Health Balance and Weekly Access: November 9, 2024

Trump Returns to White House, Spelling Uncertainty for Federal Health Policy

Former President Donald J. Trump is also President-elect Trump after winning the 2024 presidential election. He is set to re-enter the White House with plans to overhaul federal agencies, including health care. His campaign, although based on specific health proposals, suggested “theories” of health reform. Backed by Robert F. Kennedy Jr., the Trump administration could target public health initiatives, including vaccination and fluoride regulations, if Kennedy takes a leading role.

Abortion measures were decided with 7 of 10 states voting to protect access to abortion, while measures in Florida, Nebraska and South Dakota were weak. Trump’s Democratic opponent, Vice President Kamala Harris, has promoted reproductive rights, the expansion of the Affordable Care Act, and changes to drug costs, which could face changes under Trump, who instead proposed tariffs and incentives to boost domestic drug production.

Changing Physician Compensation in the New Medical Landscape

A new study suggests that physician compensation in the US could be affected by the consolidation of medical systems and the rise of Medicare Advantage enrollees. Despite a 3% increase in average physician compensation from 2022 to 2023, factors such as reductions in Medicare premiums and the shift from fee-for-service to Medicare Advantage plans could lower the income of doctors, especially in big cities. With fewer physicians entering private practice, career models are changing, often involving venture capital or private equity firms.

At the same time, the nursing workforce is expected to grow by 40% by 2033, providing a low-cost alternative for practices seeking to reduce costs. However, this change brings challenges to care coordination activities, as nurses are generally paid less but may be considered more cost-effective despite handling fewer cases. a lot.

Lessons Learned from Medicaid Relaxation as States Struggle with Eligibility Reviews

After the end of the public health emergency of COVID-19, states started checking eligibility for Medicaid and CHIP, leading to a large loss of coverage, and more than 25 million people were disenrolled in June 2024. The “opt out” process has been a challenge, as 69% of people are unregistered. it is due to administrative issues, not suitability, often due to staff shortages and outdated technology. Divisions emerged, with racial and ethnic minorities disproportionately affected, highlighting the systemic inequities in the Medicaid policy. While some states, such as Kentucky and Louisiana, have implemented systems designed to reduce the loss of security, others, such as Florida, have faced lawsuits due to procedural errors. Federal policy changes aim to reduce “churn” and improve stability, yet debates continue over Medicaid spending and the need for technology integration to support equal access.

Cancer Incidence Differences Among Asian Americans and Pacific Islanders

A recent study published in JAMA Network Open found that while the number of people dying from cancer as a whole has decreased among Asian American and Pacific Islander (AAPI) populations from 1999 to 2020, some types of cancer have shown higher death rates , which highlights significant differences in cancer type, gender, age and location. Cervical cancer and brain cancer deaths increased significantly among AAPI women, while men ages 45 to 54 experienced an increase in colorectal cancer deaths. The incidence of liver and intrahepatic bile duct cancer has increased for both sexes in all regions of the US. The study, based on CDC data, highlighted weaknesses such as the clustering of AAPI groups, which can mask disparities between races, and the lack of information on cancer and socioeconomic factors.

Privately Negotiated Center Fees in Ambulatory Surgery Centers and Hospitals

A recent review published in The American Journal of Managed Care® found that hospital charges for routine outpatient procedures were, on average, more than double those for ambulatory surgery centers (ASCs), with the lowest charges for hospitals exceeding ASCs by $3077. The study used cost data from private payers and analyzed high-quality practices at four centers, showing significant cost differences that could help nurses refer healthier patients to them. -ASC to reduce costs. Although hospital reimbursements reflect the costs associated with complex care and market forces, expanding ASCs, especially in countries with certificate-of-need laws, can help reduce spending and improve care experience. However, careful regulatory protection is needed to ensure financial transparency and prioritize the vulnerable.

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