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In the News: April 26–May 3

Obesity Prevalence Continues to Rise Among US Adults, Plateaus for Youth

A recent article in the Journal of the American Medical Association analyzed trends in obesity prevalence for US adults and youth. The authors found that youth obesity prevalence has largely plateaued; prevalence was 18.5% in 2015–2016, up from 16.8% in 2007–2008. This differed from adult obesity prevalence, which rose from 33.7% in 2007–2008 to 39.6% in 2015–2016.

Furthermore, the prevalence of severe obesity rose for US adults, from 5.7% in 2007–2008 to 7.7% in 2015–2016. Obesity prevalence increases were significant across all adult age ranges and sexes and could not be explained by demographic changes.

Obesity is associated with a wide variety of comorbid illnesses and significant costs. Given the growth in obesity prevalence across populations, Sg2 believes that multidisciplinary weight management programs are essential to combat this disease. For more information, check out Sg2’s FAQ, Comprehensive Weight Management Programs Needed to Fight Obesity Epidemic.


Humana Announces New Value-Based Payment Program for Hospitals

Last week, Humana announced its Hospital Incentive Program, a value-based payment program designed to lower duplicative services and hospital readmissions. The program, available to any hospital with an active commercial contract with Humana, distributes payments to general acute care hospitals based on how they improve patient experience, safety and outcomes compared to hospitals in their region and across the US.

The Hospital Incentive Program is the latest in Humana’s effort to invest more in outcomes-based approaches, following its recent decision to launch a bundled payment program for maternity care. The Hospital Incentive Program does not subject participating hospitals to any financial risk.

Humana’s announcement represents the latest effort to move the health care industry toward value-based care (VBC). As VBC evolves, Sg2 believes that successful organizations will need to improve population health, enhance patient experience and reduce per capita costs of care. To learn about the key competencies to successfully deliver value, read the Sg2 expert insight: Value Based Care: 8 Core Competencies Define a Road Map Forward.


CMS Proposes $1 Billion Raise for Post-Acute Care Providers in 2019

As part of its annual prospective payment rules, CMS proposed providing an additional $1B in compensation to post-acute care (PAC) providers in 2019; $850M for skilled nursing facilities; $340M for hospices; $45M for inpatient psychiatric facilities; and $75M for inpatient rehabilitation providers.

The proposal also outlines policy changes for PAC providers that would reduce reporting regulations and documentation standards. The additional reimbursement to PAC sites would link payment models to care management rather than service volumes. This latest proposal is part of CMS’s ongoing push to transition care delivery models away from fee-for-service and toward value-based care models.

Expected to experience double-digit volume growth over the next decade, PAC sites are now the target of CMS-led cost-containment efforts, with a site-neutral payment construct in the works. As PAC volumes shift to lower-cost sites, Sg2 believes that health systems will need to develop a market-driven response that promotes proper placement of postdischarge patients. To learn more about creating and leveraging a PAC approach to address the shift to value-based care, read the Sg2 report: Post-Acute Care: Planning Ahead of the Continuing Care Curve.

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As of February 11, 2016, Vizient, Inc. has completed its purchase of MedAssets Sg2 and spend and clinical resource management segments from Pamplona Capital Management, LLC. MedAssets revenue cycle business will continue to operate as a wholly-owned subsidiary of Pamplona Capital Management LLP.

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