> </ol> <p>Accredited continuing education is a powerful tool for translating research into practice, yet AHRQ dedicates minimal resources to this area. By expanding funding for CE programs, AHRQ can:</p> <ul> <li>Address critical topics such as diagnostic accuracy, patient safety, and chronic disease management.</li> <li>Incentivize participation through Maintenance of Certification (MOC) credits and other credit incentives.</li> <li>Collaborate with ACCME/ACPE/AAN and other accredited providers to design high-quality, impactful educational programs.</li> </ul> <ol start="2"> <li><strong> Simplify Grant Processes and Broaden Access</strong></li> </ol> <p>To ensure more equitable funding distribution:</p> <ul> <li>Simplify grant application and reporting processes to make them accessible to smaller institutions.</li> <li>Introduce regional funding allocations to guarantee every state receives adequate support for healthcare research.</li> <li>Develop training programs to help community organizations and rural providers successfully apply for grants.</li> </ul> <ol start="3"> <li><strong> Prioritize States with Minimal Funding</strong></li> </ol> <p>AHRQ must address the funding disparities that leave states like Maine, Louisiana, West Virginia, and Mississippi with little to no research support. These regions face unique healthcare challenges that require targeted research and resources.</p> <ol start="4"> <li><strong> Expand the Use of Digital Platforms for Dissemination</strong></li> </ol> <p>Modernize dissemination efforts by:</p> <ul> <li>Developing online CE modules, webinars, and mobile apps that integrate AHRQ resources.</li> <li>Supporting telehealth innovations and digital health tools to reach rural and underserved areas.</li> <li>Promoting learning health systems to accelerate real-time application of evidence-based practices.</li> </ul> <ol start="5"> <li><strong> Leverage Public-Private Partnerships</strong></li> </ol> <p>AHRQ can expand its reach and resources by partnering with private-sector organizations to co-fund dissemination efforts, ensuring compliance with ACCME’s standards for commercial support to maintain educational integrity.</p> <ol start="6"> <li><strong> Align Research with National Health Priorities</strong></li> </ol> <p>AHRQ’s research and dissemination should focus on:</p> <ul> <li>Reducing healthcare costs through value-based care models.</li> <li>Advancing at risk communities by studying and addressing social determinants of health. Including access to healthy diets, exercise, and family resources.</li> <li>Preparing for public health emergencies by strengthening long-term care and infection control.</li> </ul> <ol start="7"> <li><strong> Showcase Impact and Advocate for Increased Funding for Healthy Living Projects</strong></li> </ol> <p>AHRQ must demonstrate the value of its investments by:</p> <ul> <li>Tracking and publicizing the outcomes of its research through funded CE and dissemination programs.</li> <li>Adjusting its budget to support its expanded focus on dissemination and adoption.</li> </ul> <p><strong>Conclusion</strong></p> <p>Reforming AHRQ to focus on dissemination, particularly through accredited CE, and aligning its efforts with the “Make America Healthy Again” agenda can significantly enhance the agency’s impact. By addressing funding disparities, simplifying processes, and leveraging modern tools, AHRQ can ensure its research reaches the frontline of healthcare delivery. These changes will empower healthcare professionals to adopt evidence-based practices, improve patient outcomes, and make strides toward a healthier America.</p> <p>AHRQ has the tools, expertise, and opportunity to lead this transformation. The new administration offers a unique opportunity to translate government research so practicing healthcare providers adopt best practices.</p> <p>Thomas Sullivan is Editor or Policy and Medicine, Senior Vice President at Continuing Education Alliance and founder of the CME Coalition, views expressed in this editorial represent his personal views.</p> ]]></content:encoded> <wfw:commentRss>https://www.policymed.com/2024/11/reforming-the-agency-for-healthcare-research-and-quality-ahrq-a-strategic-focus-on-dissemination-and-advancing-the-make-america-healthy-again-agenda.html/feed</wfw:commentRss> <slash:comments>0</slash:comments> </item> <item> <title>Brookings Institution Finds No Surprises Act Arbitration Results in Larger than Expected Payouts</title> <link>https://www.policymed.com/2024/05/brookings-institution-finds-no-surprises-act-arbitration-results-in-larger-than-expected-payouts.html</link> <comments>https://www.policymed.com/2024/05/brookings-institution-finds-no-surprises-act-arbitration-results-in-larger-than-expected-payouts.html#respond</comments> <dc:creator><![CDATA[Thomas Sullivan]]></dc:creator> <pubDate>Wed, 22 May 2024 08:26:25 +0000</pubDate> <category><![CDATA[Drug Prices]]></category> <category><![CDATA[Healthcare Reform]]></category> <category><![CDATA[NEW]]></category> <guid isPermaLink="false">https://www.policymed.com/?p=16824</guid> <description><![CDATA[<div style="margin-bottom:20px;"><img width="1200" height="800" src="https://www.policymed.com/wp-content/uploads/2024/01/stencil.default-2024-01-31T172747.553.jpg" class="attachment-post-thumbnail size-post-thumbnail wp-post-image" alt="" decoding="async" loading="lazy" srcset="https://www.policymed.com/wp-content/uploads/2024/01/stencil.default-2024-01-31T172747.553.jpg 1200w, https://www.policymed.com/wp-content/uploads/2024/01/stencil.default-2024-01-31T172747.553-300x200.jpg 300w, https://www.policymed.com/wp-content/uploads/2024/01/stencil.default-2024-01-31T172747.553-1024x683.jpg 1024w, https://www.policymed.com/wp-content/uploads/2024/01/stencil.default-2024-01-31T172747.553-768x512.jpg 768w, https://www.policymed.com/wp-content/uploads/2024/01/stencil.default-2024-01-31T172747.553-450x300.jpg 450w" sizes="auto, (max-width: 1200px) 100vw, 1200px" /></div>The Brookings Institution recently published a study on the outcomes under the No Surprises Act arbitration process, finding that the process has tended to result in payouts larger than what Medicare and in-network private insurers would pay providers. Under the No Surprises Act, the amount a patient owes for out-of-network emergency services and non-emergency services […]]]></description> <content:encoded><![CDATA[<div style="margin-bottom:20px;"><img width="1200" height="800" src="https://www.policymed.com/wp-content/uploads/2024/01/stencil.default-2024-01-31T172747.553.jpg" class="attachment-post-thumbnail size-post-thumbnail wp-post-image" alt="" decoding="async" loading="lazy" srcset="https://www.policymed.com/wp-content/uploads/2024/01/stencil.default-2024-01-31T172747.553.jpg 1200w, https://www.policymed.com/wp-content/uploads/2024/01/stencil.default-2024-01-31T172747.553-300x200.jpg 300w, https://www.policymed.com/wp-content/uploads/2024/01/stencil.default-2024-01-31T172747.553-1024x683.jpg 1024w, https://www.policymed.com/wp-content/uploads/2024/01/stencil.default-2024-01-31T172747.553-768x512.jpg 768w, https://www.policymed.com/wp-content/uploads/2024/01/stencil.default-2024-01-31T172747.553-450x300.jpg 450w" sizes="auto, (max-width: 1200px) 100vw, 1200px" /></div><p>The Brookings Institution <a href="https://www.brookings.edu/articles/a-first-look-at-outcomes-under-the-no-surprises-act-arbitration-process/">recently published a study</a> on the outcomes under the No Surprises Act arbitration process, finding that the process has tended to result in payouts larger than what Medicare and in-network private insurers would pay providers. Under the No Surprises Act, the amount a patient owes for out-of-network emergency services and non-emergency services delivered at in-network facilities cannot exceed the cost-sharing that the patient would owe for similar in-network services. The law also created an independent dispute resolution (IDR) process to resolve disputes between insurers and providers over payment for impacted out-of-network services.</p> <p>To conduct the study, Brookings <a href="https://www.cms.gov/files/document/federal-idr-supplemental-background-2023-q1-2023-q2.pdf">reviewed data</a> on arbitration decisions during the first half of 2023 from the Centers for Medicare and Medicaid Services (CMS). In conducting the review, Brookings analyzed the IDR process to see how much providers and insurers are offering in IDR and what amounts the IDR entities ultimately decide upon.</p> <p>Brookings reported median figures rather than means because the data include some “extreme outlier decision amounts” that are suspected to be data errors. With a focus on emergency care, imaging, and neonatal/pediatric critical care, median payouts were at least 3.7 times what Medicare would pay.</p> <p>For emergency care and imaging – categories in which there are estimates of historical mean in-network commercial prices – the median payout was at least 50% higher than the historic most generous payments average for in-network care through commercial plans. For emergency care estimates, they ranged from 2.5 to 2.6 times Medicare’s price while imaging estimates ranged from 1.8 to 2/4 times Medicare’s price.</p> <p>Brookings also noted that “typical IDR decisions appear more similar to the allowed amounts that insurers historically set for the minority of services delivered out-of-network,” with estimates ranging from 3.9 to 4.7 times Medicare’s prices for emergency care and 2.9 to 3.3 times Medicare’s prices for imaging services. The insurer’s allowed amount does not necessarily reflect the amount the provider collected for the services and neither the allowed amount nor the IDR decision may reflect non-pecuniary costs that providers or insurers may incur with respect to out-of-network care.</p> <p>This means – in a surprising turn of events and the opposite of what the Congressional Budget Office predicted – the law very well may result in raised in-network prices and insurance premiums. CBO expected IDR decisions would fall close to the qualifying payment amount since it is one of the key factors considered by IDR entities in making decisions. In the disputes analyzed by Brookings, the qualifying payment amount has been lower than the mean in-network rates (absent the law) but as noted above, actual decisions in the dispute resolution process have tended to far exceed the qualifying payment amounts.</p> <p>Of course, it is not possible to predict whether future rulings will follow the same pattern, so the long-term effect on negotiations between insurers and providers is hard to predict.</p> ]]></content:encoded> <wfw:commentRss>https://www.policymed.com/2024/05/brookings-institution-finds-no-surprises-act-arbitration-results-in-larger-than-expected-payouts.html/feed</wfw:commentRss> <slash:comments>0</slash:comments> </item> <item> <title>Forging the Future of Healthcare: The US Consensus Framework for Ethical Collaboration</title> <link>https://www.policymed.com/2024/05/forging-the-future-of-healthcare-the-us-consensus-framework-for-ethical-collaboration.html</link> <comments>https://www.policymed.com/2024/05/forging-the-future-of-healthcare-the-us-consensus-framework-for-ethical-collaboration.html#respond</comments> <dc:creator><![CDATA[Thomas Sullivan]]></dc:creator> <pubDate>Tue, 14 May 2024 08:31:16 +0000</pubDate> <category><![CDATA[Healthcare Reform]]></category> <category><![CDATA[NEW]]></category> <guid isPermaLink="false">https://www.policymed.com/?p=16811</guid> <description><![CDATA[<div style="margin-bottom:20px;"><img width="1200" height="800" src="https://www.policymed.com/wp-content/uploads/2022/10/stencil.default-60.jpg" class="attachment-post-thumbnail size-post-thumbnail wp-post-image" alt="" decoding="async" loading="lazy" srcset="https://www.policymed.com/wp-content/uploads/2022/10/stencil.default-60.jpg 1200w, https://www.policymed.com/wp-content/uploads/2022/10/stencil.default-60-300x200.jpg 300w, https://www.policymed.com/wp-content/uploads/2022/10/stencil.default-60-1024x683.jpg 1024w, https://www.policymed.com/wp-content/uploads/2022/10/stencil.default-60-768x512.jpg 768w, https://www.policymed.com/wp-content/uploads/2022/10/stencil.default-60-450x300.jpg 450w" sizes="auto, (max-width: 1200px) 100vw, 1200px" /></div>In an initiative to establish a more ethical, equitable, and collaborative healthcare system in the United States, leading healthcare stakeholders came together to create the US Consensus Framework (USCF). The framework was established in 2023, guided by the collaborative efforts of various US healthcare organizations, including medical associations, patient groups, and life sciences entities. The […]]]></description> <content:encoded><![CDATA[<div style="margin-bottom:20px;"><img width="1200" height="800" src="https://www.policymed.com/wp-content/uploads/2022/10/stencil.default-60.jpg" class="attachment-post-thumbnail size-post-thumbnail wp-post-image" alt="" decoding="async" loading="lazy" srcset="https://www.policymed.com/wp-content/uploads/2022/10/stencil.default-60.jpg 1200w, https://www.policymed.com/wp-content/uploads/2022/10/stencil.default-60-300x200.jpg 300w, https://www.policymed.com/wp-content/uploads/2022/10/stencil.default-60-1024x683.jpg 1024w, https://www.policymed.com/wp-content/uploads/2022/10/stencil.default-60-768x512.jpg 768w, https://www.policymed.com/wp-content/uploads/2022/10/stencil.default-60-450x300.jpg 450w" sizes="auto, (max-width: 1200px) 100vw, 1200px" /></div><p>In an initiative to establish a more ethical, equitable, and collaborative healthcare system in the United States, leading healthcare stakeholders <a href="https://www.phrma.org/resource-center/Topics/Innovation/US-Consensus-Framework-to-Advance-Health-Equity-and-Ethical-Collaboration">came together</a> to create the US Consensus Framework (USCF). The framework was established in 2023, guided by the collaborative efforts of various US healthcare organizations, including medical associations, patient groups, and life sciences entities.</p> <p>The National Health Council (NHC), the National Medical Association (NMA), and the Pharmaceutical Research & Manufacturers of America (PhRMA) launched the USCF, which is meant to serve as a forum for stakeholders in the health care system, with the ongoing addition of key stakeholders, focused on establishing best practices and standards centered on the needs of patients and the promotion of health equity.</p> <p><strong>The Reason Behind the Framework</strong></p> <p>The United States is known for its advanced healthcare capabilities, yet it faces significant challenges such as structural, racial, environmental, and financial barriers, that hinder equitable access to healthcare. Furthermore, the burden of medical debt continues to affect a vast segment of the population, compounding disparities in healthcare access and quality. The USCF was crafted to address these pressing issues by fostering strong ethical collaboration across the healthcare ecosystem, positioning patients at the core of healthcare discussions and innovation and improving overall health outcomes.</p> <p>To help address concerns around health access, affordability, equity, and putting patients at the center of the health care industry, involved stakeholders aim for the document to be a “foundation for a more inclusive and comprehensive consensus framework that is increasingly capable of addressing the evolving needs of both today’s and tomorrow’s patients.”</p> <p><strong>The Framework</strong></p> <p>The framework takes inspiration from the International Consensus Framework for Ethical Collaboration, initially established by six global healthcare organizations including the International Alliance of Patients’ Organizations (IAPO), the International Council of Nurses (ICN), the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), the International Pharmaceutical Federation (FIP), the World Medical Association (WMA), and the International Hospital Federation (IHF).</p> <p>Founding principles of the USCF are:</p> <ol> <li>Put Patients First</li> <li>Support Ethical Research and Innovation</li> <li>Promote Transparency and Accountability</li> <li>Ensure Independence and Ethical Conduct</li> </ol> <p>Recognizing that healthcare challenges evolve, the USCF is designed as a living document. It is open for ongoing review and updates to remain relevant and responsive to new healthcare advancements, technologies, and the changing landscape of healthcare needs.</p> <p>By embodying values of respect, equity, trust, collaboration, and innovation, the US Consensus Framework aims to transform the healthcare system into one that not only meets but exceeds the needs of all patients, setting a new standard for excellence in healthcare. This initiative serves as an open invitation for all healthcare stakeholders in the US to join in this ethical collaboration, ensuring a better health system for future generations.</p> <p><em>Put Patients First</em></p> <p>Under this priority, the USCF emphasizes the importance of collaborating with patients and other health care stakeholders to improve access to health care and address barriers to optimal health.</p> <p><em>Support Ethical Research and Innovation</em></p> <p>Under this priority, the USCF encourages clinical and related research to generate information about safe, effective, and appropriate use of health treatments to reflect the diversity of the United States population. This includes not just ensuring that research involving human subjects has a legitimate scientific purpose, but also ensuring that it is sensitive to the needs, historical health experiences, and values of diverse populations. Additionally, trials should be accessible to people in diverse situations and participants should be informed about the nature and purpose of the research.</p> <p><em>Promote Transparency and Accountability</em></p> <p>The USCF notes the importance of trust between the health care industry and the public, starting with “appropriate transparency and accountability in our individual and collaborative activities.” This includes ensuring that all arrangements that require financial compensation for services not only have a legitimate purpose but also have a written contract in place prior to the start of services, with remuneration not to exceed an appropriate amount.</p> <p><em>Ensure Independence and Ethical Conduct</em></p> <p>The USCF states that interactions should always be ethical, appropriate, and professional. This includes restrictions on gifts, stating, “nothing should be offered to patients or by or between healthcare professionals, healthcare entities, or life sciences companies in a manner or on conditions that would have an inappropriate influence.”</p> <p><strong>Statements from Foundational Stakeholders</strong></p> <p>“This framework is essential to help guide partnerships that enable meaningful and appropriate patient engagement. Without patient involvement from the beginning, the effort to bring effective treatments to market and promote high-quality care is missing a critical voice – the patient. The National Health Council endorses this Framework for Ethical Collaboration to ensure patients are at the center of our health system,” <a href="https://nationalhealthcouncil.org/news-releases/launch-of-us-consensus-framework-to-advance-health-equity-ethical-collaboration/">said Randall L. Rutta, Chief Executive Officer, National Health Council</a>.</p> <p>“As the voice of Black health, the National Medical Association strives to both advance the art and science of medicine for people of African descent and support efforts towards improving the quality and availability of healthcare to underserved populations across the country. The USCF provides the platform and opportunity to advance health equity to the forefront of US healthcare discussions and sets the standard for ethical, patient-centered collaborations,” <a href="https://nationalhealthcouncil.org/news-releases/launch-of-us-consensus-framework-to-advance-health-equity-ethical-collaboration/">said Joy D. Calloway, Executive Director, National Medical Association</a>.</p> <p>“Since the inception of the PhRMA Code more than 20 years ago, PhRMA member companies have demonstrated their commitment to upholding the highest standards of business ethics and compliance. Our members’ robust ethics and compliance programs serve as the gold standard worldwide. This Consensus Framework is a historic step to build on this foundation, allowing leading health system stakeholders to partner and continue to drive thought leadership and forward progress in business ethics and equity. Today’s announcement is just the first step, and we look forward to building on this important partnership in the months ahead,” <a href="https://nationalhealthcouncil.org/news-releases/launch-of-us-consensus-framework-to-advance-health-equity-ethical-collaboration/">said Stephen J. Ubl, President and Chief Executive Officer, Pharmaceutical Researchers & Manufacturers Association</a>.</p> ]]></content:encoded> <wfw:commentRss>https://www.policymed.com/2024/05/forging-the-future-of-healthcare-the-us-consensus-framework-for-ethical-collaboration.html/feed</wfw:commentRss> <slash:comments>0</slash:comments> </item> <item> <title>Biden Administration Proposes Mental Health Parity Rules</title> <link>https://www.policymed.com/2024/01/biden-administration-proposes-mental-health-parity-rules.html</link> <comments>https://www.policymed.com/2024/01/biden-administration-proposes-mental-health-parity-rules.html#respond</comments> <dc:creator><![CDATA[Thomas Sullivan]]></dc:creator> <pubDate>Tue, 09 Jan 2024 09:35:10 +0000</pubDate> <category><![CDATA[Healthcare Reform]]></category> <category><![CDATA[NEW]]></category> <guid isPermaLink="false">https://www.policymed.com/?p=16566</guid> <description><![CDATA[<div style="margin-bottom:20px;"><img width="1200" height="800" src="https://www.policymed.com/wp-content/uploads/2023/10/stencil.default-2023-10-23T203610.146.jpg" class="attachment-post-thumbnail size-post-thumbnail wp-post-image" alt="" decoding="async" loading="lazy" srcset="https://www.policymed.com/wp-content/uploads/2023/10/stencil.default-2023-10-23T203610.146.jpg 1200w, https://www.policymed.com/wp-content/uploads/2023/10/stencil.default-2023-10-23T203610.146-300x200.jpg 300w, https://www.policymed.com/wp-content/uploads/2023/10/stencil.default-2023-10-23T203610.146-1024x683.jpg 1024w, https://www.policymed.com/wp-content/uploads/2023/10/stencil.default-2023-10-23T203610.146-768x512.jpg 768w, https://www.policymed.com/wp-content/uploads/2023/10/stencil.default-2023-10-23T203610.146-450x300.jpg 450w" sizes="auto, (max-width: 1200px) 100vw, 1200px" /></div>In August 2023, the Biden administration proposed new rules to strengthen enforcement of a 2008 law that requires insurers to cover mental health services at the same level as physical health care. Under the proposal, a health plan could only use treatment limits like prior authorization on a mental health or substance use service if […]]]></description> <content:encoded><![CDATA[<div style="margin-bottom:20px;"><img width="1200" height="800" src="https://www.policymed.com/wp-content/uploads/2023/10/stencil.default-2023-10-23T203610.146.jpg" class="attachment-post-thumbnail size-post-thumbnail wp-post-image" alt="" decoding="async" loading="lazy" srcset="https://www.policymed.com/wp-content/uploads/2023/10/stencil.default-2023-10-23T203610.146.jpg 1200w, https://www.policymed.com/wp-content/uploads/2023/10/stencil.default-2023-10-23T203610.146-300x200.jpg 300w, https://www.policymed.com/wp-content/uploads/2023/10/stencil.default-2023-10-23T203610.146-1024x683.jpg 1024w, https://www.policymed.com/wp-content/uploads/2023/10/stencil.default-2023-10-23T203610.146-768x512.jpg 768w, https://www.policymed.com/wp-content/uploads/2023/10/stencil.default-2023-10-23T203610.146-450x300.jpg 450w" sizes="auto, (max-width: 1200px) 100vw, 1200px" /></div><p>In August 2023, the Biden administration <a href="https://www.regulations.gov/document/EBSA-2023-0010-0001">proposed new rules</a> to strengthen enforcement of a 2008 law that requires insurers to cover mental health services at the same level as physical health care. Under the proposal, a health plan could only use treatment limits like prior authorization on a mental health or substance use service if it also uses the limits on two-thirds or more of its medical benefits in the same class. The rule would also require the plans to collect and evaluate data on the impact of their treatment limits on mental health benefits. Advocates strongly supported the rule in comments submitted to the government, but insurers and some employers were highly critical of the proposals.</p> <p><strong>More on Rules and Comments</strong></p> <p>The administration has accused insurers of failing to comply with parity regulations, pointing to a 2022 report to Congress from HHS and other agencies that found not one of the 156 insurance plans and issuers studied followed rules requiring them to measure their compliance. In response to the rule, over 9,000 comments were submitted by the October 17 deadline.</p> <p>The proposed rules are “so burdensome that many of our members will have no other choice but to re-think the type and level of their plans’ coverage” of mental health benefits, <a href="https://www.eric.org/wp-content/uploads/2023/10/ERIC-Mental-Health-Parity-Proposed-Regs-Final-Comments-10.17.23-as-filed.pdf">wrote</a> the ERISA Industry Committee, which advocates for employers on health benefits issues. AHIP <a href="https://www.ahip.org/documents/AHIP-Comments_MHPAEA-Proposed-Rule-10.17.23.pdf">said</a> officials should withdraw the entire proposal and restart the process to address what it says are significant legal and operational flaws in the plan. Insurers also defended the use of strategies like prior authorization to ensure that patients receive appropriate medical care. “If this approach is restricted, patients will pay more for treatment that varies widely in quality,” <a href="https://www.bcbs.com/press-releases/proposed-mental-health-parity-rule-could-limit-access-quality-mental-health-care">wrote the Blue Cross Blue Shield Association</a>. The groups, to varying degrees, took issue with proposed requirements for plans to analyze the impact of practices intended to limit unnecessary care.</p> <p>However, advocates like the Mental Health Liaison Group, strongly <a href="https://www.thekennedyforum.org/app/uploads/2023/10/MHLG-Comments-on-MHPAEA-Proposed-Rule-FINAL.pdf">supported the rule</a>. URAC, an organization offering the nation’s only mental health parity accreditation, generally supported the rules, and <a href="https://downloads.regulations.gov/EBSA-2023-0010-0112/attachment_1.pdf">promoted an accreditation safe harbor</a> as a means for plans to demonstrate compliance. Additionally, organizations like the <a href="https://www.aha.org/news/perspective/2023-08-04-strong-step-enhanced-mental-health-parity-regulations">American Hospital Association</a> and the <a href="https://www.ama-assn.org/press-center/press-releases/ama-applauds-proposed-rule-mental-health-parity-law">American Medical Association</a> were enthusiastic about the rules.</p> <p>Rep. Virginia Foxx (R-N.C.), chair of the House Education and the Workforce Committee, said the administration is going beyond its authority. “The … proposed rules will serve only to weaken parity compliance by giving prominence to bureaucratic reporting, paperwork, and audits,” <a href="https://edworkforce.house.gov/uploadedfiles/mental_health_parity_letter_final_10.17.pdf">Foxx wrote</a>. The panel’s top Democrat, Bobby Scott of Virginia, and health subcommittee ranking member Mark DeSaulnier (D-Calif.) backed the proposal <a href="https://democrats-edworkforce.house.gov/imo/media/doc/scott_desaulnier_comment_letter_to_dol_hhs_treasury_on_mental_health_parity_proposed_rule.pdf">in a letter</a> but said the administration should go further in limiting exceptions.</p> ]]></content:encoded> <wfw:commentRss>https://www.policymed.com/2024/01/biden-administration-proposes-mental-health-parity-rules.html/feed</wfw:commentRss> <slash:comments>0</slash:comments> </item> <item> <title>Healthcare Disparities: Promoting Change Through Continuing Professional Development</title> <link>https://www.policymed.com/2023/12/healthcare-disparities-promoting-change-through-continuing-professional-development.html</link> <comments>https://www.policymed.com/2023/12/healthcare-disparities-promoting-change-through-continuing-professional-development.html#respond</comments> <dc:creator><![CDATA[Thomas Sullivan]]></dc:creator> <pubDate>Fri, 29 Dec 2023 09:44:37 +0000</pubDate> <category><![CDATA[CME]]></category> <category><![CDATA[Healthcare Reform]]></category> <category><![CDATA[NEW]]></category> <guid isPermaLink="false">https://www.policymed.com/?p=16554</guid> <description><![CDATA[<div style="margin-bottom:20px;"><img width="1200" height="800" src="https://www.policymed.com/wp-content/uploads/2023/06/stencil.default-98.jpg" class="attachment-post-thumbnail size-post-thumbnail wp-post-image" alt="" decoding="async" loading="lazy" srcset="https://www.policymed.com/wp-content/uploads/2023/06/stencil.default-98.jpg 1200w, https://www.policymed.com/wp-content/uploads/2023/06/stencil.default-98-300x200.jpg 300w, https://www.policymed.com/wp-content/uploads/2023/06/stencil.default-98-1024x683.jpg 1024w, https://www.policymed.com/wp-content/uploads/2023/06/stencil.default-98-768x512.jpg 768w, https://www.policymed.com/wp-content/uploads/2023/06/stencil.default-98-450x300.jpg 450w" sizes="auto, (max-width: 1200px) 100vw, 1200px" /></div>Healthcare disparities have long been a pressing issue that impact the well-being of patients on various fronts – physical, mental, and financial. The use of Continuing Professional Development (CPD) programs has emerged as a potential solution to address and mitigate these disparities. While the impact of CPD programs focused on disparities remains an underexplored area, […]]]></description> <content:encoded><![CDATA[<div style="margin-bottom:20px;"><img width="1200" height="800" src="https://www.policymed.com/wp-content/uploads/2023/06/stencil.default-98.jpg" class="attachment-post-thumbnail size-post-thumbnail wp-post-image" alt="" decoding="async" loading="lazy" srcset="https://www.policymed.com/wp-content/uploads/2023/06/stencil.default-98.jpg 1200w, https://www.policymed.com/wp-content/uploads/2023/06/stencil.default-98-300x200.jpg 300w, https://www.policymed.com/wp-content/uploads/2023/06/stencil.default-98-1024x683.jpg 1024w, https://www.policymed.com/wp-content/uploads/2023/06/stencil.default-98-768x512.jpg 768w, https://www.policymed.com/wp-content/uploads/2023/06/stencil.default-98-450x300.jpg 450w" sizes="auto, (max-width: 1200px) 100vw, 1200px" /></div><p>Healthcare disparities have long been a pressing issue that impact the well-being of patients on various fronts – physical, mental, and financial. The use of Continuing Professional Development (CPD) programs has emerged as a potential solution to address and mitigate these disparities. While the impact of CPD programs focused on disparities remains an underexplored area, this article delves into quantitative data from seven such CPD programs, shedding light on their potential to drive change.</p> <p><strong>The Systemic Nature of Healthcare Disparities</strong></p> <p>Healthcare disparities are systemic issues that affect not only individual patients but also entire communities. In our constantly evolving world, where patients come from diverse backgrounds with varying cultures and belief systems, addressing disparities becomes an ongoing challenge. Unfortunately, many medical training programs have failed to consistently incorporate content related to disparities among underrepresented populations into their curricula.</p> <p>For example, a 2011 survey revealed that 33% of medical schools did not include any LGBTQIA+ education in their curriculum. Radiologists also reported a lack of education in healthcare disparities, with only 16.4% feeling adequately trained in this area. Similarly, a study on pharmacists found that 65% did not have social determinants of health (SDOH) addressed in their didactic curriculum, and 45% reported that SDOH were not addressed during their residency. This educational gap in healthcare training exacerbates the potential for future healthcare disparities.</p> <p><strong>CPD Programs Addressing Healthcare Disparities</strong></p> <p>In a <a href="https://www.tandfonline.com/doi/full/10.1080/28338073.2023.2269075">recent analysis</a> conducted by Richard A. Menear, Katelyn N. Hernandez, Lisa Handley, Ashley Ann Lora, and Sarah A. Nisly and published in the <a href="https://www.tandfonline.com/doi/full/10.1080/28338073.2023.2269075">Journal of CME</a>, various CPD programs focusing on healthcare disparities were examined. These programs engaged a total of 41,588 healthcare providers in educational content and the results were promising, showing a 25% improvement in knowledge-based questions and a 27% improvement in competence-based questions among learners who participated in these programs.</p> <p>Furthermore, an encouraging 2.5% of learners participated in a post-activity evaluation. Of these participants, 59% reported using information from CPD programs to enhance their current practice, while 34% expressed intentions to implement strategies aimed at reducing or mitigating healthcare disparities. These findings underline the potential of CPD to increase awareness and equip healthcare providers with the knowledge needed to address disparities effectively.</p> <p><strong>The Urgent Need for Timely Education</strong></p> <p>The absence of meaningful education in healthcare training for preventing future healthcare disparities is glaring. It underscores the importance of healthcare professionals engaging in timely education to mitigate disparities in their practice. While standalone CPD programming can be impactful, partnerships between CPD providers and healthcare entities can also yield meaningful education in healthcare disparities.</p> <p>Clinical Education Alliance (CEA), for instance, has focused on educating learners about strategies to reduce healthcare disparities, particularly in high-risk therapeutic areas. CEA emphasizes how social determinants of health (SDOH) impact the quality of care, helping learners recognize these barriers and bridge the gap between at-risk patients and improved healthcare.</p> <p><strong>Results of the CPD Programs</strong></p> <p>Between September 2021 and December 2022, the authors of the study noted above identified and summarized seven CPD programs with a focus on healthcare disparities. The programs utilized various educational formats, including live in-person and virtual meetings, as well as enduring components for asynchronous learners. Learners’ demographic information, including healthcare profession and practice specialty, was collected, and participants had the opportunity to complete pre-tests and post-tests to assess their knowledge and competency.</p> <p>Among the seven CPD programs, a total of 41,588 learners engaged with the educational content, with a balanced distribution between US and non-US participants. The professions of the learners who participated in the CPD programs varied widely. Across the programs, 43 assessment questions were included, revealing a 25% improvement in knowledge assessment items and a 27% improvement in competence assessment items.</p> <p>Of the healthcare providers who participated in the post-activity evaluation (2.5%, n = 1101), 35% expressed a willingness to make changes to their current practice. Remarkably, 59% reported that they had already implemented the procedures in practice, reflecting a proactive approach to addressing disparities. Only 6% indicated that they would not make changes to their practice. Additionally, it was found that 30% of healthcare providers identified financial issues and insurance as barriers to change, followed closely by patient adherence.</p> <p><strong>Discussion: The Way Forward</strong></p> <p>This pilot analysis showcases several encouraging aspects of CPD in addressing healthcare disparities. Importantly, more than one-third of participants expressed a willingness to make changes to their practice to address these disparities, marking an essential first step in breaking down barriers affecting marginalized populations. While quantitative findings in this area are limited, a robust foundation of qualitative data provides valuable insights into effective strategies to mitigate healthcare disparities.</p> <p>One opportunity to enhance CPD’s impact on healthcare disparities is through collaboration with patient advocacy groups. Patient representation is currently lacking in CPD programs, and including patients’ perspectives is crucial. Patients possess unique insights into their own experiences and invaluable perspectives on the challenges they face. By incorporating patient voices, CPD programs can become more relevant and responsive to real-world needs.</p> <p>Moreover, educating healthcare professional students is pivotal. To effect change in the healthcare of high-risk patients, engaging healthcare students should be a priority. Institutional education should incorporate content focused on disparities faced by specific populations. This knowledge can then be applied by post-graduate trainees in their practice settings, influencing change within healthcare systems.</p> <p>While this pilot analysis yielded noteworthy results, it’s important to acknowledge its limitations. Response bias and low response rates could contribute to discrepancies between learner activity and responses to assessment and demographic questions. Self-reported metrics also limit the ability to confirm the actual impact on patients. Furthermore, selection bias may exist in the choice of the seven CPD programs.</p> <p><strong>Conclusion</strong></p> <p>Continuing Professional Development (CPD) programs represent a promising avenue for addressing and mitigating healthcare disparities. The quantitative data presented in the study demonstrate the potential of CPD to equip healthcare providers with the knowledge and competence needed to tackle disparities effectively.</p> <p>To drive change and break down systemic barriers, it’s important that healthcare disparities education is prioritized and emphasized in both pre-graduate and post-graduate training. Additionally, collaboration with patient advocacy groups and inclusion of patient perspectives in CPD programs can enhance their relevance and impact.</p> <p>In conclusion, CPD offers a valuable tool for healthcare professionals to bridge the gap in healthcare disparities. As we move forward, let us continue to emphasize the importance of addressing healthcare disparities through education, training, and a commitment to patient-centered care.</p> <p><a href="https://www.tandfonline.com/doi/full/10.1080/28338073.2023.2269075">To access the full article</a></p> ]]></content:encoded> <wfw:commentRss>https://www.policymed.com/2023/12/healthcare-disparities-promoting-change-through-continuing-professional-development.html/feed</wfw:commentRss> <slash:comments>0</slash:comments> </item> <item> <title>Proposed Changes for the Mental Health Parity and Addiction Equity Act</title> <link>https://www.policymed.com/2023/09/proposed-changes-for-the-mental-health-parity-and-addiction-equity-act.html</link> <comments>https://www.policymed.com/2023/09/proposed-changes-for-the-mental-health-parity-and-addiction-equity-act.html#respond</comments> <dc:creator><![CDATA[Thomas Sullivan]]></dc:creator> <pubDate>Mon, 25 Sep 2023 08:36:47 +0000</pubDate> <category><![CDATA[CMS]]></category> <category><![CDATA[Guidelines]]></category> <category><![CDATA[Healthcare Reform]]></category> <category><![CDATA[HHS]]></category> <category><![CDATA[NEW]]></category> <guid isPermaLink="false">https://www.policymed.com/?p=16390</guid> <description><![CDATA[<div style="margin-bottom:20px;"><img width="1200" height="800" src="https://www.policymed.com/wp-content/uploads/2023/05/stencil.default-96.jpg" class="attachment-post-thumbnail size-post-thumbnail wp-post-image" alt="" decoding="async" loading="lazy" srcset="https://www.policymed.com/wp-content/uploads/2023/05/stencil.default-96.jpg 1200w, https://www.policymed.com/wp-content/uploads/2023/05/stencil.default-96-300x200.jpg 300w, https://www.policymed.com/wp-content/uploads/2023/05/stencil.default-96-1024x683.jpg 1024w, https://www.policymed.com/wp-content/uploads/2023/05/stencil.default-96-768x512.jpg 768w, https://www.policymed.com/wp-content/uploads/2023/05/stencil.default-96-450x300.jpg 450w" sizes="auto, (max-width: 1200px) 100vw, 1200px" /></div>Recently, the Departments of Labor, Health and Human Services, and the Treasury announced proposed changes to the Mental Health Parity and Addiction Equity Act (MHPAEA). Originally enacted in 2008, the MHPAEA helps to ensure that patients seeking care for mental health and substance use disorders do not face any greater barriers to treatment than those […]]]></description> <content:encoded><![CDATA[<div style="margin-bottom:20px;"><img width="1200" height="800" src="https://www.policymed.com/wp-content/uploads/2023/05/stencil.default-96.jpg" class="attachment-post-thumbnail size-post-thumbnail wp-post-image" alt="" decoding="async" loading="lazy" srcset="https://www.policymed.com/wp-content/uploads/2023/05/stencil.default-96.jpg 1200w, https://www.policymed.com/wp-content/uploads/2023/05/stencil.default-96-300x200.jpg 300w, https://www.policymed.com/wp-content/uploads/2023/05/stencil.default-96-1024x683.jpg 1024w, https://www.policymed.com/wp-content/uploads/2023/05/stencil.default-96-768x512.jpg 768w, https://www.policymed.com/wp-content/uploads/2023/05/stencil.default-96-450x300.jpg 450w" sizes="auto, (max-width: 1200px) 100vw, 1200px" /></div><p>Recently, the Departments of Labor, Health and Human Services, and the Treasury <a href="https://www.federalregister.gov/documents/2023/08/03/2023-15945/requirements-related-to-the-mental-health-parity-and-addiction-equity-act">announced proposed changes</a> to the Mental Health Parity and Addiction Equity Act (MHPAEA). Originally enacted in 2008, the MHPAEA helps to ensure that patients seeking care for mental health and substance use disorders do not face any greater barriers to treatment than those that are faced by patients seeking treatment for physical and/or surgical conditions. This includes prohibitions on insurance companies from imposing copayments, prior authorization, and other requirements on mental health and substance use disorder benefits that are more restrictive than those that are imposed on medical and surgical benefits.</p> <p>However, the agencies note that despite these restrictions, those who seek coverage for mental health and substance use disorder care do still face greater barriers when seeking treatment under those categories, when compared to seeking medical or surgical benefits.</p> <p>The proposed rules clarify the new MHPAEA requirements to perform and document comparative analyses of the design and application of non-quantitative treatment limitations (NQTLs) to assess the impact of the NQTLs on access to mental health and substance use disorder benefits, as compared to medical or surgical benefits. The proposed rules would also amend existing NQTL standards to prevent plans and issuers from using them to impede access to mental health or substance use disorder treatment benefits.</p> <p>The proposed rules further set forth the content requirements for NQTL comparative analyses and specify how plans and issuers must make these comparative analyses available to the Department of the Treasury (Treasury), the Department of Labor (DOL), and the Department of Health and Human Services (HHS) (collectively referred to as “the Departments”), as well as to any applicable State authority, participants, beneficiaries, and enrollees.</p> <p>The proposed rules would require plans and issuers to collect and evaluate relevant data in a manner reasonably designed to assess the impact of NQTLs on access to mental health and substance use disorder benefits and medical/surgical benefits and also sets forth a special rule with regard to network composition. The proposed rules would require plans and issuers to collect and evaluate relevant data in a manner reasonably designed to assess the impact of NQTLs on access to mental health and substance use disorder benefits and medical/surgical benefits, and would set forth a special rule with regard to network composition.</p> <p>The proposal requires plans and issuers to consider whether an NQTL is inhibiting access to treatment for mental health conditions and substance use disorders by examining whether the NQTL that applies to mental health or substance use disorder benefits is more restrictive than the predominant NQTL that applies to substantially all medical/surgical benefits within a classification of benefits set forth under the regulations. The plan or issuer will also need to consider whether the processes, strategies, evidentiary standards, or other factors that it uses to design or apply an NQTL to mental health or substance use disorder benefits in a classification are comparable to, and applied no more stringently than, those used in designing and applying the NQTL to medical/surgical benefits in the same classification.</p> <p>Under the proposal, if a plan does not satisfy any of the new NQTL classification requirements, the NQTL would violate MHPAEA and could not be imposed on mental health or substance use disorder benefits in the classification. If plans or issuers fail to comply with the requirements, it would have to make changes to the terms of the plan or coverage, or changes to the way the NQTL is designed or applied to ensure compliance with the MHPAEA.</p> <p>If enacted as proposed, the majority of the proposed changes would apply on the first day of the first plan year beginning on or after January 1, 2025. The proposed HHS regulations that extend MHPAEA requirements to health insurance issuers that offer individual health insurance coverage would apply January 1, 2026, while the provision that previously allowed plans to opt out of MHPAEA would sunset (retroactively) on December 29, 2022.</p> <p>“HHS believes all Americans should have access to mental health and substance use disorder treatment, whenever and however they need it,” <a href="https://www.hhs.gov/about/news/2023/07/25/departments-labor-health-human-services-treasury-announce-proposed-rules-strengthen-mental-health-parity-addiction-equity-act.html">said HHS Secretary Xavier Becerra</a>. “In support of the President’s Unity Agenda, we continue to take actions to address the nation’s mental health crisis. We are ensuring that mental health is treated no differently than physical health and people in need of services have equitable access to care.”</p> <p>If we are serious about solving the opioid crisis, access to mental health treatment is absolutely necessary. We believe these proposed rules go along way to greatly expand access to behavioral health to millions of American’s who are currently locked out of the system due to restrictions from insurance coverage.</p> <p>To review the entire proposed rule and submit comments see the Federal Register <a href="https://www.federalregister.gov/documents/2023/08/03/2023-15945/requirements-related-to-the-mental-health-parity-and-addiction-equity-act">here</a>. Comments must be submitted by October 2, 2023.</p> ]]></content:encoded> <wfw:commentRss>https://www.policymed.com/2023/09/proposed-changes-for-the-mental-health-parity-and-addiction-equity-act.html/feed</wfw:commentRss> <slash:comments>0</slash:comments> </item> <item> <title>Healthcare: No Value Without Equity</title> <link>https://www.policymed.com/2023/02/healthcare-no-value-without-equity.html</link> <comments>https://www.policymed.com/2023/02/healthcare-no-value-without-equity.html#respond</comments> <dc:creator><![CDATA[Thomas Sullivan]]></dc:creator> <pubDate>Wed, 15 Feb 2023 09:21:12 +0000</pubDate> <category><![CDATA[Editorials]]></category> <category><![CDATA[Healthcare Reform]]></category> <category><![CDATA[NEW]]></category> <guid isPermaLink="false">https://www.policymed.com/?p=15848</guid> <description><![CDATA[<div style="margin-bottom:20px;"><img width="1200" height="800" src="https://www.policymed.com/wp-content/uploads/2022/05/stencil.default-18.jpg" class="attachment-post-thumbnail size-post-thumbnail wp-post-image" alt="" decoding="async" loading="lazy" srcset="https://www.policymed.com/wp-content/uploads/2022/05/stencil.default-18.jpg 1200w, https://www.policymed.com/wp-content/uploads/2022/05/stencil.default-18-300x200.jpg 300w, https://www.policymed.com/wp-content/uploads/2022/05/stencil.default-18-1024x683.jpg 1024w, https://www.policymed.com/wp-content/uploads/2022/05/stencil.default-18-768x512.jpg 768w, https://www.policymed.com/wp-content/uploads/2022/05/stencil.default-18-450x300.jpg 450w" sizes="auto, (max-width: 1200px) 100vw, 1200px" /></div>The Innovation and Value Initiative (IVI) recently published a data brief focused on health equity following a series of interviews with stakeholders through the Health Equity Initiative (HEI). Building upon a 2021 public dialogue series addressing the importance of health equity and current insufficiencies, IVI notes that there were “two common themes about needed change.” […]]]></description> <content:encoded><![CDATA[<div style="margin-bottom:20px;"><img width="1200" height="800" src="https://www.policymed.com/wp-content/uploads/2022/05/stencil.default-18.jpg" class="attachment-post-thumbnail size-post-thumbnail wp-post-image" alt="" decoding="async" loading="lazy" srcset="https://www.policymed.com/wp-content/uploads/2022/05/stencil.default-18.jpg 1200w, https://www.policymed.com/wp-content/uploads/2022/05/stencil.default-18-300x200.jpg 300w, https://www.policymed.com/wp-content/uploads/2022/05/stencil.default-18-1024x683.jpg 1024w, https://www.policymed.com/wp-content/uploads/2022/05/stencil.default-18-768x512.jpg 768w, https://www.policymed.com/wp-content/uploads/2022/05/stencil.default-18-450x300.jpg 450w" sizes="auto, (max-width: 1200px) 100vw, 1200px" /></div><p>The Innovation and Value Initiative (IVI) <a href="https://thevalueinitiative.org/wp-content/uploads/2023/01/Value-Brief_No-Value-Without-Equity_FINAL.pdf">recently published a data brief</a> focused on health equity following a series of interviews with stakeholders through the Health Equity Initiative (HEI). Building upon a 2021 public dialogue series addressing the importance of health equity and current insufficiencies, IVI notes that there were “two common themes about needed change.”</p> <p>One of the common themes was that power imbalances in design and design-making need to be intentionally addressed, to give “equal leadership to lived expertise from patients, families, and communities marginalized in research and care delivery.” The other theme was that data and research needs to “reflect real-world diversity across multiple dimensions to be considered relevant and reliable for decision-making.”</p> <p>The interviews also found a “broad agreement” about the intersection of equity and value, noting that equity must be considered in who does the work of health technology assessment and that equity is multi-dimensional, in that it includes fairness, justice, access, and equal opportunity to experience health and well-being.</p> <p>Some of the early action opportunities identified by IVI relate to integrating equity into all aspects of health technology assessment include: establish the benchmark that value cannot be measured without equity; change who sets the health technology assessment agenda (to include diverse patient and family communities in priority-setting processes); change health technology assessment processes; prioritize data sharing initiatives; acknowledge gaps in methods; and explicitly communicate equity implications of HTA.</p> <p>IVI identified a handful of questions that can help to improve equity in health technology assessment, including who must be involved in prioritizing and designing HTA processes and structure, what expertise is needed on the team for equity to be a consistent driver of HTA work, how can processes and partnerships ensure data and methods are representative, and what methods for engagement of lived experience will ensure relevance of HTA results.</p> <p>“IVI is proud to join other thought leaders in identifying and activating real change to promote and uphold health equity,” <a href="https://thevalueinitiative.org/press-release-no-value-without-equity/">says Jennifer Bright</a>, Chief Strategy and Engagement Officer at IVI. “As this brief demonstrates there is strong consensus that we cannot measure value without equity.”</p> <p>“In the health technology assessment field, action must occur to ensure representativeness in all processes and data, test methods that include equity in analyses, and uphold transparency,” <a href="https://thevalueinitiative.org/press-release-no-value-without-equity/">Bright explains</a>. “Doing the hard work in all of these areas is foundational to patient-centered, equitable decision-making.”</p> <p>IVI is continuing to work towards embedding health equity throughout its research projects, educational offerings, and engagement activities to promote equity in health access and outcomes.</p> <p>For a copy of the data brief, visit <a href="https://thevalueinitiative.org/wp-content/uploads/2023/01/Value-Brief_No-Value-Without-Equity_FINAL.pdf">here</a>.</p> ]]></content:encoded> <wfw:commentRss>https://www.policymed.com/2023/02/healthcare-no-value-without-equity.html/feed</wfw:commentRss> <slash:comments>0</slash:comments> </item> <item> <title>Institute for Healthcare Improvement Partners with the AMA to Focus on Healthcare Equity</title> <link>https://www.policymed.com/2022/12/institute-for-healthcare-improvement-partners-with-the-ama-to-focus-on-healthcare-equity.html</link> <comments>https://www.policymed.com/2022/12/institute-for-healthcare-improvement-partners-with-the-ama-to-focus-on-healthcare-equity.html#respond</comments> <dc:creator><![CDATA[Thomas Sullivan]]></dc:creator> <pubDate>Thu, 22 Dec 2022 09:58:54 +0000</pubDate> <category><![CDATA[Healthcare Reform]]></category> <category><![CDATA[NEW]]></category> <guid isPermaLink="false">https://www.policymed.com/?p=15741</guid> <description><![CDATA[<div style="margin-bottom:20px;"><img width="2339" height="2560" src="https://www.policymed.com/wp-content/uploads/2022/12/Rise-to-Health-IHI-1-scaled.jpg" class="attachment-post-thumbnail size-post-thumbnail wp-post-image" alt="" decoding="async" loading="lazy" srcset="https://www.policymed.com/wp-content/uploads/2022/12/Rise-to-Health-IHI-1-scaled.jpg 2339w, https://www.policymed.com/wp-content/uploads/2022/12/Rise-to-Health-IHI-1-274x300.jpg 274w, https://www.policymed.com/wp-content/uploads/2022/12/Rise-to-Health-IHI-1-936x1024.jpg 936w, https://www.policymed.com/wp-content/uploads/2022/12/Rise-to-Health-IHI-1-768x841.jpg 768w, https://www.policymed.com/wp-content/uploads/2022/12/Rise-to-Health-IHI-1-1403x1536.jpg 1403w, https://www.policymed.com/wp-content/uploads/2022/12/Rise-to-Health-IHI-1-1871x2048.jpg 1871w" sizes="auto, (max-width: 2339px) 100vw, 2339px" /></div>On December 6, 2022, the Institute for Healthcare Improvement launched Rise to Health: a National Coalition for Equity in Healthcare, partnering with the American Medical Association and others. The coalition seeks to improve equity, not only for patients but also for staff. Rise to Health hopes to transform the “health care ecosystem” to one “where […]]]></description> <content:encoded><![CDATA[<div style="margin-bottom:20px;"><img width="2339" height="2560" src="https://www.policymed.com/wp-content/uploads/2022/12/Rise-to-Health-IHI-1-scaled.jpg" class="attachment-post-thumbnail size-post-thumbnail wp-post-image" alt="" decoding="async" loading="lazy" srcset="https://www.policymed.com/wp-content/uploads/2022/12/Rise-to-Health-IHI-1-scaled.jpg 2339w, https://www.policymed.com/wp-content/uploads/2022/12/Rise-to-Health-IHI-1-274x300.jpg 274w, https://www.policymed.com/wp-content/uploads/2022/12/Rise-to-Health-IHI-1-936x1024.jpg 936w, https://www.policymed.com/wp-content/uploads/2022/12/Rise-to-Health-IHI-1-768x841.jpg 768w, https://www.policymed.com/wp-content/uploads/2022/12/Rise-to-Health-IHI-1-1403x1536.jpg 1403w, https://www.policymed.com/wp-content/uploads/2022/12/Rise-to-Health-IHI-1-1871x2048.jpg 1871w" sizes="auto, (max-width: 2339px) 100vw, 2339px" /></div><p>On December 6, 2022, the Institute for Healthcare Improvement launched <a href="https://www.risetohealthequity.org/">Rise to Health: a National Coalition for Equity in Healthcare</a>, partnering with the American Medical Association and others. The coalition seeks to improve equity, not only for patients but also for staff.</p> <p>Rise to Health hopes to transform the “health care ecosystem” to one “where all people have the power, circumstances, and resources to achieve optimal health.” The coalition plans to build capacity, expand knowledge, and mobilize with concrete skills and tools to advance equity and racial justice in the health care ecosystem and communities. Ultimately, the coalition hopes to change mindsets and narratives within the health care industry around equity and racial justice, including by influencing policy, payment, education, standards, and practices.</p> <p>The coalition is made up of individual practitioners; health care organizations; professional societies; payers; and pharmaceutical, research, and biotechnology organizations.</p> <p>The Coalition will focus on four “critical impact areas for immediate and collective attention and action”: access, workforce, social and structural drivers of health, and quality/safety. The foundational set of actions and associated activities are broken down into six steps: (1) commit to acting for equity; (2) get grounded in history and your local context; (3) identify opportunities for improvement; (4) make equity a strategic priority; (5) take initiative; and (6) align, invest, and advocate for thriving communities.</p> <p>“Burnout is an inadequate description of what the workforce is actually experiencing,” Kedar Mate, MD, president and CEO of the Institute for Healthcare Improvement, <a href="https://www.beckershospitalreview.com/health-equity/ihi-starts-national-coalition-for-equity-in-healthcare-with-ama-race-forward.html">said in a press conference December 5</a>. “I characterize their experience as a moral injury, which describes the phenomenon of feeling tasked to do something that workers see as part of their professional commitments but are unable to fulfill them due to structural and organizational barriers.”</p> <p>During the press conference, he provided an example of an internist who described her “inability to address social inequities as being one of the reasons that drove her out” and that she felt “a sense of powerlessness, a sense that she couldn’t do more than she had originally committed herself to.”</p> <p>Dr. Mate’s wife was also a physician who left her practice during the pandemic, not because of burnout, but for similar reasons to the doctor mentioned above.</p> <p>Dr. Mate also explained the results of an intervention test using the coalition’s proposed methods during the press conference, noting that the intervention resulted in a 67% decrease in burnout measures while the comparative organization saw a 20% increase in turnover during the same time period.</p> <p>Dr. Mate noted that the Coalition has started to work with colleagues across different organizations and after launching an invitation to join, there was an overwhelming response. The Coalition was only able to accept a little over half of the initial organizations who wanted to join, but Dr. Mate is committed to finding a way to say yes to all those who want to work on equity.</p> <p>You can subscribe to the mailing list and receive the Starter Actions and Activities, as well as notification when the full website launches in Spring 2023, <a href="https://www.risetohealthequity.org/">here</a>.</p> ]]></content:encoded> <wfw:commentRss>https://www.policymed.com/2022/12/institute-for-healthcare-improvement-partners-with-the-ama-to-focus-on-healthcare-equity.html/feed</wfw:commentRss> <slash:comments>0</slash:comments> </item> <item> <title>2023 Large Employers’ Health Care Strategy and Plan Design Survey Released</title> <link>https://www.policymed.com/2022/09/2023-large-employers-health-care-strategy-and-plan-design-survey-released.html</link> <comments>https://www.policymed.com/2022/09/2023-large-employers-health-care-strategy-and-plan-design-survey-released.html#respond</comments> <dc:creator><![CDATA[Thomas Sullivan]]></dc:creator> <pubDate>Fri, 30 Sep 2022 08:56:08 +0000</pubDate> <category><![CDATA[Healthcare Reform]]></category> <category><![CDATA[NEW]]></category> <guid isPermaLink="false">https://www.policymed.com/?p=15523</guid> <description><![CDATA[<div style="margin-bottom:20px;"><img width="1200" height="800" src="https://www.policymed.com/wp-content/uploads/2022/05/stencil.default-21.jpg" class="attachment-post-thumbnail size-post-thumbnail wp-post-image" alt="" decoding="async" loading="lazy" srcset="https://www.policymed.com/wp-content/uploads/2022/05/stencil.default-21.jpg 1200w, https://www.policymed.com/wp-content/uploads/2022/05/stencil.default-21-300x200.jpg 300w, https://www.policymed.com/wp-content/uploads/2022/05/stencil.default-21-1024x683.jpg 1024w, https://www.policymed.com/wp-content/uploads/2022/05/stencil.default-21-768x512.jpg 768w, https://www.policymed.com/wp-content/uploads/2022/05/stencil.default-21-450x300.jpg 450w" sizes="auto, (max-width: 1200px) 100vw, 1200px" /></div>In August 2022, the Business Group on Health released the 2023 Large Employers’ Health Care Strategy and Plan Design Survey, covering large employers’ perspectives on critical health care topics. Some of the topics covered in the survey include the lasting impact of COVID-19 and what role health and well-being play in overall workforce strategy. The […]]]></description> <content:encoded><![CDATA[<div style="margin-bottom:20px;"><img width="1200" height="800" src="https://www.policymed.com/wp-content/uploads/2022/05/stencil.default-21.jpg" class="attachment-post-thumbnail size-post-thumbnail wp-post-image" alt="" decoding="async" loading="lazy" srcset="https://www.policymed.com/wp-content/uploads/2022/05/stencil.default-21.jpg 1200w, https://www.policymed.com/wp-content/uploads/2022/05/stencil.default-21-300x200.jpg 300w, https://www.policymed.com/wp-content/uploads/2022/05/stencil.default-21-1024x683.jpg 1024w, https://www.policymed.com/wp-content/uploads/2022/05/stencil.default-21-768x512.jpg 768w, https://www.policymed.com/wp-content/uploads/2022/05/stencil.default-21-450x300.jpg 450w" sizes="auto, (max-width: 1200px) 100vw, 1200px" /></div><p>In August 2022, the Business Group on Health released the <a href="https://www.businessgrouphealth.org/resources/2023-plan-design-full-report">2023 Large Employers’ Health Care Strategy and Plan Design Survey</a>, covering large employers’ perspectives on critical health care topics. Some of the topics covered in the survey include the lasting impact of COVID-19 and what role health and well-being play in overall workforce strategy. The information gathered from the survey was then used to create aggregate findings on how employer-sponsored healthcare may shift in the coming year.</p> <p>The survey was conducted between May 31, 2022, and July 13, 2022, and 135 large employers participating, representing more than 18 million patient lives in the United States. 27% of respondents had less than 10,000 employees; 25% had between 10,000 and 24,999 employees, 19% had between 25,000 and 49,999 employees, 16% had between 50,000 and 99,999 employees, and 13% had more than 100,000 employees. 13% of respondents were involved in the technology/telecommunications industry and another 13% were involved in the manufacturing industry. 11% were from the retail/hospitality/food services sector while 10% from the banking/financial services/securities. Less than 10% of respondents were involved in each of the following industries: consumer products and grocery (9%), insurance (8%), energy production and utilities (7%), health care (7%), pharmaceuticals and medical products (6%), transportation and shipping (4%), aerospace/defense (4%), and other (7%).</p> <p>“Survey findings function as a ‘collective snapshot’ that can guide employers as they determine how to maximize employee benefits,” said Ellen Kelsay, president and CEO of Business Group on Health. “Employers shared that they are deeply concerned about unsustainable health care costs, the devastating effects of the pandemic on employee health, and the need to work creatively with their partners toward a more positive and sustainable health care experience, among other issues.”</p> <p><strong>Areas of Focus for Employers</strong></p> <p>The following two topics were among the highest-ranked focus areas among the surveyed employers: (1) a dramatic increase in the importance of health and well-being to workforce strategy due to many factors (including COVID-19) and (2) the need to assess and improve upon virtual health options are important.</p> <p>65% of employers noted that their health and well-being strategy plays an “integral role in workforce strategy,” up from 42% in prior years. The health and well-being strategy is a wide-ranging collection of ideas from supporting employees overall health and well-being to the ability to attract and retain talent through benefits and other offerings.</p> <p>Related to that is the idea that virtual health has become so prevalent as a result of the COVID-19 pandemic. 74% of those surveyed “believe that virtual health will have a significant impact on how care is delivered in the future,” and 84% of employers “believe that integrating virtual health and in-person care delivery is essential and the most important action their partners can take.”</p> <p><strong>Rising Health Care Costs</strong></p> <p>After no increase in actual health care costs from 2019 to 2020, employers had a significant increase in costs last year, with a median 2021 cost increase of 8.2%.</p> <p>The same three conditions that drove increased health care costs last year remained the same this year: cardiovascular disease, cancer, and musculoskeletal conditions. However, 13% of employers said that they saw more late-stage cancers, with 44% of employers anticipating a continued increase into the future, likely related to pandemic-related delays in health care.</p> <p>Additionally, despite the rising costs, employers expect to continue to cover the cost of employee coverage, with employers expecting to cover 82% of the cost in 2022, up from 80% the year before. Employers are hesitant to pass on increased cost to employees and are instead focused on delivery system reforms to address the increased expenses.</p> ]]></content:encoded> <wfw:commentRss>https://www.policymed.com/2022/09/2023-large-employers-health-care-strategy-and-plan-design-survey-released.html/feed</wfw:commentRss> <slash:comments>0</slash:comments> </item> </channel> </rss>