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This Week in Managed Care: October 13, 2017

This week, the top managed care stories included a new executive order to allow sale of health insurance across state lines; Iowa wait for a response to its request to opt out of parts of the Affordable Care Act; and a new study finds childhood obesity increased 10-fold over 4 decades.


AJMC® gets ready to host the fall meeting of the ACO Coalition, Iowa tries to leave the Affordable Care Act, and World Obesity Day brings troubling news about childhood obesity rates.

Welcome to This Week in Managed Care, I’m Laura Joszt.

ACO to Meet in Nashville

If the uncertainty in today’s healthcare market concerns you, join us in Nashville for the fall meeting of the ACO & Emerging Healthcare Delivery Coalition®.

Plenary speakers Shantanu Agrawal, MD, of the National Quality Forum and Clay Alspach of Leavitt Partners lead an all-star faculty lineup to discuss topics that include clinician burnout and how to make sense of what’s happening in Washington.

Learn more and register.

Buying Insurance Across State Lines

President Trump this week signed an executive order to follow through on his promise to allow insurance sales across state lines. Specifically, the order directs federal agencies to rewrite rules and allow trade associations to offer health plans that would be exempt from regulations of the Affordable Care Act (ACA).

While these plans might save groups money in the short run, health plans and the National Association of Insurance Commissioners warn that this step could invite a, quote, race to the bottom. Trade association plans could set up in states with the least restrictive regulations, and could select the healthiest customers, health plans warn. Thus, there are concerns this step will undermine the risk pool and harm those with preexisting conditions.

The American Academy of Actuaries also opposes the order because earlier ventures with loosely regulated plans left consumers without coverage. In a policy statement, the group said, “A key to sustainability of health insurance markets is that health plans competing to enroll the same participants must operate under the same rules.”

Waiving ACA Requirements

The state of Iowa has asked for a waiver to opt out of HealthCare.gov and create a state-run system. Those in Iowa buying ACA plans face steep premium increases for 2018. But published reports say President Trump has personally intervened with HHS to oppose Iowa’s request.

Payment Reform

While the ACA remains the law of the land, employers and large purchasers of healthcare are still experimenting with new payment models. Catalyst for Payment Reform, which represents these groups, has selected 3 states to test a new set of metrics, called a Scorecard, which measures how well individual markets are doing with payment reform.

The American Journal of Managed Care® spoke with Linda Schwimmer, president and CEO of the New Jersey Health Care Quality Institute, which is 1 of 3 state-level groups that will test the new metrics.

Childhood Obesity Rates

Wednesday was World Obesity Day, and the World Health Organization used the day to highlight a study in the journal Lancet, which found that childhood obesity has increased by more than 10-fold since 1975. Obesity rates for both girls and boys were less than 1% worldwide in 1975, and are now 5.6% for girls and 7.8% for boys.

Said Leanne Riley, the study’s lead author: “The trends show that without serious, concerted action to address obesity, from improving diets and providing the means by which to increase physical activity, to implementing the health system measures required to address overweight and obesity in young people early on, then the health of millions of people will be needlessly placed in great jeopardy, leading to immense human and economic costs to communities.”

Earlier in the week, CDC released data highlighting links between rising obesity rates and certain cancers.

For all of us at the Managed Markets News Network, I’m Laura Joszt.

Thanks for joining us.

 
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