2019 is turning out to be the year of healthcare interoperability and patient empowerment. We’ve scoured the web for the top healthcare news stories, policy changes, and studies from the last three months. If you’ve missed any news this quarter, catch up now below!
Notice of Interoperability Proposed Rule
One of the most important updates in 2019 so far has been the U.S. Department of Health and Human Services (HHS) recently proposed rule to “support seamless and secure access, exchange, and use of electronic health information (EHI).”
In this proposed rule, HHS suggested changes that would support the MyHealthEData initiative and increase “the seamless flow of health information, reduce burden on patients and providers, and foster innovation” by making data more accessible to patients, researchers, and innovators.
These changes would ideally increase competition and innovation by securely providing patients and their providers with access to health data and new technology. Ultimately, this would give patients more choice in care and treatment.
HHS calls on the healthcare industry to adopt standardized application programming interfaces (APIs) to begin the transition to providing patients with secure, structured EHI using smartphone applications.
Have thoughts on this proposed rule? Send us a Tweet @formstack to join the conversation on the initiative!
New Price Transparency Rules for 2019
In August 2018, the Centers for Medicare & Medicaid Services (CMS) issued a final rule on the 2019 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Acute Care Hospital (LTCH) Prospective Payment System Final Rule (CMS-1694-F).
Among other things, the final rule updates guidelines around reporting periods, scoring methodology, and e-prescribing measures. Learn more about these changes and how your organization might go about implementing them by reading this blog post.
CMS Requests Recommendations for Selling Health Insurance Across State Lines
In a recent request for information, CMS reached out to the public for advice on eliminating barriers and enhancing insurers’ ability to sell individual insurance coverage from state-to-state. This request, which CMS stated is meant to promote competition and choice for consumers, follows President Donald Trump’s October 2017 executive order on the issue.
CMS is interested in feedback about how states could use Section 1333 of the Affordable Care Act. This section allows insurers to enter into a “healthcare choice compact” to sell out-of-state coverage if state regulators agree.
Find out more: Facilitating Insurance Sales Across State Lines
Kaiser Study: ACA Affordability Most Challenging for Middle-Income Earners
For the most part, enrollees who purchase health coverage through the Affordable Care Act (ACA) receive tax credits to make their monthly premium affordable. Enrollees are shielded from increases in premiums because subsidies rise along with them. However, middle-income enrollees with incomes above 400% of the Federal Poverty Line are not eligible for subsidies, making it difficult to afford ACA-compliant plans .
Since 2015, marketplace enrollment among subsidized enrollees has risen from 8.7 million to 9.2 million. Premiums have also significantly increased, and the number of unsubsidized enrollees in ACA-compliant plans has fallen.
This study from the Henry J Kaiser Family Foundation finds that affordability challenges are “particularly acute for older adults with incomes just above the premium subsidy cutoff,” particularly in rural areas where premiums are highest.
Read the full study: Affordability of ACAPremiums