Good morning ... One of the most isolated places on the planet is an island in the South Atlantic called, fittingly, Inaccessible Island. You can only get there via a very long boat ride, only on a couple of days per year, and there’s only one tiny stretch of walkable ground among the steep cliffs once you get there. Seems much more fun to read about this trek than to make it.
Photo: Scott Olson/Getty Images
Food and Drug Administration Commissioner Scott Gottlieb is almost ready to roll out his crackdown on e-cigarettes.
Why it matters: Gottlieb has been signaling for a while now that this is coming, reiterating that while he believes e-cigarettes can be a less risky option for people who would otherwise smoke cigarettes, their popularity with teens is a bigger concern.
Under the leadership of then-Secretary Tom Price, the Department of Health and Human Services substantially rolled back mandatory pilot programs.
How it works: HHS is on a perpetual quest to change the way Medicare pays for care. One leading part of that effort involves bundling together the many individual payments Medicare would normally make for a one procedure.
“Real experimentation ... requires a willingness to try mandatory models. We know they are the most effective way to know whether these bundles can successfully save money and improve quality,” HHS Secretary Alex Azar said yesterday.
The bottom line: Providers won’t be happy. But people who want to reform the delivery system will be.
David Feinberg, CEO of Geisinger Health System, is moving over to lead health care programs at Google, the Wall Street Journal reports.
Between the lines: Geisinger is a large system whose national profile stems largely from its integrated approach to care. It was also, WSJ notes, an early adopter of electronic medical records.
The business world, including the tech industry, is making several big-name hires as it looks for new approaches to health care. Amazon, JPMorgan Chase and Berkshire Hathaway recently tapped surgeon and writer Atul Gawande to lead their as-yet-unnamed health initiative.
Health insurers that run state Medicaid programs must have adequate networks of doctors so people don’t have to travel far. But that may change under a new federal proposal, Axios’ Bob Herman reports.
How it works: An Obama-era rule required states to come up with “time and distance” standards for Medicaid networks.
What they’re saying: “We aren’t rolling back [network] requirements,” CMS Administrator Seema Verma said in a response on Twitter.
The bottom line: This rule could allow states to create new rules under which the nearest doctors are hundreds of miles away, resulting in “much less adequate provider networks than under the current rule,” said Edwin Park, a Medicaid researcher at Georgetown University.
Critics of the Affordable Care Act have argued that it would force insurers to drop coverage or cut workers’ hours — but that hasn’t happened, according to a new analysis from the Urban Institute.
Details, via my colleague Caitlin Owens:
Yes, but: Everything isn’t worry-free in the world of employer-sponsored insurance. Deductibles and other out-of-pocket costs have been steadily rising, as health care costs go up and employers shift more of those increases onto their workers.