Primary-care Docs Not Aligned with Trump on ACA Repeal

Welcome to Practice Rounds, our weekly column exploring what's being covered in the larger world of healthcare.

ACA Approved by Primary-Care Docs

A new survey from researchers at Johns Hopkins Medicine found that only 15 percent of primary-care physicians want a full repeal the Affordable Care Act (ACA). Moreover, only 38 percent of primary-care doctors who voted for President Donald Trump say they want the ACA repealed. "What we heard is that the majority of primary care physicians are open to changes in the law, but overwhelmingly opposed full repeal," said Craig Pollack, internal medicine physician and associate professor of medicine at Johns Hopkins in a statement. For the survey, researchers polled 426 internal medicine physicians, pediatricians, geriatricians and family doctors. Many of the ACA's provisions were overwhelmingly supported by the doctors, such as prohibiting insurers from denying coverage or charging higher prices to people with pre-existing conditions.

AMA, MGMA, Others Tackle Prior Authorizations

The American Medical Association, Medical Group Management Association and 15 other healthcare organizations formed an alliance this week to try and tackle the issue of prior authorizations. The groups urged "health plans, benefit managers and others to reform prior authorization requirements imposed on medical tests, procedures, devices and drugs." The coalition said prior authorization requirements by insurers delay treatments and medical services to patients and complicate medical decisions. The coalition is looking for insurers to reassess prior authorizations programs. They cited the inconsistent rules in current prior authorization programs and how the related administrative work reduces time with patients. AMA cited a survey that said every week a medical practice completes an average of 37 prior authorization requirements per physician. This takes the physician and their staff an average of 16 hours, or the equivalent of two business days, to process.

Rural America Could be Hit Hard over Obamacare Repeal

While the fate of the Affordable Care Act remains in the balance, The Conversation reports that the repeal of the law could be disastrous for rural America. The drop in life expectancy in the United States in 2016 was particularly problematic in rural areas, which have high rates of obesity, chronic illness, drug overdose, mental illness, and alcoholism. The Conversation says the ACA has led to an expansion of Medicaid, which has made strides in improving rural population health. In areas of Kentucky and Arkansas, Medicaid expansion has led to more patients taking medications and an increase in regular doctor visits, the news site says. Moreover, it has increased the number of rural Americans covered by health insurance through the individual marketplace. The Conversation argues that if both of these were taken away, it would led into a dramatic increase in uncompensated care which could lead to more rural hospital closures.

Aetna-Humana Merger Denied

A major proposed merger between Aetna and Humana was shut down by Judge John Bates of the U.S. District Court for the District of Columbia, The Hill reports. Judge Bates agreed with the Department of Justice, which sued to block the merger. Bates said the proposed merger between the health insurance giants would cut down competition in Medicare Advantage and the Obamacare marketplaces. Aetna said it would consider appealing the decision.

Quote of the Week:

The Patient Empathy Problem Physicians Must Face

 "He said [to me], 'That was a really hard night for me.' He was talking about the night I died. I thought, am I really the person you should be saying this to?"

Rana Awdish, an internal medicine physician with a specialty in pulmonary disease, talking about a conversation she had with the resident who treated her in the emergency room after a tumor ruptured in her liver.