Axios Vitals: What's "on the table"

Plus, a JPM thought bubble | Friday, January 13, 2023

Open in app View in browser   Presented By UnitedHealthcare   Axios Vitals By Tina Reed · Jan 13, 2023 Happy Friday, Vitals readers. Today's newsletter is 1,093 words or a 4-minute read. Programming note: We are not publishing Monday in observance of Martin Luther King Jr. Day. We'll be back in your inboxes on Tuesday.     1 big thing: Debt ceiling fight looms over Medicare, Medicaid Illustration: Sarah Grillo/Axios   House Republicans don't have much of a path to get major health care changes passed with a Democratic Senate and president, with one possible exception: the debt ceiling fight, Axios' Peter Sullivan writes. Why it matters: It's not clear which spending cuts House Republicans will push for in exchange for expanding the government's borrowing authority later this year — but at least some say programs like Medicare and Medicaid should be in the discussion. What they're saying: "We're going to have to look at the whole board," Rep. Barry Loudermilk (R-Ga.) told Axios, including mandatory spending like Medicare and Medicaid. "The easiest to start with is discretionary, but the main driver of the national debt is the mandatory." "Everything's on the table," he added. Speaker Kevin McCarthy told reporters Thursday that "as Republicans, we will always protect Medicare and Social Security," but did not get into specifics. He also did not mention Medicaid. "We will protect that for the next generation going forward, but we are going to scrutinize every single dollar spent," he added. What to watch: Rep. Morgan Griffith (R-Va.), a Freedom Caucus member on the Energy and Commerce Committee, cited the possibility of raising Medicare eligibility from 65 to 67. But, he said: "Nobody needs to panic. If we're going to do something, it will be out in the future years a long way out and people will understand it and will have time to adjust for it." Reality check: The chances of major entitlement reform remain remote in a divided government. But one thing that's clear about the House this year, it's unpredictable. The other side: Dems are already on the attack. "We intend to defend Social Security and Medicare and do the responsible thing and raise the debt ceiling," said Rep. Richard Neal (D-Mass.), the top Democrat on the House Ways and Means Committee. A version of this story was published first on Axios Pro. Get news like this by subscribing. Use code POLICY100 which gives you $100 off.     2. MedPAC wants a raise for hospitals and docs Illustration: Gabriella Turrisi/Axios   Speaking of Medicare spending, Congress should raise Medicare payment rates for hospitals and physicians next year while cutting fees to skilled nursing facilities and home care providers, MedPAC recommended on Thursday. Why it matters: The adjustments from the board, which advises Congress on Medicare policy, reflect inflationary pressures facing providers and concerns about maintaining Medicare beneficiaries' access to care, MedPAC members say. They come on the heels of the massive omnibus package, which offered providers some relief, but fell short of their pleas for assistance. Among the recommendations: Hospitals should get a 1% bump next year over this year's rates. Docs should also get an increase to help keep up with inflation. Yes, but: A Republican-led House is already eyeing potential Medicare cuts, not looking to increase spending. MedPAC's recommendations aren't binding. But as Axios' Maya Goldman previously reported, CMS has to make payment updates according to current law should Congress opt not to follow them. Read the rest.     3. JPM thought bubble: Fighting workforce costs Illustration: Shoshana Gordon/Axios   A very soggy edition of the JPMorgan Healthcare Conference wrapped up in San Francisco on Thursday after filling downtown eateries and crowding hotel lobbies all week, Axios' Arielle Dreher writes. Why it matters: The annual health care takeover is arguably still the most influential gathering in the business, offering a chance for investors to get a pulse on the upcoming year and for health execs to humblebrag about how many meetings they squeezed in. Zoom in: Arielle focused on health systems that are fretting over the economy more than in past years. State of play: While nonprofit hospitals and health systems said 2022 was brutal, 2023 is looking better as revenues rebound and reliance on temporary staffing continues to decline. Many systems presenting at JPM predicted better operating margins in the new year, and some were downright optimistic. Yes, but: It's not all roses, and some health systems have a much smaller cushion to fall back on. "We have a math problem: we can't go year in, year out with expense growth outpacing revenue," Rob McMurray, chief financial officer at ChristinaCare. What to watch: As hospitals pull multiple levers to address ongoing staffing shortages, some executives are looking overseas. "We're working on international recruitment because the supply of workers in this country isn't sufficient," said Wright Lassiter, CEO of CommonSpirit Health.     A message from UnitedHealthcare HouseCalls can help identify and prevent health issues among seniors     UnitedHealthcare's Medicare Advantage HouseCalls provide free, comprehensive wellness visits in the comfort of seniors' own homes. During visits, licensed clinicians spend up to an hour with seniors and follow up with their primary care providers to help address any health issues. Learn more.     4. Data du jour: Cancer deaths fall Data: American Cancer Society; Chart: Thomas Oide/Axios U.S. cancer death rates have fallen by a third since 1991, with about 3.8 million deaths averted in that time, according to study published Thursday in CA: A Cancer Journal for Clinicians. Why it matters: Cancer is still the second leading cause of death, but the data shows progress from improved treatments and prevention efforts. That includes noteworthy drops in mortality from leukemia, melanoma, and kidney cancers between 2016–2020, despite steady or even increasing incidence. The five-year survival rate for many cancers improved from the mid-1990s and the 2012–2018 time frame, particularly for lung, breast and colon cancers. Be smart: One example of the nuances is cervical cancer. There was a 65% drop in cervical cancer incidence between 2012 through 2019 among women in their early 20s, who were part of the first cohort to receive the human papillomavirus vaccine. But there was still an overall decline in five-year cervical cancer survival since the mid-1990s. That is thought to reflect increased prevalence of cervical cancer known as adenocarcinoma, which has worse survival than squamous cell carcinoma and is less likely to be detected through Pap tests, American Cancer Society officials said. What to watch: The progress may be stymied by rising incidence of breast, prostate and uterine cancer rates, which also have the greatest racial disparities in survival, researchers said.     5. Catch up quick 👉 Transgender youth health care bans have a new target: adults. (The Hill) 🕥 The doctor won't see you now: COVID winters are making long hospital waits the new normal. (Washington Post) 👀 With the FTC's more expansive approach to antitrust, PBMs are in the crosshairs (STAT) 🤝 What's in the agreement that led to the end of the New York City nurses' strike. (ABC News)     6. Cat of the week Pax. Photo: Sarah Shelson   Meet Pax, who is taking over what is typically our dog of the week section after his human Sarah Shelson made a convincing case to feature a black cat for Friday the 13th. Pax, who lives in Arlington, Virginia, "enjoys 3 a.m. zoomies, leaving dents from his cat naps on the back of the couch, and peanut butter," Shelson writes. "We like to think he brings us good luck, not bad luck, but he did lock his humans out of their apartment once. So fingers crossed we don't have a repeat," Shelson writes.     A message from UnitedHealthcare HouseCalls meet seniors in their homes     Millions of Medicare Advantage seniors take advantage of UnitedHealthcare's free HouseCalls program. For Jack, a free, comprehensive wellness visit from HouseCalls nurse practitioner Heather helped save his life. Watch their story.   Did someone forward this email to you? Here's how to sign up. Thanks for reading, and thanks to senior editor Adriel Bettelheim and senior copy editor Bryan McBournie for the edits. Your personal policy analyst is here. Track health care policy formation at every step of the process with Axios Pro. Talk to our sales team today.   Axios thanks our partners for supporting our newsletters. Sponsorship has no influence on editorial content. Axios, 3100 Clarendon B‌lvd, Arlington VA 22201   You received this email because you signed up for newsletters from Axios. To stop receiving this newsletter, unsubscribe or manage your email preferences.   Was this email forwarded to you? Sign up now to get Axios in your inbox.   Follow Axios on social media: