Health Equity & Access Weekly Roundup: July 13, 2024

CMS Unveils Proposed 2025 Physician Fee Schedule, Maternal Health Standards

On July 10, 2023, HHS and CMS proposed the 2025 Physician Fee Schedule, which includes a 2.8% reduction in the conversion factor to $32.36 from $33.29 in 2024. This proposal aims to enhance behavioral health services, extend telehealth waivers, and introduce new Merit-based Incentive Payment System Value Pathways (MVPs). It also addresses significant, anomalous, and highly suspect (SAHS) billing activity. The rule includes expanded payments for opioid treatment programs, digital mental health devices, and new coding for mental health services. Additionally, it extends certain telehealth waivers and proposes new Quality Payment Program pathways. The Biden administration's initiative introduces federal maternal health standards for hospitals, aiming to improve maternal health outcomes, particularly for Black, Native, and rural women. Public comments on the proposed rule are open until September 9.

Integrating Maternal BP Checks in Pediatric Visits Enhances Outcomes

A study published in JAMA Network Open highlighted the benefits of integrating maternal blood pressure (BP) and preeclampsia screening into well-child visits to enhance early detection and management of postpartum hypertensive disorders (HDP). Results demonstrated a rise in readmission rates for postpartum preeclampsia from 2.1% to 5.6%. The quality improvement program facilitated earlier readmissions, improving outcomes. Despite demographic similarities between groups, those readmitted were more likely to be African American and have a prior HDP diagnosis.

Exploring Pharmaceutical Innovations, Trust, and Access With CVS Health's CMO

In this episode of Managed Care Cast, Sreekanth Chaguturu, MD, chief medical officer of CVS Health, discussed the significant impact of recent pharmaceutical innovations, particularly glucagon-like peptide-1 (GLP-1) receptor agonists and biosimilars, on patient health outcomes. The conversation delved into the importance of trust between patients and providers in the adoption of new medications and highlighted initiatives aimed at reducing drug prices and improving access to essential treatments.

Frameworks for Advancing Health Equity: LGBTQIA+ Affirming Provider Designation

In this week's episode of Frameworks for Advancing Health Equity, Kim Zynn, vice president of UPMC Health Plan's provider network and development relations team, discussed the new LGBTQIA+ affirming provider designation in UPMC Health Plan's provider directory. Developed through a collaboration between UPMC Health Plan, experts, and the National LGBTQIA+ Health Education Center at the Fenway Institute, the program offers comprehensive online training modules for continuing medical education credits, available to all providers.

New Report Highlights Health Inequities Among Medicaid-Eligible Populations in New England

The Siftwell 2024 Medicaid-Eligible Health Equity Index report revealed significant health disparities among New England's Medicaid-eligible populations, particularly racial minorities, and called for systemic changes to improve health care access and outcomes. Over half of this population faces health inequities, with notable barriers for racial minorities, women, and LGBTQ+ individuals. High usage of mental health centers and programs for pregnant women points to critical gaps in care. The report emphasizes the detrimental effects of policy changes such as work requirements and the end of continuous Medicaid enrollment, which could lead to increased mortality. Despite these challenges, community-based organizations and managed care organizations have made progress in addressing these disparities through support services and advocacy.