In the News: May 3–10

Autism Prevalence Continues to Grow in the US

According to a new CDC report, about 1 in 59 children in the US has autism spectrum disorder (ASD), with data showing childhood autism was 1.7% in 2014, up from the CDC’s previous estimate of 1.5% in 2012.

The latest findings are based on 2014 data from 11 states, with state-specific prevalence ranging from 1.3% to 2.9%. Furthermore, 4 times more boys than girls were identified as having the disorder, and compared to the previous estimate, certain ethnic groups had greater increases in prevalence, which could be due to improved outreach services to those groups.

Autism is associated with increased health care utilization beyond services directly involving ASD diagnosis and management. Given the growth in autism prevalence, Sg2 believes comprehensive developmental and behavioral health care services are important to children’s and community hospitals alike. For more on comprehensive pediatric autism programs, check out the Sg2 FAQ, Trends in Comprehensive Pediatric Autism Programs.

Yearlong Delay Proposed for 340B Rule on New Drug Price Ceilings

HHS recently proposed delaying a rule to set ceiling prices for new drugs in the 340B drug discount program and allow HHS to fine drug manufacturers intentionally charging hospitals above the price ceiling. HHS stated that the “economic impact of having no rule in place…is believed to be minimal” as HHS further considers the rule. This is the fifth time rule implementation has been delayed.

Changes to the 340B Program, which requires drug manufactures to sell drugs to safety-net providers below the Medicare reimbursement rate, are ongoing. A different 340B rule cutting ~$1.6 billion from the program went into effect in early 2018.

Sg2 believes that pharmaceutical trends, including ongoing changes to the 340B Program and rising drug costs, will continue to impact consumer out-of-pocket costs and health system budgets in the near-term. To learn more about changes in the pharmacy landscape, read the Sg2 Expert Insight, Pharmaceutical Trends: 5 Areas Health Care Leaders Should Be Asking About.

State Health System Performance Varies Widely by State and Region

The Commonwealth Fund recently released their 2018 Scorecard on State Health System Performance that assessed states and Washington, DC, on more than 40 measures spanning quality of care, access to health care, efficiency in care delivery, health outcomes and income-based disparities.

The analysis revealed states made progress in areas targeted for improvement, but rising death rates, high levels of obesity and gaps in care continue to be pressing challenges. There were also significant differences in performance between and within states and regions, with many states not getting substantial value for their health care spend.

While the health care landscape continues to advance toward value-based care, different markets are moving from volume to value at different paces. Sg2 believes that health system leaders should weigh strategic options based on their market’s specific point on the value-based care path. To learn about the various stages of transition toward value-based care, read the Sg2 report, Tracking Markets’ Evolution Toward Value-Based Care.

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