Washington Update: Monday, March 27, 2023
CDC raises alarm about drug-resistant fungus, Candida auris.
The CDC released a new report on Candida auris (or C. auris), a fungal infection which is spreading at an alarming rate. While the number of cases recorded by the CDC is only in the thousands, it is considered a serious global public health threat because it is drug resistant and has the potential to spread among the most medically vulnerable. The CDC says post-acute facilities are vulnerable given the long stay of patients. The report is published in the Annals of Internal Medicine.
Debt ceiling talks paused until Republicans release budget in May.
Congress was in recess last week and the White House was preoccupied with other economic challenges. The White House has said President Biden will not meet again with House Speaker McCarthy (R-CA) until the Republicans release their own budget, not expected until mid-May. Meanwhile, House Freedom Caucus chair Scott Perry (R-PA) says Biden should negotiate with him since his group has released a budget proposal and their votes will be crucial to raising the limit.
Secretary Becerra and Congressional Republicans disagree on MA rates.
HHS Secretary Xavier Becerra testified before Congressional committees last week. Republicans took him to task for the Biden Administration’s plans to trim MA rates. MA plans argue a 2.3% cut to MA programs for 2024 -- one part of which is a lower-rate tied to proposed risk model revisions -- will hurt plans and hamstring their ability to offer supplemental benefits. Republicans issued a letter to HHS raising doubts about the MA rate cuts. A copy is attached.
Non-profit SNFs Release Report Critical of Medicare Advantage.
Leading Age, the trade association for non-profit SNFs, issued a scathing and detailed report critical of the MA program. The report highlights other recent studies critical of MA plan practices and analyzes how MA post-acute provider networks and payments are inadequate for patients. The report concludes with 25 recommended reforms of the MA program for policymakers’ consideration. Leading Age and AHCA are the two leading SNF trade associations.
Highmark Medicare Advantage enrollment grows 12%.
The Pittsburgh-based non-profit insurer announced that its MA membership grew 12.3% for the 2023 plan year, nearly twice the rate of most insurers. In 2011, Highmark acquired the beleaguered Allegheny Health Network, a 14-hospital system in western Pennsylvania and New York. The subsequent feud between Highmark and UPMC became the stuff of local legend. Highmark reported that its labor costs skyrocketed last year -- about $100M more than expected.
With new CEO Sharon Vitti, ATI releases year-end results.
Chicago-based ATI, the nation’s 4th largest outpatient rehab operator with 900 clinics, reported results last week. ATI’s net revenue grew 1% while EBITDA decreased 83%, mainly due to higher labor costs. ATI is publicly traded on the NYSE for less than $1 per share and with a current market cap of $75M. Sharon Vitti took over as CEO last year after a rocky 2021 “SPAC” deal that valued the company at $2.5B. Sharon recently added a new C-suite team.
Gov. DeSantis highlights family roots in Pennsylvania and Ohio.
Ron DeSantis is expected to announce his candidacy for the presidency, probably in June when the Florida state legislature will recess for the year. In recent speeches, DeSantis has been emphasizing the fact his father grew up north of Pittsburgh and his mother in Youngstown, Ohio. While Ohio has become a reliable Republican state, Pennsylvania’s 20 electoral votes has become the nation’s crucial swing state for presidential candidates.
Inquirer: Shifting Pennsylvania politics are now reflected in Harrisburg.
The Philadelphia Inquirer reported on how the state’s politics have shifted over the past eight years, essentially the Donald Trump era. The biggest change is the Philadelphia swing suburbs have shifted from Republican to Democrat. This shift gave Democrats control of the state House for the first time in twelve years (when Democrats only controlled for two years). Democrats have been in the minority in the state House for 24 of the last 27 years. It’s hard to estimate how durable this shift is or if voters will switch once again if Trump leaves the political stage.
North Carolina becomes 40th state to expand Medicaid with ACA funding.
Thirteen years after the passage of the Affordable Care Act (ACA), North Carolina is poised to become the 40th state to expand Medicaid under the law, due to Democratic Gov. Roy Cooper and a growing recognition by Republican legislative leaders that 600,000 residents and their rural hospitals have the most to gain. Republicans have long objected to Medicaid expansion, as part of their opposition to the ACA.