Week in Review: It's the Time of the Season

It's the Time of the Season
Thursday, April 11th

Dear Members and Friends:

Nothing says springtime in Washington, D.C. like cherry blossoms in full bloom -- or the release of the federal budget. As expected the Obama administration's 2014 budget, released yesterday, was received with yays and nays from across the spectrum of lawmakers, advocates, and reporters. We've put together some highlights of the implications for the health care industry, and it's expected that this first round proposal is just the beginning of finalizing a bipartisan deal.

Also amidst the flurry of Capitol Hill activity this week, it appears that the Center for Medicare and Medicaid Services (CMS) may have its first confirmed head administrator since 2006, following Marilyn Tavenner's positive reception at a Senate confirmation hearing earlier this week.

And in case you missed the announcement earlier this week, we're incredibly proud of our very own Chief Operating Officer, Amy Gibson, who was selected from over 1,000 applicants to serve on the Patient-Centered Outcomes Research Institute's (PCORI) Patient Engagement Advisory Panel.

Finally, I encourage you to mark your calendar for our Monthly National Briefing on April 25th at 11AM, where representatives from the medical home accrediting organizations will provide an update on their recognition programs.

Sincerely,

Marci Nielsen, PhD, MPH
Chief Executive Officer

Federal Budget Released: Implications for Health Care

The Obama administration's proposed 2014 budget, released Wednesday, includes $306 billion in cuts to Medicare and $16.9 billion in Medicaid changes. The budget avoids any major structural changes to federal health programs and incorporates several provisions from past budgets and proposals. Major healthcare provisions include:

Wealthier seniors would pay a larger share of their Medicare Part B and D premiums;
Mandatory drug rebates for low-income seniors in Medicare Part D
$50 million in cuts to post-acute care providers.
Creation of home health services co-pay
Medicaid reimbursement reductions for durable medical equipment
$3.6 billion in changes to disproportionate share hospital (DSH) payments for the uninsured and underinsured

Full 2014 budget document.
Dept of Health and Humans Services budget.

HHS Kicks Off $54M Exchange Navigator Program

With health insurance marketplaces expected to cover 27 million Americans by 2016, the Department of Health and Human Services is providing $54 million for 33 states to set up health insurance marketplace navigators. Navigators will help train and hire people to help consumers shop for coverage in the new marketplaces ('exchanges'). The amount of funding is determined by the number of uninsured in each state (list of funding amount by state).

HHS regulations stipulate that each marketplace should have two navigators, and one must be a nonprofit organization. Among expected applicants are hospitals, county health agencies, and other community organizations.

Full grant announcement (due June 7th; awards distributed in August)

Upcoming Events

Apr 11:
Advocacy & Public Policy Center: Cabinet Call

Behavioral Health: Conference Call

Apr 15:

Financing and Policy Considerations for Medicaid Health Homes for Individuals with Behavioral Health Conditions - SAMHSA-HRSA
Apr 16:

TEDMED2013 (Washington, DC)

Care Delivery & Integration Center: Cabinet Call

Apr 17:
Improving Clinical Outcomes: Leveraging Data to Automate Population Health - Phytel
Outcomes & Evaluation Center: Cabinet Call

All Signs Point to Confirmation for CMS Nominee

Marilyn Tavenner, acting head of the Centers for Medicare & Medicaid Services (CMS) spoke before a supportive Senate Finance Committee on Tuesday, bringing her one step closer to a confirmation. Tavenner fielded questions from Senators, including Sen. Max Baucus' (D-Mont) concerns about the future of fee-for-service Medicare.

The committee has not yet voted to confirm Tavenner's position, but is expected to move fairly quickly. CMS has not had a confirmed head since Mark McClellan, MD, PhD left in 2006.

Hearing highlights (Total: 7:37; Medicare at 2:35).

Medical Home Happenings
News from Around the Country

Primary care doctors welcome mental health professionals Denver Post, 4/8. Denver primary care docs collaborate with mental health professionals to integrate patient health services.

Hospital cuts readmissions with focus on primary care Information Week, 4/8. Care coordination across emergency rooms and primary care clinics helps a Missouri hospital cut readmissions by one third.

How Independence Blue Cross is changing the medical home landscape
FierceHealthPayer, 4/5. Independence's Chief Medical Officer, Rich Snyder talks about the challenges and successes of the health plan's 3-year old medical home initiative.

State Medicaid Programs Drive PCMH Initiatives Forward AAFP News Now, 4/4. In an interview with Mary Takach of NASHP, states prove to have a significant role in driving PCMH initiatives.

April National Briefing

April 25: Q&A with the Accreditors: On Thursday April, 25th at 11AM we'll host the medical home accrediting organizations - AAAHC, NCQA, and URAC - to present on the latest updates to their medical home recognition programs, and to take your questions live!

Add to your calendar.