IHA Daily Briefing (Feb. 6)

Wednesday, February 6, 2019

President Trump Shares Key Healthcare Issues
Hospital Pricing Study Released; AHA Responds
IHA Webinars Offer Insight on CMS CoP Manual
Briefly Noted

President Trump Shares Key Healthcare Issues
Last night, after his State of the Union Address, President Trump released a healthcare fact sheet, outlining areas to improve the healthcare system and quality of life for Americans. Specifically the President is committed to action on:

  • Reducing drug prices;
  • Making healthcare prices transparent and affordable; and
  • Advancing efforts to eliminate HIV/AIDS, treat cancer and protect patients with pre-existing conditions.

“The next major priority for me, and for all of us, should be to lower the cost of healthcare and prescription drugs, and to protect patients with pre-existing conditions,” said President Trump in his address. "Already, as a result of my administration's efforts, in 2018, drug prices experienced their single largest decline in 46 years. But we must do more.  It’s unacceptable that Americans pay vastly more than people in other countries for the exact same drugs, often made in the exact same place.  This is wrong, this is unfair, and together we will stop it — and we’ll stop it fast.”

The President urged Congress to pass legislation that “finally takes on the problem of global freeloading and delivers fairness and price transparency for American patients,” noting drug companies, insurance companies and hospitals should be required to disclose “real prices to foster competition and bring costs way down.”
In addition, the President asked Congress to increase funding for childhood cancer research and to eliminate HIV/AIDS in the U.S. within 10 years.

Hospital Pricing Study Released; AHA Responds
Earlier this week, Health Affairs released findings from a Commonwealth Fund-supported study on hospital and physician prices. The study looked at prices from 2007 to 2014 for inpatient and outpatient hospital-based services along with four high-volume services: cesarean section, vaginal delivery, hospital-based outpatient colonoscopy, and knee replacement.

Overall, the study showed hospital prices grew faster than physician costs during the same time period:

  • Inpatient care hospital prices grew 42 percent while physician prices rose 18 percent;
  • Hospital prices rose 25 percent for hospital-based outpatient care while physician prices rose 6 percent; and
  • 60 percent of the total price of hospital-based care was attributed to hospital prices.

In a blog post, Tom Nickels, Executive Vice President, AHA, refuted the Health Affairs study saying it “used limited data to draw broad conclusions" and that many factors that are not included in the study.

“It is important to note that hospitals and health systems must manage a number of significant costs that do not apply to the physicians included in the study. This includes the fact that hospitals face many challenges related to a high number of regulatory requirements, which increase administrative expenses and staffing needs for compliance. Nationally, it is estimated that hospitals, health systems, and post-acute care providers spend nearly $39 billion annually on the administrative aspects of regulatory compliance. And an average-sized community hospital spends $7.6 million per year, or $1,200 per admission, to support compliance with regulations from just four federal agencies."

Additionally, he emphasized hospital care costs that include drugs and medical devices are not included in physician costs and urged future studies take into account these and other factors.

IHA Webinars Offer Insight on CMS CoP Manual
Overwhelmed by the 542-page Centers for Medicare & Medicaid Services (CMS) Hospital Conditions of Participation (CoP) manual? IHA's upcoming webinar series, CMS Hospital CoPs Made Easy, is the perfect opportunity to gain new insights and learn about specific compliance topics. The series will cover the entire manual.
This five-part series will feature presenter Sue Dill Calloway, RN, MSN, JD, an expert on healthcare law, risk management and patient safety.

Clinicians, managers and administrators in several departments are encouraged to attend, including finance, operations, legal affairs, risk management and government relations.
Each webinar in this series will be held from 9-11 a.m. Register by visiting our registration webpage and learn about the 15 percent discount available.

Briefly Noted
Mary Lou Mastro, MS, RN, FACHE, System CEO, Edward-Elmhurst Health, Naperville, has been named the 2018 Council chair of the AHA’s Constituency Section for Psychiatric and Substance Abuse Services. The Council represents 1,660 behavioral health providers across the country. During her one-year term as chair, Mastro and the 18-person council will work with AHA to identify ways to define and focus AHA policy, advocacy and member resources to improve the quality, efficiency and delivery of psychiatric and substance abuse services. Read more here.