The Most-Read In Focus Blogs for 2017

AJMC.com's “In Focus” blog offers a mix of news and policy updates—with interviews and a look at the “why” behind the daily news in healthcare. The Trump administration’s efforts put its stamp on regulations accounted for strong readership on some posts, but it was nurses spreading the word who accounted for this year’s most-read “In Focus” column.

5. What Does Trump’s Executive Order Mean for Diabetes Prevention?

This blog, which appeared January 23, 2017, tried to make sense of the Inauguration Day order to ease the regulatory burdens of the Affordable Care Act—with specific attention to the just-finished efforts by the Obama administration to have Medicare fund the Diabetes Prevention Program (DPP) that was set to start in January 2018.

Solera Health CEO Brenda Schmidt outlined specific steps that would help keep the Medicare DPP on track. It’s now set to launch in April 2018. But, just to keep things interesting, last weekend came word that CDC, which created the DPP curriculum and acts as a certifying agency for the program’s providers, was apparently told to avoid the words “evidence-based” in its upcoming budget presentation.

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4. CMS Delays Cardiac Bundled Payments and CJR Expansion, After Offering Clues

The blog showed the importance of reading the entire slide. On March 17, 2017, at the annual meeting of the American College of Cardiology (ACC), held in Washington, DC, CMS’ Kate Goodrich, MD, mentioned “some retrofitting” of a cardiac bundled payment model that had been rolled out with much fanfare in the waning days of the Obama era. By March 20, 2017, after the meeting ended and all the cardiologists had gone home, came word that the cardiac bundled payments would be delayed. The best clue was the tiny “2018” on Goodrich’s ACC slide, and her promise that CMS was “working hard” to offer more advanced alternative payment model (APM) choices. The delay also affected an expansion of the Comprehensive Care for Joint Replacement (CJR), a longtime target of former US Representative Tom Price, R-Georgia, the former orthopedic surgeon who was, at the time, the HHS Secretary.

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3. NJ's Horizon BCBS Bill Could Expand Charitable Status, but at Cost of "Blue" License

The whole world saw the photo of New Jersey Governor Chris Christie enjoying his July Fourth holiday on a barren beach, after kicking out the taxpayers who foot the bill. This June 26, 2017, blog offered the background that led Christie to shut down state government over his feud with Horizon Blue Cross Blue Shield, the state’s largest health insurer. Leaders of the insurer feared that the governor’s demands could threaten their status with the Blue Cross Blue Shield Association.

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2. CMS to Cancel Mandatory Cardiac, Expanded Joint Replacement Bundles

When then-HHS Secretary Price first delayed the cardiac and joint replacement bundles, few experts thought they were in jeopardy. But by August 15, 2017, it was becoming clear that payment reform under the Trump administration was a different ball game. By the time CMS issued the rule to cancel the cardiac bundle and rework the CJR program, it had been delayed twice.

The new CJR program, which has become final and will take effect January 1, 2018, is much smaller than it was: there are only 34 mandatory markets, down from 67 and within the mandatory markets, rural providers can opt out if they chose. Several observers say the approach shows the shift from “a carrot to a stick,” but others saw Price’s dislike for the Center for Medicare and Medicaid Innovation (CMMI) at work. (A separate effort to overhaul CMMI is ongoing). CMS has vowed that new, voluntary bundled payment options will come in 2018, but others see more promise in the growth of accountable care organizations.

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1. Texas Hospitals Use Social Networks to Seek Volunteer Nurses for Hurricane Relief Efforts

If anyone needs proof the power of social media, this blog post is it. Our August 30, 2017, this post about hospitals in Texas using social media to recruit nurses to help staff hospitals in the aftermath of Hurricane Harvey was its own social media phenomenon. Groups including the Association of Women’s Health, Obstetric and Neonatal Nurses and the New Jersey State Nurses Association spread the word quickly.

The American Journal of Managed Care^® also visited a group of New Jersey nurses heading to the hurricane zone in Texas.

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