Trump’s Initial Orders Reverse Biden on Health Care Costs, Protections from Discrimination

Stat News / By Sarah Owermohle, John Wilkerson, Rachel Cohrs Zhang, and Lizzy Lawrence
 
WASHINGTON — President Trump began his second term Monday with a sweeping order aimed at reversing dozens of former President Biden’s top priorities, from regulations aimed at lowering health care costs, to coronavirus outreach, Affordable Care Act expansions, and protections against gender-based discrimination. 
 
The “initial rescissions” order, signed in front of cheering crowds at the Capital One Arena, revokes dozens of Biden administration policies that the new White House called inflammatory, inflationary, and possibly illegal. They include an October 2022 order to test Medicare and Medicaid models that could lower health care costs, an extension, Biden said, of his administration’s signature achievement to negotiate drug prices in the Inflation Reduction Act. 
 
Trump is also peeling back certain Biden administration efforts to expand access to Covid-19 treatments and vaccines, the 2021 formation of a Gender Policy Council, and multiple gender and sex discrimination protections. He ordered federal workers to return to their offices full time, and he froze federal hiring, with some exceptions.
 
Separately, Trump ordered the U.S. to begin the process of withdrawing from the World Health Organization, which he blames for mishandling the Covid-19 pandemic.
 
Trump’s broad proclamations, like any president’s executive orders, generally begin the process of regulations and rulemaking at federal agencies. The reversals could meet legal challenges or congressional intervention. Several of Biden’s orders were tied to laws 
passed by Congress…

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How the Incoming Trump Administration Could Impact Home-Based Care

Home Health Care News / By Jim Parker

Questions always abound when a new presidential administration comes in, but Republicans’ focus on cost-cutting hold potential for home-based care — if providers can advocate for themselves in Washington. 

Though uncertainties abound when it comes to the Trump administration’s approach to health care, many notable policies have been implemented during Republican administrations. From the establishment of the Medicare Hospice Benefit under Ronald Reagan to the unveiling of Programs for All-Inclusive Care of the Elderly (PACE) under the first Bush administration, this track record can be source of optimism, according to Edo Banach, partner at Manatt Health, a division of the law firm Manatt, Phelps & Phillips, LLP.

“The optimistic note is that a lot of the positive things that have happened in health care over the last 30 years have happened under a Republican Congress, a Republican administration or both,” Banach told Home Health Care News. “I think we’re going to see an increase in opportunities when it comes to caring for vulnerable folks, people who have Medicare and Medicaid, people who are chronically and seriously ill. If the incoming administration wants to solve an economic problem, they can’t solve an economic problem without solving that problem. You’re not going to save money if you simply cut services, so you have to be smarter about the way that you deploy those services.”

Banach previously served as deputy director and senior leader at the U.S. Centers for Medicare & Medicaid Services (CMS) during the Obama administration.

A key component of this is the Republican drive to cut costs, particularly as it pertains to the Medicare trust fund. Home-based care has a proven track record of reducing the total cost of care, which could lead to increased government investment in those services.

Hospice is a great example. Hospice care saves Medicare roughly $3.5 billion for patients in their last year of life, according to a joint report from the National Alliance for Care at Home and NORC at the University of Chicago.

Likewise, participants in the home health value-based purchasing model (HHVBP) have saved Medicare more than $1.38 billion over six years in nine states, according to CMS.

The same principle extends to palliative care. Home-based palliative care could reduce societal health care costs by $103 billion within the next 20 years, the nonprofit economic research group Florida TaxWatch said in a 2019 report…

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How Home Health Agencies Can Adapt To TEAM and HHVBP Models

Home Health Agencies / By Audrie Martin

The landscape of home health care is evolving through the introduction of two key models designed to improve patient outcomes and reduce costs: the expanded Home Health Value-Based Purchasing (HHVBP) model and the Targeted Episode-Based Medicare Access and Payment (TEAM) model.

These initiatives incentivize home health agencies to provide high-quality, coordinated care while addressing the challenges associated with insufficient treatment for chronic health conditions. Ultimately, they aim to create a more efficient health care system for Medicare beneficiaries.

The primary model currently impacting home health providers is the expanded HHVBP model, according to ATI Advisory. This model adjusts Medicare payments based on a home health agency’s (HHA) performance on quality measures compared to their peers, rewarding agencies that deliver high-quality care.

In a fee-for-service health system, Medicare beneficiaries who qualify for home health care often receive inadequate and uncoordinated care for their chronic health conditions, according to ATI Advisory. This situation leads to increased emergency department (ED) visits, hospital admissions or placements in skilled nursing facilities (SNFs).

How the expanded HHVBP model affects HHAs

The expanded HHVBP model aims to improve the quality and efficiency of home health care. It was implemented on Jan. 1, 2022, and includes Medicare-certified HHAs in all 50 states, the District of Columbia and U.S. territories. The calendar year 2022 served as a pre-implementation year during which CMS provided HHAs with resources and training. The first full performance year was 2023, and the calendar year 2025 is the first year for payment adjustments based on performance in 2023.

The expanded HHVBP model builds on the success of the original model, which improved total performance scores among home health agencies by an average of 4.6%, according to the Center for Medicare and Medicaid Services (CMS). The original model also decreased unnecessary ED visits, improved patient mobility and reduced Medicare spending by $141 million…

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RFK Jr. Faces Mounting Bipartisan Criticism

The Hill / By Nathaniel Weixel

 Pressure is mounting on Robert F. Kennedy Jr. as critics squeeze senators from both sides of the aisle to oppose President Trump’s pick to be the nation’s top health official. 
Kennedy’s bipartisan opponents, including liberal advocates and an organization founded by former Vice President Pence, argue the nominee to lead the Department of Health and Human Services secretary isn’t fit to serve.  
 
Liberals point to Kennedy’s longtime advocacy against vaccines and his role as the founder of the prominent anti-vaccine organization Children’s Health Defense.  
 
Democratic-aligned group Protect Our Care is spending roughly $1 million on a campaign to highlight how Kennedy could endanger the nation’s health system, running television and digital ads about his record, releasing reports using Kennedy’s own words, and holding events in the districts of key lawmakers.  
 
In a likely preview of what Kennedy will face from Democrats in the Senate Finance Committee, Sen. Elizabeth Warren (D-Mass.) last week pressed him in a letter to answer 175 questions on a range of topics including vaccines, his shifting positions on reproductive rights, his pledge to gut the National Institutes of Health, drug pricing and the Affordable Care Act, among many others.  
 
“Given your dangerous views on vaccine safety and public health, including your baseless opposition to vaccines, and your inconsistent statements in important policy areas like reproductive rights access, I have serious concerns regarding your ability to oversee the Department,” Warren wrote.  
 
In many cases, Warren quoted Kennedy directly and asked him to explain his comments, such as when he wrote in his 2023 book about vaccines that “[t]here is virtually no science assessing the overall health effects of the vaccination schedule or its component vaccines.” …

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