Remarks of President Joe Biden — State of the Union Address As Prepared for Delivery This link is to the entire speech.
Biden's State of the Union: 13 healthcare takeaways A good summary of the health topics in the speech.
Large health system vs. payer profits in 2023 FYI
About health insurance/insurers
Cigna to help health plans limit costs amid boom in weight-loss drugs “Cigna's Evernorth unit will offer its clients a guarantee that it will limit annual increases in GLP-1 drug costs at 15%, a spokesperson said. The company aims to achieve this through various measures, including helping people with obesity and diabetes get lifestyle modification and coaching support.
Evernorth will also take on a financial risk with the guarantee, the spokesperson said.
This, in turn, would help ensure access to the drugs for appropriate patients, according to Cigna.”
What to Know About How Medicare Pays Physicians The following is a summary of the latest changes: “The 3.4% decrease to the conversion factor finalized for 2024 reflects the following adjustments to these three factors: (1) a -2.18% budget neutrality adjustment, (2) a 0% statutory increase under MACRA for 2024, and (3) -1.25% reduction in temporary payments provided by Congress for 2024 under the Consolidated Appropriations Act of 2023.
The combined impact of these changes is a -1.25% decrease in overall payments under the physician fee schedule relative to 2023, according to CMS. Payment changes are expected to vary by specialty, however. For example, clinicians most directly impacted by service-specific changes, such as those in primary care and behavioral health, are projected to see a net increase in payments, while clinicians in radiology, physical and occupational therapy, and some surgical specialties are projected to see the largest net decrease.
Congress is expected to vote on pending legislation which would mitigate the 3.4% decrease to the fee schedule conversion factor, a change which is expected to result in a modest increase to physician payment rates across all specialties, relative to current law.”
Comment: This monograph is an excellent source of information about the history and methodology behind Medicare physician payments.
About hospitals and healthcare systems
UnitedHealth offers timeline on restoring Change Healthcare's key systems “nitedHealth Group late Thursday detailed a timeline for restoring Change Healthcare's systems, which have been down for more than two weeks following the cyberattack.
The company noted that electronic prescribing services were previously restored, and that claim submission and payment transmission services were restored as of Thursday. It added that it had taken steps to ensure patients could access prescriptions in the meantime, such as having Optum Rx pharmacies send out the medications based on the date.
Change's electronic payment functionality will be back online March 15, UHG said, and it expects to begin testing connectivity to claims network and software beginning March 18. It expects to restore service that week.”
About pharma
F.D.A. Delays Action on Closely Watched Alzheimer’s Drug “Eli Lilly’s donanemab was expected to be approved this month, but the agency has decided to convene a panel of independent experts to evaluate the drug’s safety and efficacy.”
Mark Cuban's drug company inks first health system partnership to sell directly to Community Health Systems “Mark Cuban Cost Plus Drug Company has found its first national health system buyer for hospital drugs currently in short supply.
Franklin, Tennessee-based for-profit Community Health Systems has signed onto a partnership with the billionaire-backed manufacturer to purchase pharmaceuticals like epinephrine and norepinephrine for its affiliate hospitals in Texas and Pennsylvania. The products are often used in emergency departments and intensive care units, with epinephrine currently listed on the Food and Drug Administration’s list of ongoing drug shortages.”
Gilead, Merck & Co.’s oral once-weekly HIV therapy maintains viral suppression “Results for the primary endpoint showed that at week 24, only one participant in the Sunlenca-islatravir group had a viral load >50 copies/mL which was subsequently suppressed by week 30, whereas none of the Biktarvy-treated participants exceeded this threshold. Meanwhile, participants switched to the Sunlenca-islatravir combination maintained high rates of HIV suppression at week 24 comparable to Biktarvy, with rates of 94.2% in both the groups.
In terms of safety, there were no occurrences of serious adverse events in either of the groups. Gilead and Merck noted that the trial will continue through week 48, with longer-term data expected to be presented at future scientific conferences.”
Novo Nordisk's Wegovy wins FDA nod for heart health benefits “US regulators have approved a label expansion for Novo Nordisk's weight-loss drug Wegovy (semaglutide) to include reduced risk of major adverse cardiovascular events (MACE), including heart attacks and strokes. The decision could potentially broaden insurance coverage for the GLP-1 agonist and similar treatments for obesity.”
About healthcare IT
Charges for emails with doctors and other healthcare providers “The typical cost for an email messaging claim was $39 in 2021, including both the portion paid by insurance and that paid by patients. Although the health plan covered the full cost for most of these claims (82%), those patients with at least some out-of-pocket costs typically paid $25.”
About healthcare personnel
Projecting Health Workforce Supply and Demand An excellent source of information from HRSA. One of the main findings is: “Over the next 15 years (through 2036), NCHWA projects an overall shortage of 139,940 physicians.” This number includes about 68,000 primary care physicians.