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What We’re Watching: October 15, 2019

CROSS ONE OFF THE LIST

Thanks to ProvideGx, the multi-year, national shortage of cysteine hydrochloride injection has been successfully resolved. For this important shortage drug, ProvideGx partnered with Exela Pharma Sciences, the only FDA-approved manufacturer of cysteine hydrochloride

What we’re saying: Cysteine hydrochloride, a critical drug for pediatric and adult patients that require parenteral nutrition, was officially delisted from the FDA’s drug shortage website on September 4, 2019, only two months after it entered the market through a supply deal with ProvideGx. It had previously been in continual shortage since 2015. Let us know if you’d like to discuss the approach ProvideGx is taking to address drug shortages.

A BRIGHT IDEA

Premier member University Hospitals is partnering with Bright Health, a Minneapolis-based health insurance company to offer Medicare Advantage plans to Cleveland and Akron residents in 2020. Bright Health partners healthcare providers to provide health insurance that improves outcomes and reduces costs through coordinated in-network care.

What we’re saying: Bright Health has also formed partnerships in other Ohio cities with Bon Secours Mercy Health, another Premier member. The company offers $0 premium Medicare Advantage plans with $0 primary care physician copays and low or $0 Part D deductibles. In July, Premier announced a partnership with industry expert John Gorman to support our portfolio of value-based payment services for Medicare Advantage providers and participants. Learn more about how we're helping providers achieve success in Medicare Advantage.

WE TOLD YOU SO

This month, the Centers for Medicare & Medicaid Services is abandoning the fourth iteration of the resource-utilization group framework for skilled nursing facilities (SNFs), which bases pay on the volume of therapy services. It has been replaced with the Patient Driven Payment Model based on acuity and other data-driven metrics. Last week Modern Healthcare reported on the actions industry associations are calling on CMS to take as SNFs lay off and cut the pay of therapists across the country following the new patient-driven payment model.

What we’re saying: Premier anticipated that these issues would arise and has been working with health systems to help build partnerships with SNFs. These moves will make it easier to realize cost and quality improvements in accountable care organizations and bundled payment programs.

NOT A BIRD OR A PLANE

UPS announced that it had received the first government approval to operate a fleet of delivery drones throughout the United States.

What we’re saying: While the initial clearance is restricted to specific medical sites for several years, we anticipate future expansion into home and rural delivery. In fact, drones have been top of mind for many of our members. WakeMed tested the drone technology over the last year, successfully transporting blood and tissue samples across their campus.

ABOUT THOSE READMISSION PENALTIES

Eighty-three percent of hospitals’ Medicare payment is being reduced by up to 3 percent for excess 30-day readmissions for patients treated for heart failure, heart attack, pneumonia, chronic obstructive pulmonary disorder, open heart surgery and hip and knee replacement.

What we’re saying: Premier is working to change the readmissions program so that targets are transparent and measurable and that hospitals can receive both upside and downside payment based on performance. We are advocating for consolidating the readmissions and hospital acquired condition programs into one value-based purchasing program. In the meantime, we're also helping hospitals avoid unnecessary readmissions every day.

IN CASE YOU MISSED IT

What We’re Watching is a bi-weekly blog focused on the current events Premier is following and their relevance to the work of Premier and its members. Check out our last update!

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