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U.S. Healthcare Rated Last Among Developed Countries


A study looking at care process, access, administrative efficiency, and outcomes ranks U.S. healthcare system last across the board.

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

U.S. Healthcare Worst among Developed Countries

The Commonwealth Fund, a nonprofit research group, has rated the U.S. health care system last among 11 developed nations analyzed as part of a study conducted every three years. The Fund also rated the U.S. healthcare system as the worst when the last evaluation was released in 2014.

For the study, the foundation looks at care process, access, administrative efficiency, equity, and healthcare outcomes, taking into account 72 indicators from those variables. The 11 countries in the study were Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States.

One notable takeaway from the study was the America's rating in equality of coverage. Forty-four percent of low-income Americans have trouble gaining access to coverage compared with 26 percent of high-income Americans. The numbers for the U.K. are 7 percent and 4 percent, respectively. The U.S. ranked last in access, equity, and healthcare outcomes, and tenth in administrative efficiency.

New CBO Score Released for GOP Healthcare Bill

The Congressional Budget Office (CBO) concluded that the latest version of the Republican healthcare bill, The Better Care Reconciliation Act (BCRA), would leave 22 million more Americans without insurance by 2026 compared with Obamacare. In addition, the CBO also said that the revised bill would add $100 billion in deficit savings.

The number of uninsured Americans is in line with the CBO's score of previous versions of the bill, which also found that 22 million would be left without coverage, according to NPR. The CBO found that the new version of the bill would reduce average premiums in the Obamacare exchanges by 25 percent in 2026, as opposed to the last version's 20 percent.

One notable exemption from the CBO's analysis of newest version of the BCRA is the Cruz Amendment, which said that as long as an insurer offers an Obamacare-compliant plan, it can also offer noncompliant, less-comprehensive plans. The amendment was met with criticism, with the Blue Cross Blue Shield Association, calling it "simply unworkable in any form."

The BCRA is likely to undergo further changes and would need 50 senators to vote "yes" on a "motion to proceed," before Senators can debate the healthcare legislation.

Physician Groups Praise Updated Fee Schedule

The AMA, American College of Physicians (ACP), and American Academy of Family Physicians praised the latest physician fee schedule proposed rule released by CMS late last week. The physician groups pointed to positive changes, including a request for information on regulatory relief, expansion of the Diabetes Prevention Program, consolidation and modernization of the legacy value-based payment systems, and delayed implementation of appropriate use criteria.

Specifically, the physician groups applauded CMS' proposal to invite the public to offer ideas on regulatory, policy, practice, and procedural changes to reduce administrative burdens imposed on clinicians. The associations are encouraged by CMS' acknowledgment of the importance of lowering burdens for clinicians, other providers, patients and their families, as well as its action to solicit comments and request information and its openness to revisions, according to Healio.

Quote of the week:

A Doc, Health IT Exec Discuss Tech's Standing in Healthcare

"I wouldn't say [doctors] are slower to adopt, as much as I would say they've been disappointed by the options they've had in the past. That's caused a little reticence, especially [with the] EHR, where the government's subsidizing the digitization of health records may have gotten a little ahead of itself. The technology was not ready." - Ken Comée, CEO of CareCloud on EHR's. 

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