Friday Five - April 21, 2017

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April 21, 2017

It’s Friday and this week in our Friday Five series, MAXIMUS is reading up on Republicans’ renewed attempt to pass health care reform; a new rule from CMS on quality data and its effort to “start a national conversation about improving the health care delivery system;” and, why states throughout the US – even red states – are considering expanding Medicaid. 

1. Republicans Have a New Plan to Repeal Obamacare – and Here It Is

House Republicans are making another attempt at repealing the Affordable Care Act (ACA) and replacing it with their American Health Care Act (AHCA). According to CNBC, a new “MacArthur Amendment” to the AHCA – which failed to pass in March – aims to bridge the gap between moderate Republicans and the House Freedom Caucus. Learn more about the amendment and what it spells out for insurance market provisions, limited waiver options and limited waiver requirements.

2. CMS Proposes Rule for Collecting, Submitting Quality Data

The Centers for Medicare and Medicaid Services (CMS) has released a proposed rule that lays out guidelines for collecting and submitting quality information through electronic health record systems. Part of an effort to “relieve regulatory burdens,” the rule was also accompanied by a request for information on solutions that will help CMS “achieve transparency, flexibility, program simplification and innovation.” Health Data Management explains what the rule means for hospitals and how CMS aims to “start a national conversation about improving the health care delivery system.”

3. Under Trump, States May Demand Work for Medicaid

The Medicaid program covers more than 70 million US residents — about one in five — including an increasing number of working-age adults. In a break from past federal policy, Health and Human Services Secretary Tom Price has notified governors that the department stands ready to approve state waivers for "meritorious" programs that encourage work. The Associated Press details the discussion on work requirements that is happening in states across the country.

4. Why (Even Red) States Are Expanding Medicaid and What That Means for Health Systems

While Republicans gear up to try to pass the updated AHCA, many states still have big decision to make as the ACA remains the law of the land. Lawmakers on both sides of the aisle are taking a hard look at expanding state Medicaid eligibility to include most low-income adults up to 138 percent of the federal poverty level – and the data shows multiple successes in expanding Medicaid coverage. Healthcare Dive explains why states throughout the country are considering expanding Medicaid and why waivers will play big role.

5. What We Pay For in Health Care

Health care accounted for 17.8 percent of the US GDP in 2015, yet experts agree that at least one-fourth of health care spending in the US is “wasted” and does not add value for patients. What’s more, the US ranked last in a 2014 study that compared health system performance in countries like Canada, Germany, the UK and Australia. The Huffington Post explores how it is possible to improve the patient experience while decreasing “wasted” health spending.