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Entries in Announcement (143)

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
May042018

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:

 

‘Pharma Bro’ Shkreli Is In Prison, But Daraprim’s Price Is Still High 

It was 2015 when Martin Shkreli, then CEO of Turing Pharmaceuticals and the notorious “pharma bro,” jacked up the cost of the lifesaving drug Daraprim by 5,000 percent. Overnight, its price tag skyrocketed from $13.50 a pill to $750.

Kaiser Health News

Friday, May 4, 2018

Health Insurers Had Their Best Quarter in Years, Despite the Flu

U.S. health insurers just posted their best financial results in years, shrugging off worries that the worst flu season in recent history would hurt profits.

Bloomberg

Thursday, May 3, 2018

CVS ‘Moving Forward’ With Aetna Deal, Profit Tops Estimates

CVS ‘Moving Forward’ With Aetna Deal, Profit Tops Estimates CVS Health Corp. said it’s making “good progress” on getting regulatory approval for its $68 billion deal to buy health insurer Aetna Inc. -- one of two megamergers in the health-care industry that are under antitrust scrutiny.

Bloomberg

Wednesday, May 2, 2018

HHS Secretary Alex Azar to Supreme Court: Time to rule on Medicare case that affects $4 billion

Health and Human Services Secretary Alex Azar asked the U.S. Supreme Court to review an appeals court case won by numerous hospitals over disproportionate share hospital payments.

Healthcare Finance News

Wednesday, May 2, 2018

Bill Gates got President Trump fired up about a universal flu vaccine

Bill Gates was talking to President Trump in the Oval Office last month when the conversation turned to the notion of a universal flu vaccine — probably, as Gates recalled in an interview, “the longest conversation about universal flu vaccine that the president’s ever had.”

Stat News

Monday, April 30, 2018


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
Oct272017

Fighting Healthcare fraud and over-prescriptions with predictive analytics

By Claire Thayer, October 31, 2017

Earlier this summer, the U.S. Department of Justice announced the largest ever health care fraud enforcement action, involving over 412 individuals across 41 federal districts, including 115 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes. Of those charged, over 120 defendants, including doctors, were charged for their roles in prescribing and distributing opioids and other dangerous narcotics. Adoption of prescription drug monitoring programs is one way to hold health care providers accountable for overprescribing practices. Use of sophisticated claims analytic tools can help detect suspicious practice patterns as well. A health plan in the Midwest recently uncovered the case of an overprescribing neurologist using peer-to-peer analysis for comparison of practice patterns.

This recent edition of the MCOL Infographic, co-sponsored by LexisNexis, provides highlights from this case study:

 

Tuesday
Dec132016

The State of Provider Directory Accuracy

By Claire Thayer, December 13, 2016

Despite a federal mandate for all plans in the health insurance marketplace be required to have current and accurate provider directories, many health plan enrollees are finding that when it comes time to call a provider for their specialty visit or find a new primary care physician willing to take new patients, the information in the directory is often out of date or missing vital information.

We’ve posted a couple of infographics on this topic, one on the Accuracy of Health Provider Directories which outlined data points that CMS requires health plans to monitor and maintain on a monthly basis and the State of Provider Directory Accuracy Across the U.S. which outlined provider penalties that could be incurred for inaccuracies.

Last week, The New York Times published an in-depth article, Insurers’ Flawed Directories Leave Patients Scrambling for In-Network Doctors, highlighting from the consumer perspective just how frustrating the experience can be when you’re the patient shopping for health coverage and trying to find a physician willing to accept new patients.

While health plans participating in the health insurance marketplaces were to be subjected to penalties for directory inaccuracies starting in 2016, research by the New York Times found that while many directories are still incomplete, inaccurate or missing information, so far no plans have been fined or kicked off the enrollment sites for having poor doctor directories, said Aaron Albright, a spokesman for the Centers for Medicare and Medicaid Services, which would enforce the rules. A Health and Human Services Department survey of Medicare plans for those 65 and older that was released in October found errors in nearly half of the listings in doctor directories .

Last week, the MCOL Infographoid, co-sponsored by LexisNexis Health Care, offered a deeper look at the provider directory requirements on a state by state basis in the State of Provider Directory Accuracy, highlighted below:

MCOL’s weekly infoGraphoid is a benefit for MCOL Basic members and released each Wednesday as part of the MCOL Daily Factoid e-newsletter distribution service – find out more here.

Thursday
Nov102016

Changing the conversation from wellness to total wellbeing

By Claire Thayer, November 10, 2016

This week, Robin Bouvier from Aon’s Health Transformation Team, spoke in a HealthcareWebSummit webinar, co-sponsored by WebMD Health Services, on More than Meets the ROI: The Value of Investing in a Healthy Workforce.   Today’s forward thinking companies are moving towards a culture of health and changing the conversation about employee wellness from a ‘benefit’ to instead looking at health as a business imperative that’s integrated across all aspects of the organization.

Robin shares some perspective on general health of the workforce and somewhat surprisingly, the younger generations are not necessarily healthier:

 

Baby Boomers (1946-1964)

Generation X (1965 -1978)

Millennials (1979-1996)

Tobacco Use

18%

21.1%

26.5%

Obesity

33.3%

32.8%

30.9%

Depression

16%

16%

20%

Debt

$29,317

$30,039

$23,332

 

Robin tells us that wellness is evolving to an all encompassing, total wellbeing approach: “Wellbeing means having the appropriate resources, opportunities and commitment needed to achieve optimal function, health and performance for the individual and the organization.” Total wellbeing interconnects:

  • Emotional – attitudes and everyday living

  • Physical – energy to complete daily living tasks

  • Financial – confidently manage everyday and future finances

  • Social – connections to others

Robin cited recent study findings of the impact of total wellbeing:

  • 81% less like to seek out new employer in next year

  • 41% less work missed because of poor health

  • 69% of consumers say wellbeing programs health them get or stay healthy

  • 22% more profitable as organizations

  • 10% higher customer ratings

  • ½ point higher performance rating by supervisor

From the new Aon Hewitt 2016 Financial Mindset Study, Robin identifies employee needs by financial stage as:

  • Security: 30%

  • Foundation: 25%

  • Growth: 36%

  • Freedom: 9%