| | | | |  | | By Robert King and Daniel Payne | | | | | 
Doctors and hospitals say they're eager to work with the Biden administration on new ways to save Medicare money. | AP Photo | HEALTH PROVIDERS SEEK FULL FINANCIAL RISK — Some doctors and hospitals want to save more money for Medicare but feel constrained by a lack of options from the Biden administration. For more than a decade, the federal government has tried to shift how Medicare pays doctors and hospitals, moving away from reimbursements for every item or service and toward a set amount to cover the totality of care for a disease, Robert reports. The transition overall has been slow as some doctors and hospitals have been reticent to risk losing money. Some have decided to become accountable care organizations, which agree to keep their Medicare spending below a certain target and get a share of any savings it generates. The catch is an ACO must repay the federal government if it overspends. ACOs agree to take on varying levels of risk, and the most experienced ones appear ready to go full risk — if the Biden administration will let them. Right now, only one payment model, ACO REACH, enables full financial risk. “It’s just a reflection of where the market is,” said Aisha Pittman, senior vice president of government affairs for the National Association of ACOs. “With higher risk comes the opportunity to get more in the form of shared savings. You are willing to take that risk because you want to get access to those dollars to invest in more innovative processes.” What’s next: NAACOs and some ACOs have pressed the Centers for Medicare and Medicaid Services to offer a full financial risk track in the Medicare Shared Savings Program, which oversees ACOs. But CMS is reluctant to commit to such an option. Medicare Director Meena Seshamani told POLITICO in a statement that full-risk financial options in separate payment models could “inform future features of the [Medicare Shared Savings Program].” Pittman said that without riskier options, long-term ACOs could divert resources to other financial arrangements that offer full risk. The push comes as CMS hopes to meet an ambitious goal of having every Medicare beneficiary in a value-based care relationship by 2030. WELCOME TO WEDNESDAY PULSE. This is Robert King, your friendly CMS reporter filling in again today. If you have any tips or intricate health policy musings, don’t hesitate to share them with me at rking@politico.com or your regular Pulse host dpayne@politico.com. TODAY ON OUR PULSE CHECK PODCAST, host Ben Leonard chats with POLITICO's Victoria Guida about her data analysis revealing how low-income workers saw significant wage gains during the pandemic as a result of market changes and several government policies. Plus: What the data shows about health care workers.
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Former CDC head Rochelle Walensky has agreed to testify before a House subcommittee on the pandemic. | Brynn Anderson/AP Photo | CDC DIRECTOR ‘FINALLY’ AGREES TO TESTIFY — Rochelle Walensky, the director of the Centers for Disease Control and Prevention, has agreed to testify on June 13 before the House’s Select Subcommittee on the Coronavirus Pandemic. “Director Walensky’s knowledge of CDC policies and decisions is essential to the Select Subcommittee’s investigations, mission and to help prepare America for a possible future pandemic,” chair Brad Wenstrup (R-Ohio) said in a release Tuesday. One topic likely to be brought up is the CDC’s ties to the American Federation of Teachers. In March, Wenstrup wrote to Walensky, calling for all documents and communications on the teachers union’s ties to the center. The committee’s Republicans will likely grill Walensky on those ties and the agency’s controversial school reopening guidance. Walensky stepped down from the CDC earlier this month. The former head of Massachusetts General Hospital’s infectious disease division launched a strategic reorganization of the agency last year after acknowledging missteps in the response to the pandemic.
| | POLITICO’s Health Care Summit on Wednesday, June 7, will explore how tech and innovation are transforming health care and the challenges ahead for access and delivery in the U.S. Register now. | | | | | MAJOR HURDLES TO GET OPIOID TREATMENTS — Local pharmacies nationwide suffer from a lack of availability of opioid use disorder treatments like buprenorphine, a new study found. A research letter, published in JAMA Network Open, found that about 58 percent of pharmacies didn’t have buprenorphine or a combination treatment of buprenorphine and naloxone in stock when requested. Researchers found that 62 percent of chain pharmacies had the critical drugs in stock compared with 45 percent of independent pharmacies. There was wide variation among states, too. For instance, in Florida, only 37 percent of pharmacies had the treatments, while 84 percent of facilities in Washington had them. The Biden administration has tried to expand access to buprenorphine. A bill in the omnibus spending deal passed last December eliminated the so-called X-waiver requirement, which enabled doctors to prescribe buprenorphine without additional administrative requirements. The study suggests that the barriers to obtaining opioid treatment might not only be in prescribing the drugs, but also in getting them on the pharmacy shelves.
| | | | GET READY FOR GLOBAL TECH DAY: Join POLITICO Live as we launch our first Global Tech Day alongside London Tech Week on Thursday, June 15. Register now for continuing updates and to be a part of this momentous and program-packed day! From the blockchain, to AI, and autonomous vehicles, technology is changing how power is exercised around the world, so who will write the rules? REGISTER HERE. | | | | | | | | | ROSALYNN CARTER DIAGNOSED WITH DEMENTIA — Former first lady Rosalynn Carter, 95, has been diagnosed with dementia and remains at home with her husband in Georgia, reports POLITICO’s Kierra Frazier. Carter was a staunch mental health advocate, according to the Carter Center. “One in 10 older Americans have dementia, a condition that affects overall mental health,” a statement from the center said. “We recognize, as she did more than half a century ago, that stigma is often a barrier that keeps individuals and their families from seeking and getting much-needed support.” Former President Carter, 98, has been in home hospice care for several months following several hospitalizations.
| | THE VA UNMASKED — The Department of Veterans Affairs has relaxed its masking requirement at medical facilities, no longer requiring universal masking in most clinical areas. The VA announced the change Tuesday in light of the expiration of the Covid-19 public health emergency earlier this month. “Except for the highest-risk areas and situations, masking will be greatly relaxed for veterans and clinicians at VA health care facilities,” said Shereef Elnahal, the VA’s under secretary for health, in a statement. Masking will still be required for anyone in high-risk areas, including dialysis, chemotherapy, emergency department and transplant units.
| | THUMBS-DOWN FOR HEALTH PEACE INITIATIVE — The World Health Assembly failed to adopt an initiative seeking to protect the health of people in vulnerable areas or places of conflict, POLITICO’s Ashleigh Furlong reports. The Health for Peace Initiative was spearheaded by the World Health Organization to ensure that any emergency responses don’t lead to conflicts. With a goal to eventually enable building peace, WHO countries were set to adopt a roadmap during Tuesday’s assembly. However, countries decided to only “take note” of the roadmap instead of fully adopting it. “A number of doubts still persist on the language of the current draft, and how it would affect the work of health workers in conflict zones,” according to a statement from Brazil, also speaking on behalf of India and South Africa. Despite the setback, Ashleigh writes that it’s still likely that the roadmap could be adopted at next year’s health assembly.
| | | | A report from KFF found that many people in America’s “Diabetes Belt” are drowning in medical debt. Doctors are turning to a new genetic test in a bid to prevent heart attacks, according to a report in The New York Times. A POLITICO report dives into the White House’s efforts to mollify progressive Democrats over the debt ceiling deal, with officials noting it could have been worse.
| | | | DON’T MISS POLITICO’S HEALTH CARE SUMMIT: The Covid-19 pandemic helped spur innovation in health care, from the wide adoption of telemedicine, health apps and online pharmacies to mRNA vaccines. But what will the next health care innovations look like? Join POLITICO on Wednesday June 7 for our Health Care Summit to explore how tech and innovation are transforming care and the challenges ahead for access and delivery in the United States. REGISTER NOW. | | | | | | | | | Follow us on Twitter | | | | Follow us | | | | |
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