delivery of valuable services. Generally, state-based exchanges enrolled a higher percent of the eligible population than states using the federal marketplace, HealthCare.gov. Now the FCA covers any claim that derives out of a violation of the Stark Law or Anti-Kickback Statute. The last few years have been nothing short of fascinating to watch in terms of healthcare policy change and implementation. Last winter, Ezra Klein wrote a column for the Washington Post's Wonkblog in which he noted his confusion about Republicans' criticism of high-deductible plans. care spending throughout the system, but this is often easier said than done. This spring, a study published in Health Affairs found prices were most likely to increase when hospitals bought physician groups rather than establishing a looser contractual relationship with practices. A Politico report last month suggested the federal exchange option — which was supposed to be a temporary fallback for states — may become a longterm solution for the majority of states. Should federal or state governments control healthcare policy? This may include encouraging new entrants, blocking mergers, and aggressively policing anti-competitive behavior. smaller health care needs. patients value a broad choice of providers. Many Democratic presidential candidates have supported approaches like these. Connected care, upskilled workers, tax reform, a Southwest Airlines approach, private equity and the Affordable Care Act all will impact healthcare organizations in 2019, a new PwC report says. 2. For example, an ongoing project from Robert Wood Johnson Foundation, launched in 2006, is examining hospital consolidation and its effect on consumer prices and care quality. financial incentives to eliminate unnecessary services by paying them based on These policymakers often support proposals that would narrow eligibility for or reduce the generosity of those programs, particularly Medicaid and programs that subsidize individual market coverage, even though fewer people would have coverage and some people’s coverage would become less generous. Starting with the volume of Policy Issues. Amid this uncertainty, the name Jonathan Gruber has appeared a lot in the news lately. What is surprise billing for medical care? The U.S. Court of Appeals for the D.C. Two-thirds of the 753 qui tam suits filed in fiscal 2013 were in healthcare. A major Research finds that this approach Policies allowing for flextime to exercise or attend health programs; Policies that are not specifically health-related may have health impacts on employees. (The research does not distinguish between for- and nonprofit hospital mergers.). US healthcare—especially its cost and delivery—will be top of mind in 2020. Different policymakers see different problems with the way people get coverage today and, correspondingly, propose different solutions. care markets allow many providers to demand prices from private insurers that substantially Most of the people who bought policies on the exchanges received some sort of subsidy, though these subsidies were not authorized by the PPACA. PwC’s Health Industries podcast: Exploring the top health industry issues of 2020. 9. Medicare for All. The government now subsidizes buying healthcare insurance on the federal and state exchanges. and low-value services rather than just low-value services. Following is a list of, in our view, 10 of the top key policy issues facing the industry as well as some of the issues surrounding each. This has led to a tremendous growth in healthcare FCA cases. There, Bill Clinton broadly put into place a Republication tenet much to the chagrin of some Republicans. It will be most interesting to see how these, among many other issues, pan out. One is to make health care markets more competitive. These policymakers often support proposals that would broaden eligibility for existing coverage programs or make those programs more generous, even though it would require additional federal spending. Massachusetts is still trying to save its exchange, but also laying the groundwork to join HealthCare.gov. But, here too, there are tradeoffs: the benefits of lower prices on existing drugs must be weighed against the reduction in incentives to develop new drugs. all fall into this category. But the aforementioned study findings raise questions about whether FTC challenges are too few and far between, and whether the commission only pursues case that are low-hanging fruit in an industry ripe with consolidation. Seventeen states (including Washington, D.C.) decided to build their own Obamacare exchanges, while the rest of states chose a partnership model with the government or the federally-facilitated marketplace. The White House has said it anticipates an uptick in healthcare spending as newly insured utilize healthcare services, but it will be interesting to see whether or how long that persists, and if healthcare costs will start trending down for good. It usually prevails: Among cases it joined from 1987 through 2010 that had outcomes, 95 percent produced settlements or judgments by 2010, according to a Wall Street Journal report. Regardless of the outcomes, we know this to be true: It's a fascinating time to work in (and write about) the healthcare industry. many health care services patients receive or by reducing the prices paid for But the law's section on health insurance subsidies says they can be paid to anyone who signs up for coverage in "an exchange established by the State." Public health is a broad field. continue to get coverage through their jobs, if health insurance deductibles In most cases, the main reason drugs are expensive is because the government grants a time-limited monopoly to inventors of new drugs via patents and related policies. Alternatively, policymakers could lower prices by regulating them directly. Another approach is to require This stems from a 2009 drafting error in the law, a basic mistake in the wording that was never reconciled, according to Politico. "It's coming about because intransigent Republicans shunned state exchanges, and ambitious Democrats bungled them.". No one, will take it away no matter what." However, healthcare spending growth slowdown occurred in other industrialized countries as well, suggesting it is not solely attributable to the PPACA. Playback of this video is not currently available . It doesn't mention the federal exchange. Identify a health policy that is related to the health issue you selected. There have been a string of presidencies lately with at least one infamous lie that lives well beyond the commander in chief's term, such as those about weapons of mass destruction, extramarital affairs or wiretapping. Is the explosive increase and expansion in the False Claims Act warranted or overreaching? Another 5% buy coverage on the individual market, while 9% are uninsured. Or was the president dishonest when he promised Americans they could keep their current plans, if they liked them? CMS disagreed with the OIG recommendations, which may be in part due to the financial stress already facing hospitals. What policies are generally supported by both parties?
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