The Trump administration is planning new actions on overutilization, value, and top-line provider prices, according to a White House official.
Sept. 20—Congress plans to discuss ways to reduce healthcare costs with an executive from the nation’s largest hospital company next week. Looming in the background will be planned administration actions on provider spending.
On Sept. 27, the Senate Health, Education, Labor, and Pensions (HELP) Committee will hear from Jonathan Perlin, MD, PhD, president of clinical services and chief medical officer at HCA Healthcare, based in Nashville, Tenn., about how healthcare innovation can improve affordability.
Perlin is a former chair of the American Hospital Association (AHA) and current member of the Medicare Payment Advisory Commission. The hearing at which he will testify is the fifth that the Senate committee has held during the current Congress on drivers and solutions related to healthcare costs.
Niall Brennan, president of the Health Care Cost Institute (HCCI), testified at one of the earlier HELP Committee hearings on what’s driving healthcare costs. He said in an interview that he doubted whether any “sizable impact” on costs will come from the current federal focus on drug spending, price transparency, and out-of-network billing.
The hearing comes as the Trump administration is laying the groundwork for more of its own healthcare cost control initiatives. Its first wave of cost control focused on drug spending. But that may be followed by a focus on provider spending.
“I don’t know that I would say that it is up next; I would say we’re doing work on trying to wring out inefficiencies and there will be activity on that,” Joseph Grogan, associate director for health programs at the White House Office of Management and Budget, said when asked whether the administration was planning to focus on hospital spending. “I don’t want to say that specifically about the hospitals, but service delivery is definitely going to be a focus.”
The administration is focused on key components of federal healthcare spending, including what it sees as overutilization, along with value and top-line provider prices, Grogan said at a Sept. 20 media briefing.
“I don’t think providers or drug companies are doing themselves any favors with their pricing strategies,” Brennan said, noting recent high-profile news reports that have been critical of hospital chargemaster prices.
Recent HCCI research found that even with implementation of the Affordable Care Act and the introduction of “blockbuster” drugs over the last 10 years, the share of spending going to various sectors of the healthcare industry has changed little. For instance, inpatient surgery consumed 11 percent of spending in 2007 and 10 percent in 2016, while outpatient surgery took up 9 percent in 2007 and 10 percent in 2016.
“There’s inefficiencies across the healthcare spectrum, including in hospitals,” Grogan said. “And there may be more money to be saved in service delivery—not just in hospitals.”
The Trump administration’s recent focus on transparency in provider pricing included the FY19 Inpatient Prospective Payment System (IPPS) final rule. That regulation requires hospitals to begin posting online a publicly accessible list of their standard charges “in a machine-readable format” and to update the information at least annually.
Although he sees the federal government “spending way too much on health care,” Grogan was dubious of previous federally sponsored value-based payment efforts to address the problem, due to their complexity and lack of clarity on savings.
“I can tell you, some of these models I don’t understand,” Grogan said. “They are too complicated, they are too hard to evaluate, they are not saving enough money, and it’s a big test for” the Center for Medicare & Medicaid Innovation (CMMI).
He was optimistic that Adam Boehler, who was appointed earlier this year as director of CMMI, would launch simpler models that generate much larger savings.
Monday, Sept. 24
HFMA and the American Organization of Nurse Executives present a “Certificate Program in Health Care Finance for Nurse Executives” (through Sept. 25). Learn more.
Sixth annual National Association of Specialty Pharmacy (NASP) meeting, Washington, D.C. (through Sept. 26). Learn more.
Comments due on the CY19 proposed rule for the Medicare Hospital Outpatient Prospective Payment System (OPPS). Learn more.
Webinar by the Agency for Healthcare Research and Quality on “Medicaid’s Personal Responsibility Provisions.” Learn more.
Deadline for submissions to the Health Resources and Services Administration’s Maternal and Child Health Bureau “Preventing Childhood Obesity Challenge.” Learn more.
Tuesday, Sept. 25
Webinar by HFMA titled “Explore Health Care Innovations That Improve Quality and Reduce Costs.” Learn more.
Webinar by Change Healthcare titled “Episode Analytics – More Than Just Bundled Payments” (free for qualified attendees). Learn more.
Hearing by the Senate Finance Committee’s Primary Health and Retirement Security Subcommittee titled “Health Care in Rural America: Examining Experiences and Costs.” Learn more.
Webinar by America’s Health Insurance Plans (AHIP) titled “Remote Monitoring, Big Data Transform Senior Care.” Learn more.
Webinar by the Association of American Medical Colleges titled “Approaches to Hispanic Health Research.” Learn more.
Web conference by the Advisory Board titled “Use Data to Match Staffing to Demand.” Learn more.
Webinar by the American Hospital Association (AHA) titled “Hospitals and Opioids: Drug Diversion and Patient Safety.” Learn more.
Webinar by CAQH CORE titled “Prior Authorization Industry Landscape.” Learn more.
Wednesday, Sept. 26
Webinar by HFMA titled “Roadmap for Revenue Cycle Results Post EHR Implementation.” Learn more.
Hearing by the Senate Veterans Affairs Committee titled “The State of the VA: A 60 Day Report.” Learn more.
Conference call by CMS titled “Medicare Diabetes Prevention Program: New Covered Service.” Learn more.
Webinar by CMS titled “FY 2019 IPPS/LTCH PPS Final Rule Webinar—Overview of eCQM Reporting and Promoting Interoperability Programs.” Learn more.
Webinar by the American Health Lawyers Association titled “The Intersection of Public Health and Healthcare in the 21st Century: Hot Topics and Practice Tips, Part II.” Learn more.
Transform2018 Mayo Clinic conference, Rochester, Minn. (through Sept. 27). Learn more.
Webinar by AHIP titled “Accelerate Your Health Care Transformation with Data Analytics.” Learn more.
Thursday, Sept. 27
Webinar by HFMA titled “Creating a Consumer-centric Patient Financial Experience.” Learn more.
Hearing by the House Oversight and Government Reform’s Subcommittee on Intergovernmental Affairs and Subcommittee on Healthcare, Benefits, and Administrative Rules titled “The Benefits of a Deregulatory Agenda: Examples from Pioneering Governments.” Learn more.
Hearing by the House Veterans Affairs Committee titled “Veteran Suicide Prevention: Maximizing Effectiveness and Increasing Awareness.” Learn more.
Webinar by AHA titled “Understanding the Science Behind Behavioral Assessments.” Learn more.
National Summit on Promoting Well-Being and Resilience in Healthcare Providers by Ohio State University, Columbus, Ohio. Learn more.
Webinar by AHIP titled “Optimize Risk Adjustment Through Technology-Enabled Payer/Provider Collaboration.” Learn more.
Web conference by the Advisory Board titled “Tactics to Keep Your Cancer Patients Out of the ED.” Learn more.
Meeting sponsored by the American Journal of Managed Care titled “Future Perspectives on Oncology Value-Based Care,” New York City. Learn more.
Friday, Sept. 28
AHA’s Association for Healthcare Volunteer Resource Professionals 50th annual conference and exposition, Chicago (through Oct. 2). Learn more.
Registration closes for the 2018 National Ryan White Conference on HIV Care and Treatment, Oxon Hill, Md. Learn more.