Insight Entries

WHG - Issue Brief: Addressing the Social Determinants of Health in Federal Health Coverage Programs

In recent years, the Department of Health and Human Services (HHS) has advanced toward a greater recognition of the social determinants of health in federal health coverage programs, via expanded non-clinical benefit offerings, meaningful quality measures and the like. As HHS continues along a trajectory of advancing value-based payment, opportunities persist to expand the focus on addressing non-health care needs... Read More

(Wynne Health, 7/19/19) #Waivers, #Social Determinants of Health, #Delivery Reform

WHG - Updated Chart: Key Legislation on Surprise Medical Billing

We provide an updated side-by-side analysis of the major Congressional (Senate and House) legislation intended to protect patients from surprise medical billing that have been introduced thus far in the 116th Congress. We added the No Surprises Act recently advanced by the House Energy and Commerce Subcommittee on Health. For each of the four proposals outlined below, the chart examines... Read More

WHG - Weekly, July 15-19

After the Administration’s recent drug policy setbacks (drug rebates, direct-to-consumer ads, six protected classes), they are looking to move forward on a new executive order mandating a “favored nations clause” and their international price index proposal. Still, the President is leaning more heavily on Congress to fulfill his campaign promise to significantly lower prescription drug prices. Action picks up again... Read More

(Llamas, 7/15/19) #Insurance Reform, #Tax, #Prescription Drugs

WHG - Weekly, July 8-12

Lawmakers return to Washington for a four-week sprint that will likely be centered on advancing health care cost-containment legislation. As the Senate readies its bipartisan health care package, House Democrats intensify their oversight of the Trump Administration, following developments in the humanitarian crisis at the border and the ACA lawsuit over the recess. Meanwhile, the Trump Administration is contemplating a... Read More

(Llamas, 7/8/19) #Costs, #Insurance Reform, #Medicare Part D, #Prescription Drugs

WHG - Weekly, July 1-5

With Members of Congress fanning out to participate in Fourth of July parades across the country, a busy four weeks of legislating awaits. Members have made significant progress on health care legislation over the past month, particularly in the debates over surprise medical billing and prescription drug pricing. The scope of these major reforms combined with the battle over the... Read More

(Llamas, 7/1/19) #Hospitals, #Insurance Reform, #Medicare Part D, #Physicians, #Prescription Drugs

WHG - Highlights from Night Two of the Democratic Presidential Debate: Medicare for All Takes Center Stage Again, Along With Rx Drug Pricing, Women's Health, and More

On June 27, 2019, a second set of 10 candidates took the stage for what was part two of the first series of debates for the 2020 Democratic Presidential primaries. As with the first night, candidates answered questions spanning across many key policy topics, including climate change, gun safety, immigration, and foreign policy, among others. The conversation of course included... Read More

(WHG, 6/27/19) #Affordable Care Act, #Public Option, #Women’s Health, #Drug Pricing, #Medicare for All

WHG - Democratic Presidential Debate Highlights: Medicare for All, Rx Drug Pricing, Opioids and More

The first of this week’s two-part 2020 Democratic Presidential primary debate kicked-off tonight in Miami, FL, featuring 10 Democratic candidates (listed in our summary below). Initial questions focused on the national economy but quickly moved to other topics, including health care, immigration, foreign affairs (particularly focused on Iran), gun violence, and climate change. Tomorrow’s debate, also in Miami, will feature... Read More

(Pahner, 6/26/19) #Mental and Behavioral Health, #Women’s Health, #Opioids, #Delivery Reform

WHG - Weekly, June 24-28

Congressional members continue to push through hearings, markups, and negotiations this week as they get ready to depart for a weeklong fourth of July recess. Adding to the mix, President Trump plans to issue an executive order designed to improve price and quality transparency across the health care industry. Among the provisions, the Administration is expected to compel hospitals to... Read More

(Llamas, 6/24/19) #Mental and Behavioral Health, #Costs, #Insurance Reform, #Prescription Drugs

WHG - Chart re: Medicare Part D Reform Proposals

Wynne Health Group has developed a side-by-side analysis of three major Medicare Part D reform proposals. The proposals we examined are: The Medicare Payment Advisory Commission (MedPAC)’s June 2019 Report to Congress Chapter on Reforming the Medicare Part D Benefit Structure; The 2018 Policy Proposal from the American Action Forum (AAF) on Reforming Medicare Part D; and, The Draft Bill... Read More

(LaRosa, 6/20/19) #Medicare Part D, #Reinsurance, #Drug Pricing

WHG - Updated: 2019 Legislative and Regulatory Outlook

Wynne Health Group has updated its Legislative and Regulatory Outlook for 2019 to include changes stemming from the Administration’s Spring 2019 regulatory agenda. This documents seeks to provide a comprehensive collation of key federal health policy developments that we expect to see in the remaining months of this year. Of note in this update, you will find that many planned regulatory... Read More

(WHG, 6/11/19) #Food and Drug Administration, #Health Insurance Exchanges, #Medicare Part D, #Demonstration Programs

WHG - WHG Update: Recent Developments Impacting Access to Housing, Nutrition, and Other Social Determinants of Health

Much has happened in recent months with respect to social determinants of health, including administrative actions that might impact access to public benefits and health programs both in negative and potentially some positive ways. Developments related to public charge determinations, the calculation of the federal poverty level, housing assistance and nutrition program eligibility, and the removal nondiscrimination protections threaten to... Read More

(Wynne Health Group, 6/4/19) #Social Determinants of Health, #Nutrition

WHG - WHG Chart: Key Legislation on Raising the Tobacco Sale Age to 21

In the attached chart, we provide side-by-side analysis of the major Congressional (Senate and House) legislation intended to reduce youth tobacco use that have been introduced/released thus far in the 116th Congress. For each of the four proposals outlined below, the chart examines key provisions regarding tobacco products, restrictions, new enforcement authority, user fees, and preemption. Specifically, we look at:... Read More

(Llamas, 5/29/19) #Food and Drug Administration, #Public Health

WHG - WHG Chart: Key Legislation on Surprise Medical Billing

In the attached chart, we provide side-by-side analysis of the major Congressional (Senate and House) legislation intended to protect patients from surprise medical billing that have been introduced/released thus far in the 116th Congress. For each of the three proposals outlined below, the chart examines key provisions regarding prohibited balance billing scenarios, payment rates, implications for plans and providers, cost-sharing... Read More

(Wynne Health Group, 5/21/19) #Costs

WHG - A Tell-All on Telehealth: Where Is Congress Heading Next?

The Centers for Medicare and Medicaid Services (CMS) recently enacted modest but important expansions in Medicare’s telehealth policy. Telehealth, which uses telecommunications to support virtual health care delivery to improve access to and quality of health care, is moving from promise to reality. The benefits are appealing: Patients can interact with their providers remotely, which improves access to care and... Read More

(Wynne Health Group, 5/16/19) #Costs, #Health Information Technology, #Telehealth

WHG - Issue Brief: Assessing the Political Landscape and Outlook of Medicare for All

The political and public discourse around single-payer and “Medicare for All” proposals has rapidly gained momentum in 2019. Whereas in 2016, Medicare for All was championed most prominently and singularly by unsuccessful Democratic primary challenger Bernie Sanders (I-VT), in 2020 we will see nearly every Democratic presidential contender endorse a variation on the theme and will most certainly see the... Read More

(WHG, 5/13/19) #Public Option, #Single Payer

WHG - Accelerating Primary Care Redesign: CMS’ Innovation Center Announces Five New Transformative Models

On April 22, 2019, the Centers for Medicare and Medicaid Services (CMS) announced the Primary Cares Initiative (PCI), a suite of five voluntary payment models aimed at overhauling primary care. Marking the Trump Administration’s latest investment in Medicare value-based reform, PCI focuses on the role of primary care providers as the central coordinators of patient health, with the goal of enhancing... Read More

(Wynne Health Group, 4/24/19) #Primary Care, #Value-Based Purchasing, #Demonstration Programs

WHG - Health IT Policy and Interoperability Issue Brief

Attached here, please find a Wynne Health Group issue brief that provides an overview of federal health information technology (health IT) policy, beginning with the evolution of the Centers for Medicare and Medicaid Services’ (CMS) Promoting Interoperability Programs, formerly the Medicare and Medicaid Electronic Health Record Incentive Programs (EHR Incentive Programs). Next, the brief expounds upon the Medicare and Medicaid... Read More

(Wynne Health, 4/4/19) #Health Information Technology, #Medicare Access and Chip Reauthorization Act of 2015 (MACRA)

WHG - Telehealth Issue Brief

Wynne Health Group's telehealth issue brief provides an overview of telehealth policy and reimbursement beginning with Medicare fee-for-service (FFS) telehealth coverage and payment policies to other technology-based, non-face-to-face services related to but distinct from Medicare “telehealth services” – such as chronic care management (CCM), remote patient monitoring (RPM) and virtual care services. The issue brief also addresses new telehealth flexibilities... Read More

(Wynne Health Group, 3/22/19) #Medicare Advantage, #Telehealth

WHG - WHG 2019 Legislative and Regulatory Outlook

This comprehensive document reflects the Wynne Health Group's compendium of the significant federal health care regulations expected this year, as well as key Congressional dates and Administration-driven deadlines. From ‘must-pass’ legislation – including a deal necessary to raise statutory budget caps and the debt limit – to numerous Medicare/Medicaid regulations in the queue impacting CY/FY 2020 payment and program policy,... Read More

(Pahner, 1/16/19) #Affordable Care Act, #Budget

WHG - Our Take on Federal Court Ruling on the ACA

In light of the confusion created by the U.S. District Court ruling on the ACA, we wanted to provide some detail regarding what it really means and potential future developments. In brief, the ACA remains the law of the land and we believe it is highly likely to continue to be so indefinitely. Our full analysis is attached... Read More

(Wynne, 12/17/18) #Affordable Care Act, #Individual Mandate

WHG Insights