Friday Five - June 16, 2017

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June 16, 2017

It’s Friday and this week in our Friday Five series, MAXIMUS is sharing how employers can better contribute to health care innovation, efficiencies and quality; states’ growing interest in Section 1332 waivers; and, the Department of Health and Human Services’ new analysis of the House-passed American Health Care Act.

1. The Private Sector Can Lead in Delivery System and Payment Reform

Employers provide 56 percent of Americans, or 156 million citizens, with health care insurance. Employers also predict health costs will rise by 6 percent this year, along with growing monthly premiums and out-of-pocket costs for employees as wage growth remains relatively flat. Health Affairs Blog details the steps employers can take – such as calling on the government to provide more outcomes-based quality measures – to test new approaches to health care, lower costs and improve health care quality and delivery.

2. GOP Focus on Premiums Eclipses Broader Issue of Health Care Costs

Republican efforts to overhaul the Affordable Care Act (ACA) are increasingly focused on reducing insurance premiums, an approach that may overlook broader steps toward lowering overall health care costs for Americans. While Senate Republicans like Sen. Ron Johnson (R-WI) argue that the “main goal” should be passing a law that “restrains the growth in health care costs and provides better quality and better access,” critics say the US House’s American Health Care Act (AHCA) only addresses certain cost issues, and that prices for health care services should be more transparent. Morning Consult explores why the GOP is focusing on lowering insurance premiums and what they may be missing.

3. Nevada Moves Closer to a Landmark Medicaid-For-All Health Care Model

With a novel Medicaid-for-all-type bill on his desk, Nevada Gov. Brian Sandoval (R) could rewrite the way many of his constituents get health care, and establish a model that other states might eventually follow in the absence of congressional action to fix or replace the ACA. Known as the Nevada Care Plan, the bill would operate within Medicaid but would not be Medicaid – meaning reimbursements would be determined once the bill was signed into law. The Los Angeles Times breaks down what the bill could mean for Nevadans and why it’s also known as “Sprinklecare.”

4. How States Are Addressing Uncertainty With 1332 Waivers

Though Hawaii is the lone state to have received approval for a Section 1332 waiver – or a “State Innovation Waiver” that allows states to “pursue innovative strategies” to provide constituents with affordable, high quality health care – other states remain interested in using the waivers to reform their health care systems. From Alaska to Minnesota to Oklahoma, Health Affairs Blog illustrates how Section 1332 waivers are playing out across the country.

5. Trump Administration: 13 Million Uninsured Under GOP Health Plan

A new analysis of the AHCA from the Department of Health and Human Services (HHS) found that 13 million people could become uninsured by 2026. While the figure is far less than the Congressional Budget Office’s estimate of 23 million uninsured under the AHCA, both agreed that allowing states to waive out of some ACA regulations could lead to a “deteriorating or possibly failing individual market.” The Hill walks through the HHS report and its estimate of the AHCA’s impact.