Medicare changes, Social contract in health care, Michael Stollar

What are you doing on January 15th?  If you don’t have plans, we’d love to have you with us at our 2019 Hawaii State of Reform Health Policy Conference!  Consider this your save the date…

Now, onto Five Things We’re Watching in Hawaii health care for the month of May!

1.  Video: Michael Stollar, HMSA

Michael Stollar is the President and CEO of HMSA, where he was worked for more than 30 years. Before being named CEO at the start of this year, he was COO. He joins us in this episode of “What They’re Watching” to discuss the federal changes he’s tracking and how they could impact Hawaii.

“[We’re tracking] what’s happening in Washington, particularly around the executive orders and what may come out of entitlement reform and what those impacts could be on Hawaii. Certainly, we’re [also] paying very close attention to insurance sales across state lines and association health plans.”

2.  Mixed progress on health policy this session

The Legislature tackled a number of health policy bills this session, including passingseveral ACA protections. Both chambers also introduced workforce related bills. We outline three of those that passed here.

PBM transparency bill failed to pass this session after the House pulled its conferees from the conference committee meeting. California has also struggled to pass its version of a PBM transparency bill. But early this week, Alaska’s Legislature passed a bill which requires PBMs to provide pharmacies with the methodology and sources used to determine the drug pricing list.

3. Four tenets of health care’s social contract with society

I believe you can view our politics and our policy discussions through the lens of our social contract we have with one another, and the social capital we have built together to support it. I’ll talk more about social capital another time, though one of the country’s first efforts to measure social capital was just released in late April. Hawaii came in 31st on the index of states’ social capital levels.

Our social contract is the set of responsibilities we owe to one another as Americans. I would argue many, and perhaps most challenges we face in health care today result from a perceived violation of our social contract by one group or another.

I outline the idea of this social contract in a two part series:  connecting the decline of public opinion of health care to our social contract, and the four tenets that make up the contract and which have broad acceptance by a majority of Americans.

4.  Two big, recent  moves in Medicare

The Bi-Partisan Budget Act passed by Congress allows for the inclusion of non-health care services to be covered supplemental benefits for MA plans starting in 2020.  I detail some of the background on this here.  This means that strategies related to the social determinants, for example, can be funded in Medicare, if a plan chooses to cover them.

Last week, CMS proposed several updates to Medicare payment policies and rates. Among them is a requirement to have hospitals publish a list of “their standard charges” online in an effort to “empower consumers.” This is an incremental step, but a good one and one we’re likely to get more of from Seema Verma’s shop.

5.  OHA releases study of wahine health

The Office of Hawaiian Affairs released a 150-page report on the status of Native Hawaiian women and their mental, physical and economic health.  You can see our summary here, the executive summary here, and the full report here.

Among the details that stood out from reviewing the study: Native Hawaiian women make up 43.7% of the female prison population, but represent only 18.4% of the total adult population of the State of Hawaii.  And, 14.6% of high school Native Hawaiian women “have actually attempted suicide” compared to 9.9% of non-Hawaiian women.