VA pick Wilkie expected to sail through today’s nomination vote

With help from Arthur Allen (@arthurallen202) and Darius Tahir (@dariustahir)

SENATE PANEL EXPECTED TO ADVANCE WILKIE NOMINATION: President Donald Trump’s pick for Veterans Affairs Department head likely will win the endorsement of the Senate Veterans’ Affairs Committee today.

Morning eHealth’s Arthur Allen — who will be on hand — has reported that Wilkie has garnered support from all of the panel’s Republican members and at least some Democrats.

Ranking Democrat Jon Tester told Wilkie last month he expected him to be confirmed, but also warned him that he could face some of the same political challenges that forced out former Secretary David Shulkin and deputy Secretary Tom Bowman.

“We have seen politicals work to undermine a secretary and deputy secretary who were confirmed by the Senate. Those positions are vacant while the politicals continue to collect paychecks from the VA,” Tester said then.

HOUSE HHS SPENDING BILL MARKUP SLATED FOR WEDNESDAY: The House Appropriations Committee plans to mark up the Labor-HHS-Education fiscal 2019 spending bill Wednesday morning, the committee announced Monday. That markup had been postponed last month, a move Democrats suggested was aimed at minimizing backlash over the White House’s family separation policy — children who have been separated from their parents typically are put in the temporary custody of HHS. Republican aides cited scheduling conflicts. More for Pros on the markup — scheduled for 10 a.m. in Room 2175 of the Rayburn House Office Building — here.

… Elsewhere on the Hill Wednesday, the House Ways and Means Committee plans to mark up series of health care bills, including one that would place a moratorium on the ACA employer mandate and suspend the Cadillac tax through 2020. The committee also plans to take up several bills that would expand or give added flexibility to health savings accounts and flexible spending arrangements. At least one measure would pave the way for more payments for telemedicine.

ANTI-ABORTION GROUPS RALLY AROUND TRUMP’S SCOTUS PICK: Brett Kavanaugh is a Republican stalwart who has argued for strict limits on abortion and forcefully opposed Obamacare’s birth control mandate setting up a bruising confirmation battle that will center on the future of Roe v. Wade and the health care law, our colleague Adam Cancryn reports.
The D.C. Circuit Judge, announced Monday night as Trump’s nominee to replace retiring Justice Anthony Kennedy, has raised concerns among conservatives who view the Supreme Court opening as a chance to overturn Roe v. Wade.

He has passed up opportunities in legal opinions to stake out a position on the landmark 1973 decision establishing a constitutional right to abortion, and made comments 12 years ago pledging to follow Roe, calling it the “binding precedent of the court.”

But conservatives rallied around Kavanaugh on Monday evening, acknowledging the Supreme Court opening is a once-in-a-generation chance to overturn Roe and shift the ideological balance of the nation’s highest court.

The lack of a clear-cut record on reproductive rights could make Kavanaugh an easier confirmation vote for two key Republican moderates, Sens. Susan Collins and Lisa Murkowski. Read the rest of Adam’s story here.

eHealth Tweet of the day: Dr. Holly Witteman @hwitteman Lots of published science was funded by grants from public research funding agencies. The public has already paid for the work. In my view, members of the public should have access to the work they funded. (Many funders now require this, immediately or within 12 months.)

It’s TUESDAY at Morning eHealth. Your author got a strong start this week by spilling an astonishing amount of coffee in the newsroom kitchen. Share your own tales of morning mortification and news tips with [email protected]. Tweet them to @arthurallen202, @dariustahir, @ravindranize, @POLITICOPro, @Morning_eHealth.

NOTES FROM THE JOURNAL CIRCUIT:

— MIPS CONFUSION: Most of the physicians surveyed about MIPS three months after Medicare began grading their performance in it were at best slightly familiar with the program’s requirements, according to a study by University of Pennsylvania scholars. More than 60 percent of the 684 physicians who responded to the survey published Monday in Health Affairs doctors to avoid sicker or medically complex patients, focus more heavily on aspects of care that are measured, or otherwise “game the system.” A substantial number (37 percent) said MIPS could lead physicians to “discourage patients from utilizing care in situations when it might be appropriate.” Physicians generally support the goals of MIPS but are skeptical of the program’s requirements, the survey showed. Over half of respondents—mostly internists interviewed from March to May of last year--expressed “some” or “a great deal” of willingness to change their behavior to improve care and reduce unnecessary costs.

— EHR OPTIMIZATION BENEFITS SMALL HOSPITALS’ CARE QUALITY: Another study in the newest issue of Health Affairs shows that adding new functions to a hospital’s EHR decreases its mortality rate — and that effect is especially driven by small and nonteaching hospitals. Using data on hospital adoption of various attributes of IT use — from radiology images to order entry — the authors find that each new function is associated with a .21 percent decline in mortality rate per year. That effect is especially associated with small and nonteaching hospitals, which leads the authors to speculate that the big, tony hospitals may have reached a “ceiling effect” with respect to all their quality improvement efforts. The results are especially notable given the financial strictures smaller hospitals operate under, which can inhibit further IT purchases.

FIRST IN MORNING EHEALTH — STATE TELEMEDICINE SURVEY: A new analysis conducted by Manatt Health categorizes states’ telemedicine policies as “progressive,” “moderate,” or “restrictive” based on factors such as Medicaid reimbursement and licensing protocol. Massachusetts and Rhode Island are among the most restrictive, according to Manatt — Colorado, Connecticut, Minnesota, Missouri and New Jersey among the least.

BEHIND THE SCENES — CMS’S NEW SMARTPHONE GLUCOSE MONITORING POLICY: CMS announced last month that it planned to cover continuous glucose monitoring devices transmitting the wearers’ data to a smartphone — a move for which White House tech team U.S. Digital Service claims some credit.

CMS said in January that it would reimburse continuous glucose monitors, which have implantable sensors, but excluded those used in conjunction with smartphones. It reversed that decision in June.

The U.S. Digital Service’s HHS lead, Shannon Sartin, tells Morning eHealth she urged CMS policymakers to change the reimbursement protocol at the behest of USDS product manager Ju-Lie McReynolds, who uses a CGM. Sartin and her tech troubleshooting team have helped CMS craft other interoperability-related policy, encouraging the agency to release “outcomes-based” technology regulations instead of imposing strict technical requirements.

“CMS needed to set the tone that it would pay for these types of devices,” Sartin says. McReynolds says the new policy lets more patients like her track their own glucose levels in real-time, and also could help researchers quickly analyze large volumes of patient data.

FROM THE JOB BOARDS: Atul Gawande may have snaggedthe highest profile job in health tech, but we’re noticing a few other openings:

— GEISINGER HEALTH BUILDING A ‘NUDGE UNIT’: Pennsylvania -based health system Geisinger has a new “nudge unit” known as the Applied Behavioral Insights team, per Tweets from faculty leads Christopher Chabris and Michelle Meyer. The team is looking for a PhD-holding research director with expertise in “psychology, economics, decision sciences, marketing, management,” to design and evaluate “lightweight behavioral interventions.”

— CMS NEEDS MORE API ENTHUSIASTS: Though the posting closed Monday, CMS is hiring coders to expand the Blue Button 2.0 API, which allows beneficiaries to download and share claims data. Their goal is to “share more data with more partners,” according to an HHS blog post from entrepreneur-in-residence Karl Davis.

As we reportedlast month, CMS is still searching for a chief health informatics officer to lead a health data interoperability “tiger team” and to “help inform CMS health IT and information management policy and operations.”

WHAT WE’RE CLICKING ON:

— HealthDataManagement canvasses health experts on TEFCA

— The Economist explores a world in which people are paid for sharing their data with tech companies

— A Wall Street Journal column argues that Warby Parker’s model could disrupt health care

— The first in a four-part HealthcareITNews series on RFID in health

— FierceHealthcare’s story on Cerner’s $266M population health partnership with Lumeris