Friday December 14th, 2018 12:12PM

Trump uses page from 'smart policymaking 101' on health care

By The Associated Press
Related Articles
  Contact Editor

WASHINGTON (AP) — A smartphone app that lets Medicare patients access their claims information. Giving consumers a share of drug company rebates for their prescriptions. Wider access to websites that reliably compare cost and quality of medical tests.

The Trump administration is taking a pragmatic new tack on health care, with officials promising consumer friendly changes and savings in areas from computerized medical records to prescription drugs. New Health and Human Services Secretary Alex Azar has been rolling out the agenda, saying it has the full backing of President Donald Trump.

"They are taking a page out of smart policymaking 101 and hitting on themes that everybody cares about," said Kavita Patel, a health policy expert at the Brookings Institution and a veteran of the Obama administration. "But there is not a lot of detail on how they're going to do it."

The first year of the Trump administration was marked by Republicans' unsuccessful struggle to repeal the Affordable Care Act. With Azar installed as Trump's second health secretary, the administration is shifting to issues of broader concern for people with Medicare and employer-provided coverage. Many of the ideas have bipartisan support and can be advanced without legislation from Congress.

A look at new priorities outlined by Azar and Seema Verma, head of the Centers for Medicare and Medicaid Services:


Most hospitals and doctors now have electronic records, but the systems don't necessarily talk to each other and patients find that their medical information remains hard to access.

The administration wants to write new standards nudging industry to get the systems communicating. That would allow patients to easily transfer records from one provider to another.

"We're not interested in micromanaging how this process happens," Azar said. "Patients ought to have control of their records in a useful format, period."

Medicare is working with software developers on apps that can provide beneficiaries with access to their claims data, which offer important medical details but not a complete picture.

Dan Mendelson, CEO of the consulting firm Avalere Health, says the goal is within reach, perhaps over a three-year period. A lot of the groundwork has been laid by previous administrations, starting with Republican George W. Bush and advancing under Democrat Barack Obama.

"They are definitely taking a new tack on health care," Mendelson said of the Trump administration.



As a candidate, Trump called for Medicare to negotiate drug prices and for allowing U.S. patients to import lower-cost prescriptions from overseas. His administration seems to have dropped those ideas.

But Azar, who spent 10 years as a pharmaceutical executive, has lots of other proposals. They include speeding generics to market, short-circuiting maneuvers that drug companies use to ward off competitors, and changing government policies that may encourage drugmakers to raise prices because federal programs will bear the cost.

Azar praised insurer UnitedHealthcare for its recent announcement that it will pass on drugmaker rebates to some of its customers. That mirrors a Trump budget proposal for Medicare, the government's premier health insurance program, covering about 60 million seniors and disabled people.

Advocacy group CEO John Rother of the National Health Care Coalition says action to lower drug costs is the most nebulous part of the Trump agenda. "There is an open question as to whether the rhetoric is going to produce anything real," he said.



A routine test such as an echocardiogram, an ultrasound exam that can detect heart problems, can cost 10 times as much in a hospital as it does in a doctor's office. And that's just the list price. Real prices paid by different insurers and by Medicare also vary, and can be impossible for consumers to find.

Republicans have a longtime goal of getting true prices for health care goods and services in front of consumers, reasoning that could lead to a market revolution and help curb relentless spending.

Real competition has never been fully tried in our "bizarre" system, Azar told a hospital group. He's promising to use the weight of Medicare and Medicaid, a federal-state collaboration covering more than 70 million low-income people, to pull back the veil on medical pricing. That could help the increasing number of people with high-deductible health insurance who can face thousands of dollars in out-of-pocket costs.

But medical care is not like buying electronics off the shelf at Walmart. Patients rely on intermediaries such as doctors to make decisions.



Changing Medicare's piecemeal payment system so it rewards quality and not just sheer volume of tests and procedures is a long-standing goal for lawmakers of both parties. The Obama administration tried multiple experiments and made some improvements. But results were not clear-cut.

Azar is promising to go further, faster. Spokesman Ryan Murphy said HHS is reviewing all its payment rules to see if in fact Medicare is paying for value.

Azar says he intends to use an agency created under Obama — the Center for Medicare & Medicaid Innovation — to spur change.



As the administration pledges to improve quality and lower costs, it's still pursuing repeal of the Affordable Care Act, which would result in millions of low- and moderate-income people losing coverage.

"Can you really pursue positive changes in health care delivery while at the same time you start losing coverage?" asked Rother. "It is an interesting dilemma."

  • Associated Categories: Associated Press (AP), AP National News, AP Online National News, Top General short headlines, AP Online Headlines - Washington, AP Health, AP Business, AP Business - Industries, AP Business - Health Care, AP Business - Personal Finance
© Copyright 2018 AccessWDUN.com
All rights reserved. This material may not be published, broadcast, rewritten, or redistributed without permission.
Veterans home victim recalled as ebullient, caring
Executive director of treatment center killed by California veterans home gunman was dedicated to helping those afflicted by PTSD
4:18PM ( 4 minutes ago )
The Latest: Psychologist killed in vets home was pregnant
A psychologist who was killed by a former patient at a veterans treatment facility in California was seven months pregnant and is being remembered by friends for her commitment to both her family and her job
4:09PM ( 13 minutes ago )
Thousands march to protest Canada pipeline expansion project
Thousands of demonstrators marched Saturday to speak out against a pipeline expansion project that would nearly triple the flow of oil from Canada's tar sands to the Pacific Coast
4:05PM ( 17 minutes ago )
Associated Press (AP)
Trump believes North Korea will keep word on missile tests
President Donald Trump says he believes North Korea will honor its pledge to suspend missile tests while he and its leader Kim Jong Un prepare for direct talks.
3:24PM ( 59 minutes ago )
Bannon boosts France's Marine Le Pen, seeks European network
Former White House strategist Steve Bannon re-energized France's struggling far-right National Front party and its leader Marine Le Pen
3:13PM ( 1 hour ago )
Justice Department proposes banning rapid-fire bump stocks
The Trump administration says it's taken the first step in the regulatory process to ban bump stocks _ those devices that enable guns to fire like automatic weapons
2:17PM ( 2 hours ago )
AP National News
Sherwood Drive waits in vain GOP's Saccone, 'a busy man'
In Tuesday's closely watched congressional election, lots of money seems to be pouring in to help Republican Rick Saccone
12:46PM ( 3 hours ago )
Michigan seeks changes to abuse reporting law after Nassar
Michigan is looking to shore up its law that requires certain people to report suspected child sexual abuse to authorities to address gaps that were exposed after disgraced former sports doctor Larry Nassar admitted to sexually assaulting female athletes
12:03PM ( 4 hours ago )
UK security team holds emergency meeting on Russian ex-spy
British government security ministers holding emergency meeting to discuss the investigation into the poisoning in England of a Russian who spied for Britain
11:58AM ( 4 hours ago )
Top General short headlines
Dems pledge to limit superdelegates, but don't say how
The Democratic Party's hierarchy has acknowledged the "perceived influence" of insiders over voters in picking a presidential nominee, but the party doesn't know yet how to settle an issue that bedeviled the Hillary Clinton-Bernie Sanders fight.
3:00PM ( 1 hour ago )
Sessions: US prosecutors won't take on small-time pot cases
Attorney General Jeff Sessions says federal prosecutors won't take on small-time marijuana cases despite his move to lift an Obama-era Justice Department policy that discouraged U.S. authorities from cracking down in states where the drug is legal
12:18PM ( 4 hours ago )
Trump says China's Xi approves of his North Korea strategy
President Donald Trump says China is glad he's working on a diplomatic solution to the North Korean crisis rather than "going with the ominous alternative."
12:09PM ( 4 hours ago )
AP Online Headlines - Washington
AP Source: Browns trade DT Shelton to Patriots for pick
AP Source: Browns agree to trade defensive tackle Danny Shelton to New England Patriots
1:52PM ( 2 hours ago )
Steel standoff: No exemption for EU so far, despite talks
The European Union and Japan pressed U.S. President Donald Trump's trade envoy Saturday to exempt them, as longtime U.S. allies, from upcoming steel tariffs that have sparked fears of a new trade war
12:59PM ( 3 hours ago )
West Ham fans invade field, protest during loss to Burnley
Tensions at West Ham reached boiling point during a 3-0 loss to Burnley on Saturday when some fans invaded the pitch while others vented their anger at the ownership at the Olympic Stadium
12:26PM ( 3 hours ago )
AP Business
Slow recovery from latest nor'easter; 3rd storm on tap?
The arduous recovery from the latest storm to pummel the Northeast will likely stretch through the weekend as utility crews work to restore electricity to hundreds of thousands of customers
10:15PM ( 18 hours ago )
Insurers get into care, but is it good for your health?
As costs spiral and traditional boundaries blur in health care, insurers are taking more control over monitoring customer health and delivering care
4:07PM ( 1 day ago )
Report says radioactive monitors failed at nuclear plant
A new report says mistakes and mismanagement are to blame for the exposure of workers at the Hanford Nuclear Reservation in Washington state to radioactive particles in December
3:04PM ( 1 day ago )
AP Business - Industries
Cigna to spend about $52 billion for Express Scripts
Health insurer Cigna will spend about $52 billion to acquire the pharmacy benefits manager Express Scripts, the latest in a string of proposed buyouts and tie-ups in a rapidly shifting landscape for the health services industry
8:45AM ( 2 days ago )
Watchdog report: Failed VA leadership put patients at risk
Veterans Affairs Secretary David Shulkin is pledging wide-scale changes at the VA after a blistering internal investigation found "failed leadership at multiple levels" at the agency
4:35PM ( 2 days ago )
Can ride-hailing companies cure medical transportation woes?
Lyft and Uber are expanding rides to the doctor with the bill going to care providers or insurers
4:38PM ( 4 days ago )
AP Business - Health Care
Jersey Shore town seeks ferry to dock next to Kushner resort
The federal government has been advising a beach town on the Jersey Shore on plans to build a pier and start a ferry service that would speed New Yorkers to the doorstep of a resort co-owned by Jared Kushner
4:54PM ( 23 hours ago )
Stock market lifts US household wealth to $98.7 trillion
Soaring stock market lifts US household wealth to $98.7 trillion, a record high
12:55PM ( 2 days ago )
The most and least affordable places to buy a home
Everyone wants to know how much house they can afford, and the answer depends on where they live
10:26AM ( 2 days ago )
AP Business - Personal Finance
The Latest: Psychologist killed in vets home was pregnant
A psychologist who was killed by a former patient at a veterans treatment facility in California was seven months pregnant and is being remembered by friends for her commitment to both her family and her job
4:09PM ( 13 minutes ago )
Gun background check system riddled with flaws
Experts say federal legislation may be of little help for fractured background check system used during gun purchases
4:04PM ( 18 minutes ago )
UConn fires coach Kevin Ollie with school under NCAA inquiry
UConn coach Kevin Ollie fired with team under NCAA inquiry and 4 years after Huskies won title
4:00PM ( 22 minutes ago )
Gabriel, Kentucky use 3-point barrage to beat Alabama 86-63
Wenyen Gabriel shot 7-for-7 on 3s and matched his career high with 23 points, sending Kentucky past Collin Sexton and Alabama 86-63 in the Southeastern Conference Tournament semifinals
3:58PM ( 24 minutes ago )
India, France to work for Indian Ocean freedom of navigation
India and France have pledged to work together to ensure freedom of navigation in the Indian Ocean and have signed an agreement to expedite construction of a big nuclear power plant in India by a French company
3:46PM ( 36 minutes ago )