Read today’s Kaiser Health News
In other news:
RFK Jr.: If you eat doughnuts or smoke, should society pay for your health care?: Robert F. Kennedy Jr. asked whether society should pay for the health care of Americans who eat doughnuts or smoke when they know those habits can contribute to poor health outcomes.
“If you’re smoking three packs of cigarettes a day, should you expect society to pay when you get sick?” the nation’s top health official asked in an interview released Wednesday with CBS News chief medical correspondent, physician Jon LaPook.
Comment: This remark raises the ever-present question: to what extent are we responsible for our own health behaviors and is there is a monetary cost to bad habits?
Society covers some cost of individual bad behaviors through taxation, such as tobacco taxes. But what about untaxed items and taxes that do not pay for the costs of care?
Health Spending Issues to Watch This Year Great overview from KFF.
About health insurance/insurers
Trump to end federal funding of certain non-medical services in Medicaid The Trump administration said Thursday that it will no longer help states fund non-medical services that often are aimed at improving housing and nutrition for people in the Medicaid program. The change is a departure from the Biden administration’s efforts to improve the health of Medicaid enrollees by paying for non-medical services.
The Centers for Medicare and Medicaid Services sent a letter to states notifying them that it no longer intends to let states use federal matching funds for two types of programs: designated state health programs (DSHP) and designated state investment programs (DSIP). It said it won’t take new applications for these programs, or renew existing efforts as they expire.
About healthcare IT
Lack of Financial Resources, Determining a Cohesive Enterprise Strategy Cited as Top Implementation Concerns
Key results from the survey include:
Payer Responses:
• For the API requirements, 43% have not yet started work and 31% are one quarter completed.
• The top three challenges reported are: 1) determining a cohesive enterprise strategy for interoperability; 2) digitizing prior authorization policies; and 3) sufficient funding.
• The majority (35%) estimate a cost of $1 million - $5 million for implementing the API components of the rule.
Provider Responses:
• For the API requirements, 52% reported they had not yet started work.
• The top three implementation issues reported are: 1) sufficient funding; 2) determining a cohesive enterprise strategy for interoperability; and 3) sorting out the various networks and how they interplay (e.g., TEFCA, QHIN, HIE, etc.).
• A majority (44%) are unsure of the total cost for implementing the final rule requirements and training their employees.
• Most (79%) view having the majority of their payers supporting the prior authorization requirements as very important or extremely important.
Clearinghouse Responses:
• A strong majority (84%) intend to assist payers and providers with the API requirements of the rule.
• For the Prior Authorization API, 81% plan to implement both the FHIR and X12 solutions.
Vendor Responses:
• Eighty-one percent plan to assist payers and providers comply with the requirements of the rule.
• Thirty-six percent plan to support consumers with the Patient Access API, while 32% do not.