In the News: Feb 1–8

Asthma Mortality Declines as Care Management Improves

The CDC released a report on asthma mortality among persons aged 15–64 years, utilizing data from 1999–2016 and including key characteristics such as industry and occupation. According to the report, the death rate among the 15- to 24-year-old population was 3.62 and continued to increase with age. Furthermore, an estimated 11% to 21% of asthma deaths could be attributable to occupational exposures and, therefore, are potentially avoidable—the authors discuss the elimination of exposures as key prevention methods.

Understanding triggers and making lifelong health-conscious decisions are critical in pediatric asthma management. To learn about key pediatric asthma trends, including the short- and long-term impacts of improved disease management, read pages 8 and 9 of the Sg2 report, Pediatrics Service Line Forecast 2017.

Amazon, JP Morgan and Berkshire Hathaway Plan Health Care Company

Last week, Amazon, JP Morgan Chase and Berkshire Hathaway announced their plan to create an independent company that will reduce health care costs for their employees. According to the press release, the announcement of the new venture, set to be “free from profit-making incentives and constraints,” did not provide many details. However, the initial focus will be on unspecified “technology solutions” to reduce costs and provide better health care.

This major announcement comes after a lengthy period of speculation that Amazon would eventually enter the health care market in some capacity. Amazon’s move is the most recent example of established health care boundaries being broken—to learn more about the latest trends that will break boundaries at the national and market level, watch the Sg2 on-demand webinar, 2018: The Year Ahead.

CMS Proposes a Rate Hike for Medicare Advantage (MA) Plans in 2019

Last week, CMS announced a proposed increase of 1.84% to baseline MA payment rates in 2019, which is higher than the 0.45% payment rate increase MA plans received for 2018. CMS also proposed to increase the use of encounter data to determine risk scores for plans: 75% based on traditional fee-for-service (FFS) data and 25% based on encounter data. This differs from the 2018 risk score blend of 85% and 15% for FFS and encounter data, respectively.

With MA covering more than a third of people eligible for Medicare, MA has become one of the largest value-based payment models in the US. Sg2 believes that MA penetration will reach over 40% in 5 years, requiring organizations to reassess their value-based strategy. To learn more about the changing MA market dynamics, register for the upcoming Sg2 webinar, Medicare Advantage: Planning for Growth.

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