Master the upcoming ICD-10 code and IPPS changes! Prepare your team for the upcoming changes taking effect on October 1. Discover the benefits of IPPSPalooza and how it can drive your success. Click here >

Storm Chasing: Tracking Sweeping Healthcare Policies

New initiatives capture attention on Capitol Hill.

New this week: the rebirth of one sweeping health policy, the presumed death of another, and a hint of things to come from a third policy initiative.

First, President Biden has revived his Cancer Moonshot initiative, first launched when Biden was vice president in 2016. The new “supercharged” initiative’s goal is to reduce cancer deaths by 50 percent in the next 25 years. Biden says that one of the reasons he ran for president was to improve cancer outcomes.

Biden’s son Beau died of brain cancer at the age of 46, and Vice President Kamala Harris’s mother also died of cancer.

Cancer remains one of the leading causes of death; it’s number two in the U.S., especially in certain populations, although death rates from cancer overall has fallen 25 percent in the last two decades.

The revived Cancer Moonshot will focus on population-level efforts to develop better ways to screen for cancer, especially targeting specific communities. For example, people of color have higher death rates for many cancer types. One way to do this, says the National Cancer Institute, would be to develop a test that would provide early detection of multiple cancers at once.

The head of the National Cancer Institute said this week that we are in the golden age of cancer research, with certain recent advances making the goal of the initiative possible.

Technology used to develop coronavirus vaccines could also stop cancer cells from growing.

Our second area of focus is the apparent demise of state-level single-payer healthcare, at least for this year. The idea of single-payer healthcare was a major theme in the 2020 presidential campaigns, and seemed to get an extra boost during the pandemic, when fissures in our current health system became apparent.

Indeed, legislation for single-payer has been introduced this year in Kansas, Maryland, New York, and California; the most likely chance for success of the policy was in California, where Democrats have a supermajority in the legislature.

Single-payer has been introduced in California before, but never with a plan on how to pay for it. This year, supporters presented a new bill, complete with proposed taxes to support it. But while advocates found the money to pay for the legislation, they could not find the votes to pass it.

Even California’s Governor Gavin Newsom, who ran his campaign on single-payer, would not support the bill, given its cost.

So last week, California’s single-payer legislation was killed before it was even put up for a vote.

In our final story, as a harbinger of what we may see from sweeping price transparency requirements, Mass General Brigham hospital ‒ the dominant, tax-exempt academic hospital in Massachusetts ‒ must submit a plan to the state government to lower costs. The hospital could be fined half a million dollars if doesn’t address its current prices, which, according to a new report, are the highest in the state.

As consumers are provided more and more transparency into hospital prices, we can expect other state governments to follow Massachusetts’s example, going after specific hospitals for their pricing.

Programming Note: Listen to Matthew Albright’s live reports on federal legislation Mondays on Monitor Mondays 10 Eastern, sponsored by Zelis.

Print Friendly, PDF & Email
Facebook
Twitter
LinkedIn
Email
Print

Matthew Albright

Matthew Albright is the chief legislative affairs officer at Zelis Healthcare. Previously, Albright was senior manager at CAQH CORE, and earlier, he was the acting deputy director of the Office of E-Health and Services for the Centers for Medicare & Medicaid Services.

Related Stories

Leave a Reply

Please log in to your account to comment on this article.

Featured Webcasts

Mastering the Two-Midnight Rule: Keys to Navigating Short-Stay Admissions with Confidence

Mastering the Two-Midnight Rule: Keys to Navigating Short-Stay Admissions with Confidence

The CMS Two-Midnight Rule and short-stay audits are here to stay, impacting inpatient and outpatient admissions, ASC procedures, and Medicare Parts C & D. New for 2024, the Two-Midnight Rule applies to Medicare Advantage patients, requiring differentiation between Medicare plans affecting Case Managers, Utilization Review, and operational processes and knowledge of a vital distinction between these patients that influences post-discharge medical reviews and compliance risk. Join Michael G. Calahan for a comprehensive webcast covering federal laws for all admission processes. Gain the knowledge needed to navigate audits effectively and optimize patient access points, personnel, and compliance strategies. Learn Two-Midnight Rule essentials, Medicare Advantage implications, and compliance best practices. Discover operational insights for short-stay admissions, outpatient observation, and the ever-changing Inpatient-Only Listing.

Print Friendly, PDF & Email
September 19, 2023
Secondary Diagnosis Coding: A Deep Dive into Guidelines and Best Practices

Secondary Diagnosis Coding: A Deep Dive into Guidelines and Best Practices

Explore comprehensive guidelines and best practices for secondary diagnosis coding in our illuminating webcast. Delve into the intricacies of accurately assigning secondary diagnosis codes to ensure precise medical documentation. Learn how to navigate complex scenarios and adhere to coding regulations while enhancing coding proficiency. Our expert-led webcast covers essential insights, including documentation requirements, sequencing strategies, and industry updates. Elevate your coding skills and stay current with the latest coding advancements so you can determine the correct DRG assignment to optimize reimbursement, support medical decision-making, and maintain compliance.

Print Friendly, PDF & Email
September 20, 2023
Principal Diagnosis Coding: Mastering Selection and Sequencing

Principal Diagnosis Coding: Mastering Selection and Sequencing

Enhance your inpatient coding precision and revenue with Principal Diagnosis Coding: Mastering Selection and Sequencing. Join our expert-led webcast to conquer the challenges of principal diagnosis selection and sequencing. We’ll decode the intricacies of ICD-10-CM guidelines, equipping you with a clear grasp of the rules and the official UHDDS principal diagnosis definition. Uncover the crucial role of coding conventions, master the sequencing of related conditions, and confidently tackle cases with equally valid principal diagnoses.

Print Friendly, PDF & Email
September 14, 2023
2024 IPPS Summit: Final Rule Update with Expert Insights and Analysis

2024 IPPS Summit: Final Rule Update with Expert Insights and Analysis

Only ICD10monitor delivers what you need: updates on must-know changes associated with the FY24 Inpatient Prospective Payment System (IPPS) Final Rule, including new ICD-10-CM/PCS codes, plus insights, analysis and answers to questions from the country’s most respected subject matter experts.

Print Friendly, PDF & Email
2024 IPPS Summit Day 3: MS-DRG Shifts and NTAPs

2024 IPPS Summit Day 3: MS-DRG Shifts and NTAPs

This third session in our 2024 IPPS Summit will feature a review of FY24 changes to the MS-DRG methodology and new technology add-on payments (NTAPs), presented by senior healthcare consultant Laurie Johnson, with bonus insights and analysis from two acclaimed subject matter experts

Print Friendly, PDF & Email
August 17, 2023

Trending News