In the News: Jan 10–17

Legal Challenges to 340B Continue

A Washington, DC, district court judge recently blocked a rule set to reduce payments by 28% to the 2000+ hospitals participating in the 340B drug discount program. There is a fear among hospital groups that the cuts would affect several of these hospitals’ ability to treat low-income patients.

Groups like the American Hospital Association and the Association of American Medical Colleges have been fighting this change in court since it was announced in 2017, previously losing a ruling to block the policy last summer. The change to the 340B program was an attempt by the current administration to lower prescription drug prices.

The challenges to the 340B payment rule, along with changes to CMS accountable care organization participation, were some of the big health policy stories in 2018. For a look back at what changed in 2018 and what major policy changes Sg2 anticipates in 2019, check out our Experts Live Q&A: Payment and Policy Update.

Partnership Aims to Improve Post-Acute Care Platforms

A recent Business Wire article discusses a partnership between Kindred Healthcare and Netsmart to create a new technology platform to support integrated post-acute solutions. Netsmart will leverage its enterprise solutions with Kindred’s experience in long-term acute care solutions to meet post-acute care demands and the aging population’s unique needs. This initiative aligns with the efforts toward a value-based care environment to ultimately improve care outcomes and address gaps within patient care.

Sg2 projects that post-acute care is poised for double-digit growth over the next 10 years. As CMS draws close to adopting a site-neutral payment construct, volumes will shift to lower-cost sites, and it is expected that some markets will lack the capacity to accommodate the downshift. For more on how health systems can address obstacles and ensure proper postdischarge placement for their patients, read the Sg2 report Post-Acute Care: Planning Ahead of the Continuing Care Curve.

Number of Nurse Practitioners Is on the Rise

For a recent JAMA study, researchers analyzed US census data, physician workforce data from the American Medical Association, and billing records from Medicare on physicians and nurses providing primary care and found that more nurse practitioners (NPs) are providing primary care in low-income and rural US areas where the physician labor pool is decreasing.

Though primary care physicians still outnumber primary care NPs, recent trends show the gap is closing quickly. In 2010, there were about 226,000 primary care physicians and 59,000 primary care NPs; in 2016, there were 244,000 primary care physicians compared to 123,000 NPs providing primary care. This is due to the flatlining of the primary care physician workforce and the simultaneous increase in working NPs.

Currently, the most-largely seen effect is occurring in rural and low-income areas. In the study period, the average number of NPs in communities with low-income residents increased from 19.8 to 41.1 for every 100,000 people, while the average number of physicians fell from 52.9 to 52. Meanwhile, the average number of NPs in rural areas also increased from 25.2 to 41.3 for every 100,000 people, while the average number of physicians fell from 59.5 to 47.8.

NPs serve as one example of advanced practitioners (APs) in the medical field. As physician workforce declines, APs will be increasingly utilized in care organizations, and the future impact of APs on organizations will be significant—as is already seen in rural and low-income populations. In fact, Sg2 believes that APs will deliver nearly one-third of all primary care by 2020 and will significantly affect an organization’s bottom line and market position. To learn more about optimizing the use of APs in your organization, watch the Sg2 on-demand webinar Optimizing Use of Advanced Practitioners: Staying Ahead of the Curve.

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