Five takeaways from the National Health Policy Conference

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Crystal Yednak Senior Manager, Health Research Institute, PwC US February 14, 2020

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Health policy insiders gathered in DC for the annual National Health Policy Conference, held jointly with Health Datapalooza. Here’s a look at the issues that were top of mind:

HHS defends federal interoperability push.

During the keynote address, HHS Secretary Alex Azar stressed the importance of the government’s proposed interoperability rules, which have triggered pushback from some in the industry and cheers from others. Azar shared his own struggle to gain access to his electronic health records, and he derided stakeholders who he said are using scare tactics to protect a “Balkanized” system. Still, he did not say when the final interoperability rules would be released.

Speaking at the conference, Don Rucker, head of the Office of the National Coordinator for Health IT, hinted that the rules in final form would include additional protections for patient data privacy. 

Panel of federal policymakers: Apps that access sensitive patient health information present a concerning gray area.

While there is excitement about what an interoperable health system might achieve, there’s also fear that bad actors could gain access to the data and use it for ill purposes, said a panel of federal policymakers from HHS Office for Civil Rights and the Federal Trade Commission.

The HHS Office for Civil Rights and the Federal Trade Commission play enforcement roles when it comes to patient data privacy, they said. The flow of patient health information to third parties, a key goal of the interoperability rules, raises questions about who qualifies as a “business associate” under HIPAA. It also raises questions about where and how patients should give consent for their data to be shared. (For more on how the interoperability rules could transform parts of the healthcare industry, see HRI’s new report.)

Congressional staffers: Bills on drug pricing and surprise billing still have life to them, even in this election year.

Legislation addressing both issues has bipartisan support, Congressional staffers told the audience. In late May, the continuing resolution that extends funding for some Medicare and Medicaid programs expires and Congress will have to pass another extension. That is seen as a potential vehicle for a bipartisan agreement. 

On Tuesday, for example, the House Education and Labor Committee voted 32-13 to advance HR 5800, the Ban Surprise Billing Act, to the full House. HR 5800 echoes Senate legislation that has garnered bipartisan support. Under HR 5800, consumers would be responsible only for in-network charges and cost sharing for emergency services provided at out-of-network providers, medical services provided by out-of-network clinicians at in-network providers, and air ambulance transports. The bill would set up an independent mediation process for providers and payers to settle disputes over bills that are more than $750 (or $25,000 for air ambulance bills).

The House Ways and Means Committee also voted this week to advance a surprise billing bill, HR 5826, dubbed the Consumer Protections Against Surprise Medical Bills Act of 2020, which has support from the American Hospital Association. That bill doesn’t set a floor for arbitration and doesn’t create a process for dealing with air ambulance bills.

Employers have had it with the mystery of what they are paying for in healthcare.

After recent research by the Rand Corp. shed light on how much more employers were paying hospitals compared with what Medicare pays—300% more in some cases—coalitions in states like Colorado, Indiana and Wisconsin have tried different approaches to force more transparent negotiations with providers and payers, according to a panel of speakers from employer purchasing coalitions. (HRI details the activist role some employers have taken to curtail healthcare costs in Medical Cost Trend: Behind the Numbers 2020.)

Expect continued efforts to target social determinants of health.

Talk about social determinants of health was everywhere. This hot topic was mentioned on numerous panels and in informal networking discussions at the event. Recent HRI research has documented the impact that coalitions can have to improve patient health and cut costs by coming together around data-driven strategies on social determinants of health.

Read our research

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Trine K. Tsouderos

HRI Regulatory Center Leader, PwC US

Tel: +1 (312) 241 3824

Crystal Yednak

Senior Manager, Health Research Institute, PwC US

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