Today's News and Commentary

About health insurance

1 in 5 employers may face the ACA's 'Cadillac' tax on high-cost health plans: Health benefits are deductible expenses for employers and tax free benefits for employees. If these benefits expand in place of higher salaries (which are taxable), the government loses more money. Further, such a system discourages prudent purchasing of insurance. In this setting, the ACA mandated a so-called “Cadillac tax” ( a 40% excise tax) on an employer health plan when its cost surpasses $11,200 for an individual and $30,100 for a family. Both major political parties do not like this provision. One reason is it was not indexed to inflation or even geared to rising healthcare costs, thus causing the burden to fall on the middle class. The start date for this tax has been delayed but is now set to go into effect in 2022. If it proceeds as planned, this new study estimates that about 21% of “employers offering health plans will have at least one plan affected.” The House is expected to vote this week on a full repeal of this tax.

Biden reveals healthcare plan piggybacking on ACA: Add one more variation…Biden proposes that a Medicare-like system be offered with Medicaid benefits. This option would be offered for those who would qualify for Medicaid if their states had signed on for the expansion.

CMS Proposing Bundled Payment Model for Radiation Oncology: The title speaks for itself. This proposal has been months in the making. "Participation would be mandatory for certain geographic areas during the model's projected five-year timeline…” and prospective payments will be linked to quality metrics.

U.S. appeals court blocks Trump administration birth control exemptions: “A federal appeals court on Friday blocked the Trump administration from enforcing new rules allowing employers to obtain exemptions from an Obamacare requirement they provide health insurance that covers women’s birth control.”

About healthcare quality

Quality Payment Program Releases 2017 Physician Compare Data and Sees Increases in Clinician Participation Rates and Success for 2018: CMS Administrator Seema Verma announced that the number of Qualified Practitioners participating in the Advanced APM programs for quality reporting “nearly doubled in 2018 from the previous year, increasing from 99,076 to 183,306 clinicians…Additionally, nearly 90% of clinicians in small practices participated in 2018, which was an increase from 81% in 2017.” Any recent economic and clinical benefits still need to be assessed.

CMS to delay star ratings update pending expert panel review: This February, CMS started to look at changes in the quality assessment methodology that underpins the star reports for hospitals. After receiving more than 800 comments from a solicitation, CMS decided to delay its summer report and instead look at revisions in the program.

Serious misdiagnosis-related harms in malpractice claims: The “Big Three” – vascular events, infections, and cancers: The authors of this study looked at malpractice claims and found that '“ vascular events, infections, and cancers… account for about three-fourths of serious misdiagnosis-related harms.” They concluded that initial programs to improve diagnoses should be targeted at these conditions.