At a Glance…
- House appropriations starting off with extreme cuts to health funding
- Congress adds pressure on VA to get EHR right
- New grants from ONC on AI and health care
- And more…
Don’t forget to register for the Annual Research Meeting in Baltimore!
AcademyHealth’s Annual Research Meeting is a great opportunity to hear about the latest research and ideas in health policy and health care delivery. This year the conference will be in Baltimore from June 29 to July 2, and there is still space to register. Learn more here.
House Appropriations Committee releases subcommittee allocations with extreme cuts
The House Appropriations Committee announced that they intend to write funding bills for FY25 that will lead to at least a $67 billion cut in nondefense investments from what Congress passed in FY24. House Appropriations Committee Chairman Tom Cole (R-OK) announced his intention that Labor-HHS be cut by at least 10 percent from the FY24 levels. The Senate Appropriations Committee intends on fulfilling the entire Fiscal Responsibility Act agreement, which included side deals, and has an average 1 percent increase across nondefense accounts.
House Majority Leader Steve Scalise (R-LA) is planning a House vote on the Floor on all 12 appropriations bills before the August recess, with the Labor-HHS bill happening at the end of July. Last year, the House was able to report only 10 of the 12 bills to the Floor, passing seven of those. Due to the expected and significant differences between the House and Senate appropriations strategies, it is unlikely that any of the 12 will be agreed to between the Chambers and signed into law before the start of the next fiscal year on October 1.
Congress grows impatient with VA quality standards for EHR
Bipartisan leaders of the House and Senate Veterans’ Affairs Committees introduced legislation designed to enhance the Department of Veterans Affairs’ oversight of its electronic health record system. VA’s effort to deploy a modernized EHR system at its medical facilities has been beset by technical challenges, patient safety concerns, and cost overruns since the agency signed a five-year contract with Cerner in 2018 to modernize its legacy software. The project, which has been linked to veterans’ deaths and is significantly over budget, has been under scrutiny, with costs ballooning from an estimated $10 billion to over $50 billion. The Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act would among other things require additional metrics to be reported to Congress by the VA and would sunset Oracle Cerner EHR system if the rollout does not show more improvement.
Department of Commerce released an Equitable Data Playbook
The Chief Data Officer of the Department of Commerce released an Equitable Data Playbook, which seeks to inform programs managers on how data can be applied at every stage of a program lifecycle for improving equitable program implementation. This includes implementing equitable data practices across the program lifecycle, designing an administrative data system fit for evidence-building, communicating data needs in funding opportunities, allocating funds for data, tech, and evaluation capacity, and engaging stakeholders for ongoing improvements.
New bipartisan House caucus seeks to tackle the obesity crisis
Rep. Vern Buchanan (R-FL) and Rep. Gwen Moore (D-WI) formed the Congressional Prevention Health and Wellness Caucus to bring awareness to the obesity crisis. The bipartisan group will focus on prevention, Medical Research and Innovation (MRI), Food as Medicine (FAM), exercise, health disparities, coverage, stigma, obesity’s effect on military readiness and physical fitness. They also plan to quantify the potential savings incurred by preventing obesity, introduce legislation that focuses on prevention, research and treatment, hold hearings and briefings, and hold congressional roundtable discussions.
Patients with Long COVID frustrated by lack of research funding
The Long COVID Campaign has called on Congressional leaders to appropriate at least $1.2 Billion in FY25 funding for Long COVID research, with other patient groups advocating for even higher levels of funding to meet the scale of need. They claim that the President’s Budget Request for FY25 had notably insufficient funding for Long COVID research, treatment, or care.
ONC is offering new funding on AI and behavioral health care
The Office of the National Coordinator for Health Information Technology is offering new funding for projects on artificial intelligence and behavioral healthcare. The agency is looking for proposals for evaluating and improving the quality of healthcare data used by AI tools, and projects that speed the use of health IT products in mental healthcare. ONC will award up to $2 million for the two projects in fiscal year 2024. Applications are due July 12.
HHS finds that states do not consistently define paid amount data for Medicaid drug claims
In Medicaid managed care, consistent and accurate data on the amount pharmacies were reimbursed for filling prescriptions are critical for CMS and States to administer the program and oversee drug spending. If these paid amount data do not consistently and accurately reflect pharmacy reimbursement, this could undermine states’ use of these data to determine actual Medicaid drug spending; to develop plans’ capitation rates; and to combat fraud, waste, and abuse in Medicaid managed care. The Office of the Inspector General at HHS found that state requirements varied for how plans should report the paid amount for drug claims and many did not validate the data.
CMS expediting claims for patients denied emergency abortions
Patients who say they were denied emergency abortions and other emergency care can now file complaints directly with the Centers for Medicare and Medicaid Services. Federal officials have created a web portal for patients to send complaints directly to CMS, which enforces the federal emergency care law, rather than to a state agency. Under the Emergency Medical Treatment and Labor Act — a nearly 40-year-old federal law known as EMTALA — hospitals receiving federal funds must stabilize or transfer patients needing emergency care. Hospitals must provide the care regardless of the patient’s insurance status, mental illness or other complications that might otherwise lead hospitals to turn them away. If patients believe they were wrongly turned away, they can file a complaint, a process that can trigger a state-federal investigation and threaten the hospital’s funding.
What we’re reading
Distrust with public health agencies and scientists remains a complicated and frustrating phenomenon in the years after the start of the Covid-19 pandemic. SteelFisher et al wrote in JAMA about their research in studying public priorities for public health agencies alongside stated levels of trust. They found wide public support for public health work, even among the least trusting of respondents, including action on chronic diseases, mental health, infant mortality, and opioids. Knowing what areas that are more universally supported show pathways for building back trust elsewhere.
It seems surprising in today’s day and age that so much of research does not sufficiently consider sex and gender. Haupt et al comment in Nature about how few investigators are sufficiently incorporating sex and gender into the design of clinical trials or into the practice of medicine. For example, women’s risks of heart attacks was overlooked because the Global Registry of Acute Coronary Events (GRACE) score was derived from studies that mainly used men.
More data is coming out that states with abortion bans are exacerbating healthcare workforce shortages. NPR reported on how a greater number of medical residents are starting to avoid states that have abortion bans in them. Data gathered by the Association of American Medical Colleges (AAMC), showed that for the second year in a row, students graduating from U.S. medical schools this year were less likely to apply for residency positions in states with abortion bans and other significant abortion restrictions. The AAMC analysis notes that even in states with abortion bans, residency programs are filling their positions — mostly because there are more graduating medical students in the U.S. and abroad than there are residency slots.