• On April 8, 2015, the CMS Center for Consumer Information and Insurance Oversight (CCIIO) released a document entitled “Essential Health Benefits: List of the Largest Three Small Group Products by State”. This document provides information to facilitate States’ selection of the benchmark plans that will serve as the reference plan for the essential health benefits (EHB). Using data from HealthCare.gov, this document provides a list of the three largest small group insurance products ranked by enrollment in the first quarter of 2014 for each State. In addition, CMS is providing a list of the three largest nationally available Federal Employee Health Benefit Program (FEHBP) plans, which is another benchmark option under 45 CFR 156.100(a). CMS is also providing the single largest Federal Employees Dental and Vision Insurance Program (FEDVIP) dental and vision plans respectively, based on enrollment in the first quarter of 2014. 
  • On April 7, 2015, Accenture published an analysis which finds that enrollment in private health insurance exchanges doubled to nearly 6 million in 2015. Accenture’s findings show midsize employers, defined as companies with 100 to 2,500 employees, contributed most to the adoption of private health exchanges increase. Based on its research, Accenture forecasts that enrollment in private health insurance exchanges will grow to 12 million in 2016 and 22 million in 2017. As previously forecasted, Accenture expects total enrollment in private exchanges to ultimately surpass state and federally funded exchanges, reaching 40 million by 2018. 
  • The April issue of Health Affairs, which may be accessed here, includes a number of articles on the cost and quality of cancer care. One study compared cancer care across sixteen countries over time, examining changes in cancer spending and two measures of cancer mortality (amenable and excess mortality). Study authors found that compared to low-spending health systems, high-spending systems had consistently lower cancer mortality in the period 1995–2007. Similarly, they found that the countries that increased spending the most had a 17 percent decrease in amenable mortality, compared to 8 percent in the countries with the lowest growth in cancer spending. For excess mortality, the corresponding decreases were 13 percent and 9 percent. Additionally, the rate of decrease for the countries with the highest spending growth was faster than the all-country trend. These findings are consistent with the existence of a link between higher cancer spending and lower cancer mortality. 
  • study released this week by the Robert Wood Johnson Foundation finds that Medicaid expansion states are seeing significant budget savings and revenue gains. Savings and revenues by the end of 2015 (1.5 years into expansion) are expected to exceed $1.8 billion across the eight states that were analyzed (Arkansas, Colorado, Kentucky, Michigan, New Mexico, Oregon, Washington, and West Virginia). In Arkansas and Kentucky, savings and revenue gains are expected to offset costs of the expansion at least through state fiscal year 2021. Findings from these eight states suggest that every expansion state should expect to: 1) reduce state spending on programs for the uninsured; 2) see savings related to previously eligible Medicaid beneficiaries now eligible for the new adult group under expansion; and 3) see revenue gains related to existing insurer or provider taxes. 
  • On April 7, 2015, Avalere Health released a report which finds that state-based exchanges saw higher attrition from 2014 to 2015 than federally-facilitated exchanges. Federally-facilitated exchange states re-enrolled 78 percent of their 2014 enrollees in 2015, on average. In state-run exchange states, that percentage drops to 69 percent of 2014 enrollees. California, the state with the highest enrollment in 2014, only retained 65 percent of their 2014 enrollees. In total, federally-facilitated exchange enrollment in 2015 increased by 61 percent from 2014, rising to 8.8M. By contrast, state-run exchange enrollment only increased by 12 percent, to 2.8M. Large federally-facilitated states like Florida and Texas increased enrollment by 62 percent and 64 percent respectively. Conversely, large enrollment state-run exchanges like California and New York increased enrollment by 1 percent and 10 percent respectively, according to Avalere. 
  • The Office of the National Coordinator for Health Information Technology (ONC) released its April 2015 Report to Congress this week on Health Information Blocking. Information blocking occurs when persons or entities knowingly and unreasonably interfere with the exchange or use of electronic health information. The report finds that, “While the evidence is in some respects limited, there is little doubt that information blocking is occurring and that it is interfering with the exchange of electronic health information.” ONC believes that information blocking is best addressed through a combination of targeted actions aimed at deterring and remedying information blocking, and broader strategies and approaches that engage the larger context in which information blocking occurs. This report details actions that ONC is currently taking or has proposed to take, in coordination with HHS and other federal agencies, to target and address information blocking. According to the report, “Successful strategies to prevent information blocking will likely require congressional intervention.”