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Friday
Jun072019

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

Why Some CEOs Figure ‘Medicare For All’ Is Good For Business 

Walk into a big-box retailer such as Walmart or Michaels and you’re likely to see MCS Industries’ picture frames, decorative mirrors or kitschy wall décor.

Kaiser Health News

Friday, June 7, 2019

U.S. Records 1,000th Case of Measles, Officials Blame Misinformation for Outbreak

The United States has recorded 1,001 measles cases so far this year in the worst outbreak of the highly contagious disease in more than a quarter-century, federal health officials said on Wednesday as they issued a new plea for parents to vaccinate their children.

NY Times

Thursday, June 6, 2019

Growing Hack of Health-Care Data Gets Scrutiny From Congress

A hack of health-care data involving a medical bill collector and two major diagnostics companies has grown to almost 20 million people, and is now attracting more questions from key members of Congress.

Bloomberg

Thursday, June 6, 2019

CVS to expand health hubs to 1,500 stores by end of 2021

CVS Health Corp said it would offer expanded health services such as nutrition counseling and blood pressure screenings in 1,500 stores by the end of 2021, following through on plans announced during the pharmacy chain’s 2018 acquisition of health insurer Aetna.

Reuters

Wednesday, June 5, 2019

Supreme Court rules against Obama-era provision on Medicare reimbursements 

The Supreme Court on Monday ruled that an Obama-era rule change on how Medicare reimbursements to hospitals are made should be removed because officials did not follow the proper notice and comment regulations in implementing the formula.

The Hill

Tuesday, June 4, 2019

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday
May312019

ACA Exchange 2020 Final Rule Changes and Survey of Exchange Health Plan Participation and Expectations

By Clive Riddle, May 31, 2019 

Last month CMS issued their final rule with ACA benefit and payment parameters for 2020. Their changes for 2020 included: 

  • The method for calculation of premium assistance for lower-income enrollees (projected to lower the total amount of financial assistance provided by $900 million, when compared with 2019, and result in 100,000 fewer exchange enrollees in 2020.)
  • Allowing plans to make mid-year changes to their drug formularies
  • Allowing plans to implement cost-sharing requirements if enrollees choose a brand-name drug when a medically appropriate generic version of the drug is available (even when out-of-pocket spending maximum is reached)
  • Allowing plans to implement copayment accumulator programs for prescription drugs
  • Lowering user fees for the 2020 coverage year by half a percentage point
  • Increases maximum out-of-pocket spending limits by 3.2%, from $7,900 to $8,150 for individual plans and from $15,800 to $16,300 for family plans      

 

How will these changes, and overall market forces, impact health plan participation in the ACA exchanges for 2020? eHealth has just released survey results from 17 plans that collectively cover 80 million lives that participate in ACA exchanges, that found “more than twice as many insurers intend to increase plan offerings for 2020 as compared with 2019, with premiums holding fairly steady.”

 

 

Here’s some of their detailed findings: 

  • 45% intend to add to the number of ACA plans they'll offer in 2020, compared to 21% who did so for the 2019 plan year
  • 42% expect to raise premiums between 5 and 10 percent over 2019 rates. 33% do not expect to make any noteworthy changes to premiums, while 23% expect to reduce monthly premiums by 5 percent or more.
  • 69% said that sales during the last open enrollment period were within 10 percent of their expectations. 15% reported that sales outpaced expectations by 10 to 15 percent, while another 15% of said sales were 10 percent or more below expectations.
  • 71% said they are paying attention to public discussions about "Medicare for all" but don't expect major changes, compared to 67% in 2018

 

 

Friday
May312019

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

 

Prescription Drug Spending Varies by Private, Public Payers

Total prescription drug spending reached $333 million in 2017, but the way that lump sum was divided among Medicare, Medicaid, and employer-sponsored health plans may reveal differences between the populations each payer covers, according to a May analysis from the Kaiser Family Foundation (KFF).

HealthPayer Intelligence

Thursday, May 30, 2019

 

Executive order may leave out disclosure of negotiated rates

After intense opposition from health care stakeholders, sources say language calling for disclosure of rates negotiated between insurers and health care providers could be dropped from the final version of a Trump administration executive order on health care price transparency that is expected to be announced by mid-June.

Washington Post

Thursday, May 30, 2019

 

Report from The Leapfrog Group Finds Only 1 in 5 U.S. Hospitals Fully Meet Payor Standards for Maternity Care

The Leapfrog Group, a national watchdog organization of employers and other purchasers focused on health care safety and quality, today released its 2019 Maternity Care Report.

The Leapfrog Group

Wednesday, May 29, 2019

 

5 names to know at Facebook: the people behind its push into health care

When it comes to building out a health business, Facebook is often seen as having much more modest ambitions than its Big Tech competitors.

Stat News

Wednesday, May 29, 2019

 

J&J's Greed Helped Spawn Opioid Epidemic Oklahoma’s AG Argues

Johnson & Johnson’s greed for more sales of its addictive opioid painkillers helped create a deadly epidemic in Oklahoma that claimed thousands of lives, and the company should pay billions of dollars as compensation, the state’s top law-enforcement officer told a judge.

Bloomberg

Wednesday, May 29, 2019

 

 

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

 

Friday
May242019

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

House leaders propose restructuring Medicare Part D

U.S. House of Representatives health committee leaders have drafted new reforms to Medicare Part D as Congress prepares for a final legislative sprint on drug pricing.

Modern Healthcare

Friday, May 24, 2019

Bipartisan senators reveal sweeping health care package

A sweeping draft legislative package from the bipartisan leaders of the Senate Health Committee seeks to lower health care costs by addressing surprise medical bills and adding transparency to drug prices, among other provisions.

The Hill

Friday, May 24, 2019

CBO: Medicare for All gives 'many more' coverage but 'potentially disruptive'

Experts from Congress’s nonpartisan budget office testified Wednesday that a single-payer health care system would result in “many more” people with health insurance but would also be “potentially disruptive” and increase government control.

The Hill

Thursday, May 23, 2019

Measles outbreak spreads to 24 states

The number of measles cases in the United States climbed again this week, bringing the number to 880 cases across 24 states, according to the Centers for Disease Control and Prevention (CDC).

The Hill

Tuesday, May 21, 2019

Poll: Many Rural Americans Struggle with Financial Insecurity, Access To Health Care

Polling by NPR finds that while rural Americans are mostly satisfied with life, there is a strong undercurrent of financial insecurity that can create very serious problems for many people living in rural communities.

NPR

Tuesday, May 21, 2019

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Thursday
May232019

The Health Tech Our Toddlers Should Never Know

by Kim Bellard, May 23, 2019

Joanna Stern wrote a fun article for The Wall Street Journal: "The Tech My Toddler Will Never Know: Six Gadgets Headed for the Graveyard."  My immediate thought was about health tech's equivalent list.  There certainly is a lot of health tech that should be headed to the graveyard, but, knowing healthcare's propensity to hang on to its technology way too long, I had to modify her more optimistic headline to say "should" instead of "will."

One can always hope.  Here's my healthcare tech list:

1.  Faxes:  You knew it had to be at the top of the list.  Anyone under thirty who knows how to work a fax machine probably works in healthcare.  The reason faxes persist is because they supposedly offer some security advantages, but one suspects inertia plays at least a big a role. There are other options that can be equally "secure," while making the information digital. 

2.  Phone Trees:  We've all had to call healthcare organizations -- doctors' offices, testing facility, health plans, etc.  Most times, you first have to navigate a series of prompts to help specify why you are calling, presumably to get you closer to the right person.  There are probably studies that show it saves money for the companies that use them, and perhaps some that even claim its saves customers time, but this is not a technology most people like. By 2030 I want my AI -- Alexa, Siri, etc. -- to deal directly with the companies' AI to spare me from phone trees. 

3.  Multiple health records: I have at least five distinct health records that I know of, only two of which communicate to the other at all.  For people with more doctors and/or more complex health issues, I'm sure the situation is even worse.  EHRs are old technology, the cable of healthcare.  By 2030, we should each have a single health record that reflects the broad range of our health.

4.  Stethoscopes:   You've seen them. Your doctor probably has one.  Find the oldest photographs of doctors that exist and you might find them with stethoscopes; they are that old.” It's not that they are useless, but as it is that there are better alternatives, such as handheld ultrasounds or even smartphone apps.  For Pete's sake, people are working on real-life tricorders.   By 2030, seriously, can we be using its 21st century alternatives?  

5.  Endoscopes: Perhaps you've had a colonoscopy or other endoscopic procedure; not much fun, right?  We do a lot of them, they cost a lot of money (at least, in the U.S.), and they involve some impressive technology, but they're outdated. By 2030, we should be using things like ingestible pill cameras, with ingestible robots to take any needed samples or even conduct any microsurgery. 

6.  Chemotherapy: Chemotherapy is literally a lifesaver for many cancer patients, and a life-extender for many others.  We're constantly getting new breakthroughs in it, allowing more remissions or more months of life.  But it can pose a terrible burden -- physically, emotionally, and financially -- on the people getting it.  Chemotherapy has been likened to carpet bombing, with significant collateral damage.  Increasingly, there are alternatives that are more like "smart bombing" -- precision strikes that target only cancer cells, either killing or inhibiting them.  By 2030, perhaps cancer patients won't fear the treatments almost as much as the cancer.

Healthcare certainly has no shortage of technology that we should hope today's toddlers will never have to use or experience.  The above are just six suggestions, and you may have your own examples.  We can make these happen, by 2030; the question is, will we?

This post is an abridged version of the posting in Kim Bellard’s blogsite. Click here to read the full posting.