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November 8, 2017

In what could be a sign of what’s to come in 2018—that the direction of the country is more toward embrace of the ACA, than rejection—Maine became the first state to vote to expand Medicaid at the polls yesterday while Virginia Democrats’ gains in the state’s House of Delegates made Medicaid expansion a much more realistic prospect. Exit polls in Virginia showed that healthcare was the top issue for nearly 40 percent of voters.

Meanwhile, Congressional Republicans and the White House continue to press for legislation similar to Graham/Cassidy to block grant funds to the states and significantly erode the ACA in 2018, but those efforts still look to be an uphill battle. At the same time, bipartisan legislation to stabilize the individual markets, crafted by HELP Committee Chair Lamar Alexander and Ranking Member Patty Murray, is still in play.

President Trump continues to encourage repealing the individual mandate as part of the package, but that agreement isn’t likely to muster the necessary 60 votes to pass the Senate. Senator Orrin Hatch and Congressman Kevin Brady are pushing for a similar plan that includes the mandate repeal, but its passage is an uphill battle.

Read more.

High-Deductible Health Plans Pose Challenge

A recent Health Affairs blog, “Tension Between High-Deductible Health Plans And Payment And Delivery Reform,” discusses the rise of HDHPs and their potential collision course with value-based payment reforms.

According to the blog, “The evidence thus far shows that consumers decrease their use of health care services under HDHPs. However, this reduction includes both care that is potentially wasteful and care that may be valuable to the consumer.” For providers who are increasingly paid on the health outcomes of their patients, lack of control over which services patients choose to use can be detrimental.

The authors offer some approaches for better aligning these two strategies and conclude, “Current reforms won’t reach their potential unless we find a way to pair these payment and benefit design strategies well.”

Read the blog.

Introducing Vital Signs

This month, Leader’s Edge magazine unveils Vital Signs, a new section that takes a deeper dive into some of the core issues plaguing our healthcare system.

The section is part of a broader effort by Leader’s Edge and The Council to engage in the ongoing healthcare dialogue in our country and educate various stakeholders on issues such as pricing transparency, legitimate pricing and alternative payment models. This effort was inspired by the Council of Employee Benefits Executives (CEBE), whose members have grown increasingly frustrated at the lack of attention paid to these core issues during the ongoing ACA debates.

Jenn Walsh, chair of the CEBE board and SVP and partner at Woodruff, Sawyer & Co., gives a detailed explanation of this initiative in her column, “Too Costly to Ignore.

Walk the Talk

Zenefits and OneDigital recently announced that they are forging a new, unprecedented partnership that will give clients access to leading technology and advisory services.

Leader’s Edge chatted with Zenefits’ vice president of carrier relations Colin Rogers about what made Zenefits change its tune on brokers, how the company will continue to evolve and what makes OneDigital special.

Read more.

Joel Wood, SVP, Government Affairs
Key Takeaways from Tuesday’s Elections
The New York Times

Cheryl Matochik, SVP, Strategic Resources & Initiatives
Health Companies Race To Catch UnitedHealth As Amazon Laces Up
Kaiser Health News