The country’s health care spending will grow an average of 5.4% per year between 2022 and 2031, accounting for about $1 out of every $5 spent in the US by the end of the period, according to new projections from the Centers for Medicare & Medicaid Services published in Health Affairs. The agency expects that recent legislative changes, such as the expiration of regulations surrounding the COVID-19 public health emergency and the implementation of the Inflation Reduction Act’s prescription drug provisions, will drive some of the health expenditure trends. [JAMA Network]

In addition, estimates suggested that health care spending for physician and clinical services grew more slowly in 2022 than 2021. The researchers noted this may have been because patients avoided medical visits amid high inflation or because the number of available appointments was limited. The Centers for Medicare & Medicaid Services projects the growth of health expenditures for clinicians’ services will increase to 5.1% in 2023, and then remain relatively stable through 2031. Medicare spending will likely increase faster than private health insurance spending as more US residents age into the program, the researchers reported.

###

When it came time to split up the first batch of $15 billion Congress set aside last year to replace toxic lead pipes, Illinois officials had plenty of reasons to expect they would get the biggest share. [Chicago Tribune]

Utility groups have long estimated the state leads the nation in the number of lead service lines connecting homes and two-flats to municipal water systems, largely because Chicago’s plumbing code required use of the brain-damaging metal until 1986, decades after most other major U.S. cities had banned it.

Plumbers in Michigan, Ohio, Pennsylvania and Wisconsin also installed tens of thousands of lead pipes during the last century to convey drinking water to homes and apartments.

But when the U.S. Environmental Protection Agency announced last month how it plans to share nearly $3 billion this year, Florida got the biggest cut. Another state surprisingly in the top 10: Texas.

More>

###

Though efforts to replace potentially dangerous lead service lines across Illinois have been slow and costly, Cook County government Tuesday announced a new program to replace at least 550 such lines at suburban home-based day cares over the next two years. [Chicago Tribune 6.27.2023]

Under the new LeadCare Cook County, providers in Calumet City, Cicero, Hazel Crest, Harvey and Maywood can apply now to have lead service lines — the pipes that deliver water from the main to the building — removed and replaced.

The goal is to reach “all interested communities in suburban Cook County by 2025,” County Board President Toni Preckwinkle said at a Monday news conference rolling out the program. The $15 million pilot is funded by a portion of the $1 billion the county received in federal pandemic relief through the American Rescue Plan.

The county has hundreds of millions of federal relief money left to spend, according to the county’s latest budget forecast.

More>

###

Charity care may cut some cost-related barriers to cancer screening access, but organizations need a bigger safety net for potential cancer treatments.

It’s not uncommon for healthcare organizations to set up free breast cancer screening events as part of their charity care efforts to serve low-income, uninsured people. But what happens when a screening turns into a breast cancer diagnosis, and that person is left on the hook for treatment costs?
That’s the looming question for healthcare organizations nationwide that are trying to close gaps in cancer screening by way of free or subsidized programs. While those screening events can move the needle on the number of people getting a breast cancer screen—especially low-income folks and people of color who are traditionally underserved by medicine and m]ay experience distrust—they only get at part of the problem. [PatientEngagement Hit]

More>https://patientengagementhit.com/features/expanding-cancer-screening-access-beyond-charity-care?utm_source=nl&utm_medium=email&utm_campaign=newsletter

###

Today, the Biden-Harris Administration awarded $50 million to launch the Persistent Poverty Initiative, an initiative to alleviate the cumulative effects of persistent poverty on cancer outcomes by building research capacity, fostering cancer prevention research, and promoting the implementation of community-based programs. The Persistent Poverty Initiative is the first major program to address the structural and institutional factors of persistent poverty in the context of cancer. It is coordinated by the National Cancer Institute (NCI), part of the National Institutes of Health (NIH). These awards create five new Centers for Cancer Control Research in Persistent Poverty Areas that will advance key priorities of the Administration’s Cancer Moonshot — to reduce inequities in the structural drivers of cancer and prevent more cancers before they start by reducing tobacco use and making sure everyone has access to healthy food. [NIH]

Persistent poverty areas are defined as those where, for the past 30 years, 20% or more of the population has lived below the federal poverty line. People who live in such areas have a higher incidence of cancer, experience delays in cancer diagnosis and treatment, and are more likely to die from cancer than people who do not live in poverty. However, there has been limited research on how to improve cancer outcomes in persistent poverty areas.

More>

###

New estimates predict more than 1.3 billion people worldwide will have diabetes by 2050, up from about 529 million in 2021, according to research published in The Lancet.  [Beckers Clinical Leadership & Infection Control}

"Diabetes will be a defining disease of this century," journal editors wrote in an accompanying editorial on the findings. "How the health community deals with diabetes in the next two decades will shape population health and life expectancy for the next 80 years."

The surge is expected to be driven by type 2 diabetes, which is largely driven by the prevalence of obesity. In the editorial, researchers pointed to structural racism and geographical inequity as drivers of diabetes, underscoring the importance of social determinants of health. 

"Addressing structural racism must become a core component of preventive strategies and health promotion — areas that invariably receive too little investment," the editorial said. 

###

The Department of Healthcare and Family Services released proposed rules last week intended to address the rising costs of a program that provides Medicaid-like coverage for certain undocumented individuals. [Health News Illinois]

That includes a pause for new enrollees between 42 and 64 on July 1. Seniors can still join, unless their enrollment reaches 16,500. The department said it will reopen enrollment “as soon as fiscally possible.”

Additionally, the department may implement copays for hospital services not eligible for a federal match, such as $250 for inpatient hospitalizations and $100 for emergency room visits.

The program offers coverage to undocumented immigrants 42 years and older who do not qualify for other medical assistance and have an income at or below 138 percent of the federal poverty level.

Officials have estimated the program will cost the state $1.1 billion without restrictions. Advocates of the program have pushed back on those figures.

The agency said it has already taken steps to enhance revenue for the program, including maximizing “federal reimbursement for emergency medical expenses” and pursuing supplemental prescription drug rebates for the covered undocumented population.

It will also transition enrollees to Medicaid managed care next year, which HFS said will generate additional funds through taxes it collects on managed care organizations.

The Illinois Legislative Latino Caucus said in a statement that the proposal “is disappointing but is also a call to action.”

“We will continue to fight for healthcare for all Illinoisans,” they said. “Latino Caucus members have not given up — and will pursue closing the gap in coverage until we achieve healthcare for all residents. The often-disenfranchised communities we represent sent us to Springfield to be their voice; we will never turn our backs on them.”

The Healthy Illinois Campaign condemned the agency’s proposal, calling on the Pritzker administration to work with lawmakers and advocates to ensure healthcare access.

“By slashing live-saving health coverage for Illinois immigrants, Gov. Pritzker is turning his back on the communities he claims Illinois welcomes and aligning himself with anti-immigrant Republicans around the country,” they said in a statement.

###

Since the US Supreme Court overturned Roe v Wade in the summer of 2022, almost half of states have banned abortion or placed gestational limits on the procedure. These restrictions disproportionately impact individuals who live in the South and Midwest—and much has been written about the dire consequences for women who face reproductive emergencies and physicians who face potential prosecution (or license forfeiture) for exercising their professional judgment in providing care. The consequences for training in lifesaving procedures is another area of great and growing concern.

There is another consequence to restricting abortion that many policy makers may not have considered: banning abortion is likely to deter physicians from practicing in those states altogether.

More>