Healthcare consolidation goes beyond usual players: This article covers many sectors of the healthcare industry and documents how consolidated it has become.
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About health insurance
Comparison of Costs of Care for Medicare Patients Hospitalized in Teaching and Nonteaching Hospitals: Because of the fear of high costs, insurers are reluctant to send members to academic medical centers. This study used 2014-2015 Medicare data to test this assumption. The findings: “Medicare patients treated at major teaching hospitals had lower Medicare spending at 30 days and similar costs at 90 days compared with Medicare patients at non teaching hospitals. These findings appear to raise doubts that care at teaching hospitals is necessarily more expensive than care at nonteaching hospitals.”
‘Death by a thousand lawsuits’: The legal battles that could dog ‘Medicare for All’: This article provides a nice overview of the legal challenges Medicare for All could face if enacted.
Early Adoption of New Supplemental Benefits by Medicare Advantage Plans: Last year CMS announced that it would allow Medicare Advantage plans to expand their member benefits, even beyond medical services. The research looks at the effect of this permission so far:
“This analysis suggests that in the first year of expansion, there has been limited adoption of new supplemental benefits in Medicare Advantage, with 20.8% of Medicare Advantage enrollees in a plan that offered a new supplemental benefit. Limited adoption may be attributable to plans’ risk aversion amidst changing regulations, a lack of evidence of new benefits’ profitability, or limited time to add new benefits between the regulation change announcement in April 2018 and the benefit proposal due date in June.”
As Sharing Health-Care Costs Takes Off, States Warn: It Isn’t Insurance: A growing insurance sector is based on faith-based health plans: “More than a million people have joined the groups, known as health-care sharing ministries, up from an estimated 200,000 before the Affordable Care Act.” But the coverage does not conform to ACA requirements and can exclude services such as coverage of preexisting conditions and recommended routine preventive services.
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About pharma
INSYS Therapeutics files for bankruptcy in wake of US settlement over Subsys marketing practices: The legal fallout from the opioid crisis is staring to have severe repercussions for manufacturers (other than the large settlements).
A Judge Rules Against One Stem-Cell Clinic. There Are Hundreds of Them: As previously reported, a judge in Florida held that stem cell treatments should be considered drugs and regulated by the FDA. In this case, another judge came to the same conclusion about stem cells derived from the patient’s own fat cells.
Read the story (NY Times but appears to have open access)
About the public’s health
Meta-Research: A comprehensive review of randomized clinical trials in three medical journals reveals 396 medical reversals: The authors surveyed 3 medical journals (JAMA, the Lancet and New England Journal of Medicine) and found 396 instances of reversals of results. Examples are cited and the instances are sorted by specialty. The message: Confirmatory studies and time are essential in evaluating even the best peer-reviewed studies in major medical journals.