Public Policy Weekly Roundup: February 2, 2016

February 2, 2016 · Paul Cotton


Every Tuesday NCQA gives a rundown of the best national, state and private sector health care articles from the week. Here are our picks for today’s Public Policy Weekly Roundup:


USPSTF recommended depression screening for all adults, including pregnant & postpartum women.

Medicare banned Cigna from signing up any new Medicare Advantage enrollees over coverage denials.

Most new Medicare Advantage plans for 2016 – 58%- are sponsored by providers.

The Aetna-Humana merger would corner ¼ of the Medicare Advantage market, according to CAP.

Marketplace premiums rose on average 6% for 2016 but as much as 37% in some states.

CMS proposed using regional instead of national benchmarks to increase incentives for Medicare ACOs.

Most uninsured have not tried to enroll, do not know open enrollment ends & that penalties are up.

CBO lowered Marketplace enrollment projections by 40% but increased Medicaid growth estimates.

Social network analysis that assesses relationships among providers may improve network adequacy.

Federal health spending topped Social Security outlays for the first time.

AHRQ released CG-CAHPS 3.0 with fewer items and a new care coordination measure.

61% of adults say their health plan is “good” or “excellent” for its cost & 71% say the same for its care.

The percentage of patients satisfied with doctor visits rose by 5% from 2012 to 88%.

Just 1% all physicians account for 32% of paid malpractice claims & 4% with paid claims had at least 3.

Patients with high mental health utilization incur over 30% more costs than other high-cost patients.

CMS released a guide on preventing readmissions among racially and ethnically diverse patients.

Cardiac surgery patients visited 2X by PAs in their first week home had 41% fewer readmissions.

Chronic pain sufferers often use more than recommended doses of non-prescription pain relievers.

More Americans – about half – are now willing to upload personal health data to providers’ secure sites.

Centene lost 6 hard drives with personal health information on nearly 1M members.


California’s 4 largest insurers may owe $10B in back taxes to the state.

Kentucky’s Health Collaborative combines 10 health systems for a state-wide effort to improve.

New York is implementing special Medicaid plans for serious mental illness & substance use patients.

Pennsylvania’s insurance commissioner proposed binding arbitration to resolve surprise balance bills.

Washington’s duals demo saved 6% ($21.6M) for Medicare from 7/13-12/14, according to CMS.


Some cost-conscious employers are excluding outpatient surgeries in their health plans.

The ACA Cadillac tax delay may slow private exchange enrollment surge.

A U.S. District Court said employers can require HRAs & screenings as a condition of coverage. 

Fidelity will offer a private health exchange for midsized firms.

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