WASHINGTON -- The unstable marketplaces have many insurers contemplating their exit, while simultaneously lobbying for reforms to the president's signature law.
Insurers Look for Reforms to Stabilize Fragile Markets
If the Affordable Care Act is to survive the next few decades, Congress and our next president will need to safeguard the fragile insurance exchanges, said policy analysts and insurers at a congressional briefing on Wednesday hosted by the National Institute for HealthCare Management.
"In Alaska, we're the last carrier standing up there. Everybody else has pulled out," said Jeff Roe, president and CEO of Premera Blue Cross in Seattle.
And unless a $55 million appropriation to establish reinsurance pools for high-risk individuals is passed in Washington state, there likely won't be any carriers left in that market at all, he said.
"In most states the Blues are the only plans left," said J.D. Hickey, MD, president and CEO of BlueCross BlueShield of Tennessee. And he said other insurers continually tell him that "'maybe one more year is all I can hang on,' which means some of those fixes need to be very quick." The deadline for insurers to submit their next bids is April 2017, he noted.
AMA Offers Free Tools to Help Docs Deal with MACRA
Having trouble figuring out how to navigate the new Medicare payment system? The American Medical Association (AMA) wants to help.
The new system, outlined in the Medicare Access and CHIP Reauthorization Act (MACRA) "represents the most significant change to Medicare in a generation," AMA president Andrew Gurman, MD, said Wednesday on a conference call with reporters. "The AMA is working to help physicians navigate this change and ... make sure they're prepared for it."
The association unveiled three tools, all of which are free to both members and nonmembers. These include an interactive "Payment Model Evaluator," an educational module focused on practice improvement, and a seven-episode podcast.
Including Pharmacists in Primary Care Saves $$$, Helps Patients
Pharmacists can help control costs and improve patient care by working with primary care teams to optimize medication management.
Medication errors, unnecessary emergency room visits, preventable hospital readmissions -- all of these health costs can be reduced through better medication management, and new collaborative care models can lead the way, said panelists at a congressional briefing here hosted by the Partnership to Fight Chronic Disease and the University of North Carolina (UNC) Eshelman School of Pharmacy.
"For every dollar we're spending on prescription medications, we're spending another dollar trying to resolve a problem due to that medication," said Mary Roth McClurg, PharmD, MHS, of the UNC Eshelman School of Pharmacy in Chapel Hill, N.C.
FDA Splits on Naloxone Dose
A joint FDA advisory panel was split on whether the injectable 0.4 mg dose of naloxone should remain the current standard by which products containing the opioid overdose reversal drug should be measured -- though they agreed that a lack of data made the decision more challenging.
Slightly more panelists voted to increase the minimum acceptable dose rather than maintain it (15 to 13) during the joint meeting of the Anesthetic and Analgesic Drug Products Advisory Committee (AADPAC) and the Drug Safety and Risk Management Advisory Committee (DSaRM).
"I have more questions now than when I got here," said panelist Anita Gupta, DO, PharmD, of Drexel University in Philadelphia, who voted to maintain the current minimum standard. "Since so many questions remain unanswered, I couldn't drift from the current standard."
Next Week
Congress is on recess.
On Thursday, the FDA's Vaccines and Related Biological Products Advisory Committee will discuss potential influenza virus strains to include in next season's vaccines.